A Study on Acute Management of Colorectal Cancer Presenting as an Emergency.

Introduction Many patients in Greater Manchester underwent emergency/urgent surgery, but limited data are available about managing these patients and their outcomes. We aimed to study the clinico-demographic profile, management trends, and outcomes of the patients presenting to the ED in the real world. Methods All patients with lower GI cancer (known or newly diagnosed on the present visit) in the ED requiring admission under surgeons for treatment were identified prospectively over six months and were included in the study.

The ectodomain sheddase ADAM10 restricts HIV-1 propagation and is counteracted by Nef.

HIV-1 Nef enhances virus propagation by down-regulating CD4 and SERINC5. However, recent evidence points to the existence of an additional Nef-sensitive restriction mechanism. We now show that Nef suppresses the aberrant cleavage of HIV-1 gp41 by ADAM10, a virion-associated cellular ectodomain sheddase, and thus increases the amount of HIV-1 envelope glycoprotein (Env) on virions.

Creating an Inclusive Definition for High Users of Inpatient Hospital Systems That Considers Different Levels of Rurality.

Multiple definitions have been used to identify individuals who are high system users (HSUs), through economic costs, frequency of use, or length of stay for inpatient care users. However, no definition has been validated to be representative of those residing in rural communities, who face unique service accessibility. This paper identifies an HSU definition for rural Canada that is inclusive of various levels of rurality, longitudinal patient experiences, and types of hospitalizations experienced.

Exploring barriers to accessing health care services by young women in rural settings: a qualitative study in Australia, Canada, and Sweden.

Background: The aim of this study is to explore young rural women's perceived barriers in accessing healthcare services with a focus on the interrelation between three marginalization criteria: age (youth), gender (female), and place of residence (rural areas) in Australia, Canada, and Sweden.

Methods: Using a qualitative interpretive approach, we conducted semi-structured in-depth interviews with 31 young women aged 18 to 24 in selected rural communities. Data collection took place from May 2019 to January 2021, and the qualitative data were analyzed using NVivo software.

Where should we go - Estimating travel times for modelling accessibility to 24-hour emergency departments in Canada.

Estimating travel time to 24-hour emergency services is an important component to modelling accessibility of health services, particularly for rural areas. However, methods used to estimate travel time vary significantly, are not representative of the residential population, and are not openly validated. This makes the assessment of travel-based accessibility metrics between studies incomparable.

Does Artificial Intelligence Outperform Humans Using Fluoroscopic-Assisted Computer Navigation for Total Hip Arthroplasty?

Background: Successful total hip arthroplasty (THA) relies on the correct implant position. THA accuracy can be improved with the use of intraoperative fluoroscopic-assisted computer navigation. Artificial intelligence (AI) software may enhance fluoroscopic navigation; however, the accuracy of the AI compared to human-controlled software in assessing acetabular component position and leg length discrepancy (LLD) has not been studied.

Fluoroscopy-Assisted Computer Navigation Accurately Determines Cup Position and Leg Length for Anterior Hip Arthroplasty.

Background: Recently, fluoroscopy-assisted computer navigation has been developed to assess intraoperative cup inclination/anteversion and leg-length discrepancy (LLD) in the operating room. However, there is a relative dearth of studies investigating the accuracy of this software compared with postoperative radiographs.

Materials And Methods: We prospectively enrolled 211 navigated anterior total hip arthroplasties using fluoroscopy-assisted computer navigation software.

Racial/Ethnic Disparities in Psychiatric Traits and Diagnoses within a Community-based Sample of Children and Youth: Disparités raciales/ethniques dans les traits et diagnostics psychiatriques au sein d'un échantillon communautaire d'enfants et de jeunes.

Objective: Racial/ethnic disparities in the prevalence of psychiatric disorders have been reported, but have not accounted for the prevalence of the traits that underlie these disorders. Examining rates of diagnoses in relation to traits may yield a clearer understanding of the degree to which racial/ethnic minority youth in Canada differ in their access to care. We sought to examine differences in self/parent-reported rates of diagnoses for obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders after adjusting for differences in trait levels between youth from three racial/ethnic groups: White, South Asian and East Asian.

Posterior Capsule Reconstruction with Polypropylene Mesh After Total Hip Arthroplasty.

Instability remains a challenge after total hip arthroplasty (THA). We have previously utilized a monofilament polypropylene mesh to reconstruct the posterior capsule for unstable THA. This study identified 24 hips that underwent mesh reconstruction of the posterior capsule for instability.

Health Service Implementation and Antifragile Characteristics in Rural Communities: A Dirt Research Approach.

The implementation of health and care services within rural communities requires necessary sensitivity to the unique facets of rural places. Often, rural service implementation is executed with inappropriate frameworks based on assumptions derived from urban centres. To understand the characteristics of rural communities that can facilitate successful program implementation better, ethnographic accounts of rural health and care services were compiled in rural communities within Canada, Australia, and Iceland.

Characteristics of High-Resource Health System Users in Rural and Remote Regions: A Scoping Review.

A small proportion of health care users are recognized to use a significantly higher proportion of health system resources, largely due to systemic, inequitable access and disproportionate health burdens. These high-resource health system users are routinely characterized as older, with multiple comorbidities, and reduced access to adequate health care. Geographic trends also emerge, with more rural and isolated regions demonstrating higher rates of high-resource use than others.

