Posterior Compartment Debridement and Varus Deformity Correction in Total Knee Arthroplasty.

BACKGROUND: Restoration of joint-line position and deformity correction remain important tenets for preserving stability and function after total knee arthroplasty (TKA). We sought to characterize the role of posterior osteophytes in the correction of alignment deformity during TKA. METHODS: We evaluated 57 patients (57 TKAs) who participated in a trial of robotic-arm assisted TKA outcomes. Weight-bearing and fixed preoperative alignment was measured using long-standing radiographs and tools of the robotic-arm tracking system, respectively. Total volume (cm3) of posterior osteophytes was quantified using preoperative planning computed tomography scans. Joint-line position was evaluated using bone resection thicknesses measured using a caliper. RESULTS: The mean (minimum to maximum) initial fixed deformity was 4 degrees (range, 0 to 11) of varus. All patients showed asymmetric posterior osteophytes. Mean total osteophyte volume was 3 cm3 (range, 1 to 9). Total osteophyte volume was positively correlated with severity of fixed deformity (r = 0.48, P = .0001). Removal of osteophytes allowed for the correction of functional alignment to within 3 degrees of neutral in all cases (mean 0 degree), with none requiring release of the superficial medial collateral ligament. Tibial joint-line position was restored to within 3 millimeters in all but 2 cases (mean increase of height, 0.6 [range, -4 to +5]). CONCLUSION: In the end-stage diseased knee, posterior osteophytes typically occupy space in the posterior capsule on the concave side of the deformity. Thorough debridement of posterior osteophytes may help facilitate management of modest varus deformity with decreased need for soft-tissue releases or adjustments to planned bone resection.

Assessment of quality, absorbability, and educational value of YouTube videos regarding ankle fractures.

Aims & objectives: YouTube is a non-peer-reviewed platform with a large library of healthcare-related videos which attempt to provide educational content. The goal of this study is to analyze the quality, absorbability, and educational content of videos available to patients on YouTube regarding ankle fractures. Materials & methods: On May 31, 2022, over 550 videos populated the initial search of "ankle fracture" within YouTube's platform. The first 100 videos were reviewed, and 62 videos were included in the final analysis. Video characteristics were recorded and evaluated. Videos were assessed using three objective scoring systems: (1) the Journal of American Medical Association (JAMA) benchmark criteria, (2) the Patient Education Materials Assessment Tool for audio and visual materials (PEMAT), and (3) the novel Ankle Fracture Content Score (AFCS). Results: Each scoring system had high internal consistency and interrater reliability. The mean JAMA, PEMAT understandability, PEMAT actionability, and AFCS were 2.92, 61.85%, 16.38%, and 4.67, respectively. No association was seen between video popularity metrics and quality of information. The understandability of the patient-targeted videos was greater than those targeted at healthcare professionals (P = 0.049). Conclusion: The information regarding ankle fractures available on YouTube for patient education is poor with no correlation between quality and popularity. This study illustrates the need for future collaboration between YouTube and trusted medical societies to provide patients with the highest quality information.

An inverse planned oil release validation method for estimating oil slick thickness from thermal contrast remote sensing by in-scene calibration.

This study demonstrates a method to estimate floating oil slick thickness based on remote sensing of thermal infrared contrast. The approach was demonstrated for thick oil slicks from natural seeps in the Coal Oil Point seep field, offshore southern California. Airborne thermal infrared and visible spectrum remote sensing imagery were acquired along with position and orientation data by the SeaSpires™ science package. Remote sensing data were acquired in the cross-slick direction of oil slick segments that were targeted for collection, termed "collects." A collect consisted of booming, skimming, and offloading the oil slick segment into buckets for analysis at the laboratory. Each collect provided an in-scene calibration point of oil thickness versus brightness temperature contrast, ΔTB , where TB is the sensor-reported temperature based on the emitted thermal radiation and differs from the true temperature due to the oil's emissivity. ΔTB is the TB difference between the oil and oil-free sea surface. Thus, this study is a reverse planned oil-release experiment that demonstrates the value of natural seeps for oil spill science. • Novel approach to quantify floating oil thickness • Custom modified weir skimmer used with added floor and structural strengthening.

Complex Shoulder Girdle Stabilization Using Allograft Capsular Reconstruction and Pectoralis Major Transfer: A Case Report.

CASE: A 21-year-old woman with a history of multiple failed surgical and conservative management for recurrent involuntary shoulder instability presented with 1-year history of shoulder pain. Physical examination demonstrated intractable static anterior glenohumeral instability, deficient capsular tissue, with reducible scapular winging secondary to long thoracic nerve palsy. Allograft capsular reconstruction and open split pectoralis major tendon transfer were performed to salvage shoulder motion and stabilize her shoulder girdle. CONCLUSION: This report presents a novel repair option for intractable shoulder instability and scapular winging. Surgeons should recognize potential causes of shoulder instability and familiarize themselves with multiple stabilization techniques as potential salvage options before glenohumeral fusion.

Estimating exposure to hydrogen sulfide from animal husbandry operations using satellite ammonia as a proxy: Methodology demonstration.

