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

Short-term effectiveness of nutrition therapy to treat type 2 diabetes in low-income and middle-income countries: systematic review and meta-analysis of randomised controlled trials

OBJECTIVES: This review examined the evidence arising from randomised controlled trials regarding the impact of nutrition therapy on glycaemic control in people living with type 2 diabetes mellitus (T2DM) in low/middle-income countries (LMICs). DESIGN: Systematic review and meta-analysis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Approach. DATA SOURCES: MEDLINE, EMBASE, Web of Science, OpenGrey and the International Clinical Trials Registry were searched (up to July 3 2020). ELIGIBILITY CRITERIA: Trials were included if they evaluated nutrition therapy in adults diagnosed with T2DM, were conducted in LMICs, measured glycaemic control and the trial included a 3-month post-intervention assessment. Nutrition therapy was defined according to American Diabetes Association recommendations. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened the database. Study characteristics and outcome data were extracted using a data collection form. Meta-analyses were conducted for glycated haemoglobin (HbA1c) and fasting blood glucose. Trials were assessed for risk of bias (Cochrane Risk-of-Bias, Version 2.0) and overall certainty of evidence (GRADE). RESULTS: Four trials met inclusion criteria (total n=463), conducted in Malaysia, Iran and South Africa. All trials focused on nutrition education with no direct prescription or manipulation of diet. Mean differences between intervention and standard care were −0.63% (95% CI −1.47% to 0.21%) for HbA1c and −13.63 mg/dL (95% CI −37.61 to 10.34) for fasting blood glucose in favour of the intervention. Given the small number of eligible trials, moderate to high risk of publication bias and serious concerns regarding consistency and precision of the evidence, certainty of evidence was deemed to be very low. CONCLUSIONS: There is a lack of well-conducted randomised controlled trials that examine the long-term impact of nutrition therapy in LMICs, preventing firm conclusions to be made on their effectiveness. Further research is essential to discover realistic, evidence-based solutions. PROSPERO REGISTRATION NUMBER: CRD42020188435

Bibliography of Mountain Biking Research: 1990-2021

Since the 1980s, mountain biking as an outdoor recreation activity has grown rapidly worldwide. Research on mountain biking is growing across many academic disciplines, from medicine to outdoor recreation and tourism research. This bibliography includes peer-reviewed research published on mountain biking within the context of natural resource management from 1990-2021

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

The woods around the ivory tower: A systematic review examining the value and relevance of school forests in the United States

Throughout the United States, many institutions of higher education own forested tracts, often called school forests, which they use for teaching, research, and demonstration purposes. These school forests provide a range of benefits to the communities in which they are located. However, because administration is often decoupled from research and teaching, those benefits might not always be evident to the individuals who make decisions about the management and use of school forests, which may undervalue their services and put these areas at risk for sale, development, or over-harvesting to generate revenue. To understand what messages are being conveyed about the value and relevance of school forests, we conducted a systematic literature review and qualitatively coded the resulting literature content using an ecosystem services framework. While school forests provide many important benefits to academic and local communities, we found that most of the existing literature omits discussions about cultural ecosystem services that people may receive from school forests. We discuss the implications of this omission and make recommendations for addressing it

Vaccinating the Young Calf with a Parenteral Adjuvanted Vaccine to Develop a Protective BRSV IgA nasal Response

Objective The purpose of this study was to evaluate the efficacy of an adjuvanted modified live virus (MLV) vaccine in the presence of well-defined maternal passive immunity.Study Description Calves were vaccinated at approximately 1 month of age and challenged ~90 days later when BRSV systemic antibodies were less than 1:4. Clinical signs, nasal secretions and blood samples for virus measurement [polymerase chain reaction (PCR) and virus isolation (VI)] and to measure for mucosal BRSV IgA antibodies were collected and the animals were euthanized and necropsied 8 days post infection. Body temperature and other clinical signs were lower at 6 and 7 days post challenge in the vaccinates. Nasal viral shed was 3–4 times lower in the vaccinated animals as measured by VI and PCR compared to the controls. On day 8 following challenge, animals were necropsied, and lung lobes were scored and tested for virus by PCR and indirect fluorescent assay (IFA). There was a 25-fold reduction in PCR virus detection in vaccinates and two of the vaccinated calves’ lungs were PCR negative. Only 29.4% of vaccinated calves were BRSV positive on IFA testing at necropsy, while 87.5% of control calves were BRSV positive. Vaccinated calves developed a mucosal BRSV IgA response with over 50% of the vaccinated calves having IgA prior to challenge and all vaccinated calves were positive following challenge

Coastal Resident Knowledge of New Marine Reserves in Oregon: The Impact of Proximity and Attachment

