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Perioperative medical management during total hip arthroplasty (THA) is continuously improving, allowing an increasing number of medically complex patients to undergo total joint arthroplasty. This study examined mortalities, medical complications, implant survivorships, and clinical outcomes of THA in patients who have pulmonary hypertension (HTN).We identified 638 patients who had pulmonary HTN and underwent 508 primary THAs and 191 revision THAs from 2000 to 2016 at a tertiary care center. Patients were followed up at regular intervals until death, revision surgery, or last clinical follow-up. Perioperative medical complications were individually reviewed. The risk of death was examined by calculating standardized mortality ratios and Cox proportional hazards regression models. Cumulative incidence analyses were used for reporting mortality, reoperation, and revision with death as a competing risk.The 90-day mortality was 1.8 and 3.1% for primary and revision THAs, respectively. The risk of death was approximately two-fold higher compared to primary (HR 2.69) and revision (HR 2.04) THA patients who did not have pulmonary HTN. Rate of medical complications within 90 days from surgery were 6.2 and 13.1% in primary and revision THAs, respectively. The 10-year cumulative incidence of any revision was 9 and 14% following primaries and revisions, respectively.Patients who had pulmonary HTN undergoing primary and revision THAs had increased risk of death and experienced a high rate of medical complications within 90 days of surgery. Counseling of risks, medical optimization, and referral to medical centers expert at managing complex medical problems should be considered.

Background No approved treatment for peanut allergy exists for children younger than 4 years of age, and the efficacy and safety of epicutaneous immunotherapy with a peanut patch in toddlers with peanut allergy are unknown. Methods We conducted this phase 3, multicenter, double-blind, randomized, placebo-controlled trial involving children 1 to 3 years of age with peanut allergy confirmed by a double-blind, placebo-controlled food challenge. Patients who had an eliciting dose (the dose necessary to elicit an allergic reaction) of 300 mg or less of peanut protein were assigned in a 2:1 ratio to receive epicutaneous immunotherapy delivered by means of a peanut patch (intervention group) or to receive placebo administered daily for 12 months. The primary end point was a treatment response as measured by the eliciting dose of peanut protein at 12 months. Safety was assessed according to the occurrence of adverse events during the use of the peanut patch or placebo. Results Of the 362 patients who underwent randomization, 84.8% completed the trial. The primary efficacy end point result was observed in 67.0% of children in the intervention group as compared with 33.5% of those in the placebo group (risk difference, 33.4 percentage points; 95% confidence interval, 22.4 to 44.5; P

Covalent inhibitors of Bruton tyrosine kinase (BTK) have transformed the therapy of chronic lymphocytic leukemia (CLL), but continuous therapy has been complicated by the development of resistance. The most common resistance mechanism in patients whose disease progresses on covalent BTK inhibitors (BTKis) is a mutation in the BTK 481 cysteine residue to which the inhibitors bind covalently. Pirtobrutinib is a highly selective, noncovalent BTKi with substantial clinical activity in patients whose disease has progressed on covalent BTKi, regardless of BTK mutation status. Using in vitro ibrutinib-resistant models and cells from patients with CLL, we show that pirtobrutinib potently inhibits BTK-mediated functions including B-cell receptor (BCR) signaling, cell viability, and CCL3/CCL4 chemokine production in both BTK wild-type and C481S mutant CLL cells. We demonstrate that primary CLL cells from responding patients on the pirtobrutinib trial show reduced BCR signaling, cell survival, and CCL3/CCL4 chemokine secretion. At time of progression, these primary CLL cells show increasing resistance to pirtobrutinib in signaling inhibition, cell viability, and cytokine production. We employed longitudinal whole-exome sequencing on 2 patients whose disease progressed on pirtobrutinib and identified selection of alternative-site BTK mutations, providing clinical evidence that secondary BTK mutations lead to resistance to noncovalent BTKis.

