The Learning Curve of Third-Generation Percutaneous Chevron and Akin Osteotomy (PECA) for Hallux Valgus.

The learning curve to reach technical proficiency for third-generation percutaneous or minimally invasive chevron and Akin osteotomies (PECA/MICA) is recognized to be steep however it is poorly defined in the literature. This study is a retrospective review of the first 58 consecutive PECA cases of a single surgeon. The primary outcome was the number of cases required to reach technical proficiency as defined by the operation time.

Strong Margin Influence on the Arctic Ocean Barium Cycle Revealed by Pan-Arctic Synthesis.

Early studies revealed relationships between barium (Ba), particulate organic carbon and silicate, suggesting applications for Ba as a paleoproductivity tracer and as a tracer of modern ocean circulation. Here, we investigated the Arctic Ocean Ba cycle through a one-of-a-kind data set containing dissolved (dBa), particulate (pBa), and stable isotope Ba ratio (δBa) data from four Arctic GEOTRACES expeditions conducted in 2015. We hypothesized that margins would be a substantial source of Ba to the Arctic Ocean water column.

Oysters for legacy and emerging per- and polyfluoroalkyl substances (PFASs) monitoring in estuarine and coastal waters: Phase distribution and bioconcentration profile.

Per- and polyfluoroalkyl substances (PFASs) are a diverse group of widely used anthropogenic chemicals that are environmentally persistent and bioaccumulative, especially in aquatic ecosystem. The heavily industrialized and urbanized Greater Bay Area in China represents a notable contamination source for PFASs, which may potentially influence the health of local oysters as a keystone species in local ecosystems and a popular seafood. In this study, samples of oysters and their surrounding waters were collected from the littoral zones of the Pearl River Estuary (PRE), China during winter 2020, where 44 PFASs, including 19 perfluoroalkyl acids (PFAAs), 8 emerging PFASs, and 17 PFAA precursors (or intermediates), were analyzed.

Augmentation of rotator cuff repair with gelatin-resorcin-formalin glue: a biomechanical study.

Introduction: Rotator cuff tendons are typically reattached to the proximal humerus using transosseous sutures or suture anchors. Their primary mode of failure is at the tendon-bone interface.

Methods: We investigated the addition of an adhesive, gelatin-resorcin-formalin (GRF) glue, to a single-row rotator cuff repair (RCR) on ex vivo sheep models.

Pain, paresthesia, and the rotator cuff: the prevalence and magnitude of shoulder pain and hand numbness and tingling before and after rotator cuff repair.

Background: Shoulder pain and loss of function are classically associated with rotator cuff tears, while paresthesia of the hand is not. We noted anecdotally that paresthesia of the arm was common in patients presenting with rotator cuff tears. The purpose of this study was to determine the prevalence and magnitude of hand paresthesia, its relationship to pain, and how surgery affected these symptoms.

Hepatocellular carcinoma: measures to improve the outlook in sub-Saharan Africa.

Hepatocellular carcinoma is a leading public health concern in sub-Saharan Africa, and it is most prevalent in young adults (median 45 years [IQR 35-57]). Overall, outcomes are poor, with a median survival of 2·5 months after presentation. Major risk factors for hepatocellular carcinoma are hepatitis B virus (HBV), hepatitis C virus, aflatoxin B1 exposure, and alcohol consumption, with metabolic dysfunction-associated fatty liver disease slowly emerging as a risk factor over the past few years.

Significant input of organophosphate esters through particle-mediated transport into the Pearl River Estuary, China.

Most organophosphate esters (OPEs) enter the marine environment through atmospheric deposition and surface runoff, yet the role of particle-mediated transport in their inputs and loss processes remains poorly understood. To fill this knowledge gap, samples of size-segregated atmospheric particles, suspended particulate matter (SPM) in seawater, and sediments in the Pearl River Estuary (PRE) were collected and analyzed for OPEs. Total concentrations of atmospheric particulate OPEs showed a decreasing trend with increasing offshore distance in the PRE.