Husbandry trace gases that have climate change implications such as carbon dioxide (CO2), methane (CH4) and ammonia (NH3) can be quantified through remote sensing; however, many husbandry gases with health implications such as hydrogen sulfide (H2S), cannot. This pilot study demonstrates an approach to derive H2S concentrations by coupling in situ and remote sensing data. Using AMOG (AutoMObile trace Gas) Surveyor, a mobile air quality and meteorology laboratory, we measured in situ concentrations of CH4, CO2, NH3, H2S, and wind at a southern California university research dairy. Emissions were 0.13, 1.93, 0.022 and 0.0064 Gg yr-1; emission factors (EF) were 422, 6333, 74, and 21 kg cow-1 yr-1, respectively, for the 306 head herd. Contributing to these strong EF were spillway emissions from a grate between the main cowshed and the waste lagoon identified in airborne remote sensing data acquired by the hyperspectral thermal infrared imager, Mako. NH3 emissions from the Chino Dairy Complex, also in southern California, were calculated from Infrared Atmospheric Sounding Interferometer (IASI) satellite data for 2008-2017 using average morning winds, yielding a flushing time of 2.7 h, and 8.9 Gg yr-1. The ratio of EF(H2S) to EF(NH3) for the research dairy from AMOG data were applied to IASI NH3 emissions to derive H2S exposure concentration maps for the Chino area, which ranged to 10-30 ppb H2S for many populated areas. Combining remote sensing with in situ concentrations of multiple emitted gases can allow derivation of emissions at the sub-facility, facility, and larger scales, providing spatial and temporal coverage that can translate into exposure estimates for use in epidemiology studies and regulation development. Furthermore, with high fidelity information at the sub-facility level we can identify best practices and opportunities to sustainably and holistically reduce husbandry emissions.

Validation of mobile in situ measurements of dairy husbandry emissions by fusion of airborne/surface remote sensing with seasonal context from the Chino Dairy Complex.

Mobile in situ concentration and meteorology data were collected for the Chino Dairy Complex in the Los Angeles Basin by AMOG (AutoMObile trace Gas) Surveyor on 25 June 2015 to characterize husbandry emissions in the near and far field in convoy mode with MISTIR (Mobile Infrared Sensor for Tactical Incident Response), a mobile upwards-looking, column remote sensing spectrometer. MISTIR reference flux validated AMOG plume inversions at different information levels including multiple gases, GoogleEarth imagery, and airborne trace gas remote sensing data. Long-term (9-yr.) Infrared Atmospheric Sounding Interferometer satellite data provided spatial and trace gas temporal context. For the Chino dairies, MISTIR-AMOG ammonia (NH3) agreement was within 5% (15.7 versus 14.9 Gg yr-1, respectively) using all information. Methane (CH4) emissions were 30 Gg yr-1 for a 45,200 herd size, indicating that Chino emission factors are greater than previously reported. Single dairy inversions were much less successful. AMOG-MISTIR agreement was 57% due to wind heterogeneity from downwind structures in these near-field measurements and emissions unsteadiness. AMOG CH4, NH3, and CO2 emissions were 91, 209, and 8200 Mg yr-1, implying 2480, 1870, and 1720 head using published emission factors. Plumes fingerprinting identified likely sources including manure storage, cowsheds, and a structure with likely natural gas combustion. NH3 downwind of Chino showed a seasonal variation of a factor of ten, three times larger than literature suggests. Chino husbandry practices and trends in herd size and production were reviewed and unlikely to add seasonality. Higher emission seasonality was proposed as legacy soil emissions, the results of a century of husbandry, supported by airborne remote sensing data showing widespread emissions from neighborhoods that were dairies 15 years prior, and AMOG and MISTIR observations. Seasonal variations provide insights into the implications of global climate change and must be considered when comparing surveys from different seasons.

Remote sensing and in situ measurements of methane and ammonia emissions from a megacity dairy complex: Chino, CA.

Methane (CH4) and ammonia (NH3) directly and indirectly affect the atmospheric radiative balance with the latter leading to aerosol generation. Both have important spectral features in the Thermal InfraRed (TIR) that can be studied by remote sensing, with NH3 allowing discrimination of husbandry from other CH4 sources. Airborne hyperspectral imagery was collected for the Chino Dairy Complex in the Los Angeles Basin as well as in situ CH4, carbon dioxide (CO2) and NH3 data. TIR data showed good spatial agreement with in situ measurements and showed significant emissions heterogeneity between dairies. Airborne remote sensing mapped plume transport for ∼20 km downwind, documenting topographic effects on plume advection. Repeated multiple gas in situ measurements showed that emissions were persistent on half-year timescales. Inversion of one dairy plume found annual emissions of 4.1 × 105 kg CH4, 2.2 × 105 kg NH3, and 2.3 × 107 kg CO2, suggesting 2300, 4000, and 2100 head of cattle, respectively, and Chino Dairy Complex emissions of 42 Gg CH4 and 8.4 Gg NH3 implying ∼200k cows, ∼30% more than Peischl et al. (2013) estimated for June 2010. Far-field data showed chemical conversion and/or deposition of Chino NH3 occurs within the confines of the Los Angeles Basin on a four to six h timescale, faster than most published rates, and likely from higher Los Angeles oxidant loads. Satellite observations from 2011 to 2014 confirmed that observed in situ transport patterns were representative and suggests much of the Chino Dairy Complex emissions are driven towards eastern Orange County, with a lesser amount transported to Palm Springs, CA. Given interest in mitigating husbandry health impacts from air pollution emissions, this study highlights how satellite observations can be leveraged to understand exposure and how multiple gas in situ emissions studies can inform on best practices given that emissions reduction of one gas could increase those of others.

