Ship-mediated Marine Bioinvasions: Need for a Comprehensive Global Action Plan

Concern for marine bioinvasion has drawn international attention. The action plans in place to address this issue and those that are being promulgated are in need of a reassessment. A review of invertebrate invasions across the world indicates inter-linkages between vectors. In this paper an effort is made to illustrate the geographical spread of invasive invertebrate organisms from different bioregions and the possible causes for their success. Shipping, which is the major vector identified for the success of marine bioinvasion, needs to be addressed in tandem with domestic, intra- and inter-regional precautionary measures, as prevention is the only cure

Virtual Interviews in the Era of COVID-19: Expectations and Perceptions of Orthopaedic Surgery Residency Candidates and Program Directors

Orthopaedic surgery residency program directors (PDs) and candidates consider interviews to be central to the application process. In-person interviews are typical, but virtual interviews present a potentially appealing alternative. Candidate and PD expectations and perceptions of virtual interviews during the 2020/2021 orthopaedic surgery application cycle were assessed. Methods: Candidates and PDs were surveyed electronically. Questions covered pre-virtual-interview and post-virtual-interview expectations and perceptions, and past in-person experiences (PDs and reapplicants) on the relative importance of application components, ability to assess fit, interview costs, and preferred interview mode. Identical questions allowed between-group comparisons. Results: Responses included n = 29 PDs and n = 99 candidates. PDs reported diminished ability to assess candidate fit; social, clinical, and surgical skills; and genuine interest in the virtual context (each p ≤ 0.01). They placed greater importance on research and less on the interview in the virtual vs. in-person context (each p = 0.02). Most candidates (78%) reported fair/good ability to demonstrate potential and were better able to assess research opportunities than expected (p \u3c 0.01). Candidates expected virtual interviews to increase the importance of research, transcripts, and recommendations (for each, p ≤ 0.02) and decrease the importance of the interview itself (p \u3c 0.01). Compared with PDs, candidates overvalued research, United States Medical Licensing Examination scores, transcripts, and recommendations (each p ≤ 0.02) and may have slightly undervalued the virtual interview (p = 0.08). Most candidates (81%) and PDs (79%) preferred in-person interviews, despite both groups reporting monetary savings. Conclusions: Despite cost savings associated with virtual interviews, orthopaedic surgery residency PDs and candidates identified reduced abilities to assess candidate or program fit and displayed a preference for in-person interviews

Radiographic Measurements Correlate to Isolated Posterolateral Corner (PLC) Injury in a Novel Cadaveric Model

Introduction: Injury to the posterolateral corner (PLC) of the knee often requires surgical reconstruction. There remains no consensus on treatment for PLC injury, and, therefore, it is imperative to have a reproducible injury model to improve the general knowledge of PLC injuries. A novel cadaveric model of isolated PLC injury is proposed and evaluated using radiographic parameters as well as gross dissection. Material and methods: All protocols were reviewed by the Human Investigation and Research Committee of the home institution and were approved. Translational force in a defined posterior and lateral direction was applied to cadaveric native knees to induce PLC injury. Varus and recurvatum stress fluoroscopic imaging was obtained of each specimen before and after the injury model. Lateral joint distance and recurvatum angle after stress was measured on each image via picture archiving and communication software (PACS) imaging software. After the injury model, injured structures were assessed via saline loading and gross dissection. Any specimens found to be fractured were excluded from the analysis of stress radiography. Results: A total of 12 knees underwent testing and 6/12 successfully induced PLC injury without fracture. The lateral capsule was torn in every specimen. The popliteofibular ligament (PFL) was torn in 83% of specimens and the fibular collateral ligament (FCL) in 66.7% of specimens. The median lateral gapping after injury under varus stress radiography was 5.39 mm and the median recurvatum angle after injury was 14.25°. Radiographic parameters had a direct relationship with a number of structures injured. Conclusions: This is the first successful cadaver model of PLC injury. The lateral capsule was injured in every specimen emphasizing the importance of this structure to the PLC

