Anatomic Total Shoulder Arthroplasty Outcomes Were Not Negatively Affected by the COVID-19 Pandemic / Os desfechos da artroplastia anatômica total do ombro não foram afetados negativamente pela pandemia de Covid-19

Abstract Objective To investigate whether patients undergoing anatomic total shoulder arthroplasty (ATSA) between January and March 2020 experienced different postoperative outcomes than patients in 2019. We hypothesized that patients in 2020 would have less access to physical therapy (PT) and experience different postoperative outcomes. Methods Records from patients who received ATSA between January 1st, 2019, and March 17th, 2019, and January 1st, 2020, to March 17th, 2020, were analyzed. Patient data, including demographic information, range of motion (ROM), strength, and PT was collected and compared between the two groups. The 2020 patients were contacted by phone during October 2022 and patient-reported metrics were gathered. Results The present study identified 24 patients in 2019 and 27 patients in 2020 who underwent ATSA during the specified time frame and had a minimum 1-year follow-up. Patients in 2019 experienced improvements in forward elevation (FE) ROM (125.4° to 146.7°; p = 0.008), external rotation (ER; 33.0° to 47.7°; p < 0.001), and internal rotation (IR; S1 to L4; p = 0.019). Patients in 2020 also experienced significant improvements in FE (120.2° to 141.1°; p = 0.009), ER (32.9° to 42.0°; p = 0.037), and IR (S1 to L3; p = 0.002). Patients in 2020 terminated PT earlier (2019: 125.8 days; 2020: 91.1 days; p = 0.046) and completed fewer sessions (2019: 21.4 sessions; 2020: 13.1 sessions; p = 0.003). At the final follow-up, patients in 2020 reported an average Visual Analogue Scale (VAS) pain score of 1.67 ± 1.1. Conclusion Despite decreased PT, patients who underwent ATSA in 2020 had significant improvements in ROM and strength and were comparable to patients in 2019.

Resumo Objetivo Investigar se os pacientes submetidos à artroplastia total anatômica do ombro (ATAO) entre janeiro e março de 2020 tiveram resultados pós-operatórios diferentes dos pacientes operados em 2019. Nossa hipótese é a de que os pacientes de 2020 teriam menos acesso à fisioterapia (FT) e apresentariam desfechos pós-opera-tórios diferentes. Métodos Foram analisados os prontuários de pacientes submetidos à ATAO de 1° de janeiro de 2019 a 17 de março de 2019 e de 1° de janeiro de 2020 a 17 de março de 2020. Os dados dos pacientes, incluindo informações demográficas, amplitude de movimento (ADM), força e FT foram coletados e comparados entre os dois grupos. Os pacientes de 2020 foram contatados por telefone durante outubro de 2022, e as métricas relatadas por eles pacientes foram coletadas. Resultados Este estudo identificou 24 pacientes em 2019 e 27 pacientes em 2020 que foram submetidos à ATAO durante o período especificado e tiveram acompanhamento mínimo de 1 ano. Os pacientes em 2019 apresentaram melhoras na ADM de elevação anterior (EA; 125,4° a 146,7°; p = 0,008), rotação externa (RE; 33,0° a 47,7°; p < 0,001) e rotação interna (RI; S1 a L4; p = 0,019). Os pacientes em 2020 também apresentaram melhoras significativas de EA (120,2° a 141,1°; p = 0,009), RE (32,9° a 42,0°; p = 0,037) e RI (S1 a L3; p = 0,002). Os pacientes de 2020 terminaram a FT mais cedo (2019: 125,8 dias; 2020: 91,1 dias; p = 0,046) e fizeram menos sessões (2019: 21,4 sessões; 2020: 13,1 sessões; p = 0,003). No acompanhamento final, os pacientes de 2020 relataram uma pontuação média de dor na Escala Visual Analógica (EVA) de 1,67 ± 1,1. Conclusão Apesar da menor realização de FT, os pacientes submetidos à ATAO em 2020 apresentaram melhoras significativas na ADM e na força e foram comparáveis aos pacientes de 2019.

Incorporating adaptation and resilience into an integrated watershed and coral reef management plan.

Changing environmental conditions are forcing natural resource managers and communities to adapt their strategies to account for global shifts in precipitation, temperature, sea level and more, all of which are occurring in addition to local human impacts. Adapting to threats from climate change requires a fundamental shift in the practice of natural resource management through the development of forward-looking "climate-smart" goals and strategies. Here we present a proof-of-concept application of a decision-support tool to help design climate-smart management actions for the watershed and coral reef management plan for Guánica Bay watershed in southwest Puerto Rico. We also explore the connection between adaptation planning and coral reef resilience, using a recently developed Puerto Rico-wide reef resilience assessment. In the first phase of the study, we used the publicly available Adaptation Design Tool to draft initial climate-smart versions of twelve proposed management actions. In the second phase, two actions (dirt road management on steep slopes, and coral reef restoration) were further refined through consultations with local experts to make more detailed design adjustments; this included the option to use information from the coral reef resilience assessment to inform design improvements. The first phase resulted in moderately detailed assessments that broadly accounted for anticipated direct and indirect effects of climate change on the planned management actions. The second phase resulted in more site-specific technical assessments and additional important design details. The expert panel charged with discussing climate-smart reef restoration around Guánica used the reef resilience assessment to guide discussion of reef restoration, highlighting the importance of having such information available for adaptation planning. This study demonstrates how climate change impacts can be effectively incorporated into a management plan at the most granular level of planning and how a structured, formalized process can be as valuable as the resulting adaptation information.

