Do Outcomes of Arthroscopic Subscapularis Tendon Repairs Depend on Rotator Cuff Fatty Infiltration?

Background:Rotator cuff fatty infiltration has been correlated with poorer radiographic and clinical outcomes in supraspinatus and infraspinatus tendon repairs, but this has not been well-studied in subscapularis tendon repairs. Purpose:To evaluate the influence of preoperative rotator cuff fatty infiltration on postoperative outcomes for patients undergoing arthroscopic subscapularis tendon repair. Study Design:Cohort study; Level of evidence, 3. Methods:Patients who underwent arthroscopic subscapularis repair between 2010 and 2016 were retrospectively identified, and demographic data and surgical findings were recorded. The extent of fatty infiltration was determined on preoperative magnetic resonance imaging by the Fuchs modification of the Goutallier classification. At the most recent follow-up, patients completed the Patient-Reported Outcomes Measurement Information System for Upper Extremity (PROMIS-UE) computer adaptive test and a postoperative visual analog scale for pain. The distribution of fatty infiltration was compared between patients undergoing subscapularis tendon repair versus subscapularis tendon repair combined with a posterior cuff repair. Outcomes were compared for patients using Goutallier grade 0-1 versus grade ≥2 changes in each rotator cuff muscle. Multivariate linear regression analysis was performed to evaluate the influence of muscle quality, as well as demographic factors, on PROMIS-UE scores. Significance was defined as P < .05. Results:There were 140 shoulders included (mean age, 61.8 years; 42.1% female; mean follow-up, 51.7 months). The prevalence of Goutallier grade 2 changes or higher was significantly greater in patients with multitendon repair relative to isolated subscapularis tendon repair. For the overall group of all patients undergoing subscapularis tendon repair, whether in isolation or as part of a multitendon repair, PROMIS-UE scores were significantly lower for patients with infraspinatus muscle grade 2 or higher Goutallier changes relative to grade 0 or 1. After adjustment for age, body mass index, patient sex, and fatty infiltration in other rotator cuff muscles, poor infraspinatus muscle quality remained the only significant predictor for lower PROMIS-UE scores. Conclusion:Patients undergoing arthroscopic subscapularis tendon repair with poor infraspinatus muscle quality had worse patient-reported outcomes. This was true whether subscapularis tendon repair was isolated or was performed in conjunction with supraspinatus and infraspinatus tendon repairs

The Federal Institute for Access to Information in Mexico and a Culture of Transparency

In the family of freedom of information laws globally, Mexico is a leader, partly because of its Federal Institute for Access to Public Information in Mexico (IFAI) set up under the country’s new Transparency Law. The William and Flora Hewlett Foundation asked an international team to study how IFAI has made a difference as the legislation furthers public understanding of government and provides for an informed citizenry. Evaluating performance was the first priority. But for an institution like IFAI to survive and flower and for it to make its greatestcontribution, it must also be perceived to be performing in accordance with legislative hopes. Two stakeholders—the “obligated agencies” or agencies covered by the underlying law and the public that uses the transparency law were canvassed as part of the study. We conducted a survey of the staff of IFAI itself as to its understanding of its role and performance. IFAI, as part of the architecture of government openness, has already contributed enormously to a culture of transparency in Mexico. That culture of transparency has contributed to undergirding democratic processes. Much of this progress is attributable to the Commissioners and staff at IFAI. They recognize, however, that there remain substantial opportunities to deepen and broaden this process. Our study seeks to make specific recommendations that will reinforce and advance what IFAI has alreadyaccomplished. Among IFAI’s important mandates are: resolving appeals of a denied request under the law, training public servants as well in access to information and protection of personal data, monitoring compliance with the law, promoting and disseminating the use of the right of access to information, establishing guidelines for the management of personal data, and disseminating information about how the Transparency Law works. The study focused on these particular mandates as a basis for framing recommendations. In particular, there is an emphasis on extending the work of IFAI to as many groups and citizens as possible to make the Transparency Law effective. This outreach must extend to public servants subject to the law and the community at large. Indeed, for a deeply ingrained, robust “culture of transparency” to be established in Mexico, IFAI must involve state and municipal governments to promote transparency on the local level. The Transparency Law is largely an accomplishment of the Mexican civil society that lobbied and won its passage. It is a law that stands for unprecedented public openness in Mexico’s history. The underlying hopes are that reach citizen throughout Mexico’s thirty-one states benefit, directly or indirectly, from the functioning of the transparency laws and the discipline and educative support of IFAI

Reflections on Experiences Abroad

Reflections on Experiences Abroad is a collection of essays written by Ouachita Baptist University faculty and staff who have lived outside of the United States. Students in Professor Margaret Reed\u27s Fall 2022 ENGL 3383 Editing class copyedited and helped prepare this volume. It is a one-time publication that gave Reed\u27s students an opportunity to demonstrate their editing skills at the end of the course. The student editors were Darby Jones, Sydney Motl, and Addie Woods

Interobserver Agreement in the Clinical Assessment of Children With Blunt Abdominal Trauma