Background Late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) offers the potential to noninvasively characterize the phenotypic substrate for sudden cardiac death (SCD). Objectives The authors assessed the utility of infarct characterization by CMR, including scar microstructure analysis, to predict SCD in patients with coronary artery disease (CAD). Methods Patients with stable CAD were prospectively recruited into a CMR registry. LGE quantification of core infarction and the peri-infarct zone (PIZ) was performed alongside computational image analysis to extract morphologic and texture scar microstructure features. The primary outcome was SCD or aborted SCD. Results Of 437 patients (mean age: 64 years; mean left ventricular ejection fraction [LVEF]: 47%) followed for a median of 6.3 years, 49 patients (11.2%) experienced the primary outcome. On multivariable analysis, PIZ mass and core infarct mass were independently associated with the primary outcome (per gram: HR: 1.07 [95% CI: 1.02-1.12]; P = 0.002 and HR: 1.03 [95% CI: 1.01-1.05]; P = 0.01, respectively), and the addition of both parameters improved discrimination of the model (Harrell’s C-statistic: 0.64-0.79). PIZ mass, however, did not provide incremental prognostic value over core infarct mass based on Harrell’s C-statistic or risk reclassification analysis. Severely reduced LVEF did not predict the primary endpoint after adjustment for scar mass. On scar microstructure analysis, the number of LGE islands in addition to scar transmurality, radiality, interface area, and entropy were all associated with the primary outcome after adjustment for severely reduced LVEF and New York Heart Association functional class of >1. No scar microstructure feature remained associated with the primary endpoint when PIZ mass and core infarct mass were added to the regression models. Conclusions Comprehensive LGE characterization independently predicted SCD risk beyond conventional predictors used in implantable cardioverter-defibrillator (ICD) insertion guidelines. These results signify the potential for a more personalized approach to determining ICD candidacy in CAD.

Background Non-physician practitioners (NPPS), including nurse practitioners (NPs) and physician assistants (PAs) are expanding their scope of practice outside of primary care and performing more procedures in dermatology. Objective To understand the scope and geographic pattern of practice by NPs and PAs in dermatology in the US. Methods Cross-sectional retrospective cohort analysis of dermatology practices in the 2014 Medicare Physician/Supplier Procedure Summary Master File, which reflects Part B carrier and durable medical equipment fee-for-service claims in the US. Results Over 4 million procedures were billed independently by NPs and PAs, which accounts for 11.51% of all. Injection, simple repair, and biopsy were the most commonly billed by non-physician practitioners, but complex procedures were also increasingly billed independently by NPs and PAs. Proportions of their claims are higher in the East Coast, Midwest, and Mountain states. Limitations Data is at the state level, limited to Medicare beneficiaries, and doesn’t include billing incident-to physicians. Conclusions This study demonstrated the increasing scope of practice of NPs and PAs in dermatology, despite limited training and lack of uniform regulations. To ensure quality and safety of care, it is prudent to set benchmarks for proper supervision and utilization of procedures in dermatology.

Funder: Amazon Web Services (AWS) Imagine Grant, Funder: Kingston University (Kingston University, London); doi: https://doi.org/10.13039/100010049, Funder: Association Nationale de la Recherche et de la Technologie (National Association for Research and Technology); doi: https://doi.org/10.13039/501100003032, Funder: Association Nationale de la Recherche Scientifique and Pacifica (CIFRE grant 2017/0245), Funder: PRIMUS/20/HUM/009, Funder: UID/PSI/03125/2019 from the Portuguese National Foundation for Science and Technology (FCT)., Funder: PSA research grant ($285.59) for the PSACR projects data collection, Funder: The work of Dmitrii Dubrov was supported within the framework of the Basic Research Program at HSE University, RF, Funder: Agentúra na podporu výskumu a vývoja (Slovak Research and Development Agency) - APVV-17-0596, Funder: Progres Q18, Charles University, Funder: JSPS KAKENHI Grant Numbers JP18K12015 and JP20H04581, Funder: National Science Centre, Poland (2019/35/B/HS6/00528), Funder: Slovak Research and Development Agency - APVV-17-0596, Funder: Huo Family Foundation, Funder: The Japan Society for the Promotion of Science KAKENHI [19K14370], Funder: The Institute of Psychology, Jagiellonian University, Funder: Program FUTURE LEADER of Lorraine Université d’Excellence within the program Investissements Avenir (ANR-15-IDEX-04-LUE) operated by the French National Research Agency, Funder: Rubicon grant (019.183SG.007) from the Netherlands Organization for Scientific Research (NWO), Funder: Australian Research Council (DP180102384), Funder: HSE University Basic Research Program, Funder: Horizon 2020 grant 964728 (JITSUVAX) from the European Commission and was supported by a United Kingdom Research and Innovation (UKRI) Research Fellowship grant ES/V011901/1, Funder: Social Science and Humanities Research Council of Canada, Funder: Dominican University Faculty Support Grant, Funder: FONDECYT 1221538, Funder: Vicerrectoria de Investigaciones, Uniandes, Funder: Statutory funds of the Institute of Psychology, University of Wroclaw, Funder: University of Desarrollo, Faculty of Psychology, Funder: IDN Being Human Lab (University of Wrocław), Funder: ANID - Fondecyt 1201513, In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures for each experimental study, a general questionnaire examining health prevention behaviors and COVID-19 experience, geographical and cultural context characterization, and demographic information for each participant. Each participant started the study with the same general questions and then was randomized to complete either one longer experiment or two shorter experiments. Data were provided by 73,223 participants with varying completion rates. Participants completed the survey from 111 geopolitical regions in 44 unique languages/dialects. The anonymized dataset described here is provided in both raw and processed formats to facilitate re-use and further analyses. The dataset offers secondary analytic opportunities to explore coping, framing, and self-determination across a diverse, global sample obtained at the onset of the COVID-19 pandemic, which can be merged with other time-sampled or geographic data.

