The Bear Hug Test Improves Sensitivity Compared With the Belly Press Test for Identifying Subscapularis Tendon Tears, but Both Tests Miss the Majority of Partial Tears

Purpose: To investigate the performance of the bear hug (BH) and belly press (BP) tests in diagnosing tears of the subscapularis (SSC). Methods: A retrospective review was conducted on prospectively maintained data on patients who underwent arthroscopic rotator cuff repair (ARCR) of SSC tears between 2011 and 2021. A control group also was obtained of ARCRs with an intact SSC tendon. All examinations and ARCRs were performed by one high-volume shoulder surgeon. The BH test and BP test results were compared with arthroscopic findings as the gold-standard diagnostic modality. Tear type was classified based on the Lafosse classification. Sensitivity, specificity, positive and negative predictive values, false-positive and false-negative rates, and accuracy were calculated for both tests. Results: A total of 1,122 patients were included for analysis, 866 with intraoperatively confirmed SSC tears (77%) and 256 without (23%). The BH test diagnosed SSC tears with a sensitivity of 46.1% and a specificity of 83.2%, whereas the BP test diagnosed tears with a sensitivity of 23.3% and a specificity of 93.4%. Overall, both tests missed SSC tears in 42.3% (n = 475) of cases. The BH test had accuracy rates of 25.9% for SSC type I tear, 48.7% for type II tear, 65% for type III tear, and 81.7% for type IV-V tear. In contrast, the BP test had accuracy rates of 7.6% for type I tear, 14.7% for type II tear, 42% for type III tear, and 68.7% for type IV-V tear. Conclusions: The BH test had greater sensitivity than the BP test in identifying SSC tears. Both tests showed low accuracy in identifying SSC tears as tear size decreased. Combining both tests did not provide any additional benefits over using the BH test alone. Level of Evidence: Level III, diagnostic study

Patient-reported outcome tools and baseline scores vary by country and region for arthroscopic repair of massive rotator cuff tears: a systematic review

Background: Different patient-reported outcome (PRO) tools are used in patients with arthroscopic rotator cuff repair (ARCR) which complicates outcome comparisons. The purpose of this systematic review was to compare PRO usage and baseline scores across world regions and countries in patients with ARCR of massive rotator cuff tears (MRCT). Methods: A systematic review was performed on ARCR for MRCT. The search was conducted from September to November of 2022 using the MEDLINE database for articles published in the last 15 years. Thirty-seven articles were included after initial screening and full-text review. In each article, PRO usage, baseline scores, and country of origin were collected. PRO usage was reported in percentages and baseline scores were normalized for each region to facilitate comparisons. Normalization was performed using the PRO means from each article. These averages were converted to fractions using the worst and best possible scores. These were combined into a single numerical value, expressed as a decimal from 0 to 1, using the total sample size for each tool per region. Values closer to 0 represent worse functional outcomes. Results: Thirty-two percent (n = 12) of articles were from Asia, 43.2% (n = 16) from Europe, 5.4% (n = 2) from the Middle East, and 18.9% (n = 7) from North America. The most commonly reported PRO tools were American Shoulder and Elbow Surgeons (ASES) in 19 papers, Constant–Murley Score (CMS) in 26 papers, Visual Analog Scale for pain (VAS) in 19 papers, and University of California in Los Angeles (UCLA) in 11 papers. ASES was reported in 51% of articles with 63% being from Asia (n = 12) compared to 21% from North America (n = 4). CMS was reported in 70% of studies with 58% being from Europe. Upon normalization, the preoperative score ranged from 0.30 to 0.44. Europe (0.39), and North America (0.40) showed similar scores. The lowest and highest scores were seen in the Middle East (0.3) and Asia (0.44) respectively. Conclusion: There is no standardized method to report outcomes in patients undergoing ARCR for MRCT. Great variation in usage exists in PROs which complicates data comparison between world regions. With normalization, baseline scores where similar among Asia, North America, and Europe, and lowest in the Middle East

CPEB4–CLOCK crosstalk during temporal lobe epilepsy

Objective: Posttranscriptional mechanisms are increasingly recognized as important contributors to the formation of hyperexcitable networks in epilepsy. Messenger RNA (mRNA) polyadenylation is a key regulatory mechanism governing protein expression by enhancing mRNA stability and translation. Previous studies have shown large-scale changes in mRNA polyadenylation in the hippocampus of mice during epilepsy development. The cytoplasmic polyadenylation element-binding protein CPEB4 was found to drive epilepsy-induced poly(A) tail changes, and mice lacking CPEB4 develop a more severe seizure and epilepsy phenotype. The mechanisms controlling CPEB4 function and the downstream pathways that influence the recurrence of spontaneous seizures in epilepsy remain poorly understood. Methods: Status epilepticus was induced in wild-type and CPEB4-deficient male mice via an intra-amygdala microinjection of kainic acid. CLOCK binding to the CPEB4 promoter was analyzed via chromatin immunoprecipitation assay and melatonin levels via high-performance liquid chromatography in plasma. Results: Here, we show increased binding of CLOCK to recognition sites in the CPEB4 promoter region during status epilepticus in mice and increased Cpeb4 mRNA levels in N2A cells overexpressing CLOCK. Bioinformatic analysis of CPEB4-dependent genes undergoing changes in their poly(A) tail during epilepsy found that genes involved in the regulation of circadian rhythms are particularly enriched. Clock transcripts displayed a longer poly(A) tail length in the hippocampus of mice post-status epilepticus and during epilepsy. Moreover, CLOCK expression was increased in the hippocampus in mice post-status epilepticus and during epilepsy, and in resected hippocampus and cortex of patients with drug-resistant temporal lobe epilepsy. Furthermore, CPEB4 is required for CLOCK expression after status epilepticus, with lower levels in CPEB4-deficient compared to wild-type mice. Last, CPEB4-deficient mice showed altered circadian function, including altered melatonin blood levels and altered clustering of spontaneous seizures during the day. Significance: Our results reveal a new positive transcriptional–translational feedback loop involving CPEB4 and CLOCK, which may contribute to the regulation of the sleep–wake cycle during epilepsy.Science Foundation IrelandEuropean Regional Development FundFutureNeuro industryMarie Skłodowska-Curie Actions Individual FellowshipIrish Research Council Postdoctoral FellowshipPrograma de Atracción de Talento de la Comunidad de MadridSpanish Ministry of Economy and Competitiveness/Ministry of Science, Innovation, and UniversitiesDepto. de Optometría y VisiónFac. de Óptica y OptometríaTRUEinpres

