The effect of uncemented acetabular liner geometry and lip size on the risk of revision for instability or loosening

Aims The aim of this study was to determine if uncemented acetabular polyethylene (PE) liner geometry, and lip size, influenced the risk of revision for instability or loosening. Methods A total of 202,511 primary total hip arthroplasties (THAs) with uncemented acetabular components were identified from the National Joint Registry (NJR) dataset between 2003 and 2017. The effect of liner geometry on the risk of revision for instability or loosening was investigated using competing risk regression analyses adjusting for age, sex, American Society of Anesthesiologists grade, indication, side, institution type, surgeon grade, surgical approach, head size, and polyethylene crosslinking. Stratified analyses by surgical approach were performed, including pairwise comparisons of liner geometries. Results The distribution of liner geometries were neutral (39.4%; 79,822), 10° (34.5%; 69,894), 15° (21.6%; 43,722), offset reorientating (2.8%; 5705), offset neutral (0.9%; 1,767), and 20° (0.8%; 1,601). There were 690 (0.34%) revisions for instability. Compared to neutral liners, the adjusted subhazard ratios of revision for instability were: 10°, 0.64 (p < 0.001); 15°, 0.48 (p < 0.001); and offset reorientating, 1.6 (p = 0.010). No association was found with other geometries. 10° and 15° liners had a time-dependent lower risk of revision for instability within the first 1.2 years. In posterior approaches, 10° and 15° liners had a lower risk of revision for instability, with no significant difference between them. The protective effect of lipped over neutral liners was not observed in laterally approached THAs. There were 604 (0.3%) revisions for loosening, but no association between liner geometry and revision for loosening was found. Conclusion This registry-based study confirms a lower risk of revision for instability in posterior approach THAs with 10° or 15° lipped liners compared to neutral liners, but no significant difference between these lip sizes. A higher revision risk is seen with offset reorientating liners. The benefit of lipped geometries against revision for instability was not seen in laterally approached THAs. Liner geometry does not seem to influence the risk of revision for loosening. Cite this article: Bone Joint J 2021;103-B(12):1774–1782.

Epidemiology of norovirus and viral gastroenteritis in Ontario, Canada, 2009–2014

Background: Norovirus is the most common cause of acute gastroenteritis in Canada. The illness causes great morbidity and high societal costs. The objective of this article is to describe the epidemiology of norovirus in the province of Ontario, Canada from 2009 to 2014. Methods: To assess activity of norovirus and viral gastroenteritis (VGE) in Ontario, three datasets were acquired from the provincial government: two traditional surveillance datasets (outbreak and laboratory) and syndromic surveillance data (telehealth), all spanning 2009–2014. All outbreaks, laboratory submissions and telehealth calls were first assessed for total VGE. Norovirus and norovirus-like illness totals were calculated as a proportion of VGE to estimate agent-specific activity levels. Affected institution types, sexes and age groups were also analyzed. Results: Between 2009 and 2014, 41.5% of VGE outbreaks, 63.4% of VGE laboratory submissions and 36.6% of all acute gastroenteritis-related (not restricted to viral causes) telehealth calls were attributed to norovirus and norovirus-like illness in Ontario. The most commonly affected institution type was long-term care homes and the most commonly affected age groups were younger (younger than five years) and older (older than 65 years) individuals. Females were slightly more frequently affected than males. Conclusion: Norovirus and norovirus-like illnesses were the leading cause of VGE in Ontario between 2009 and 2014. They comprised the greatest percentage of VGE when compared with all other VGE-associated viruses. Additional work is needed to determine all component costs and necessary public health actions to reduce the burden of disease.

The Role of Peer Influence and Tertiary Institution Type on Attitude Towards Cohabitation Among Adolescents in Nigeria

The descriptive study examined the role of peer influence and tertiary institution type on attitude toward cohabitation among adolescents in southwestern Nigeria. A sample of 620 males and females with (M=19.56 years, SD=6.18) completed a survey that comprised demographic information, measures of attitude toward cohabitation and peer pressure. Findings revealed that there was significant influence of peer influence on attitude toward cohabitation. There was no influence of tertiary institution type on attitude toward cohabitation. The study concluded that peer influence was a major determinant of attitude toward cohabitation. The study therefore recommended that psychologists should give proper orientation to students on the destructive tendencies that peer influence could have on their intention to have positive attitude toward cohabitation.

