Arthroscopic remplissage is safe and effective: clinical and magnetic resonance results at a minimum 3 years of follow-up

Background Large Hill–Sachs lesions are considered a risk factor for recurrence of instability after arthroscopic Bankart repair alone. The aim of this study was to demonstrate that remplissage is a safe procedure that effectively reduces the risk of recurrent dislocations without causing fatty degeneration of the infraspinatus at medium-term follow-up. Methods Patients who underwent arthroscopic Bankart repair and remplissage with a minimum 3 years of follow-up were included. Constant–Murley (CMS), American Shoulder and Elbow Surgeons (ASES), and Walch–Duplay scores were evaluated. Magnetic resonance imaging (MRI) was performed to detect the appearance of fatty infiltration inside the infraspinatus muscle, the percentage of the Hill–Sachs lesion filled by the tendon and its integration, and the onset of rotator cuff tears. Results Thirteen patients (14 shoulders) with a mean follow-up of 55.93 (± 18.16) months were enrolled. The Walch–Duplay score was 95.00 [87.25–100.00], with a return to sport rate of 100%. Both the CMS and the ASES indicated excellent results. The affected shoulders showed a statistically significant reduction in active external rotation both with the arm at the side (ER1) and with the arm at 90° of abduction (ER2) (p = 0.0005 and p = 0.0010, respectively). A reduction in infraspinatus isometric strength was found for both ER1 and ER2, but this reduction was only statistically relevant in ER2 (p = 0.0342). There was a traumatic recurrence of instability in two cases (14.28%). MRI evaluation demonstrated an absence of adipose infiltration in 50% of cases and only a minimal amount in the remaining 50%. In 12 cases (85.72%), the capsulotenodesis completely filled the lesion and good tendon–bone integration was observed. Conclusion Arthroscopic remplissage provided successful clinical outcomes without fatty infiltration of the infraspinatus and with good healing of the tissues. The low risk of recurrence was associated with an objective limitation on active external rotation, but this did not influence the patients' daily or sports activities. Level of evidence: Cohort study, level of evidence 3.

Adaptive Erasure Coded Fault Tolerant Linear System Solver

As parallel and distributed systems scale, fault tolerance is an increasingly important problem—particularly on systems with limited I/O capacity and bandwidth. Erasure coded computations address this problem by augmenting a given problem instance with redundant data and then solving the augmented problem in a fault oblivious manner in a faulty parallel environment. In the event of faults, a computationally inexpensive procedure is used to compute the true solution from a potentially fault-prone solution. These techniques are significantly more efficient than conventional solutions to the fault tolerance problem. In this article, we show how we can minimize, to optimality, the overhead associated with our problem augmentation techniques for linear system solvers. Specifically, we present a technique that adaptively augments the problem only when faults are detected. At any point in execution, we only solve a system whose size is identical to the original input system. This has several advantages in terms of maintaining the size and conditioning of the system, as well as in only adding the minimal amount of computation needed to tolerate observed faults. We present, in detail, the augmentation process, the parallel formulation, and evaluation of performance of our technique. Specifically, we show that the proposed adaptive fault tolerance mechanism has minimal overhead in terms of FLOP counts with respect to the original solver executing in a non-faulty environment, has good convergence properties, and yields excellent parallel performance. We also demonstrate that our approach significantly outperforms an optimized application-level checkpointing scheme that only checkpoints needed data structures.

COOLING PERFORMANCE OF ADDITIVELY MANUFACTURED PIN FINS IN STACKED MICROCHANNELS FOR THE INSIDE-OUT CERAMIC TURBINE SHROUD-COOLING RING

The Inside-out ceramic turbine (ICT), a novel microturbine rotor architecture, has an air-cooled ring which keeps its composite rotating structural shroud within operating temperature. The cooling ring must achieve a significant radial temperature gradient with a minimal amount of cooling. The cooling ring is made through additive manufacturing, which opens the design space to tailored cooling geometries. Additively manufactured pin fin heat transfer enhancers are explored in this work to assess whether they hold any significant performance benefit over current rectangular cross-section open channels. Experimental friction factors and Nusselt numbers were determined for small, densely-packed pin fins over an asymmetrical thermal load. Results indicate that pressure loss is similar to what can be expected for additively manufactured pin fins, whereas heat transfer is lower due to the extremely tight streamwise pin spacing, in both in-line and staggered pin configurations. A design study presented in this paper suggests that pin fins are beneficial to an ICT for reducing cooling mass flow rate up to 40 %, against an increase in cooling ring mass of roughly 50%.

A loop-mediated isothermal DNA amplification (LAMP) assay for detection of the clubroot pathogen Plasmodiophora brassicae

Clubroot caused by Plasmodiophora brassicae is a serious threat to cruciferous crops around the world. The resting spores of P. brassicae are primary source of infection and can survive in soil for many years. Detection of resting spores in soil is essential for forecasting clubroot prevalence. Detection of P. brassicae has been relying on plant bioassays or polymerase chain reaction (PCR)-based methods. The loop-mediated isothermal DNA amplification (LAMP) is a promising approach for microorganism detection with the advantage of high sensitivity, being accurate and convenient to visualize. In this study, we developed a LAMP assay for detection of P. brassicae in soil, roots and seeds. This method can detect P. brassicae at a minimal amount of 1 fg plasmid DNA or 10 resting spores in the soil. Compared to conventional PCR, the LAMP was more sensitive in detection P. brassicae at the lower levels in soil samples. In conclusion, we elaborated a sensitive, accurate and easy-to-use LAMP assay to detect P. brassicae, which will facilitate to plan sustainable clubroot management.

