Post-operative Outcomes and Survivorship for Shoulder Arthroplasty following Glenohumeral Tumor Resection.

A paucity of data exists for post-operative complications and survivorship in patients undergoing resection arthroplasty procedures for treatment of glenohumeral tumors. This study investigates patient and tumor characteristics, 90-day and long-term post-operative complications, and overall survivorship following glenohumeral tumor resection arthroplasty procedures. This single-center retrospective review identified 13 patients, with mean age of 51.6 ± 15.7 years, mean body mass index of 26.5 ± 6.4 kg/m2, and mean Charlson Comorbidity Index of 4.9 ± 2.4, who underwent shoulder arthroplasty procedures for glenohumeral tumors, most commonly for chondrosarcoma (n = 5) and metastatic disease (n = 3). Nine patients (69.2%) underwent revision surgeries at a median of 677 days, most commonly for prosthesis instability, dislocation (n=4) or aseptic loosening (n = 3). Seven patients (53.8%) were deceased at a median of 593.6 days. Resection arthroplasty in the treatment of glenohumeral tumors demonstrates low rates of complications during the global period but are fraught with long-term complications. This data provides pertinent information to pre-operatively counsel patients on post-operative expectations. (Journal of Surgical Orthopaedic Advances 31(4):248-251, 2022).

June: open-source individual-based epidemiology simulation.

We introduce June, an open-source framework for the detailed simulation of epidemics on the basis of social interactions in a virtual population constructed from geographically granular census data, reflecting age, sex, ethnicity and socio-economic indicators. Interactions between individuals are modelled in groups of various sizes and properties, such as households, schools and workplaces, and other social activities using social mixing matrices. June provides a suite of flexible parametrizations that describe infectious diseases, how they are transmitted and affect contaminated individuals. In this paper, we apply June to the specific case of modelling the spread of COVID-19 in England. We discuss the quality of initial model outputs which reproduce reported hospital admission and mortality statistics at national and regional levels as well as by age strata.

Single-Step Synthesis of Small, Azide-Functionalized Gold Nanoparticles: Versatile, Water-Dispersible Reagents for Click Chemistry.

Nanoparticles possessing functional groups that can be readily conjugated (e.g., through click chemistry) are important precursors for the preparation of customized nanohybrid products. Such nanoparticles, if they are stable against agglomeration, are easily dispersible and have well-defined surface chemistry and size. As click-ready reagents, they can be stored until their time of use and then simply dispersed and reacted with an appropriate substrate. Gold nanoparticles (AuNPs) are excellent candidates for this purpose, and some clickable gold nanoparticles have been developed; however, AuNPs for use in aqueous systems are often prepared through difficult multistep processes and/or can be poorly dispersible in water. Here we report a single-step synthesis of clickable, water-dispersible AuNPs. The synthesis yields uniform, 3.5 nm diameter cores coated with a well-defined molecular ligand shell that makes the AuNPs stable and dispersible in water. The AuNP mixed ligand shell consists of hydroxyl-terminated ethylene glycol-based ligands to promote dispersion in water and a small number of azide-terminated ligands that readily undergo click reactions with alkynes. The use of a mesofluidic reactor affords fine control over the core size and ligand shell composition and ensures reproducible results (e.g., less than 0.1 nm variation in core diameter between batches). The purified reagents were successfully coupled to a variety of alkyne-containing substrates using both Cu-catalyzed and strain-promoted click reactions. Particle size, morphology, stability, and surface composition were thoroughly characterized using small-angle X-ray scattering, transmission electron microscopy, X-ray photoelectron spectroscopy, UV-vis, and 1H NMR before and after the click reactions. Both the parent nanoparticles and their click chemistry products are stable during storage and remained dispersible for over a year in water, suggesting their potential for environmental, biological, and biomedical applications.

Aplastic Posterior Tibial Artery in the Presence of Trimalleolar Ankle Fracture Dislocation Resulting in Below-the-Knee Amputation.

We present an interesting, but unfortunate, case of an 86-year-old female who sustained a trimalleolar ankle fracture dislocation that resulted in below-the-knee amputation after open reduction and internal fixation of the fracture. To the best of our knowledge, this is the first case report describing popliteal variants that ultimately resulted in critical limb ischemia and below-the-knee amputation after foot and ankle trauma. The anatomic variation altered the expected outcome from a relatively straightforward surgical case. We introduce the previously described lower extremity Allen test and describe how it can be a useful adjunct in the initial physical examination of lower extremity trauma. The ability to identify abnormal distal perfusion to the foot could provide enough insight to warrant evaluating the patient with angiography or computed tomography angiography.

Subnanometer Control of Mean Core Size during Mesofluidic Synthesis of Small (D(core) < 10 nm) Water-Soluble, Ligand-Stabilized Gold Nanoparticles.