A Survey Analysis of Patient Understanding and Preferences for Podiatrists Versus Foot and Ankle Orthopaedic Surgeons.

Background: Recent studies suggest poorer outcomes and higher costs associated with patients treated by podiatrists, yet no studies have evaluated patient perception and preference for foot and ankle providers. This study aims to determine patient perception of training for podiatrists compared to orthopaedic surgeons and patient preference for type of provider seen.

Methods: A 20-question survey was administered to new patients seeing either a podiatrist or foot and ankle orthopaedic surgeon.

Handheld Navigation Improves Accuracy in Direct Anterior Total Hip Replacement.

Background: This study sought to determine the accuracy in placing the acetabular component, estimation of leg length, offset, radiation time and dose, and operative time using a handheld navigation device compared to conventional anterior total hip arthroplasty (THA). It also examined the learning curve of the handheld navigation device.

Methods: Data were prospectively collected for a consecutive series of 159 THAs; 99 THAs with handheld navigation and 60 conventional THAs.

Total Hip Arthroplasty in Patients With Severe Chronic Pubic Diastasis.

Background: Total hip arthroplasty (THA) in patients with severe chronic pubic diastasis from either congenital or acquired causes presents an exceptionally difficult challenge that has rarely been addressed in the arthroplasty literature. The purpose of this paper is to present a series of THAs in patients with severe chronic pubic diastasis, asking the following research questions: (1) What is the survivorship and clinical outcomes after THA in patients with severe chronic pubic diastasis? And (2) What is the rate of complications after THA surgery in this challenging patient population? We additionally describe our algorithm for preoperative planning and rationale for surgical technique and implant position.

Material And Methods: We retrospectively queried the prospective arthroplasty database of 2 high-volume referral centers, yielding 6 THA in 4 patients with severe chronic pubic diastasis (minimum 8 cm) with a mean follow-up of 2.

What a Pandemic Has Taught Us About the Potential for Innovation in Rural Health: Commencing an Ethnography in Canada, the United States, Sweden, and Australia.

The COVID-19 pandemic coincided with a multi-national federally funded research project examining the potential for health and care services in small rural areas to identify and implement innovations in service delivery. The project has a strong focus on electronic health (eHealth) but covers other areas of innovation as well. The project has been designed as an ethnography to prelude a realist evaluation, asking the question The project had already engaged with several health care practitioners and research students based in Canada, Sweden, Australia, and the United States.

HIV-1 propagation is highly dependent on basal levels of the restriction factor BST2.

BST2 is an interferon-inducible antiviral host protein antagonized by HIV-1 Vpu that entraps nascent HIV-1 virions on the cell surface. Unexpectedly, we find that HIV-1 lacking Nef can revert to full replication competence simply by losing the ability to antagonize BST2. Using gene editing together with cell sorting, we demonstrate that even the propagation of wild-type HIV-1 is strikingly dependent on BST2, including in primary human cells.

Is Dislocation Risk due to Posterior Pelvic Tilt Reduced With Direct Anterior Approach Total Hip Arthroplasty?

Background: Pelvic tilt affects acetabular anteversion, and thus total hip arthroplasty (THA) dislocation risk. The pubic symphysis-sacrococcygeal distance (PSCD) is an indicator of pelvic tilt, and a PSCD < 0 mm (ie, excessive posterior pelvic tilt) is associated with a 3.7-fold increase in postoperative dislocation rate.

Gallstone Ileus: Uncommon Presentation Followed by Less Common Spontaneous Resolution.

Gallstone ileus is a rare but significant cause of bowel obstruction. An 82-year-old female was admitted to the hospital with abdominal pain and was initially treated for a possible urinary tract infection. Following a surgical review and based on history, clinical examination as well as radiological findings, a diagnosis of gallstone ileus was made.

Accelerometer-based navigation improves early patient-reported outcomes after gap-balanced total knee arthroplasty.

Objective: To investigate the effect of accelerometry-based navigation (ABN) on early clinical outcomes after TKA.

Methods: 71 TKAs were performed via ABN and 37 TKAs via standard instrumentation (STD). Patients were assessed at the second post-operative visit to determine early KOOS, JR scores.

Acetabular Exposure Is Enhanced With Self-Retaining Retractors During Direct Anterior Total Hip Arthroplasty.

Acetabular exposure for direct anterior (DA) total hip arthroplasty (THA) can be performed using hands-free, self-retaining retractors. No current study quantitatively compares this self-retaining technique with the traditional manual technique. In 65 consecutive DA THA hips, two "best-view" digital photographs were taken of the exposure-one using Charnley/self-retaining retractors and one using a traditional three-retractor manual technique.

Patient and provider perspectives on eHealth interventions in Canada and Australia: a scoping review.

Introduction: Despite the promises of universal health care in most developed countries, health inequities remain prevalent within and between rural and remote communities. Remote health technologies are often promoted as solutions to increase health system efficiency, to enhance quality of care, and to decrease gaps in access to care for rural and remote communities. However, there is mixed evidence for these interventions, particularly related to how they are received and perceived by health providers and by patients.

Surgical automation reduces operating time while maintaining accuracy for direct anterior total hip arthroplasty.

Objective: Investigate the efficiency/accuracy of surgical automation versus manual component implantation in DA THA.

Methods: Retrospective review of 111 hips: 51 hips via automation and 60 hips via manual technique for DA THA.

Results: OR time averaged 8 min faster in the Automated group, compared to Manual group ( = 0.