A general partitioned fluid-structure interaction model for non matching unstructured mesh

Dans le présent article, une solution faible-forte pour l'interaction fluide-structure est présentée, dans laquelle la solution structure est résolue en éléments finis, et la solution fluide en volumes finis. Les solutions sont intégrées et optimisées à partir d'une interface unique. A partir de ce modèle éprouvé, une application industrielle est présentée, concernant des vibrations aéro-élastiques de structures ajoutées en sorties de tuyères de nacelles de moteurs d'avions de ligne

Biofouling Community Structure in a Tropical Estuary of Goa on the West Coast of India

Biofouling community structure was studied in a tropical monsoon-influenced Mandovi estuary in Goa, west coast of India. Monthly, seasonal and yearly observations on biofouling on polyvinyl chloride (PVC) panels immersed at subsurface water level were recorded and photographed from May 2012 to September 2013. The barnacle Balanus amphitrite was the dominant fouling organism followed by calcareous polychaetes. The settlement and recruitment of barnacles took place year-round, with the exception of July 2012 and June 2013 (monsoon months). However, their peak abundance was observed during the later months of monsoon (August and September). Polychaetes were dominant during late post-monsoon and pre-monsoon months (December 2012 to April 2013). Silt and slime were observed throughout the observation period. Comparing the fouling pressure of barnacles in the two monsoon seasons (2012 and 2013), fouling was more intense during the monsoon of 2013, indicating an inter-annual variation in the fouling community

Effects of Ohio Opioid Prescribing Policy on Postsurgical Prescriptions Following Sports Procedures

Background: Prescribed opioid medication after orthopedic sports surgery has been shown to exceed patient requirements. In 2017, as a response to the opioid epidemic, Ohio passed Opioid Prescribing Guidelines (OPG) limiting narcotic prescriptions for acute pain. This study sought to evaluate the effects of the OPG on prescribing behavior of orthopedists following knee arthroscopy (KA), shoulder arthroscopy (SA), and anterior cruciate ligament reconstruction (ACLR). Methods: An institutional database was queried to calculate morphine equivalent dose (MED) prescribed at discharge, acute follow-up (\u3c90 days), and chronic follow-up (\u3e90 days) and compare MED pre- and post-OPG. Cases were identified over a 2-year period starting 1 year prior to OPG implementation. Individual surgeon data were tracked to control for inter-surgeon variability. Results: A total of 1663 patients were included in the analysis. Demographic variables were similar pre- and post-OPG for each procedure group. With all surgeons included, average discharge MED decreased significantly for all procedures from pre- to post-OPG. Surgeons qualified for individual analysis if they had at least 10 surgeries pre- and post-OPG. Of qualifying providers, 80% of KA, 25% of SA, and 0% of ACLR surgeons reduced discharge MED prescribed post-OPG. MED prescribed during follow-up was largely unaffected by implementation of the OPG. Conclusion: Average discharge morphine equivalent dose (MED) prescribed after SA, KA, and ACLR decreased following the implementation of the OPG. The MED reduction effect of the OPG was the greatest in magnitude after SA, and SA was the only surgery that showed MED reductions that persisted during acute follow up. Opioid prescriptions beyond 90 days postoperatively were unchanged by the OPG for all surgeries. Policy that restricts postoperative opioid prescriptions can be an effective, but incomplete method to address the opioid crisis

Effects of Ohio Opioid Prescribing Policy on Postsurgical Prescriptions Following Sports Procedures