Linear and nonlinear two-coordinate vanadium complexes: synthesis, characterization, and magnetic properties of V(II) amides.

The synthesis and characterization of the first stable two-coordinate vanadium complexes are described. The vanadium(II) primary amido derivative V{N(H)Ar(iPr6)}2 [Ar(iPr6) = C6H3-2,6-(C6H2-2,4,6-iPr3)2] (1) was synthesized via the reaction of LiN(H)Ar(iPr6) with the V(III) complex VCl3·2NMe3 or the V(II) salt [V2Cl3(THF)6](+)I(-) in a 2:1 and 4:1 stoichiometry, respectively. Reaction of the less crowded LiN(H)Ar(Me6) with [V2Cl3(THF)6](+)I(-) afforded V{N(H)Ar(Me6)}2 [Ar(Me6) = C6H3-2,6-(C6H2-2,4,6-Me3)2] (2), which has a nonlinear [N-V-N = 123.47(9)°] vanadium coordination. Magnetometry studies showed that V{N(H)Ar(iPr6)}2 and V{N(H)Ar(Me6)}2 have ambient temperature magnetic moments of 3.41 and 2.77 µB, respectively, which are consistent with a high-spin d(3) electron configuration. These values suggest a significant spin orbital angular momentum contribution that leads to a magnetic moment that is lower than their spin-only value of 3.87 µB. DFT calculations showed that the major absorptions in their UV-vis spectra were due to ligand to metal charge transfer transitions. Exposure of the reaction mixture for 2 to dry O2 resulted in the formation of the diamagnetic V(V) oxocluster [V{N(H)Ar(Me6)}2]2(µ-O-Li-O)2 (3).

Reliability of video motion-analysis systems to measure amplitude and velocity of shoulder elevation.

CONTEXT: Dynamic shoulder motion can be captured using video capture systems, but reliability has not yet been established. OBJECTIVE: To compare the reliability of 2 systems in measuring dynamic shoulder kinematics during forward-elevation movements and to determine differences in these kinematics between healthy and injured subjects. DESIGN: Reliability and cohort. SETTING: Research laboratory. PARTICIPANTS: 11 healthy subjects and 10 post-superior labrum anteroposterior lesion patients (SLAP). INTERVENTION: Contrasting markers were placed at the hip, elbow, and shoulder to represent shoulder elevation and were videotaped in 2 dimensions. Subjects performed 6 repetitions of active elevation (AE) and active assisted elevation of the shoulder, and 3 trials were analyzed using Datapac (comprehensive system) and Dartfish (basic system). MAIN OUTCOME MEASURES: Amplitudes and velocities of the shoulder angle were calculated. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and levels of agreement (LOA) were used to determine intersystem and intertrial reliability. RESULTS: For AE, the amplitude maximum (ICC = .98-.99, SEM = 2-3°, LOA = -9° to 5°) and average velocity (ICC = .94-.97, SEM = 1°/s, LOA = -4° to 1°/s) indicated excellent intersystem reliability between systems. Intratrial reliability for minimum velocity was moderate for Datapac (ICC = .64, SEM = 4°/s, LOA = 7°/s) and poor for Dartfish (ICC = .52, SEM = 20°/s, LOA = 37°/s). Cohort results demonstrated for AE a greater amplitude for healthy v SLAP (139° ± 11° v 113° ± 13°; P = .001) and interaction for an average velocity increase of 2°/s in healthy and decrease of 2°/s in SLAP patients over the 3 trials (P = .02). CONCLUSIONS: Reliability ranges provide the means to assess the clinical meaningfulness of results. The cohort differences are supported when the values exceed the ranges of the SEM; hence the amplitude results are meaningful. For dynamic shoulder elevation measured using video, the assessment of velocity was found to produce moderate to good reliability. The results suggest that with these measures subtle changes in both measures may be possible with further investigations.

Optical detection of honeybees by use of wing-beat modulation of scattered laser light for locating explosives and land mines.

An instrument is demonstrated that can be used for optical detection of honeybees in a cluttered environment. The instrument uses a continuous-wave diode laser with a center wavelength of 808 nm and an output power of 28 mW as the laser transmitter source. Light scattered from moving honeybee wings will produce an intensity-modulated signal at a characteristic wing-beat frequency (170-270 Hz) that can be used to detect the honeybees against a cluttered background. The optical detection of honeybees has application in the biological detection of land mines and explosives, as was recently demonstrated.