Current Outcomes Following Reverse Total Shoulder Arthroplasty: A Composite

Reverse Total Shoulder Arthroplasty (RTSA) is a popular treatment for patients with rotator cuff damage, glenohumeral arthritis, complex fractures, and previously failed total shoulder arthroplasty given its ability to alleviate pain and increase range of motion and function. Although RTSA significantly improves functionality, pain, and satisfaction, patients need to be given realistic expectations for when to expect improvements, peak performance, and plateaus as well as potential risks for negative outcomes. As with any surgical procedure, patients are at risk for intraoperative, perioperative, short-term, and long-term complications. Thus, the purpose of this review is to discuss the short-term and long-term complications, metrics, and length of follow-up for patients who have undergone RTSA. In addition, we provide recommendations for a cut-off point between short-term and long-term outcomes for RTSA

The benefit of poor mixing: kinetics of coacervation

Complex coacervation has become a prominent area of research in the fields of food science, personal care, drug stabilization, and more. However, little has been reported on the kinetics of assembly of coacervation itself. Here, we describe a simple, low-cost way of looking at the kinetics of coacervation by creating poorly mixed samples. In particular, we examine how polymer chain length, the patterning and symmetry of charges on the oppositely charged polyelectrolytes, and the presence of salt and a zwitterionic buffer affect the kinetics of complex coacervation. Our results suggest an interesting relationship between the time for equilibration and the order of addition of polymers with asymmetric patterns of charge. Furthermore, we demonstrated that increasing polymer chain length resulted in a non-monotonic trend in the sample equilibration times as a result of opposing factors such as excluded volume and diffusion. We also observed differences in the rate of sample equilibration based on the presence of a neutral, zwitterionic buffer, as well as the presence and identity of added salt, consistent with previous reports of salt-specific effects on the rheology of complex coacervates. While not a replacement for more advanced characterization strategies, this turbidity-based method could serve as a screening tool to identify interesting and unique phenomena for further study

Misalignment of Career and Educational Aspirations in Middle School: Differences Across Race, Ethnicity, and Socioeconomic Status

Misalignment of educational and career goals (i.e., educational aspirations expressed are inadequate for attaining one’s desired occupation) is associated with lower educational attainment and a lack of college readiness, and may contribute to persistent educational and employment disparities. Drawing on data from 249 sixth graders in low-income schools, this research examines misalignment between educational and career aspirations across racial and ethnic and socioeconomic groups. Findings indicate that students in low-income schools aspire to middle and upper middle class careers, but sometimes lack an understanding of the educational degrees required to achieve their goals. Latinos are significantly more likely than other groups to report misaligned aspirations, as are students in the free and reduced lunch program and those without a college-educated parent. Consequently, early gaps in misaligned career and educational goals for disadvantaged students may set them on a trajectory that perpetuates educational and occupational inequalities in this population. We discuss the programmatic implications of these findings in light of the elevated college and career planning needs of students traditionally underrepresented in higher education

A qualitative study of clinicians’ experience of a clinical trial for displaced distal radius fractures

Aims: The aim of this study was to explore clinicians’ experience of a paediatric randomized controlled trial (RCT) comparing surgical reduction with non-surgical casting for displaced distal radius fractures. Methods: Overall, 22 staff from 15 hospitals who participated in the RCT took part in an interview. Interviews were informed by phenomenology and analyzed using thematic analysis. Results: Analysis of the findings identified the overarching theme of “overcoming obstacles”, which described the challenge of alleviating staff concerns about the use of non-surgical casting and recruiting families where there was treatment uncertainty. In order to embed and recruit to the Children’s Radius Acute Fracture Fixation Trial (CRAFFT), staff needed to fit the study within clinical practice, work together, negotiate treatment decisions, and support families. Conclusion: Recruiting families to this RCT was challenging because staff were uncertain about longer-term patient outcomes, and the difficulties were exacerbated by interdisciplinary tensions. Strong family and clinician beliefs, coupled with the complex nature of emergency departments and patient pathways that differed site-by-site, served as barriers to recruitment. Cementing a strong research culture, and exploring families’ treatment preferences, helped to overcome recruitment obstacles

Being recovered: a qualitative study of parents’ experience of their child’s recovery up to a year after a displaced distal radius fracture

Aims The aim of this study was to explore parents’ experience of their child’s recovery, and their thoughts about their decision to enrol their child in a randomized controlled trial (RCT) of surgery versus non-surgical casting for a displaced distal radius fracture. Methods A total of 20 parents of children from 13 hospitals participating in the RCT took part in an interview five to 11 months after injury. Interviews were informed by phenomenology and analyzed using thematic analysis. Results Analysis of the findings identified the theme “being recovered”, which conveyed: 1) parents’ acceptance and belief that their child received the best treatment for them; 2) their memory of the psychological impact of the injury for their child; and 3) their pride in how their child coped with their cast and returned to activities. The process of recovery was underpinned by three elements of experience: accepting the treatment, supporting their child through challenges during recovery, and appreciating their child’s resilience. These findings extend our framework that highlights parents’ desire to protect their child during early recovery from injury, by making the right decision, worrying about recovery, and comforting their child. Conclusion By one year after injury, parents in both treatment groups considered their child “recovered”. They had overcome early concerns about healing, the appearance of the wrist, and coping after cast removal. Greater educational support for families during recovery would enable parents and their child to cope with the uncertainty of recovery, particularly addressing the loss of confidence, worry about reinjury, and the appearance of their wrist

Concert recording 2017-11-30a

[Track 1]. Sérénade aux étoiles / Cécile Chaminade -- [Track 2-3]. Five pieces in folk style, op. 102 / Robert Schumann -- [Track 4]. Reflective mood / Sammy Nestico -- [Track 5]. Syrinx / Claude Debussy -- [Track 6]. Duet mit zwei obligaten Augengläsern, WoO 32 / L.V. Beethoven -- [Track 7]. Old wine in new bottles. I. The wraggle taggle Gypsies [Track 8]. II. The three ravens [Track 9]. III. Begone, dull care [Track 10]. IV. Early one morning / Gordon Jacob

Viral CpG Deficiency Provides No Evidence That Dogs Were Intermediate Hosts for SARS-CoV-2.

Due to the scope and impact of the COVID-19 pandemic there exists a strong desire to understand where the SARS-CoV-2 virus came from and how it jumped species boundaries to humans. Molecular evolutionary analyses can trace viral origins by establishing relatedness and divergence times of viruses and identifying past selective pressures. However, we must uphold rigorous standards of inference and interpretation on this topic because of the ramifications of being wrong. Here, we dispute the conclusions of Xia (2020. Extreme genomic CpG deficiency in SARS-CoV-2 and evasion of host antiviral defense. Mol Biol Evol. doi:10.1093/molbev/masa095) that dogs are a likely intermediate host of a SARS-CoV-2 ancestor. We highlight major flaws in Xia's inference process and his analysis of CpG deficiencies, and conclude that there is no direct evidence for the role of dogs as intermediate hosts. Bats and pangolins currently have the greatest support as ancestral hosts of SARS-CoV-2, with the strong caveat that sampling of wildlife species for coronaviruses has been limited