A convenient, single-step synthesis is reported that produces ligand-stabilized, water-soluble gold nanoparticles (AuNPs) with subnanometer-level precision of the mean core diameter over a range of 2-9 nm for a series of desired surface chemistries. The synthesis involves the reduction of a Au(III) species with sodium borohydride in the presence of a functionalized alkyl thiosulfate (Bunte salt) to yield thiolate-protected AuNPs. A key advantage of this synthesis is that simply adjusting the pH of the gold salt solution leads to control over the AuNP core size. The speciation of Au(III), and therefore the kinetics for its reduction and the core size produced, depends upon pH. The use of pH as the sole variable to control core size is a more reliable and convenient method than traditional approaches that rely on adjusting the concentrations and ratios of ligand, metal salt, and reducing agent. The average core size increased as the pH was raised for each ligand studied. Because the influence of pH was different for each of the ligands, working curves were plotted for each ligand to identify conditions to synthesize particles with specific, targeted core diameters. Using this approach, reaction conditions can be rapidly optimized using a combination of a mesofluidic reactor and small-angle X-ray scattering (SAXS) size analysis. The use of the mesofluidic reactor was needed to ensure fast mixing given the rapid kinetics for core formation. Using the reactor, it is possible to obtain reproducible sizes across multiple syntheses (<1-2% core size variation) and subnanometer control of the mean core dimensions. The synthetic method demonstrated here provides an attractive alternative to two-step syntheses involving ligand exchange because it is more efficient and eliminates the possibility of nanoparticle core size changes during exchange steps. This approach enables the development of "size ladders" of particles with the same surface chemistry for investigations of structure-function relationships.

Removal of thiol ligands from surface-confined nanoparticles without particle growth or desorption.

Size-dependent properties of surface-confined inorganic nanostructures are of interest for applications ranging from sensing to catalysis and energy production. Ligand-stabilized nanoparticles are attractive precursors for producing such nanostructures because the stabilizing ligands may be used to direct assembly of thoroughly characterized nanoparticles on the surface. Upon assembly; however, the ligands block the active surface of the nanoparticle. Methods used to remove these ligands typically result in release of nanoparticles from the surface or cause undesired growth of the nanoparticle core. Here, we demonstrate that mild chemical oxidation (50 ppm of ozone in nitrogen) oxidizes the thiolate headgroups, lowering the ligand's affinity for the gold nanoparticle surface and permitting the removal of the ligands at room temperature by rinsing with water. XPS and TEM measurements, performed using a custom planar analysis platform that permits detailed imaging and chemical analysis, provide insight into the mechanism of ligand removal and show that the particles retain their core size and remain tethered on the surface core during treatment. By varying the ozone exposure time, it is possible to control the amount of ligand removed. Catalytic carbon monoxide oxidation was used as a functional assay to demonstrate ligand removal from the gold surface for nanoparticles assembled on a high surface area support (fumed silica).

Grazing and no-till cropping impacts on nitrogen retention in dryland agroecosystems.

As the world's population increases, marginal lands such as drylands are likely to become more important for food production. One proven strategy for improving crop production in drylands involves shifting from conventional tillage to no-till to increase water use efficiency, especially when this shift is coupled with more intensive crop rotations. Practices such as no-till that reduce soil disturbance and increase crop residues may promote C and N storage in soil organic matter, thus promoting N retention and reducing N losses. By sampling soils 15 yr after a N tracer addition, this study compared long-term soil N retention across several agricultural management strategies in current and converted shortgrass steppe ecosystems: grazed and ungrazed native grassland, occasionally mowed planted perennial grassland, and three cropping intensities of no-till dryland cropping. We also examined effects of the environmental variables site location and topography on N retention. Overall, the long-term soil N retention of >18% in these managed semiarid ecosystems was high compared with published values for other cropped or grassland ecosystems. Cropping practices strongly influenced long-term N retention, with planted perennial grass systems retaining >90% of N in soil compared with 30% for croplands. Grazing management, topography, and site location had smaller effects on long-term N retention. Estimated 15-yr N losses were low for intact and cropped systems. This work suggests that semiarid perennial grass ecosystems are highly N retentive and that increased intensity of semiarid land management can increase the amount of protein harvested without increasing N losses.

Elucidating inorganic nanoscale species in solution: complementary and corroborative approaches.

The challenge of defining a length on the nanoscale is non-trivial. For a well-defined inorganic nanoscale species, a size measurement can describe a number of different dimensions (core, shell, solvation sphere). Often size is reported out of context or even inadvertently misrepresented. Since many of the techniques used to measure size depend on significant and sometimes destructive sample preparation, an additional challenge is defining "what size means" for a nanoscale species in solution. In this Concept, the distinction is made between complementary techniques that can be used together to unveil more information about the material in question, and corroborative techniques, which are used to make multiple measurements of the same property. Additionally, corroborative techniques can be used to measure the same property in and out-of solution so as to reveal details about solution behaviour. We highlight various approaches to this characterization challenge in the context of three case studies that demonstrate the use of both complementary and corroborative techniques to elucidate the various functional dimensions of different types of inorganic nanoscale species in solution.