Alternative Splicing and Its Roles in Plant Metabolism.

Plant metabolism, including primary metabolism such as tricarboxylic acid cycle, glycolysis, shikimate and amino acid pathways as well as specialized metabolism such as biosynthesis of phenolics, alkaloids and saponins, contributes to plant survival, growth, development and interactions with the environment. To this end, these metabolic processes are tightly and finely regulated transcriptionally, post-transcriptionally, translationally and post-translationally in response to different growth and developmental stages as well as the constantly changing environment. In this review, we summarize and describe the current knowledge of the regulation of plant metabolism by alternative splicing, a post-transcriptional regulatory mechanism that generates multiple protein isoforms from a single gene by using alternative splice sites during splicing.

Analysis of Worsening Heart Failure Events in an Integrated Health Care System.

Background: There is growing interest to disentangle worsening heart failure (WHF) from location of care and move away from hospitalization as a surrogate for acuity.

Objectives: The purpose of this study was to describe the incidence of WHF events across the care continuum from ambulatory encounters to hospitalizations.

Methods: We studied calendar year cohorts of adults with diagnosed heart failure (HF) from 2010-2019 within a large, integrated health care delivery system.

Improving mobility in the intensive care unit with a protocolized, early mobilization program: observations of a single center before-and-after the implementation of a multidisciplinary program.

Background: Early intensive care unit (ICU) protocolized rehabilitative programs have been described previously, yet with differing starting time points and mostly on mechanically ventilated patients. We extended the concept to all admitted ICU patients and investigate the efficacy of early mobilization in improving mobility of the critically ill, address issues surrounding the timing and intensity of an early rehabilitative program.

Methods: Prospective cohorts of patients admitted consecutively before-and-after (control, n=92; intervention, n=90) the introduction of an early mobilization program in a single center, general hospital ICU.

Spatiotemporal variations of retinoic acids and their metabolites in the marine environment of Hong Kong.

Excessive intake of retinoic acids (RAs) and the oxidative metabolites, 4-oxo-RAs, can lead to abnormal morphological development in animals. This study investigated spatiotemporal variations of concentrations and compositions of these compounds in Hong Kong's seawater and during algal blooms. Total concentrations of the studied compounds in seawater were up to 0.

Initiation of anti-hypertensive drugs and outcomes in patients with heart failure with preserved ejection fraction and persistent hypertension.

Background: National heart failure (HF) guidelines recommend that in patients with HF with preserved ejection fraction (EF;HFpEF) and hypertension, systolic blood pressure (SBP) should be maintained below 130 mmHg. The objective of the study is to examine the association between initiation of anti-hypertensive drugs and outcomes in patients with HFpEF with persistent hypertension.

Methods: Of the 8873 hospitalized patients with HFpEF (EF ≥50%) with a history of hypertension without renal failure in Medicare-linked OPTIMIZE-HF, 3315 had a discharge SBP ≥130 mmHg, of whom 1971 were not receiving anti-hypertensive drugs, thiazides and calcium channel blockers, before hospitalization.

Spatiotemporal occurrence of phthalate esters in stormwater drains of Hong Kong, China: Mass loading and source identification.

Urban stormwater is an important pathway for transporting anthropogenic pollutants to water bodies. Phthalate esters (PAEs) are endocrine disruptors owing to their estrogenic activity and potential carcinogenicity and their ubiquitous presence has garnered global interest. However, their transportation by urban stormwater has been largely overlooked.

Postoperative Pain and Paresthesia in Labral Repairs of the Shoulder: Location Does Matter.

Background: Favorable outcomes have been reported regarding postoperative shoulder pain and function after repair of anteroinferior (Bankart) glenohumeral labral tears. However, the outcomes of patients after repair of isolated superior labral anterior-posterior (SLAP) tears are a contentious topic. The authors have also anecdotally noted that patients evaluated with labral tears complained of numbness and tingling in their ipsilateral hand.

Widespread occurrence of emerging E-waste contaminants - Liquid crystal monomers in sediments of the Pearl River Estuary, China.

