Ninety-day complication rate based on 532 Latarjet procedures in Dutch hospitals with different operation volumes

Background: In this study, we aimed to provide insight into the 90-day complication rates following the Latarjet procedure. Data from 2015 were collected from multiple hospitals in the Netherlands, with different volumes of Latarjet procedures. Our second aim was to examine which patient and surgical factors were associated with complications.Methods: We conducted a retrospective chart review of 13 hospitals between 2015 and 2022. Data regarding complications within 90 days of Latarjet procedures were extracted. The effect of sex, age, body mass index (BMI), smoking, previous shoulder operations, fixation material, hospital volume, screw size, and operation time on the complication rate was assessed by multivariable logistic regression analysis.Results: Of the 532 included patients, 58 (10.9%) had complications. The most common complications were material failure (n = 19, 3.6%) and nerve injury (n = 13, 2.4%). The risk of complications was lower for male patients than for female patients (odds ratio, 0.40; 95% confidence interval, 0.21-0.77; P = .006). Age, BMI, smoking, previous shoulder operations, type of fixation material, hospital volume, screw size, and operation time were not associated with complications.Conclusion: The 90-day complication rate after the Latarjet procedure was 10.9% and was higher in female patients than in male patients. Age, BMI, smoking, previous shoulder operations, type of fixation material, hospital volume, screw size, and operation time did not affect complication rates. We advise setting up a national registry to prevent under-reporting of complications.</p

Palladium‐Catalyzed Cascade to Benzoxepins by Using Vinyl‐Substituted Donor–Acceptor Cyclopropanes

A palladium‐catalyzed intermolecular cascade (4+3) cyclocondensation of salicylaldehydes and vinylcyclopropanes is reported. A key feature of the reaction is the use of a phosphonate group as an acceptor moiety on the cyclopropane, exploiting its propensity to undergo olefination with aldehydes. Subsequent O‐allylation enabled the formation of a range of substituted benzoxepinsWith a novel chiral ligand, the products were obtained in generally good yield and with reasonable enantioselectivity

Making sense of palaeoclimate sensitivity

Many palaeoclimate studies have quantified pre-anthropogenic climate change to calculate climate sensitivity (equilibrium temperature change in response to radiative forcing change), but a lack of consistent methodologies produces a wide range of estimates and hinders comparability of results. Here we present a stricter approach, to improve intercomparison of palaeoclimate sensitivity estimates in a manner compatible with equilibrium projections for future climate change. Over the past 65 million years, this reveals a climate sensitivity (in K W-1 m 2) of 0.3-1.9 or 0.6-1.3 at 95% or 68% probability, respectively. The latter implies a warming of 2.2-4.8 K per doubling of atmospheric CO2, which agrees with IPCC estimates

Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study

Context: Sleep deprivation has detrimental metabolic consequences. Osteopenia and sarcopenia usually occur together and increase risk of fractures and disease. Results from studies linking sleep parameters to osteopenia or sarcopenia are scarce and inconsistent. Objective: To examine the associations of sleep parameters with osteopenia and sarcopenia, considering the influence of sex and menopause. Design, setting and participants: Cross-sectional analysis of 915 participants (45-65 years, 56% women, BMI 26 (range: 18-56) kg/m2) in the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study. Sleep duration, quality, and timing were assessed with the Pittsburgh Sleep Quality Index (PSQI); bone mineral density and relative appendicular muscle mass were measured by DXA scans. Linear and logistic regressions were performed to associate sleep parameters to bone mineral density, relative appendicular muscle mass, osteopenia (t-score between -1 and -2.5) and sarcopenia (1 SD below average muscle mass). Results: After adjustment for confounding factors, one unit increase in PSQI score (OR and 95% CI, 1.09,1.03-1.14), declined self-rated sleep quality (1.76,1.03-3.01), sleep latency (1.18, 1.06-1.31), and a one hour later sleep timing (1.51,1.08-2.11), but not sleep duration (1.05, 0.90-1.23), were associated with osteopenia. PSQI score (1.10, 1.02-1.19) was also associated with sarcopenia; OR's of sleep latency and later mid-sleep time with sarcopenia were 1.14 (0.99-1.31) and 1.54 (0.91-2.61), respectively. Associations were somewhat stronger in women and varied per menopausal status. Conclusions: These results suggest that decreased sleep quality and a later sleep timing are risk factors for osteopenia and sarcopenia in middle aged individuals

Lessons on Climate Sensitivity From Past Climate Changes.

Over the last decade, our understanding of climate sensitivity has improved considerably. The climate system shows variability on many timescales, is subject to non-stationary forcing and it is most likely out of equilibrium with the changes in the radiative forcing. Slow and fast feedbacks complicate the interpretation of geological records as feedback strengths vary over time. In the geological past, the forcing timescales were different than at present, suggesting that the response may have behaved differently. Do these insights constrain the climate sensitivity relevant for the present day? In this paper, we review the progress made in theoretical understanding of climate sensitivity and on the estimation of climate sensitivity from proxy records. Particular focus lies on the background state dependence of feedback processes and on the impact of tipping points on the climate system. We suggest how to further use palaeo data to advance our understanding of the currently ongoing climate change