Objectives The objective was to determine the interobserver agreement of historical and physical examination findings assessed during the emergency department (ED) evaluation of children with blunt abdominal trauma. Methods This was a planned substudy of a multicenter, prospective cohort study of children younger than 18 years of age evaluated for blunt abdominal trauma. Patients were excluded if injury occurred more than 24 hours prior to evaluation or if computed tomography (CT) imaging was obtained at another hospital prior to transfer to a study site. Two clinicians independently recorded their clinical assessments of a convenience sample of patients onto data collection forms within 60 minutes of each other and prior to CT imaging (if obtained) or knowledge of laboratory results. The authors categorized variables as either subjective symptoms (i.e., patient history) or objective findings (i.e., physical examination). For each variable recorded by the two observers, the agreement beyond that expected by chance was estimated, using the kappa (κ) statistic for categorical variables and weighted κ for ordinal variables. Variables with 95% lower confidence limits (LCLs) κ ≥ 0.4 (moderate agreement or better) were considered to have acceptable agreement. Results A total of 632 pairs of physician observations were obtained on 23 candidate variables. Acceptable agreement was achieved in 16 (70%) of the 23 variables tested. For six subjective symptoms, κ ranged from 0.48 (complaint of shortness of breath) to 0.90 (mechanism of injury), and only the complaint of shortness of breath had a 95% LCL κ < 0.4. For the 17 objective findings, κ ranged from –0.01 (pelvis instability) to 0.82 (seat belt sign present). The 95% LCL for κ was <0.4 for flank tenderness, abnormal chest auscultation, suspicion of alcohol or drug intoxication, pelvis instability, absence of bowel sounds, and peritoneal irritation. Conclusions Observers can achieve at least acceptable agreement on the majority of historical and physical examination variables in children with blunt abdominal trauma evaluated in the ED. Those variables are candidates for consideration for development of a clinical prediction rule for intra‐abdominal injury in children with blunt trauma. Resumen Concordancia Interobservador en la Valoración Clínica de los Niños con Traumatismo Abdominal Cerrado Objetivos Determinar la concordancia interobservador de los hallazgos de la historia clínica y la exploración física obtenidos durante la valoración de los niños con traumatismo abdominal de alta energía en el servicio de urgencias (SU). Metodología Se diseñó un subestudio de un estudio de cohorte prospectivo y multicéntrico de niños de 18 años o menos evaluados por traumatismo abdominal cerrado. Se excluyeron los pacientes si el traumatismo había ocurrido más de 24 horas antes de la primera valoración, o si las imágenes de la tomografía computarizada (TC) se obtuvieron en otro hospital previamente a trasladarse al lugar del estudio. Dos clínicos recogieron de forma independiente su valoración clínica en un formulario de datos, de una muestra de conveniencia de pacientes, en los primeros 60 minutos, y previamente a las imágenes de la TC (si ésta se realizó) o al conocimiento de los resultados del laboratorio. Se clasificaron las variables como síntomas subjetivos (ej.: historia del paciente) o hallazgos objetivos (ej.: exploración física). Para cada variable recogida por los dos observadores, se estimó la concordancia más allá de la esperada por el azar usando el índice kappa (κ) para las variables categóricas y índice κ ponderado para las variables ordinales. Se consideró que existía una concordancia aceptable para las variables con una κ ≥ 0,4 (concordancia moderada o buena) en el límite inferior del intervalo de confianza del 95% (IC 95%). Resultados Se obtuvieron 632 pares de observaciones clínicas en 23 variables candidatas. Se alcanzó la concordancia aceptable en 16 (70%) de ellas. Para los seis síntomas subjetivos, el rango de κ fue de 0,48 (queja de dificultad respiratoria) a 0,90 (mecanismo de la lesión), y sólo la queja de dificultad respiratoria tuvo una κ < 0,4 en el límite inferior del IC 95%. Para los 17 hallazgos objetivos, el rango de κ fue desde ‐0,01 (inestabilidad pelvis) a 0,82 (presencia del signo del cinturón de seguridad). El dolor en el flanco, la auscultación torácica alterada, la sospecha de intoxicación por alcohol o tóxicos, la inestabilidad de pelvis, la ausencia de ruidos intestinales y la irritación peritoneal tuvieron una κ < 0,4 en el límite inferior del IC 95%. Conclusiones Los observadores pueden alcanzar al menos una concordancia aceptable en la mayoría de las variables de la historia clínica y la exploración física en los niños con traumatismo abdominal cerrado evaluado en el SU. Estas variables son candidatas para considerarse en el desarrollo de una regla de predicción clínica para la lesión intrabdominal en los niños con traumatismo de cerrado.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98339/1/acem12132.pd

The Radio Sky at Meter Wavelengths: m-Mode Analysis Imaging with the Owens Valley Long Wavelength Array