Background The transition from military service to civilian life is a high-risk period for suicide attempts (SAs). Although stressful life events (SLEs) faced by transitioning soldiers are thought to be implicated, systematic prospective evidence is lacking. Methods Participants in the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) completed baseline self-report surveys while on active duty in 2011–2014. Two self-report follow-up Longitudinal Surveys (LS1: 2016–2018; LS2: 2018–2019) were subsequently administered to probability subsamples of these baseline respondents. As detailed in a previous report, a SA risk index based on survey, administrative, and geospatial data collected before separation/deactivation identified 15% of the LS respondents who had separated/deactivated as being high-risk for self-reported post-separation/deactivation SAs. The current report presents an investigation of the extent to which self-reported SLEs occurring in the 12 months before each LS survey might have mediated/modified the association between this SA risk index and post-separation/deactivation SAs. Results The 15% of respondents identified as high-risk had a significantly elevated prevalence of some post-separation/deactivation SLEs. In addition, the associations of some SLEs with SAs were significantly stronger among predicted high-risk than lower-risk respondents. Demographic rate decomposition showed that 59.5% (s.e. = 10.2) of the overall association between the predicted high-risk index and subsequent SAs was linked to these SLEs. Conclusions It might be possible to prevent a substantial proportion of post-separation/deactivation SAs by providing high-risk soldiers with targeted preventive interventions for exposure/vulnerability to commonly occurring SLEs.

Background: Widely used psychotropic medications for obsessive-compulsive disorder (OCD) may change the volumes of subcortical brain structures, and differently in children vs. adults. We measured subcortical volumes cross-sectionally in patients finely stratified for age taking various common classes of OCD drugs. Methods: The ENIGMA-OCD consortium sample (1081 medicated/1159 unmedicated OCD patients and 2057 healthy controls aged 6–65) was divided into six successive 6–10-year age-groups. Individual structural MRIs were parcellated automatically using FreeSurfer into 8 regions-of-interest (ROIs). ROI volumes were compared between unmedicated and medicated patients and controls, and between patients taking serotonin reuptake inhibitors (SRIs), tricyclics (TCs), antipsychotics (APs), or benzodiazepines (BZs) and unmedicated patients. Results: Compared to unmedicated patients, volumes of accumbens, caudate, and/or putamen were lower in children aged 6–13 and adults aged 50–65 with OCD taking SRIs (Cohen's d = −0.24 to −0.74). Volumes of putamen, pallidum (d = 0.18–0.40), and ventricles (d = 0.31–0.66) were greater in patients aged 20–29 receiving APs. Hippocampal volumes were smaller in patients aged 20 and older taking TCs and/or BZs (d = −0.27 to −1.31). Conclusions: Results suggest that TCs and BZs could potentially aggravate hippocampal atrophy of normal aging in older adults with OCD, whereas SRIs may reduce striatal volumes in young children and older adults. Similar to patients with psychotic disorders, OCD patients aged 20–29 may experience subcortical nuclear and ventricular hypertrophy in relation to APs. Although cross-sectional, present results suggest that commonly prescribed agents exert macroscopic effects on subcortical nuclei of unknown relation to therapeutic response.