Background: Prescribed opioid medication after orthopedic sports surgery has been shown to exceed patient requirements. In 2017, as a response to the opioid epidemic, Ohio passed Opioid Prescribing Guidelines (OPG) limiting narcotic prescriptions for acute pain. This study sought to evaluate the effects of the OPG on prescribing behavior of orthopedists following knee arthroscopy (KA), shoulder arthroscopy (SA), and anterior cruciate ligament reconstruction (ACLR). Methods: An institutional database was queried to calculate morphine equivalent dose (MED) prescribed at discharge, acute follow-up (\u3c90 days), and chronic follow-up (\u3e90 days) and compare MED pre- and post-OPG. Cases were identified over a 2-year period starting 1 year prior to OPG implementation. Individual surgeon data were tracked to control for inter-surgeon variability. Results: A total of 1663 patients were included in the analysis. Demographic variables were similar pre- and post-OPG for each procedure group. With all surgeons included, average discharge MED decreased significantly for all procedures from pre- to post-OPG. Surgeons qualified for individual analysis if they had at least 10 surgeries pre- and post-OPG. Of qualifying providers, 80% of KA, 25% of SA, and 0% of ACLR surgeons reduced discharge MED prescribed post-OPG. MED prescribed during follow-up was largely unaffected by implementation of the OPG. Conclusion: Average discharge morphine equivalent dose (MED) prescribed after SA, KA, and ACLR decreased following the implementation of the OPG. The MED reduction effect of the OPG was the greatest in magnitude after SA, and SA was the only surgery that showed MED reductions that persisted during acute follow up. Opioid prescriptions beyond 90 days postoperatively were unchanged by the OPG for all surgeries. Policy that restricts postoperative opioid prescriptions can be an effective, but incomplete method to address the opioid crisis

Effect of hydrodynamic cavitation on zooplankton: a tool for disinfection

Application of hydrodynamic cavitation for disinfection of water is gaining momentum, as it provides environmentally and economically sound options. In this effort, the effect of cavitating conditions created by differential pump valve opening and that created by flowing through a cavitating element (orifice plates) on the microbes (zooplankton in sea water) is described. The experimental results are compared with modelling of cavitating conditions that includes cavity dynamics, turbulence generated by individual oscillating cavity, cell wall strength and geometrical and operating parameters of cavitation device. Theoretical model for quantifying the cavitationally generated turbulent shear and extent of microbial disinfection has been developed. Experimental results indicated that cavitation and/or turbulent fluid shear dominantly originating from cavitation are effective tools for sea water disinfection as more than 80% of the zooplankton present in the sea water were killed. It was also observed that shock waves generated due to cavitation is not the sole cause for zooplankton disruption. A correct physical mechanism accounting fluid turbulence and shear, generated from stable oscillation of cavity, significantly contribute towards the disruption. Further refinement of the model presented will serve as a basis for higher degree of disinfection and provide a practical tool for sea water disinfection

Hepatoprotective effect of obeticholic acid on acetaminophen induced hepatotoxicity in mice

Acetaminophen (APAP) is commonly used as analgesic and antipyretic drug for relieving mild and moderate pain, but at high doses produces hepatic necrosis. Though, Obeticholic acid (OCA) has been tested in range of diseases, its therapeutic potential against APAP-induced hepatic injury remains to be elucidated. Thus, in this study, we investigated the preventive effect of OCA along with N-acetylcysteine (NAC) and Silymarin (SIL) against acetaminophen-induced hepatotoxicity in mice. SIL (100 mg/kg, po) and OCA (30 mg/kg, po) were administered continuously for six days prior to APAP administration. After sixth dose, animas were fasted for 12 h and treated with 300 mg/kg APAP and then received SIL (100 mg/kg, po), NAC (500 mg/kg, ip) and OCA (30 mg/kg, po) at 1 h after APAP. Mice were sacrificed 6 h after APAP injection. Analysis of serum Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), liver glutathione (GSH) and histopathology were employed for assessment of hepatotoxicity. APAP group showed a significant increase in ALT, AST, ALP and centriolobular hepatic necrosis with a significant decrease in glutathione in comparison to control group. All these parameters were significantly improved in all the three treated groups when compared to APAP group. In conclusion, Obeticholic acid (OCA), Silymarin (SIL) and N-acetylcysteine (NAC) are suggested to protect against APAP-induced hepatotoxicity in mice by ameliorating liver enzymes, antioxidant effect and decreasing liver necrosis