While forward elevation, abduction, and external rotation are often successfully restored, internal rotation (IR) is frequently not satisfactorily recovered following reverse shoulder arthroplasty ...(RSA), affecting patients’ ability to perform certain daily activities. This study examined the prevalence of limited IR in patients receiving modern RSA and its impact on clinical outcomes and patient satisfaction with their RSA.
A cross-sectional study was conducted on patients who had undergone primary RSA using a modern RSA prosthesis with a minimum one-year follow-up. Patients returned for a research visit where they were examined for range of motion and surveyed for patient-reported outcome measures (PROMs) and subjective rating of the success level of their RSA. Postoperative range of motion data were compared with the preoperative data. The relationship of postoperative IR with PROMs and patients’ subjective rating of RSA was analyzed. Logistic regression was performed to identify factors affecting patients’ subjective rating of RSA.
A total of 78 patients met the criteria and completed the study. A significant portion (59%) reported subjective IR limitations, and 41% showed objective IR limitations. Comparison of preoperative and postoperative IR showed that 24% had worsened IR, while 33% improved. Limited IR was associated with lower patients’ subjective rating of RSA and negatively impacted PROMs, especially when the dominant side was operated on. Regression analysis showed that limited IR was the only independent determining factor that was significantly associated with lower subjective rating of RSA.
Despite advancements in RSA design, limited IR remains a prevalent issue, significantly affecting patients’ satisfaction and clinical outcomes. This study underscores the need for setting appropriate expectations regarding IR through patient education and focused efforts to improve IR limitations in RSA patients, particularly on the dominant side.
Background Irreversible muscle changes after rotator cuff tears is a well-known negative prognostic factor after shoulder surgery. Currently, little is known about the pathomechanism of fatty ...degeneration of the rotator cuff muscles after chronic cuff tears. The purposes of this study were to (1) develop a rodent animal model of chronic rotator cuff tears that can reproduce fatty degeneration of the cuff muscles seen clinically, (2) describe the effects of tear size and concomitant nerve injury on muscle degeneration, and (3) evaluate the changes in gene expression of relevant myogenic and adipogenic factors after rotator cuff tears using the animal model. Materials and methods Rotator cuff tears were created in rodents with and without transection of the suprascapular nerve. The supraspinatus and infraspinatus muscles were examined at 2, 8, and 16 weeks after injury for histologic evidence of fatty degeneration and expression of myogenic and adipogenic genes. Results Histologic analysis revealed adipocytes, intramuscular fat globules, and intramyocellular fat droplets in the tenotomized and neurotomized supraspinatus and infraspinatus muscles. Changes increased with time and were most severe in the muscles with combined tenotomy and neurotomy. Adipogenic and myogenic transcription factors and markers were upregulated in muscles treated with tenotomy or tenotomy combined with neurotomy compared with normal muscles. Conclusions The rodent animal model described in this study produces fatty degeneration of the rotator cuff muscles similar to human muscles after chronic cuff tears. The severity of changes was associated with tear size and concomitant nerve injury.
Nanoparticles are an emerging class of functional materials defined by size-dependent properties. Application fields range from medical imaging, new drug delivery technologies to various industrial ...products. Due to the expanding use of nanoparticles, the risk of human exposure rapidly increases and reliable toxicity test systems are urgently needed. Currently, nanoparticle cytotoxicity testing is based on
in vitro methods established for hazard characterization of chemicals. However, evidence is accumulating that nanoparticles differ largely from these materials and may interfere with commonly used test systems. Here, we present an overview of current
in vitro toxicity test methods for nanoparticle risk assessment and focus on their limitations resulting from specific nanoparticle properties. Nanoparticle features such as high adsorption capacity, hydrophobicity, surface charge, optical and magnetic properties, or catalytic activity may interfere with assay components or detection systems, which has to be considered in nanoparticle toxicity studies by characterization of specific particle properties and a careful test system validation. Future studies require well-characterized materials, the use of available reference materials and an extensive characterization of the applicability of the test methods employed. The resulting challenge for nanoparticle toxicity testing is the development of new standardized
in vitro methods that cannot be affected by nanoparticle properties.
