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Abstract Purpose Clinical and patient reported outcomes are often collected before and after the procedure to benchmark and study outcomes for patients. These outcomes and scores are useful for tracking patient outcomes after surgery, however, the fact that these commonly used measures typically provide information about a patient’s level of pain and function at a single point in time is a limitation. Methods We present early functional recovery and return to work outcomes after primary THA from a novel questionnaire administered in a global, multi-center, prospective clinical study. Results By 6 and 12 weeks post-op, a large proportion of study subjects were able to perform functional recovery outcomes after their THA: walk without an aid (74%; 94%); drive (76%; 97%); basic activities of daily living (94%; 99%); perform light household duties (91%; 96%); perform moderate-to-heavy household duties (54%; 86%); go up and down a flight of stairs (92%; 99%); put on socks/stockings (77%; 93%); bend down to pick up an object from the floor (87%; 97%); stand up from a chair (96%; 99%); perform leisure recreational activities (54%; 84%); perform primary goal identified pre-THA (69%; 86%). 60% were able to return to work by 12 weeks post-op. These questions showed strong association with the Forgotten Joint Score. Conclusion Excellent patient reported early functional recovery outcomes and satisfaction were observed at 6- and 12-weeks post-op in this cohort and is the first reported data using a novel PRO. Clinical trial registration NCT03189303, registered June 14, 2017.

Abstract Background Acetabular cup positioning in total hip arthroplasty (THA) is closely related to outcomes. The literature has suggested cup parameters defined by the Lewinnek safe zone; however, the validity of such measures is in question. Several studies have raised concerns about the benefits of using the Lewinnek safe zone as a predictor of success. In this study we elected to use prospective surgeon targets as the basis for comparison to see how successful surgeons are positioning their cup using standard instruments and techniques. Methods A prospective, global, multicenter study was conducted. Cup positioning success was defined as a composite endpoint. Both cup inclination and version needed to be within 10° of the surgeon target to be considered a success. Radiographic analysis was conducted by a third-party reviewer. Results In 170 subjects, inclination, target versus actual, was 44.8° [standard deviation (SD 0.9°)] and 43.1° (SD 7.6°), respectively (p = 0.0029). Inclination was considered successful in 84.1% of cases. Mean version, target versus actual, was 19.4° (SD 3.9°) and 27.2° (SD 5.6°), respectively (p

Background: Impaction in total hip arthroplasty has typically been conducted using a mallet. A surgical automated impactor has been developed with the goal of reducing surgeon variability, fatigue, and injury. There is also potential to reduce the variability of each impaction step in which automated impaction is used, through reproducible and consistent application of force. Methods: Patients were randomized into either the mallet control group, or the automated impaction study group (1:1 randomization). The primary endpoint analysis was conducted to demonstrate that femoral broaching time (in minutes) with an automated impactor is noninferior to femoral broaching time with manual instruments (mallet) under a noninferiority (NI) margin of 1.25 minutes, with a subsequent test of superiority. A total of 218 patients were randomized and treated (109 in each group). Results: Mean femoral broaching time was 5.8 minutes in the automated impaction study group (automated), and 8.1 minutes in the mallet control group (mallet), a 28.4% reduction (P = .0005). However, there was not a difference in surgery duration between the groups. Three fractures were reported in the mallet group and 1 in the automated group. Conclusions: In this randomized multicenter study, an automated impactor was shown to reduce femoral broaching time in primary total hip arthroplasty, with no increase in fractures, but no decrease in operating room time was noted.

Network optimality has been described in genes, proteins and human communicative networks. In the latter, optimality leads to the efficient transmission of information with a minimum number of connections. Whilst studies show that differences in centrality exist in animal networks with central individuals having higher fitness, network efficiency has never been studied in animal groups. Here we studied 78 groups of primates (24 species). We found that group size and neocortex ratio were correlated with network efficiency. Centralisation (whether several individuals are central in the group) and modularity (how a group is clustered) had opposing effects on network efficiency, showing that tolerant species have more efficient networks. Such network properties affecting individual fitness could be shaped by natural selection. Our results are in accordance with the social brain and cultural intelligence hypotheses, which suggest that the importance of network efficiency and information flow through social learning relates to cognitive abilities.