This article examines resident proximity and attachment to a new system of marine reserves in Oregon (USA), and the extent that these factors are related to both self-assessed and factual knowledge about these reserves. Data were from a survey of residents along the Oregon coast (n = 596). Residents reported higher self-assessed than factual knowledge about these reserves, which was low with 65% answering half or fewer of 16 factual questions correctly. Self-assessed and factual knowledge did not differ between communities proximate to (i.e., communities of place within 10 miles of these reserves) and more distant from these reserves (i.e., rest of coast). Factual knowledge also did not differ based on attachment to these areas, but place attachment was slightly related to aspects of self-assessed knowledge where those with higher attachment believed they were somewhat more knowledgeable about these reserves. Implications of these results for management and research are discussed.Keywords: proximity, knowledge, marine protected areas, residents, place attachment, marine reserve

Aerosol meteorology of Maritime Continent for the 2012 7SEAS southwest monsoon intensive study - Part 2: Philippine receptor observations of fine-scale aerosol behavior

Abstract. The largest 7 Southeast Asian Studies (7SEAS) operations period within the Maritime Continent (MC) occurred in the August–September 2012 biomass burning season. Data included were observations aboard the M/Y Vasco, dispatched to the Palawan Archipelago and Sulu Sea of the Philippines for September 2012. At these locations, the Vasco observed MC smoke and pollution entering the southwest monsoon (SWM) monsoonal trough. Here we describe the research cruise findings and the finer-scale aerosol meteorology of this convectively active region. This 2012 cruise complemented a 2-week cruise in 2011 and was generally consistent with previous findings in terms of how smoke emission and transport related to monsoonal flows, tropical cyclones (TC), and the covariance between smoke transport events and the atmosphere's thermodynamic structure. Biomass burning plumes were usually mixed with significant amounts of anthropogenic pollution. Also key to aerosol behavior were squall lines and cold pools propagating across the South China Sea (SCS) and scavenging aerosol particles in their path. However, the 2012 cruise showed much higher modulation in aerosol frequency than its 2011 counterpart. Whereas in 2011 large synoptic-scale aerosol events transported high concentrations of smoke into the Philippines over days, in 2012 measured aerosol events exhibited a much shorter-term variation, sometimes only 3–12 h. Strong monsoonal flow reversals were also experienced in 2012. Nucleation events in cleaner and polluted conditions, as well as in urban plumes, were observed. Perhaps most interestingly, several cases of squall lines preceding major aerosol events were observed, as opposed to 2011 observations where these lines largely scavenged aerosol particles from the marine boundary layer. Combined, these observations indicate pockets of high and low particle counts that are not uncommon in the region. These perturbations are difficult to observe by satellite and very difficult to model. Indeed, the Navy Aerosol Analysis and Prediction System (NAAPS) simulations captured longer period aerosol events quite well but largely failed to capture the timing of high-frequency phenomena. Ultimately, the research findings of these cruises demonstrate the real world challenges of satellite-based missions, significant aerosol life cycle questions such as those the future Aerosol/Clouds/Ecosystems (ACE) will investigate, and the importance of small-scale phenomena such as sea breezes, squall lines, and nucleation events embedded within SWM patterns in dominating aerosol life cycle and potential relationships to clouds

Epidemiology of Coxiella burnetii infection in Africa: a OneHealth systematic review

Background: Q fever is a common cause of febrile illness and community-acquired pneumonia in resource-limited settings. Coxiella burnetii, the causative pathogen, is transmitted among varied host species, but the epidemiology of the organism in Africa is poorly understood. We conducted a systematic review of C. burnetii epidemiology in Africa from a “One Health” perspective to synthesize the published data and identify knowledge gaps.<p></p> Methods/Principal Findings: We searched nine databases to identify articles relevant to four key aspects of C. burnetii epidemiology in human and animal populations in Africa: infection prevalence; disease incidence; transmission risk factors; and infection control efforts. We identified 929 unique articles, 100 of which remained after full-text review. Of these, 41 articles describing 51 studies qualified for data extraction. Animal seroprevalence studies revealed infection by C. burnetii (≤13%) among cattle except for studies in Western and Middle Africa (18–55%). Small ruminant seroprevalence ranged from 11–33%. Human seroprevalence was <8% with the exception of studies among children and in Egypt (10–32%). Close contact with camels and rural residence were associated with increased seropositivity among humans. C. burnetii infection has been associated with livestock abortion. In human cohort studies, Q fever accounted for 2–9% of febrile illness hospitalizations and 1–3% of infective endocarditis cases. We found no studies of disease incidence estimates or disease control efforts.<p></p> Conclusions/Significance: C. burnetii infection is detected in humans and in a wide range of animal species across Africa, but seroprevalence varies widely by species and location. Risk factors underlying this variability are poorly understood as is the role of C. burnetii in livestock abortion. Q fever consistently accounts for a notable proportion of undifferentiated human febrile illness and infective endocarditis in cohort studies, but incidence estimates are lacking. C. burnetii presents a real yet underappreciated threat to human and animal health throughout Africa.<p></p&gt