A host of new low-frequency radio telescopes seek to measure the 21-cm transition of neutral hydrogen from the early universe. These telescopes have the potential to directly probe star and galaxy formation at redshifts $20 \gtrsim z \gtrsim 7$, but are limited by the dynamic range they can achieve against foreground sources of low-frequency radio emission. Consequently, there is a growing demand for modern, high-fidelity maps of the sky at frequencies below 200 MHz for use in foreground modeling and removal. We describe a new widefield imaging technique for drift-scanning interferometers, Tikhonov-regularized $m$-mode analysis imaging. This technique constructs images of the entire sky in a single synthesis imaging step with exact treatment of widefield effects. We describe how the CLEAN algorithm can be adapted to deconvolve maps generated by $m$-mode analysis imaging. We demonstrate Tikhonov-regularized $m$-mode analysis imaging using the Owens Valley Long Wavelength Array (OVRO-LWA) by generating 8 new maps of the sky north of $\delta=-30^\circ$ with 15 arcmin angular resolution, at frequencies evenly spaced between 36.528 MHz and 73.152 MHz, and $\sim$800 mJy/beam thermal noise. These maps are a 10-fold improvement in angular resolution over existing full-sky maps at comparable frequencies, which have angular resolutions $\ge 2^\circ$. Each map is constructed exclusively from interferometric observations and does not represent the globally averaged sky brightness. Future improvements will incorporate total power radiometry, improved thermal noise, and improved angular resolution -- due to the planned expansion of the OVRO-LWA to 2.6 km baselines. These maps serve as a first step on the path to the use of more sophisticated foreground filters in 21-cm cosmology incorporating the measured angular and frequency structure of all foreground contaminants.Comment: 27 pages, 18 figure

Quantum-Information Processing with Semiconductor Macroatoms

An all optical implementation of quantum information processing with semiconductor macroatoms is proposed. Our quantum hardware consists of an array of semiconductor quantum dots and the computational degrees of freedom are energy-selected interband optical transitions. The proposed quantum-computing strategy exploits exciton-exciton interactions driven by ultrafast sequences of multi-color laser pulses. Contrary to existing proposals based on charge excitations, the present all-optical implementation does not require the application of time-dependent electric fields, thus allowing for a sub-picosecond, i.e. decoherence-free, operation time-scale in realistic state-of-the-art semiconductor nanostructures.Comment: 11 pages, 5 figures, to be published in Phys. Rev. Lett., significant changes in the text and new simulations (figure 3

Control of Decoherence: Dynamical Decoupling versus Quantum Zeno Effect - a case study for trapped ions

The control of thermal decoherence via dynamical decoupling and via the quantum Zeno effect (Zeno control) is investigated for a model of trapped ion, where the dynamics of two low lying hyperfine states undergoes decoherence due to the thermal interaction with an excited state. Dynamical decoupling is a procedure that consists in periodically driving the excited state, while the Zeno control consists in frequently measuring it. When the control frequency is high enough, decoherence is shown to be suppressed. Otherwise, both controls may accelerate decoherence.Comment: 24 pages, 8 figure

Simulating open quantum systems: from many-body interactions to stabilizer pumping

In a recent experiment, Barreiro et al. demonstrated the fundamental building blocks of an open-system quantum simulator with trapped ions [Nature 470, 486 (2011)]. Using up to five ions, single- and multi-qubit entangling gate operations were combined with optical pumping in stroboscopic sequences. This enabled the implementation of both coherent many-body dynamics as well as dissipative processes by controlling the coupling of the system to an artificial, suitably tailored environment. This engineering was illustrated by the dissipative preparation of entangled two- and four-qubit states, the simulation of coherent four-body spin interactions and the quantum non-demolition measurement of a multi-qubit stabilizer operator. In the present paper, we present the theoretical framework of this gate-based ("digital") simulation approach for open-system dynamics with trapped ions. In addition, we discuss how within this simulation approach minimal instances of spin models of interest in the context of topological quantum computing and condensed matter physics can be realized in state-of-the-art linear ion-trap quantum computing architectures. We outline concrete simulation schemes for Kitaev's toric code Hamiltonian and a recently suggested color code model. The presented simulation protocols can be adapted to scalable and two-dimensional ion-trap architectures, which are currently under development.Comment: 27 pages, 9 figures, submitted to NJP Focus on Topological Quantum Computatio

The Grizzly, April 27, 1999

USGA Calls Do-Over • Faculty to Prepare for Laptops • It Happened One Wednesday • IR Club Encourages Global Awareness, Student Involvement • Dance at UC • STAR Raises Awareness of Sexual Assault on Campus • Scholar Speaks on African Women Writers • Opinion: Free Laptops, What Could Possibly be Wrong With That?; Administration Unresponsive to Student Problem; Don\u27t Be Too Quick to Name This Devil; Blood Lessons: How America Responds to Tragedy and Why we Don\u27t Learn From it • Final Exam Schedule • Student Art Exhibit Opens, Prizes Awarded • Restaurant Review: The Perk, A Taste of History • Ursinus Softball Suffers Through Wild Week • Wayne Gretzky Retires • Golf Takes on Centennial Conference • Baseball Drops Two, but Remains Atop Centennial Conference • Lacrosse Reigns in Centennial Conferencehttps://digitalcommons.ursinus.edu/grizzlynews/1442/thumbnail.jp