High correlation of the subjective elbow value with Mayo Elbow Performance Score and Oxford Elbow Score in patients with elbow dislocation.

Background: The purpose of this study was to analyze the correlation of the Subjective Elbow Value (SEV) with 2 widely used elbow scoring systems: Mayo Elbow Performance Score (MEPS) and Oxford Elbow Score (OES) in patients following elbow dislocation. Methods: In this retrospective single-center study, patients who sustained an elbow dislocation between January 2008 and December 2019 and were at least 2 years out from injury were included. SEV, OES and MEPS were assessed and statistical correlation was calculated using Pearson's correlation coefficient. Results: A total of 114 patients (61 male, 53 female) with a mean age of 47.1 years (range, 16-70) were analyzed following elbow dislocation. The mean SEV was 87.4% (95% confidence interval (CI) 84.2-90.7), mean MEPS was 88.1 (95% CI 85.1-91.0) points and mean OES was 40.0 (95% CI 38.4-41.7) points. Both MEPS (r = 0.710, P < .001), and OES (r = 0.764, P < .001) demonstrated high correlation with the SEV. Conclusion: This study demonstrates that the SEV is a valid tool to assess overall status of the elbow in patients following elbow dislocations and presents an expressive but easy to perform addition to more complex scoring systems.

Advancing equity and justice through community science programming in design, construction, and research of a nature-based solution: the Duwamish Floating Wetlands Project.

Dxwdəw refers to the Black-Green Rivers confluences that made the Duwamish River in Seattle, Washington, USA, prior to the 1910s. Significant industrial activity and human-made diversions to these rivers caused heavy pollution and eliminated 97% of historic wetlands, forever altering the historic river systems, salmon runs and human and aquatic health. Today the Green-Duwamish River and Duwamish Estuary are an industrial and commercial corridor, albeit also a site of cultural significance and fishing rights for urban Indigenous and Coast Salish tribes, and home and workplace to diverse urban populations of sustenance fishers, immigrants and refugees, communities of color, and low-income neighborhoods. Using a socio-ecological and environmental justice perspective within a nature-based solution, the Duwamish Floating Wetlands Project designed and piloted four constructed floating wetland structures for two years on the Duwamish River and researched their feasibility to provide habitat for out-migrating juvenile salmon. A multi-pronged community team (community leaders, liaisons, stewards and scientists) worked alongside academics and professionals. This paper showcases the formulation and adaptation of a two-year citizen/community science program integrated into the project. We outline the frameworks, approach, outcomes, and lessons-learned of the community science and outreach program, and compiled these in a list of guidelines to provide practitioner, researcher and community insight into the value and necessity of prioritizing environmental justice, racial equity, and ecosystem needs in nature-based solutions.

Competing Flow Between Partial Circulatory Support and Native Cardiac Output: A Clinical Computational Fluid Dynamics Study.

Partial circulatory support is a promising concept for the treatment of heart failure patients. A better understanding of induced hemodynamic changes is essential for optimizing treatment efficacy. Computational fluid dynamics (CFD) is an alternative method to gain insight into flow phenomena difficult to obtain in vivo. In 10 patients implanted with a Circulite Synergy Micro-pump (HeartWare, Framingham, Massachusetts) (a continuous flow partial circulatory assist device connecting the left atrium to the right subclavian artery), transient CFD simulations were performed. Patients were divided into two groups depending on their cardiac output (CO; high CO group: 5.5 ± 1.1 L/min, low CO group: 1.7 ± 0.7 L/min). The partial assist device provided a supporting flow of 1.5 ± 0.8 L/min. Support was highest at diastole and decreased during systole because of a collision of the blood flows from the partial assist device and the CO. Reversed flow counteracting the flow of the device was significantly higher for the high CO group (mean flow in peak systole: -2.18 ± 1.08 vs. 0.23 ± 0.59 L/min; p = 0.002) showing an inverse correlation between CO and amount of reversed flow during peak systole (R = -0.7; p < 0.02). The flow collision lead to higher total pressures at the point of collision and consequently in the Circulite outflow graft. The CFD simulations allow quantifying hemodynamic alterations in patients with partial support consisting of a flow collision, thereby reducing effectiveness of the circulatory support. Partial support in heart failure patients alternates their hemodynamics not only in providing support for the circulation but also inducing unfavorable changes in flow patterns.