Treatment of Failed Allograft Prosthesis Composites Used for Hip Arthroplasty in the Setting of Severe Proximal Femoral Bone Defects

This study assessed failures of allograft prosthesis composites (APC) and revisions with a new APC. Twenty-one patients with failed APC’s after revision hip arthroplasty with severe proximal femoral bone loss underwent revision with a new APC. Causes of failure were aseptic loosening (18 patients), infection (3 patients). Of these 21 APC revisions, two patients failed (after 60, 156 months). The 5 and 10 year survival rates were 83.5% (95% CI, 79–100%, number at risk 12 and 6 accordingly). In addition, two patients had non-union at the host-allograft bone junction and were augmented with bone autograft and plate. These results suggest that failed APCs may be revised to a new APC with a predictable outcome.     

Engaging Older Adults with Dementia in Creative Occupations Using Artificially Intelligent Assistive Technology

Engagement in creative occupations has been shown to promote well-being for older adults with dementia. Providing access to such occupations is often difficult, as successful participation requires face-time with a person who is knowledgeable in facilitating engagement as well as access to any required resources, such as an arts studio. In response, a computer-based device, the Engaging Platform for Art Development (ePAD), was created to with the aim of enabling more independent access to art creation. ePAD is a an artificially intelligent touch-screen device that estimates a client's level of engagement and provides prompts to encourage engagement if the client becomes disengaged. ePAD is customizable such that an art therapist can choose themes and tools that they feel reflect their client's needs and preferences. This article presents a mixed-methods study that evaluated ePAD's usability by six older adult (with mild-to-moderate dementia) and art therapist dyads. Usability measures suggest that all participants found ePAD engaging but did not find prompts effective. Future development of ePAD includes improving the prompts, implementing the recommendations made by participants in this research, and long-term testing in more naturalistic art therapy contexts.     

Carbon Monoxide and Driving Skills

Eighty milliliters of carbon monoxide (CO) or 80 ml of air was administered doubleblind to 50 adults (32 men, 18 women). Blood carboxyhemoglobin (COHb) levels increased by 3.4% in those receiving CO. Brake reaction time, night vision, glare vision, glare recovery, hand-steadiness, and depth perception all showed small and individually insignificant deterioration in the group receiving CO; grouping data in a nonparametric analysis, the performance difference became significant (P < .005). During operation of a driving simulator, the CO-exposed group showed a highly significant deficit in “careful driving” skills (P < .005), with a statistically insignificant facilitation of emergency-type movements. Since a 3.4% increase of COHb level is sufficient to prejudice safe driving, there is a need to revise the permitted eight-hour industrial CO exposure level of 50 ppm.