Understanding soil organic carbon (SOC) sequestration is important to develop strategies to increase the SOC stock and, thereby, offset some of the increases in atmospheric carbon dioxide. Although ...the capacity of soils to store SOC in a stable form is commonly attributed to the fine (clay + fine silt) fraction, the properties of the fine fraction that determine the SOC stabilization capacity are poorly known. The aim of this study was to develop an improved model to estimate the SOC stabilization capacity of Allophanic (Andisols) and non‐Allophanic topsoils (0–15 cm) and, as a case study, to apply the model to predict the sequestration potential of pastoral soils across New Zealand. A quantile (90th) regression model, based on the specific surface area and extractable aluminium (pyrophosphate) content of soils, provided the best prediction of the upper limit of fine fraction carbon (FFC) (i.e. the stabilization capacity), but with different coefficients for Allophanic and non‐Allophanic soils. The carbon (C) saturation deficit was estimated as the difference between the stabilization capacity of individual soils and their current C concentration. For long‐term pastures, the mean saturation deficit of Allophanic soils (20.3 mg C g−1) was greater than that of non‐Allophanic soils (16.3 mg C g−1). The saturation deficit of cropped soils was 1.14–1.89 times that of pasture soils. The sequestration potential of pasture soils ranged from 10 t C ha−1 (Ultic soils) to 42 t C ha−1 (Melanic soils). Although meeting the estimated national soil C sequestration potential (124 Mt C) is unrealistic, improved management practices targeted to those soils with the greatest sequestration potential could contribute significantly to off‐setting New Zealand's greenhouse gas emissions. As the first national‐scale estimate of SOC sequestration potential that encompasses both Allophanic and non‐Allophanic soils, this serves as an informative case study for the international community.
A quantile regression model was developed and used to estimate the soil C stabilization capacity and saturation deficit for a wide range of New Zealand pasture and cropping soils. The overall mean saturation deficit for these soils was 15.1 ± 0.8 mg C g−1 soil. Accounting for differences in bulk density and land area, the mean saturation deficit of each major soil Order was used to estimate a national C sequestration potential of 124 ± 37 Mt C.
With recent FDA approval of two recombinant adeno‐associated virus (rAAV)‐based gene therapies, these vectors have proven that they are suitable to address monogenic diseases. However, rAAVs are ...relatively new modalities, and their production and therapy costs significantly exceed those of conventional biologics. Thus, significant efforts are made to improve the processes, methods, and techniques used in manufacturing and quality control (QC). Here, we evaluate transmission electron microscopy (TEM), analytical ultracentrifugation (AUC), and two modes of capillary electrophoresis (CE) for their ability to analyze the DNA encapsidated by rAAVs. While TEM and AUC are well‐established methods for rAAV, capillary gel electrophoresis (CGE) has been just recently proposed for viral genome sizing. The data presented reflect that samples are very complex, with various DNA species incorporated in the virus, including small fragments as well as DNA that is larger than the targeted transgene. CGE provides a good insight in the filling of rAAVs, but the workflow is tedious and the method is not applicable for the determination of DNA titer, since a procedure for the absolute quantification (e.g., calibration) is not yet established. For estimating the genome titer, we propose a simplified capillary zone electrophoresis approach with minimal sample preparation and short separation times (<5 min/run). Our data show the benefits of using the four techniques combined, since each of them alone is prone to delivering ambiguous results. For this reason, a clear view of the rAAV interior can only be provided by using several analytical methods simultaneously.
Abstract Background In symptomatic end-stage osteoarthritis of the ankle joint, total ankle replacement and ankle arthrodesis are the two primary surgical options for patients for whom conservative ...treatment fails. Published revision rates are often biased and difficult to compare. In this study, unplanned reoperation rates and revision rates were determined for both surgical interventions based on a large dataset, and risk factors for unplanned reoperations were identified. Methods German-wide health data of the largest German health-care insurance carrier between 2001 and 2012 were retrospectively analyzed, and unplanned reoperation rates within 10 years were determined for index surgeries conducted in 2001 and 2002. Unplanned reoperation rates within 5 years for index surgeries conducted in 2001/2002 were compared to index surgeries conducted in 2006/2007. Multivariate logistic regression was used to identify risk factors for unplanned reoperations. Results After ankle arthrodesis, 19% (95% confidence interval CI, 16–22%) of 741 patients needed to undergo an unplanned reoperation within ten years. After total ankle replacement, the unplanned reoperation rate was 38% 95% CI, 29–48% among 172 patients. For initial surgeries conducted at a later date, unplanned reoperation rates within five years were 21% 95% CI, 19–24% for 1,168 ankle arthrodesis patients and 23% 95% CI, 19–28% for 561 total ankle replacement patients. Significant risk factors for unplanned reoperations after ankle arthrodesis in the initial cohort were age < 50 years (odds ratio OR = 4.65 95% CI 1.10;19.56) and osteoporosis (OR = 3.72 95% CI, 1.06;13.11); after total ankle replacement, they were osteoporosis (OR = 2.96 95% CI, 1.65;5.31), Patient Clinical Complexity Level (PCCL) grade 3 (OR = 2.19 95% CI, 1.19;4.03), PCCL grade 4 (OR = 2.51 95% CI, 1.22;5.17) and diabetes mellitus (OR = 2.48 95% CI, 1.33;4.66). Kaplan-Meier analyses including 1,525 ankle arthrodesis patients and 644 total ankle replacement patients revealed an average unplanned reoperation-free time of approximately 17 years for both procedures. Conclusions Similar revision rates and unplanned reoperation rates for both procedures in the later-date cohort can likely be attributed to a learning curve for surgeons as well as advances in implant design. This analysis of billing health insurance data supports an increase in total ankle replacement surgeries.
