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PyMC is a probabilistic programming library for Python that provides tools for constructing and fitting Bayesian models. It offers an intuitive, readable syntax that is close to the natural syntax statisticians use to describe models. PyMC leverages the symbolic computation library PyTensor, allowing it to be compiled into a variety of computational backends, such as C, JAX, and Numba, which in turn offer access to different computational architectures including CPU, GPU, and TPU. Being a general modeling framework, PyMC supports a variety of models including generalized hierarchical linear regression and classification, time series, ordinary differential equations (ODEs), and non-parametric models such as Gaussian processes (GPs). We demonstrate PyMC’s versatility and ease of use with examples spanning a range of common statistical models. Additionally, we discuss the positive role of PyMC in the development of the open-source ecosystem for probabilistic programming.

Spatiotemporal datasets, which consist of spatially-referenced time series, are ubiquitous in diverse applications, such as air pollution monitoring, disease tracking, and cloud-demand forecasting. As the scale of modern datasets increases, there is a growing need for statistical methods that are flexible enough to capture complex spatiotemporal dynamics and scalable enough to handle many observations. This article introduces the Bayesian Neural Field (B ayes NF), a domain-general statistical model that infers rich spatiotemporal probability distributions for data-analysis tasks including forecasting, interpolation, and variography. B ayes NF integrates a deep neural network architecture for high-capacity function estimation with hierarchical Bayesian inference for robust predictive uncertainty quantification. Evaluations against prominent baselines show that B ayes NF delivers improvements on prediction problems from climate and public health data containing tens to hundreds of thousands of measurements. Accompanying the paper is an open-source software package ( https://github.com/google/bayesnf ) that runs on GPU and TPU accelerators through the Jax machine learning platform. Spatiotemporal data consisting of measurements gathered at different times and locations is challenging to analyse due to variability and noise impact across different scales. The authors propose a statistical approach that delivers models of large-scale spatiotemporal datasets applicable to data-analysis tasks of forecasting and interpolation.

Tension pneumothorax is commonly treated with needle decompression (ND) at the 2nd intercostal space midclavicular line (2nd ICS MCL) but is thought to have a high failure rate. Few studies have attempted to directly measure the failure rate in patients receiving the intervention. We performed a retrospective analysis of 10 years of patients receiving prehospital ND. CT scans were reviewed to record the location of catheters left indwelling and the proportion of patients who did not have any pneumothorax. Chest wall thickness was measured on both injured and uninjured sides at the 2nd ICS MCL and compared with the recommended alternative, the 5th ICS anterior axillary line (5th ICS AAL). We identified 335 patients that underwent prehospital ND who had CT scans performed. Using our two different radiologic methods of assessing failure, 39 per cent and 76 per cent of attempts at ND failed to reach the pleural space. In addition, at least 39 per cent of patients did not have a tension pneumothorax. Injured chest walls were significantly thicker than uninjured chest walls at both the 2nd ICS MCL and the 5th ICS AAL (both P < 0.005.) Increasing chest wall thickness correlated with the failure of the catheter to reach the pleural space. Using an 8-cm catheter at the 5th ICS AAL, iatrogenic cardiac injury was at risk in 42 per cent of patients. This series confirms the high failure rate of ND at the 2nd ICS MCL, but further studies are needed to assure the safety of using larger catheters at the 5th ICS AAL.

Patellar instability is a common orthopedic condition in the pediatric population. Many factors contribute to patellar instability, including trochlear dysplasia. However, patellar instability and its treatments are not well documented in the literature for patients with osteogenesis imperfecta. After medial patellofemoral ligament (MPFL) reconstruction, a 17-year-old male with osteogenesis imperfecta had a patellar dislocation that resulted in a patellar fracture. The patient subsequently had a revision of his MPFL reconstruction, and at 2½ years postoperation has had no episodes of recurrent patellar instability. The combination of bone fragility, trochlear dysplasia, and strength of the allograft used for MPFL reconstruction compared to the patient's bone strength led to dislocation and patellar fracture. Research into alternative methods for patellar fixation and postoperative physical therapy protocols for patients with osteogenesis imperfecta is needed. Special considerations must be made for this patient population.

The purpose of this study was to determine the incidence of and evaluate the risk for complications and mortality following open treatment of acetabular fractures in the Medicare population. Patients treated with open reduction and internal fixation (ORIF) for acetabular fractures were identified using current procedural terminology codes in a 5% national sample of Medicare records. Complications within 90 days and within 1 year were evaluated based on the presence of ICD-9-CM diagnosis codes and Current Procedural Terminology reoperation codes. A total of 1286 fractures were treated closed and 359 were treated with ORIF. Multivariate Cox regression was performed to compare complication rates and risk factors. The incidence of acetabular fractures in the Medicare population has increased by 29% since 1998. Complications in the ORIF group included cardiac complications, deep venous thrombosis, infection, pulmonary embolism, refixation, and conversion to total hip arthroplasty. Risk factors for complications with ORIF included advanced age and comorbidities. Mortality in the ORIF group was 14.4% at 1 year. The incidence of reoperation with conversion to total hip arthroplasty or revision fixation following ORIF is 10% and 15%, respectively. Further investigation is required to improve outcomes and decrease complications in this group of patients, especially cardiac, deep vein thrombosis, and infection.

