National joint registries under-report revisions for periprosthetic joint infection (PJI). We aimed to validate PJI reporting to the Australian Orthopaedic Association National Joint Arthroplasty ...Registry (AOANJRR) and the factors associated with its accuracy. We then applied these data to refine estimates of the total national burden of PJI.
A total of 561 Australian cases of confirmed PJI were captured by a large, prospective observational study, and matched to data available for the same patients through the AOANJRR.
In all, 501 (89.3%) cases of PJI recruited to the prospective observational study were successfully matched with the AOANJRR database. Of these, 376 (75.0%) were captured by the registry, while 125 (25.0%) did not have a revision or reoperation for PJI recorded. In a multivariate logistic regression analysis, early (within 30 days of implantation) PJIs were less likely to be reported (adjusted odds ratio (OR) 0.56; 95% confidence interval (CI) 0.34 to 0.93; p = 0.020), while two-stage revision procedures were more likely to be reported as a PJI to the registry (OR 5.3 (95% CI 2.37 to 14.0); p ≤ 0.001) than debridement and implant retention or other surgical procedures. Based on this data, the true estimate of the incidence of PJI in Australia is up to 3,900 cases per year.
In Australia, infection was not recorded as the indication for revision or reoperation in one-quarter of those with confirmed PJI. This is better than in other registries, but suggests that registry-captured estimates of the total national burden of PJI are underestimated by at least one-third. Inconsistent PJI reporting is multifactorial but could be improved by developing a nested PJI registry embedded within the national arthroplasty registry. Cite this article:
2022;3(5):367-373.
The extinct moa of New Zealand included three families (Megalapterygidae; Dinornithidae; Emeidae) of flightless palaeognath bird, ranging in mass from <15 kg to >200 kg. They are perceived to have ...evolved extremely robust leg bones, yet current estimates of body mass have very wide confidence intervals. Without reliable estimators of mass, the extent to which dinornithid and emeid hindlimbs were more robust than modern species remains unclear. Using the convex hull volumetric-based method on CT-scanned skeletons, we estimate the mass of a female Dinornis robustus (Dinornithidae) at 196 kg (range 155-245 kg) and of a female Pachyornis australis (Emeidae) as 50 kg (range 33-68 kg). Finite element analysis of CT-scanned femora and tibiotarsi of two moa and six species of modern palaeognath showed that P. australis experienced the lowest values for stress under all loading conditions, confirming it to be highly robust. In contrast, stress values in the femur of D. robustus were similar to those of modern flightless birds, whereas the tibiotarsus experienced the highest level of stress of any palaeognath. We consider that these two families of Dinornithiformes diverged in their biomechanical responses to selection for robustness and mobility, and exaggerated hindlimb strength was not the only successful evolutionary pathway.
This paper argues that Donald Davidson’s infamous denial in “A Nice Derangement of Epitaphs” that there is any such thing as a language, though it may not be fully supported by the arguments given ...for it in that paper, is nonetheless entailed by his semantic views generally, according to which the literal, linguistic meaning of a speaker’s words on an occasion is determined by how the speaker intended to be understood. In favor of this view, and thus against conventional languages, the paper then argues that this understanding of linguistic meaning promises, in a way the conventional view of meaning does not, to make sense of linguistic normativity.
Roughly, behaviorist accounts of self-knowledge hold that first persons acquire knowledge of their own minds in just the same way other persons do: by means of behavioral evidence. One obvious ...problem for such accounts is that the fail to explain the great asymmetry between the authority of first person as opposed to other person attributions of thoughts and other mental states and events. Another is that the means of acquisition seems so different: other persons must infer my mental contents from my behavior, whereas I need not. In this paper, I articulate a specifically Sellarsian behavioristic account of our knowledge of our own and others’ minds, and defend it against these two obvious objections. I further defend it against objections from Davidson, to the effect that Sellars’ account in particular cannot properly formulate the asymmetry at issue, and that behaviorism in general cannot account for the a priori character of the asymmetry. I argue that Davidson misinterprets Sellars at key points, and also misconstrues his own explanandum: What Sellars account can explain is an asymmetry in the reliability of first and other person attributions, but this asymmetry is not a priori. What is a priori is an asymmetry in the practice of according epistemic authority to such attributions. I argue that this asymmetry is what Davidson can and does explain, by appeal to the constitutive features of radical interpretation. But accepting this explanation does not require the rejection of Sellars’ account of the way that first and other persons in fact arrive at beliefs about their mental contents. The two approaches — one descriptive and empirical, the other constitutive and ideal — are compatible.
Finnish samples have been extensively utilized in studying single-gene disorders, where the founder effect has clearly aided in discovery, and more recently in genome-wide association studies of ...complex traits, where the founder effect has had less obvious impacts. As the field starts to explore rare variants’ contribution to polygenic traits, it is of great importance to characterize and confirm the Finnish founder effect in sequencing data and to assess its implications for rare-variant association studies. Here, we employ forward simulation, guided by empirical deep resequencing data, to model the genetic architecture of quantitative polygenic traits in both the general European and the Finnish populations simultaneously. We demonstrate that power of rare-variant association tests is higher in the Finnish population, especially when variants’ phenotypic effects are tightly coupled with fitness effects and therefore reflect a greater contribution of rarer variants. SKAT-O, variable-threshold tests, and single-variant tests are more powerful than other rare-variant methods in the Finnish population across a range of genetic models. We also compare the relative power and efficiency of exome array genotyping to those of high-coverage exome sequencing. At a fixed cost, less expensive genotyping strategies have far greater power than sequencing; in a fixed number of samples, however, genotyping arrays miss a substantial portion of genetic signals detected in sequencing, even in the Finnish founder population. As genetic studies probe sequence variation at greater depth in more diverse populations, our simulation approach provides a framework for evaluating various study designs for gene discovery.
This article seeks to achieve three goals:(1) clarification of 'extremism's' conceptual boundaries and problematic relationship with democracy; (2) articulation of a framework for locating incumbency ...among a range of strategic responses to political extremists; and (3) systematic cross-national comparison of incumbency's consequences for right-populist/nationalist politicians and parties. In particular, the study addresses a fundamental question in the study of political extremism-how accurate (and how generalisable) is the argument that participation in government will ultimately serve to moderate 'extreme' parties and politicians? The subsidiary question is whether denying power to electorally successful extremist parties is in the interest of-or antithetical to-democracy. Pursuit of answers to these questions should advance our understanding of the fates of extremist parties under democratic political rules.
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