As soils under permanent pasture and grasslands have large topsoil carbon (C) stocks, the scope to sequester additional C may be limited. However, because C in pasture/grassland soils declines with ...depth, there may be potential to sequester additional C in the subsoil. Data from 247 continuous pasture sites in New Zealand (representing five major soil Orders and ~80% of the grassland area) showed that, on average, the 0.15–0.30 m layer contained 25–34 t ha−1 less C than the top 0.15 m. High‐production grazed pastures require periodic renewal (re‐seeding) every 7–14 years to maintain productivity. Our objective was to assess whether a one‐time pasture renewal, involving full inversion tillage (FIT) to a depth of 0.30 m, has potential to increase C storage by burying C‐rich topsoil and bringing low‐C subsoil to the surface where C inputs from pasture production are greatest. Data from the 247 pasture sites were used to model changes in C stocks following FIT pasture renewal by predicting (1) the C accumulation in the new 0–0.15 m layer and (2) the decomposition of buried‐C in the new 0.15–0.30 m layer. In the 20 years following FIT pasture renewal, soil C was predicted to increase by an average of 7.3–10.3 (Sedimentary soils) and 9.6–12.7 t C ha−1 (Allophanic soils), depending on the assumptions applied. Adoption of FIT for pasture renewal across all suitable soils (2.0–2.6 M ha) in New Zealand was predicted to sequester ~20–36 Mt C, sufficient to offset 9.6–17.5% of the country's cumulative greenhouse gas emissions from agriculture over 20 years at the current rate of emissions. Given that grasslands account for ~70% of global agricultural land, FIT renewal of pastures or grassland could offer a significant opportunity to sequester soil C and offset greenhouse gas emissions.
Soil organic C (SOC) stocks in permanent pastures and grasslands tend to be strongly stratified, being high near the surface and declining with depth. A one‐time use of full inversion tillage during pasture renewal (FIT‐PR) could increase SOC storage by burying C‐rich topsoil and bringing low‐C subsoil to the surface where C inputs from pasture are greatest. Data from New Zealand permanent pasture soils indicate the potential for FIT‐PR to increase average SOC stocks (over 20 years) in allophanic (9.6–12.7 t C ha−1) and sedimentary (7.3–10.3 t C ha−1) soils, with the amount sequestered related to pre‐renewal SOC stratification ratio.
Atmospheric particulate matter (PM) has the potential to diminish solar energy production by direct and indirect radiative forcing as well as by being deposited on solar panel surfaces, thereby ...reducing solar energy transmittance to photovoltaics. Worldwide solar energy production is expected to increase more rapidly than any other energy source into the middle of this century, especially in regions that experience high levels of dust and/or anthropogenic particulate pollutants, including large areas of India, China, and the Arabian Peninsula. Here we combine field measurements and global modeling to estimate the influence of dust and PM related to anthropogenic sources (e.g., fossil and biomass fuel combustion) on solar electricity generation. Results indicate that solar energy production is currently reduced by ∼17–25% across these regions, with roughly equal contributions from ambient PM and PM deposited on photovoltaic surfaces. Reductions due to dust and anthropogenic PM are comparable in northern India, whereas over eastern China, anthropogenic PM dominates. On the basis of current solar generation capacity, PM is responsible for ∼1 and ∼11 GW of solar power reduction in India and China, respectively, underscoring the large role that PM plays in reducing solar power generation output.
Value estimates of ecosystem goods and services are useful to justify the allocation of resources towards conservation, but inconclusive estimates risk unsustainable resource allocations. Here we ...present replacement costs as a more accurate value estimate of insect pollination as an ecosystem service, although this method could also be applied to other services. The importance of insect pollination to agriculture is unequivocal. However, whether this service is largely provided by wild pollinators (genuine ecosystem service) or managed pollinators (commercial service), and which of these requires immediate action amidst reports of pollinator decline, remains contested. If crop pollination is used to argue for biodiversity conservation, clear distinction should be made between values of managed- and wild pollination services. Current methods either under-estimate or over-estimate the pollination service value, and make use of criticised general insect and managed pollinator dependence factors. We apply the theoretical concept of ascribing a value to a service by calculating the cost to replace it, as a novel way of valuing wild and managed pollination services. Adjusted insect and managed pollinator dependence factors were used to estimate the cost of replacing insect- and managed pollination services for the Western Cape deciduous fruit industry of South Africa. Using pollen dusting and hand pollination as suitable replacements, we value pollination services significantly higher than current market prices for commercial pollination, although lower than traditional proportional estimates. The complexity associated with inclusive value estimation of pollination services required several defendable assumptions, but made estimates more inclusive than previous attempts. Consequently this study provides the basis for continued improvement in context specific pollination service value estimates.
PDF