Conversational agents (CAs) can analyze online conversations using natural language techniques and effectively facilitate group discussions by sending supervisory messages. However, if a CA makes imperfect interventions, users may stop trusting the CA and discontinue using it. In this study, we demonstrate how inaccurate interventions of a CA and a conversational repair strategy can influence user acceptance of the CA, members' participation in the discussion, perceived discussion experience between the members, and group performance. We built a CA that encourages the participation of members with low contributions in an online chat discussion in which a small group (3-6 members) performs a decision-making task. Two types of errors can occur when detecting under-contributing members: 1) false-positive (FP) errors happen when the CA falsely identifies a member as under-contributing and 2) false-negative (FN) errors occur when the CA misses detecting an under-contributing member. We designed a conversational repair strategy that gives users a chance to contest the detection results and the agent sends a correctional message if an error is detected. Through an online study with 175 participants, we found that participants who received FN error messages reported higher acceptance of the CA and better discussion experience, but participated less compared to those who received FP error messages. The conversational repair strategy moderated the effect of errors such as improving the perceived discussion experience of participants who received FP error messages. Based on our findings, we offer design implications for which model should be selected by practitioners between high precision (i.e., fewer FP errors) and high recall (i.e., fewer FN errors) models depending on the desired effects. When frequent FP errors are expected, we suggest using the conversational repair strategy to improve the perceived discussion experience.

Peer evaluations are a well-established tool for evaluating individual and team performance in collaborative contexts, but are susceptible to social and cognitive biases. Current peer evaluation tools have also yet to address the unique opportunities that online collaborative technologies provide for addressing these biases. In this work, we explore the potential of one such opportunity for peer evaluations: data traces automatically generated by collaborative tools, which we refer to as "activity traces". We conduct a between-subjects experiment with 101 students and MTurk workers, investigating the effects of reviewing activity traces on peer evaluations of team members in an online collaborative task. Our findings show that the usage of activity traces led participants to make more and greater revisions to their evaluations compared to a control condition. These revisions also increased the consistency and participants' perceived accuracy of the evaluations that they received. Our findings demonstrate the value of activity traces as an approach for performing more reliable and objective peer evaluations of teamwork. Based on our findings as well as qualitative analysis of free-form responses in our study, we also identify and discuss key considerations and design recommendations for incorporating activity traces into real-world peer evaluation systems.

Jillian Kallman Price,1 Lynn H Gerber,1,2 Maria Stepanova,1– 3 Leyla de Avila,1 Ali A Weinstein,4 Huong Pham,1 Fatema Nader,1 Mariam Afendy,1 Kathy Terra,3 Patrick Austin,1 Wisna’odom Keo,1 Andrei Racila,1 James Michael Estep,1 Suzannah Gerber,1 Manisha Verma,1 Pegah Golabi,1 Brian P Lam,1– 3 Zobair Younossi1– 3 1Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA; 2Inova Medicine, Inova Health System, Falls Church, VA, USA; 3Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; 4Department of Global and Community Health, George Mason University, Fairfax, VA, USACorrespondence: Jillian Kallman Price, Research Investigator, Outcomes Research, Beatty Liver and Obesity Research Program, Center for Integrated Research, Department of Medicine, Inova Health System, Claude Moore Health Education and Research Building, Inova Fairfax Medical Campus, 3300 Gallows Road, Falls Church, VA, 22042, USA, Tel +1-703-776-3032, Fax +1-703- 776-4386, Email Jillian.Price@inova.orgIntroduction: Many with post-acute SARS-CoV-2 (PASC) have persistent symptoms impacting physical and cognitive function, decreased health and health-related life quality. Monoclonal antibody (mAb) treatment was available to acutely infected patients which might improve these outcomes.Purpose: To compare patient perception of PASC symptoms for those receiving bamlanivimab or casirivimab and imdevimab (mAbs) to those not receiving this treatment (non-mAbs). To compare changes between these groups in symptoms, function and quality of life over a 6-month follow-up.Patients and Methods: Consented adults > 28 days post-infection with positive SARS-CoV-2 qPCR or antigen test and SARS-CoV-2 infection between March of 2020 and July of 2022 were enrolled. This prospective, repeated measure observational study reports baseline through 6-month follow-up. Extensive sociodemographic data, detailed medical history, COVID-19 symptom history, and standardized measures of well-being, depression, anxiety, stigma, cognition, symptom assessment, distress, and health status were collected.Results: 323 participants [101 mAb, 221 non-mAb, 52.7± 15.5 years, 47.7% male, body mass index (BMI) 31.4± 8.4] were analyzed. Fewer symptoms at baseline were reported in mAb versus non-mAb participants (1.06± 1.31 vs 1.78± 2.15, respectively p=0.0177) 6 months: (0.911± 1.276 mAb vs.1.75± 2.22 non-mAb, p=0.0427). Both groups showed significant within-group decreases in symptom number (52 to 21 mAb, 126 to 63 non-mAb) and symptom burden (p=0.0088 mAb, p< 0.00001 non-mAb). mAb patients had significantly shorter infection-to-baseline interval (days) (120.4± 55.3 mAb vs 194.0± 89.3 non-mAb, p< 0.00001); less frequent history of myocardial infarction (0.0 vs 3.9%, p=0.0464); headache (2.0% vs.11.8%, p=0.0046), rash (3.1% vs 9.9%, p=0.0377), and miscellaneous muscle complaints (2.0% vs 12.3%, p=0.0035), plus significantly better 6-month mood. (2.2% vs 13.2%, p=0.0390).Conclusion: mAb treated participants had reduced symptom burden and consistently reported fewer symptoms than non-mAb at all time points despite less time since acute illness. Both groups reported a statistically significant decrease in symptoms by 6-month visit with no statistically significant differences between them at follow-up.Keywords: monoclonal antibodies, patient-reported outcomes, symptom burden, recovery, COVID-19

