No abstract

In patients with severe OA, HRQL significantly improved at 36 months after TKR, especially in the pain dimension. Lower preoperative WOMAC scores, chronic pain unrelated to knee OA, and severe obesity negatively influenced postoperative WOMAC scores. This disease-specific questionnaire may help to identify patients at increased risk of negative outcomes after surgery.

Klebsiella pneumoniae is a Gram-negative bacterium capable of colonizing, invading, and causing infections in different anatomical sites of the human body. Its ability to evade the immune system, its increasing antimicrobial resistance and the emergence of hypervirulent pathotypes have become a major challenge in the medical field. In this study, 127 strains from different clinical sources (urine, respiratory tract or blood) were characterized for antimicrobial resistance, the presence of virulence factor genes, serum resistance, hypermucoviscosity and the ability to form biofilms. Specific characteristics of the uropathogenic strains were examined and compared with the other clinical groups. Differences were found between urine and the other groups of strains. Urine strains showed the highest antibiotic resistance (64.91%) compared to blood (63.64%) or respiratory strains (51.35%) as well as the highest extended-spectrum beta-lactamases (ESBL) production. These strains also showed statistically significant high resistance to fosfomycin (24.56%) compared to the other groups (p = 0.008). Regarding virulence, 84.21% of the urine strains presented the uge gene, showing a statistically significant difference (p = 0.03) compared to the other clinical sources, indicating a possible role of this gene in the development of urinary tract infection. In addition, 46% of biofilm-forming strains belonged to the urine sample group (p = 0.043). In conclusion, K. pneumoniae strains isolated from urine samples showed higher antimicrobial resistance, ESBL production, and biofilm-forming ability compared to those isolated from respiratory or blood samples. The rapid spread of clinical strains with these characteristics is of concern, and new therapeutic alternatives are essential to mitigate their harmful effects.

We analyze how self-employed and employed mothers allocate their time throughout the day in order to balance their work and family responsibilities. To that end, we use time diary information from Spain, a country with a low level of women's participation in the labor market (Spanish Time Use Survey, 2002. We find that self-employed mothers devote less time to market work, and more time to tertiary (e.g., sleeping, eating) and leisure activities, than employed mothers in a working day. We also find differences between employed and self-employed mothers in the timing of market work, child care and housework throughout the day, and we find complementarities between the timingof market work of working mothers and the timing of child care of their male partners. Our results on timing are consistent with the hypothesis that self-employment stands as a possible way for mothers to have greater control over the timing of work (flexible hours), and that they may therefore be able to work odd shifts, when the spouse is available to care for the children.JEL: C14, D13, J12, J13, J22