A proposed methodology for the definition of background and reference values for trace elements in fluvial sediments.

The Water Framework Directive (WFD, 2000/60/EC) mandates member states to consider trace element background values when establishing environmental quality standards (EQS) for sediments. This study proposes defining the "background" value as the trace element concentration that is consistently present in the unaltered natural environment, and the "reference" value as an upper limit of variation of naturally occurring concentrations, suggestive of anthropogenic enrichment if exceeded. We argue that background and reference values can be computed as the upper limits of the one-sided 95 % confidence interval for the median and for the 90th percentile, respectively.

Normalization of the Constant score in the Spanish population.

Background: Normal Constant score values for healthy shoulders can vary between regions and change over the years as life expectancy increases and physical condition improves. Spain's population is one of the healthiest and has one of the highest life expectancies in the world, which could be reflected in its normal Constant score values. The purpose of this study is finding the normal Constant score values in the Spanish population.

Long-term outcomes of reverse shoulder arthroplasty versus nonoperative treatment for 3- or 4- part proximal humerus fractures in elderly patients: Results from a prior randomized clinical trial.

Background And Objectives: Proximal humerus fractures (PHFs) are among the most common fractures in elderly patients, yet there is insufficient evidence from randomized controlled trials (RCTs) to determine the most appropriate interventions for their management. This study presents the long-term results of the first prospective RCT comparing surgical treatment with reverse shoulder arthroplasty (RSA) versus nonoperative treatment in displaced PHFs in elderly patients.

Materials And Methods: Patients from a previously published RCT of 62 patients, in which RSA was compared with nonoperative treatment, were followed up long term.

Fracture patterns, outcomes, and complications of terrible triad injury in elderly patients.

Hypothesis: This study hypothesized that patients older than 65 years with terrible triad elbow injuries (TTEI) exhibit complex fracture patterns, a high prevalence of associated injuries, and increased rates of complications and reinterventions.

Methods: A retrospective study of 29 patients, mean follow-up of 48.7 ± 4.