Reducing treatment burden is a priority for people with cystic fibrosis, whose health has benefited from using new modulators that substantially increase CFTR protein function. The SIMPLIFY study aimed to assess the effects of discontinuing nebulised hypertonic saline or dornase alfa in individuals using the CFTR modulator elexacaftor plus tezacaftor plus ivacaftor (ETI).The SIMPLIFY study included two parallel, multicentre, open-label, randomised, controlled, non-inferiority trials at 80 participating clinics across the USA in the Cystic Fibrosis Therapeutics Development Network. We included individuals with cystic fibrosis aged 12-17 years with percent predicted FEVFrom Aug 25, 2020, to May 25, 2022, a total of 672 unique participants were screened for eligibility for one or both trials, resulting in 847 total random assignments across both trials with 594 unique participants. 370 participants were randomly assigned in the hypertonic saline trial and 477 in the dornase alfa trial. Participants across both trials had an average ppFEVIn individuals with cystic fibrosis on ETI with relatively well preserved pulmonary function, discontinuing daily hypertonic saline or dornase alfa for 6 weeks did not result in clinically meaningful differences in pulmonary function when compared with continuing treatment.

Japan’s decision to accept the terms of the Potsdam Declaration was one of the most pivotal events in the country’s modern history. Most students of the decision-making process agree that Foreign Minister Tōgō Shigenori was the principal motive force supporting acceptance of the Allies’ demands throughout the debate over the action. Some recent historiography in Japan has questioned Tōgō’s approach, focusing particularly on his decision to seek the mediation of the Soviet Union and on the question of why he did not bring hostilities to an end sooner. Historical materials that were previously unavailable to scholars shed some light on these questions. In combination with Tōgō’s daily planner (in the author’s possession), his memoirs, and the author’s own recollection of anecdotes his parents told to him, these materials make possible a detailed examination of Tōgō’s thoughts and actions in the days leading to the acceptance of the Potsdam Declaration. This shows that Tōgō, facing stubborn resistance from the military and from public opinion, nevertheless persevered in his quest to bring the war to an end. He also maintained the trust and respect of not only Emperor Hirohito, but also of Army Minister Anami Korechika, his principal antagonist in the debate.

We present the discovery of a new highly compact quadruple star system, TIC 219006972, consisting of two eclipsing binary stars with orbital periods of 8.3 days and 13.7 days, and an outer orbital period of only 168 days. This period is a full factor of 2 shorter than the quadruple with the shortest outer period reported previously, VW LMi, where the two binary components orbit each other every 355 days. The target was observed by TESS in Full-Frame Images in sectors 14-16, 21-23, 41, 48 and 49, and produced two sets of primary and secondary eclipses. These show strongly non-linear eclipse timing variations (ETVs) with an amplitude of $\sim$0.1 days, where the ETVs of the primary and secondary eclipses, and of the two binaries are all largely positively correlated. This highlights the strong dynamical interactions between the two binaries and confirms the compact quadruple configuration of TIC 219006972. The two eclipsing binaries are nearly circular whereas the quadruple system has an outer eccentricity of about 0.25. The entire system is nearly edge-on, with a mutual orbital inclination between the two eclipsing binary star systems of about 1 degree., 16 pages, 13 figures, 4 tables, MNRAS accepted