Liquid crystal monomers (LCMs), commonly used in screens of electronic devices, have recently been identified as a group of emerging chemicals of concern associated with e-waste. They are potentially persistent, bioaccumulative, and toxic substances, and may pose a threat to the marine ecosystem. The Pearl River Estuary (PRE) receives organic contaminants discharged from the Pearl River Delta region, where primitive handling of e-waste is widespread.

Treatment Adherence and Health-Related Quality of Life in Patients with Hemophilia in Hong Kong.

Background: This study aims to identify factors affecting health-related quality of life (HRQoL) in Chinese patients with hemophilia in Hong Kong, and to examine the association between treatment adherence and HRQoL outcomes. Methods: Patients with hemophilia A or B from a non-governmental organization reported their HRQoL and treatment adherence to prophylactic therapy using validated tools. Univariate tests and multivariable regression analysis were used to compare differences in outcomes across clinically relevant subgroups.

Enhancing the precision limits of interferometric satellite geodesy missions.

Satellite geodesy uses the measurement of the motion of one or more satellites to infer precise information about the Earth's gravitational field. In this work, we consider the achievable precision limits on such measurements by examining approximate models for the three main noise sources in the measurement process of the current Gravitational Recovery and Climate Experiment (GRACE) Follow-On mission: laser phase noise, accelerometer noise and quantum noise. We show that, through time-delay interferometry, it is possible to remove the laser phase noise from the measurement, allowing for almost three orders of magnitude improvement in the signal-to-noise ratio.

Valgus Second Toe Deformity Treated With a Percutaneous Extracapsular Closing-Wedge Osteotomy of the Proximal Phalanx.

Background: Coronal and sagittal plane deformities of the lesser toes are common yet challenging to treat. Traditional open releases and translational Weil osteotomies can be unpredictable and lead to postoperative stiffness. We present the results of a percutaneous closing wedge extracapsular osteotomy of the proximal phalanx to treat valgus deformity of the second toe.

Frequency-specific medial septal nucleus deep brain stimulation improves spatial memory in MK-801-treated male rats.

Background: Few treatments exist for the cognitive symptoms of schizophrenia. Pharmacological agents resulting in glutamate N-methyl-d-aspartate (NMDA) receptor hypofunction, such as MK-801, mimic many of these symptoms and disrupt neural activity. Recent evidence suggests that deep brain stimulation (DBS) of the medial septal nucleus (MSN) can modulate medial prefrontal cortex (mPFC) and hippocampal activity and improve spatial memory.

Fluorine mass balance analysis and per- and polyfluoroalkyl substances in the atmosphere.

Given that only a small number of per- and polyfluoroalkyl substances (PFAS) are routinely monitored, levels of PFAS in the atmosphere may be underestimated. A protocol including analyses of target PFAS (n = 50), water-soluble fluoride, and total fluorine has been proposed and applied to atmospheric samples. The whole method recovery (including extraction recovery and sampling efficiency) of 90-110% were obtained for the majority of compounds (48/50) with low deviations between replicates (< 20%).

The utility of routine autologous bone-flap swab cultures in predicting post-cranioplasty infection.

Objective: To evaluate the utility of autologous bone-flap swab cultures performed at the time of cranioplasty in predicting postcranioplasty surgical site infection (SSI).

Design: Retrospective cohort study.

Participants: Patients undergoing craniectomy (with bone-flap storage in tissue bank), followed by delayed autologous bone-flap replacement cranioplasty between January 1, 2010, and November 30, 2020.

From half-metallic to magnetic semiconducting triazine g-CN: computational designs and insight.

We have given, for the first time, physicochemical insight into the electronic structure routes from half-metallic to magnetic semiconducting triazine g-CN. To this end, three material designs have been proposed using density functional calculations. In one design, this half-metal is first made semiconducting hydrogenation, then tailored with B and N atomic species, which gives a new prototype of the antiferromagnetic semiconductor monolayer HCNBN.