EARLINET correlative observations for CALIPSO (2006-2010)

A European Aerosol Research Lidar Network to Establish an Aerosol ClimatologyAerosols affect life on earth in several ways. They play an important role in the climate system; the effect of aerosols on the global climate system is one of the major uncertainties of present climate predictions. They play a major role in atmospheric chemistry and hence affect the concentrations of other potentially harmful atmospheric constituents, e.g. ozone. They are an important controlling factor for the radiation budget, in particular in the UV-B part of the spectrum. At ground level, they can be harmful, even toxic, to man, animals, and plants. Because of these adverse effects that aerosols can have on human life, it is necessary to achieve an advanced understanding of the processes that generate, redistribute, and remove aerosols in the atmosphere.A quantitative dataset describing the aerosol vertical, horizontal, and temporal distribution, including its variability on a continental scale, is necessary. The dataset is used to validate and improve models that predict the future state of the atmosphere and its dependence on different scenarios describing economic development, including those actions taken to preserve the quality of the environment. The EARLINET data set is the most comprehensive compilation of data available for this purpose.This project description is taken from: http://www.earlinet.org/index.php?id=earlinet_homepageSummary: Since the beginning of CALIPSO observations in June 2006 EARLINET has performed correlative measurements during nearby overpasses of the satellite at individual stations following a dedicated observational strategy. The EARLINET-CALIPSO correlative measurement plan considers the criteria established in the CALIPSO validation plan (http://calipsovalidation.hamptonu.edu). Participating EARLINET stations perform measurements, as close in time as possible and for a period of at least 30 min up to several hours, when CALIPSO overpasses their location within a horizontal radius of 100 km. Within the 16-day observational cycle of CALIPSO each station is overpassed within this distance 1-2 times during daytime (typically between 1100 and 1400 UTC) and 1-2 times during night time (typically between 0000 and 0300 UTC). Additional measurements are performed, mainly on a non-regular basis, when CALIPSO overpasses a neighboring station in order to study the horizontal variability of the aerosol distribution. The time schedule for correlative observations is calculated starting from the high-resolution ground-track data provided by NASA, and is updated and distributed to whole network weekly. The EARLINET-CALIPSO correlative dataset represents a statistically significant data set to be used for the validation and full exploitation of the CALIPSO mission, for studying the representativeness of cross sections along an orbit against network observations on a continental scale, and for supporting the continuous, harmonized observation of aerosol and clouds with remote-sensing techniques from space over long time periods

EARLINET observations related to volcanic eruptions (2000-2010)

A European Aerosol Research Lidar Network to Establish an Aerosol ClimatologyAerosols affect life on earth in several ways. They play an important role in the climate system; the effect of aerosols on the global climate system is one of the major uncertainties of present climate predictions. They play a major role in atmospheric chemistry and hence affect the concentrations of other potentially harmful atmospheric constituents, e.g. ozone. They are an important controlling factor for the radiation budget, in particular in the UV-B part of the spectrum. At ground level, they can be harmful, even toxic, to man, animals, and plants. Because of these adverse effects that aerosols can have on human life, it is necessary to achieve an advanced understanding of the processes that generate, redistribute, and remove aerosols in the atmosphere.A quantitative dataset describing the aerosol vertical, horizontal, and temporal distribution, including its variability on a continental scale, is necessary. The dataset is used to validate and improve models that predict the future state of the atmosphere and its dependence on different scenarios describing economic development, including those actions taken to preserve the quality of the environment. The EARLINET data set is the most comprehensive compilation of data available for this purpose.This project description is taken from: http://www.earlinet.org/index.php?id=earlinet_homepageSummary: Aerosols originating from volcanic emissions have an impact on the climate: sulfate and ash particles from volcanic emissions reflect solar radiation, act as cloud condensation and ice nuclei, and modify the radiative properties and lifetime of clouds, and therefore influence the precipitation cycle. These volcanic particles can also have an impact on environmental conditions and could be very dangerous for aircraft in flight. In addition to the routine measurements, further EARLINET observations are devoted to monitor volcano eruptions. The EARLINET volcanic dataset includes extended observations related to two different volcanoes in Europe Mt. Etna (2001 and 2002 eruptions), and the Eyjafjallajokull volcano in Iceland (April - May 2010 eruption). This dataset includes also recent events of volcanic eruptions in the North Pacific region (2008-2010) that emitted sulfuric acid droplets into the upper troposphere - lower stratosphere (UTLS) height region of the northern hemisphere. The EARLINET volcanic observations in the UTLS are complemented by the long-term stratospheric aerosol observations collected in the Stratosphere category