The Arabidopsis (Arabidopsis thaliana) BYPASS1 (BPS1) gene encodes a protein with no functionally characterized domains, and loss-of-function mutants (e.g. bps1-2 in Col-0) present a severe growth arrest phenotype that is evoked by a root-derived graft-transmissible small molecule that we call dalekin. The root-to-shoot nature of dalekin signaling suggests it could be an endogenous signaling molecule. Here, we report a natural variant screen that allowed us to identify enhancers and suppressors of the bps1-2 mutant phenotype (in Col-0). We identified a strong semi-dominant suppressor in the Apost-1 accession that largely restored shoot development in bps1 and yet continued to overproduce dalekin. Using bulked segregant analysis and allele-specific transgenic complementation, we showed that the suppressor is the Apost-1 allele of a BPS1 paralog, BYPASS2 (BPS2). BPS2 is one of four members of the BPS gene family in Arabidopsis, and phylogenetic analysis demonstrated that the BPS family is conserved in land plants and the four Arabidopsis paralogs are retained duplicates from whole genome duplications. The strong conservation of BPS1 and paralogous proteins throughout land plants, and the similar functions of paralogs in Arabidopsis, suggests that dalekin signaling might be retained across land plants.

Background Risk of suicide-related behaviors is elevated among military personnel transitioning to civilian life. An earlier report showed that high-risk U.S. Army soldiers could be identified shortly before this transition with a machine learning model that included predictors from administrative systems, self-report surveys, and geospatial data. Based on this result, a Veterans Affairs and Army initiative was launched to evaluate a suicide-prevention intervention for high-risk transitioning soldiers. To make targeting practical, though, a streamlined model and risk calculator were needed that used only a short series of self-report survey questions. Methods We revised the original model in a sample of n = 8335 observations from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS) who participated in one of three Army STARRS 2011–2014 baseline surveys while in service and in one or more subsequent panel surveys (LS1: 2016–2018, LS2: 2018–2019) after leaving service. We trained ensemble machine learning models with constrained numbers of item-level survey predictors in a 70% training sample. The outcome was self-reported post-transition suicide attempts (SA). The models were validated in the 30% test sample. Results Twelve-month post-transition SA prevalence was 1.0% (s.e. = 0.1). The best constrained model, with only 17 predictors, had a test sample ROC-AUC of 0.85 (s.e. = 0.03). The 10–30% of respondents with the highest predicted risk included 44.9–92.5% of 12-month SAs. Conclusions An accurate SA risk calculator based on a short self-report survey can target transitioning soldiers shortly before leaving service for intervention to prevent post-transition SA.

AimsThe purpose of this study was to assess mid-term survivorship following primary total knee arthroplasty (TKA) with Optetrak Logic components and identify the most common revision indications at a single institution.MethodsWe identified a retrospective cohort of 7,941 Optetrak primary TKAs performed from January 2010 to December 2018. We reviewed the intraoperative findings of 369 TKAs that required revision TKA from January 2010 to December 2021 and the details of the revision implants used. Kaplan-Meier analysis was used to determine survivorship. Cox regression analysis was used to examine the impact of patient variables and year of implantation on survival time.ResultsThe estimated survivorship free of all-cause revision was 98% (95% confidence interval (CI) 97% to 98%), 95% (95% CI 95% to 96%), and 86% (95% CI 83% to 88%) at two, five, and ten years, respectively. In 209/369 revisions there was a consistent constellation of findings with varying severity that included polyethylene wear and associated synovitis, osteolysis, and component loosening. This failure mode, which we refer to as aseptic mechanical failure, was the most common revision indication. The mean time from primary TKA to revision for aseptic mechanical failure was five years (5 months to 11 years).ConclusionIn this series of nearly 8,000 primary TKAs performed with a specific implant, we identified a lower-than-expected mid-term survivorship and a high number of revisions with a unique presentation. This study, along with the recent recall of the implant, confirms the need for frequent monitoring of patients with Optetrak TKAs given the incidence of polyethylene failure, osteolysis, and component loosening.Cite this article: Bone Joint J 2023;105-B(3):277–283.

The novelty effect has a long history in sport facility research with most research examining new facility construction. The present study explores the impact of renovated facilities, specifically the novelty effect, as it pertains to revenue and secondarily attendance. Within, we also explore four different renovation types as classified by the U.S. National Registry of Historic Places to look at any individual impact or revelation using institutions participating in the National Collegiate Athletic Association Division I Football Bowl Subdivision. Results from ordinary least squares and Tobit estimations from a sample period covering 1993 through 2017 conclude a novelty effect associated with renovations does exist for attendance. However, the effect is shorter in duration and delayed by a few seasons based upon the type of renovation. As for revenues, we find some positive impact on revenues. Those impacts are delayed are on based on certain types of renovation.