Animals commonly face fluctuations in their environment and resources. To maximize their benefits,they need to integrate the risks attached to potential pay-offs. We do not know, however, to what extent individuals account for irregularity in the latter. We tested the sensitivity of monkeys (Cebusapella, Macaca tonkeana, M. fascicularis) to the irregularity of pay-offs in two different tasks. In a first experiment, the subjects were given an exchange task where the reward probability varied between different conditions, but yielded the same average pay-off. There was no evidence of subjects favoring either condition, meaning that they behaved in accordance with the predictions ofthe classical decision theory (Expected Utility Theory). In a second experiment, we offered to subjects a choice between two options involving different pay-off regularity. In this case, a wide range of inter-individual variation was found in the choices of individuals. Whereas monkeys accepted irregular pay-off in a rational way, there were individual biases in their preferences. These results indicate that the preferences of animals in a risky situation were not unequivocally shaped by the environment in which species have evolved.

Retraining and resuming competition following surgery is challenging for athletes due to the prolonged period of reduced physical activity and subsequent alteration of body composition and physical performance. This is even more challenging for master athletes who endure the additional effect of aging. Within this context, the purpose of this study was to evaluate the feasibility and benefits that evidence-based nutritional and training recommendations could have on the time course of reconditioning and retraining following hip arthroplasty in an endurance master triathlete. During 38 weeks (from 6 weeks prior to surgery through to the return to competition in week 32), the athlete was provided with detailed training and nutritional recommendations. Dietary intake (via the remote food photographic method), body composition (via DXA), peak oxygen uptake (VO2peak), peak power output (PPO), cycling efficiency (GE), and energy availability (EA) were assessed 6 weeks pre- and 8, 12, 18, 21, and 25-weeks post-surgery. Training load was quantified (via TRIMP score and energy expenditure) daily during the retraining. Total body mass increased by 8.2 kg (attributable to a 3.5–4.6 kg increase in fat mass and lean mass, respectively) between week −6 and 8 despite a reduction in carbohydrate (CHO) intake post-surgery (

Macaques are the most geographically widespread and behaviorally diverse primate genus, and although macaque species share the same, basic social structure, they display broad inter specificvariation in patterns of adult social behavior. Based on these patterns, macaque species have been arranged along a 4-grade scale for social style. At one end of the scale, there are grade 1 species (e.g., Japanese macaques) that have highly hierarchical and despotic social systems, and at the other end, grade 4 species (e.g., Tonkean macaques) that have more relaxed and egalitarian social systems. We predicted that a species from the more despotic end of the spectrum should have more competitive play fights and that a species from the egalitarian end, more cooperative ones. A detailed analysis of videotaped sequences of juvenile play fighting in Tonkean and Japanese macaques was used to characterize the targets and tactics of attack and defense. Even though the two species have a similar behavioral repertoire, there are significant differences in how that repertoire is used and these differences are consistent with one species having more competitive interactions than the other. Contrasting multi-animal play fights versus pairs showed that the more cooperative style of the Tonkean macaques is further exaggerated. The results suggest that differences in styles of attack anddefense in play fighting may be influenced by differences in the species’ social systems.

The study of the metabolome within tissues, organisms, cells or biofluids can be carried out by several bioanalytical techniques. Among them, nuclear magnetic resonance (NMR) is one of the principal spectroscopic methods. This is due to a sample rotation technique, high-resolution magic angle spinning (HR-MAS), which targets the analysis of heterogeneous specimens with a bulk sample mass from 5 to 10 mg. Recently, a new approach, high-resolution micro-magic angle spinning (HR-μMAS), has been introduced. It opens, for the first time, the possibility of investigating microscopic specimens (

The ability to wait for a reward is a necessary capacity for economic transactions. This study is an age-related investigation of children's ability to delay gratification in an exchange task requiring them to wait for a significant reward. We gave 252 children aged 2-4 a small piece of cookie, then offered them an opportunity to wait for a predetermined delay period before exchanging it for a larger one. In a first experiment, the children had to exchange the initial food item for rewards two, four or eight times larger. Results showed that children aged 3-4 years old sustained longer time lags for larger rewards than for smaller rewards. This effect was not found in 2-year-old subjects. In a second experiment, a reward 40 times larger than the initial piece was offered to determine the maximum waiting time that children could sustain. All age groups increased their performances. Older children were more successful at waiting, but some children as young as 2 years old were able to tolerate delays of up to 16 min. Older children who chose to give up waiting earlier than their known capacity demonstrated anticipation skills which had not been seen in younger children, showing that they had anticipated an increase in the time lag, and that they had considered both time and reward value when making their decision. Despite the age effect, we did not establish any limits for delaying gratification in children. This study may have educational implications for dealing with behavioral misconduct, which is known to be related to impulsivity control in young children. (Contains 5 figures and 1 table.)