Students from Portuguese Speaking African Countries in Portuguese Higher Education

Recently, African countries have been making efforts to expand their higher education systems. However, neither capacity nor quality have kept pace with demand, leading to a steady increase in students studying abroad. In this paper, we aim to analyse the development of enrolments in Portugal, one of the main destinations for students from Portuguese-speaking African countries (PALOP). Descriptive analyses were performed, disaggregating enrolments according to degree level, disciplinary area of study, and institution type. The results show that the choices of students from PALOP countries have followed different trajectories, in some cases with similarities. The public sector has the largest presence of these students, and polytechnic institutions have been the most frequent choice. Most of the students were enrolled in first degrees, except for those from Mozambique. Enrolments in Health, Services and "hard" sciences have increased, which may reflect the growing demand for highly qualified labour force in these countries. This paper highlights the continued importance of PALOP students for the internationalisation of Portuguese higher education and the need to avoid considering them as a homogeneous group of students.

Do No Harm: Graduate Admissions Letters of Recommendation and Unconscious Bias

Purpose Faculty members commonly write letters of recommendation (LOR) for students. Although letters can be helpful, they may do more harm if they include language that can negatively bias readers. The purpose of this article is to examine LORs written for Black applicants to speech-language pathology graduate programs for the presence of phrases that may bias readers (PBRs). Method Using data from our program, we analyzed LORs for evidence of bias. Results Across the 161 LORs, there were 202 instances of PBRs. The most PBRs were grindstone adjectives and doubt raisers/hedges. PBRs were not related to applicants' GPA, undergraduate institution type, or LOR word length. PBRs were related to admission offers. Conclusions Results suggest a negative impact of PBRs in LORs written for Black applicants. Implications are discussed and recommendations for writing less-biased LORs are provided.

Disproportionate Burden: Estimating the Cost of FAFSA Verification for Public Colleges and Universities

Verification is a federally mandated process that requires selected students to further attest that the information reported on their Free Application for Federal Student Aid (FAFSA) is accurate and complete. In this brief, we estimate institutional costs of administrating the FAFSA verification mandate and consider variation in costs by institution type and sector. Using data from 2014, we estimate that compliance costs to institutions in that year totaled nearly US$500 million with the burden falling disproportionately on public institutions and community colleges, in particular. Specifically, we estimate that 22% of an average community college’s financial aid office operating budget is devoted to verification procedures, compared with 15% at public 4-year institutions. Our analysis is timely, given that rates of FAFSA verification have increased in recent years.

Examining Variations in Surfactant Administration (ENVISION): A Neonatology Insights Pilot Project

Variability in neonatal clinical practice is well recognized. Respiratory management involves interdisciplinary care and often is protocol driven. The most recent published guidelines for management of respiratory distress syndrome and surfactant administration were published in 2014 and may not reflect current clinical practice in the United States. The goal of this project was to better understand variability in surfactant administration through conduct of health care provider (HCP) interviews. Questions focused on known practice variations included: use of premedication, decisions to treat, technique of surfactant administration and use of guidelines. Data were analyzed for trends and results were communicated with participants. A total of 54 HCPs participated from June to September 2020. In almost all settings, neonatologists or nurse practitioners intubated the infant and respiratory therapists administered surfactant. The INSURE (INtubation-SURrfactant-Extubation) technique was practiced by 83% of participants. Premedication prior to intubation was used by 76% of HCPs. An FiO2 ≥ 30% was the most common threshold for surfactant administration (48%). In conclusion, clinical practice variations exist in respiratory management and surfactant administration and do not seem to be specific to NICU level or institution type. It is unknown what effects the variability in clinical practice might have on clinical outcomes.

Institutional Differences in the Stewardship and Research Output of United States Herbaria

Public policy decisions regarding institutional frameworks that govern the stewardship of biodiversity data at public and private institutions are an area of increasing importance. Museums, government agencies, and academic institutions across the United States maintain collections of biological specimens and information critical to scientific discovery. One subset of these natural history collections are herbaria, or collections of preserved plant matter and their associated data. In this study, I evaluate the current state of the digitization and databasing of herbariums contributing data to the SEInet Regional Network of North American Herbaria, and assess the impact of characteristics, particularly institution type (cultural sector institutions, public universities, private universities, or public land institutions), on the metrics of herbaria richness, digitization, and research usage. The results of this study suggest that institution type is significantly associated with the size, diversity, and digitization efforts of a herbarium collection. Specifically, cultural sector institutions tend to have larger and more diverse collections, followed by public and private universities, and finally public land institutions. Additionally, as herbarium size and richness increases, the research output of associated staff also increases. These results highlight that some institutions, particularly larger institutions located at universities or cultural sector institutions, may be better supported in the curation, stewardship, and digitization of large collections, allowing long-term access to the associated biodiversity data. Smaller institutions at public land institutions may need additional support in these endeavors, and may represent an area of unmet needs for digitization and curatorial funding and resources.