Resilience assessment of Puerto Rico's coral reefs to inform reef management.

Globally increasing sea surface temperatures threaten coral reefs, both directly and through interactions with local stressors. More resilient reefs have a higher likelihood of returning to a coral-dominated state following a disturbance, such as a mass bleaching event. To advance practical approaches to reef resilience assessments and aid resilience-based management of coral reefs, we conducted a resilience assessment for Puerto Rico's coral reefs, modified from methods used in other U.S. jurisdictions. We calculated relative resilience scores for 103 sites from an existing commonwealth-wide survey using eight resilience indicators-such as coral diversity, macroalgae percent cover, and herbivorous fish biomass-and assessed which indicators most drove resilience. We found that sites of very different relative resilience were generally highly spatially intermixed, underscoring the importance and necessity of decision making and management at fine scales. In combination with information on levels of two localized stressors (fishing pressure and pollution exposure), we used the resilience indicators to assess which of seven potential management actions could be used at each site to maintain or improve resilience. Fishery management was the management action that applied to the most sites. Furthermore, we combined sites' resilience scores with projected ocean warming to assign sites to vulnerability categories. Island-wide or community-level managers can use the actions and vulnerability information as a starting point for resilience-based management of their reefs. This assessment differs from many previous ones because we tested how much information could be yielded by a "desktop" assessment using freely-available, existing data rather than from a customized, resilience-focused field survey. The available data still permitted analyses comparable to previous assessments, demonstrating that desktop resilience assessments can substitute for assessments with field components under some circumstances.

Adaptation Design Tool for Climate-Smart Management of Coral Reefs and Other Natural Resources.

Scientists and managers of natural resources have recognized an urgent need for improved methods and tools to enable effective adaptation of management measures in the face of climate change. This paper presents an Adaptation Design Tool that uses a structured approach to break down an otherwise overwhelming and complex process into tractable steps. The tool contains worksheets that guide users through a series of design considerations for adapting their planned management actions to be more climate-smart given changing environmental stressors. Also provided with other worksheets is a framework for brainstorming new adaptation options in response to climate threats not yet addressed in the current plan. Developed and tested in collaboration with practitioners in Hawai'i and Puerto Rico using coral reefs as a pilot ecosystem, the tool and associated reference materials consist of worksheets, instructions and lessons-learned from real-world examples. On the basis of stakeholder feedback from expert consultations during tool development, we present insights and recommendations regarding how to maximize tool efficiency, gain the greatest value from the thought process, and deal with issues of scale and uncertainty. We conclude by reflecting on how the tool advances the theory and practice of assessment and decision-making science, informs higher level strategic planning, and serves as a platform for a systematic, transparent and inclusive process to tackle the practical implications of climate change for management of natural resources.

Group hunting-a reason for sociality in molossid bats?

Many bat species live in groups, some of them in highly complex social systems, but the reasons for sociality in bats remain largely unresolved. Increased foraging efficiency through passive information transfer in species foraging for ephemeral insects has been postulated as a reason for group formation of male bats in the temperate zones. We hypothesized that benefits from group hunting might also entice tropical bats of both sexes to live in groups. Here we investigate whether Molossus molossus, a small insectivorous bat in Panama, hunts in groups. We use a phased antenna array setup to reduce error in telemetry bearings. Our results confirmed that simultaneously radiotracked individuals from the same colony foraged together significantly more than expected by chance. Our data are consistent with the hypothesis that many bats are social because of information transfer between foraging group members. We suggest this reason for sociality to be more widespread than currently assumed. Furthermore, benefits from group hunting may also have contributed to the evolution of group living in other animals specialized on ephemeral food sources.

El programa Cornell-Bahia, 1975-1978: establecimiento de un laboratorio para combatir las enfermedades transmisibles tropicales. / The Cornell-Bahia program, 1975-1978: establishment of a laboratory to control communicable diseases

En 1975 se inicio un programa de colaboracion internacional para establecer un centro de estudio y control de las enfermedades transmisibles en el nordeste de Brasil El presente articulo constituye una evaluacion preliminar de ese programa

Transporte de muestras microbiológicas a un centro de enfermedades transmisibles en el trópico / Transport of microbiological specimens to a tropical communicable disease center

El transporte práctico y eficiente de muestras clínicas es parte esencial del laboratorio de salud pública y de la investigación epidemiológica. Este artículo describe un sistema de transporte de muestras ideado en Bahía, Brasil, cuyas características pueden ser aplicables en cierto grado en muchos países tropicales en desarrollo (AU)

El Programa Cornell-Bahía, 1975-1978: establecimiento de un laboratorio para combatir las enfermedades transmisbles tropicales / The Cornell-Bahia Program, 1975-1978: development of a tropical communicable diseases laboratory center

En 1975 se inició un programa de colaboración internacional para establecer un centro de estudio y control de las enfermedades transmisibles en el nordeste de Brasil. El presente artículo constituye una evaluación preliminar de ese programa (AU)