Complete talar extrusion is a rare injury that is typically caused by high-energy impact. Treatment for a completely extruded talus is limited and has variable outcomes and complications. Tibiocalcaneal arthrodesis is one of the best treatments for restoring stability and reducing pain in the affected limb. A 52-year-old male had complete talar extrusion after a pedestrian vs vehicle accident, and his recovery was complicated by wound dehiscence and recurrent infections of the ankle. Three years after his original injury, the patient was treated with a tibiocalcaneal arthrodesis with tantalum metal cone spacer, autologous bone grafting with tibial reamer irrigator aspirator, and retrograde hindfoot nail. The fusion healed well without signs of nonunion. Following wound healing and recovery, the patient was able to ambulate without any assistive devices. To our knowledge, our case is the first report of the use of a metal spacer in conjunction with autologous bone grafting multiple years after an initial complete talar extrusion injury. The patient's novel treatment resulted in good postoperative outcomes, including significant improvement in pain, ankle stability, and independent ambulation.

Δ-9-tetrahydrocannabinol (Δ-9-THC) and Cannabidiol (CBD), the two main ingredients of the Cannabis sativa plant have distinct symptomatic and behavioral effects. We used functional magnetic resonance imaging (fMRI) in healthy volunteers to examine whether Δ-9-THC and CBD had opposite effects on regional brain function. We then assessed whether pretreatment with CBD can prevent the acute psychotic symptoms induced by Δ-9-THC. Fifteen healthy men with minimal earlier exposure to cannabis were scanned while performing a verbal memory task, a response inhibition task, a sensory processing task, and when viewing fearful faces. Subjects were scanned on three occasions, each preceded by oral administration of Δ-9-THC, CBD, or placebo. BOLD responses were measured using fMRI. In a second experiment, six healthy volunteers were administered Δ-9-THC intravenously on two occasions, after placebo or CBD pretreatment to examine whether CBD could block the psychotic symptoms induced by Δ-9-THC. Δ-9-THC and CBD had opposite effects on activation relative to placebo in the striatum during verbal recall, in the hippocampus during the response inhibition task, in the amygdala when subjects viewed fearful faces, in the superior temporal cortex when subjects listened to speech, and in the occipital cortex during visual processing. In the second experiment, pretreatment with CBD prevented the acute induction of psychotic symptoms by Δ-9-tetrahydrocannabinol. Δ-9-THC and CBD can have opposite effects on regional brain function, which may underlie their different symptomatic and behavioral effects, and CBD's ability to block the psychotogenic effects of Δ-9-THC.

Background: There is a lack of research specifically looking at the rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing meniscal repair. Many studies view arthroscopic knee surgery as a single group including meniscal debridement, meniscal repair, and chondral surgery, as well as ligament reconstruction. Hypothesis: Patients who underwent meniscal repair, specifically meniscus root repair, at >40 years old would have higher rates of DVT and PE than those who underwent meniscal debridement regardless of age and meniscal repair at ≤40 years old. Study Design: Cohort study; Level of evidence, 3. Methods: This study analyzed patients between the ages of 8 and 80 years who underwent arthroscopic meniscal repair versus meniscectomy at a single center. These 2 groups were then subdivided into patients who were >40 years of age and those ≤40 years of age. The 4 groups then had the rates of postoperative DVT and PE recorded and compared and the risk factors for DVT and PE analyzed. Results: Patients who underwent meniscal repair at >40 years of age were found to have significantly higher rates of DVT (P < .01) than those who underwent debridement regardless of age and those that underwent repair ≤40 years old (P = .02). All DVTs and PEs in the meniscal repair group >40 years old were in patients who had meniscus root repairs with a DVT incidence of 10.7% and PE incidence of 3.6%. Risk factors for the development of DVT were age as well as history of DVT. Conclusion: Meniscal repairs, specifically root repairs, in patients aged >40 years had high rates of DVT, which has not been documented in the literature.

Background: Hip fracture is a common orthopedic condition that leads to many hospitalizations each year. Intertrochanteric femur fractures are commonly treated with cephalomedullary nail fixation. Superior gluteal artery bleed is a rare complication of cephalomedullary nail fixation, especially when the trochanteric approach is used.Case Report: A 63-year-old male presented to the emergency department with a right intertrochanteric femur fracture after a fall from standing height. Cephalomedullary nail fixation was performed without any complications during the operation. The patient's postoperative course was complicated by decreasing hemoglobin levels despite blood transfusions. Superior gluteal artery bleed with a large hematoma was discovered on postoperative day 4. The bleed was embolized, and the patient was stabilized and discharged.Conclusion: We found only 1 published report of a superior gluteal artery bleed associated with nail placement. During the operative procedure, guidewire placement requires careful consideration because of the risk of vascular damage. Superior gluteal artery injury, although rare, should be considered in patients with unstable hemoglobin levels after nail placement.

Increasing the conditionality of welfare benefits is a growing trend in many developed countries, particularly in relation to some groups who may be perceived as undeserving of state support. Problem drug users (PDUs) are one such group, and in the UK most PDUs do not work and a high proportion claim benefits. Facilitating the movement of these individuals into employment is a policy aim, because it is believed to improve the circumstances of drug users (and promote future abstinence) and because moving all groups off benefits and into work is a primary purpose of recent welfare reforms. Yet little is known about the interactions of PDUs with the UK benefits system or how recent moves to increase the conditionality of benefits are likely to affect this vulnerable group. This paper begins to address this gap by exploring the perceptions that PDUs and relevant frontline staff have of drug users’ interactions with the welfare system and the factors affecting their prospects for employment. The findings suggest some aspects of recent welfare reforms, notably the simplification of benefits, may help PDUs interact with the system. However, the data also reinforce claims that the increased use of sanctions is unlikely to succeed in improving employment rates amongst this group without intensive support and demand-side interventions.