Thermal Characterization of Non-Functionalized Low Content Graphene Nanoplatelets (GNP) Added Nylon 66 Polymer

Thermal behaviour of graphene nanoplatelets (GNP) reinforced nylon 66 nanocomposites were investigated using differential calorimetric scanning (DSC), thermogravimetric analyzer (TGA) and dynamic mechanical analysis (DMA). The influence of low content GNP on thermal properties of GNP/nylon 66 nanocomposites was studied for low GNP content (0.3, 0.5 and 1.0 wt%). DSC results indicate that addition of GNP increases crystallization temperature and degree of crystallinity of the nanocomposites. Thermal stability and mass loss were studied through TGA analysis. The results show that thermal stability and weight loss of GNP/nylon 66 nanocomposites slightly improve with the GNP addition with an increase in the onset of degradation temperature as much as 10 °C. DMA analysis shows that GNP in the nylon 66 matrix act similar to plasticizer; it decreases the storage modulus and glass transition temperatures of the nanocomposites. GNP addition also reduces tan δ indicating an improvement in the damping property of the nanocomposites. Overall, this study concludes that a minimal amount of 0.3 wt% of GNP is effective in improving the thermal properties of nylon 66 composites.

Holographic M5 branes in AdS7 × S4

We study classical M5 brane solutions in the probe limit in the AdS7× S4 background geometry that preserve the minimal amount of supersymmetry. These solutions describe the holography of codimension-2 defects in the 6d boundary dual $$ \mathcal{N} $$ N = (0, 2) supersymmetric gauge theories. The general solution is described in terms of holomorphic functions that satisfy a scaling condition. We show the behavior of the world-volume of a special class of BPS solutions near the AdS boundary region can be characterized by general equations, which describe it as intersections of the zeros of holomorphic functions in three complex variables with a 5-sphere.

Para-aortic lymphadenopathy associated with adult COVID-19 multisystem inflammatory syndrome

A 21-year-old woman arrived at the emergency department with dyspnoea, arterial hypotension and abdominal pain after 5 days with a influenza-like syndrome. SARS-CoV-2 was detected by reverse transcription PCR in a nasopharyngeal swab specimen. CT of the chest and abdomen with contrast demonstrated a minimal amount of free intraperitoneal fluid, gallbladder with wall oedema, multiple para-aortic lymph node and interlobular septal thickening with ground glass opacities on the lungs. No pleural effusion or thromboembolism. Early broad-spectrum antibiotics, high-flow nasal cannula and norepinephrine were started. She was successfully treated with intravenous immunoglobulin and pulse corticosteroid therapy with methylprednisolone. The patient was discharged home with complete resolution of her symptoms and returned to her previous health status.

Whole body regeneration and developmental competition in two botryllid ascidians

Background Botryllid ascidians are a group of marine invertebrate chordates that are colonial and grow by repeated rounds of asexual reproduction to form a colony of individual bodies, called zooids, linked by a common vascular network. Two distinct processes are responsible for zooid regeneration. In the first, called blastogenesis, new zooids arise from a region of multipotent epithelium from a pre-existing zooid. In the second, called whole body regeneration (WBR), mobile cells in the vasculature coalesce and are the source of the new zooid. In some botryllid species, blastogenesis and WBR occur concurrently, while in others, blastogenesis is used exclusively for growth, while WBR only occurs following injury or exiting periods of dormancy. In species such as Botrylloides diegensis, injury induced WBR is triggered by the surgical isolation of a small piece of vasculature. However, Botryllus schlosseri has unique requirements that must be met for successful injury induced WBR. Our goal was to understand why there would be different requirements between these two species. Results While WBR in B. diegensis was robust, we found that in B. schlosseri, new zooid growth following injury is unlikely due to circulatory cells, but instead a result of ectopic development of tissues leftover from the blastogenic process. These tissues could be whole, damaged, or partially resorbed developing zooids, and we defined the minimal amount of vascular biomass to support ectopic regeneration. We did find a common theme between the two species: a competitive process exists which results in only a single zooid reaching maturity following injury. We utilized this phenomenon and found that competition is reversible and mediated by circulating factors and/or cells. Conclusions We propose that WBR does not occur in B. schlosseri and that the unique requirements defined in other studies only serve to increase the chances of ectopic development. This is likely a response to injury as we have discovered a vascular-based reversible competitive mechanism which ensures that only a single zooid completes development. This competition has been described in other species, but the unique response of B. schlosseri to injury provides a new model to study resource allocation and competition within an individual.

Influence of Preseason Versus In-Season Play on Achilles Tendon Injuries in the National Football League

Background: A ruptured Achilles tendon (AT) can sideline a player for 6 to 12 months and reduce their power rankings by more than 50%. Previous research has compared AT rupture rates in different game conditions. Purpose: To determine environmental and physiological risk factors for AT tears, given the minimal amount of research on AT ruptures in the National Football League (NFL). Study Design: Case series; Level of evidence, 4. Methods: NFL players with a diagnosed AT tear between 2009 and 2016 were selected as the study population for this retrospective analysis. Data on NFL injury were collected from an established database composed of publicly available information. Player profiles were employed to determine position, team, and game statistics at the time of injury. The proportion of NFL rookies was approximated by summing the number of draft picks and the number of signed, undrafted free agents and measured against the number of roster spots before the season. Results: Between 2009 and 2016, there were 101 documented AT tears. Of these, 64% (65/101) occurred before the official season, including preseason games. Of the 36 tears that occurred in-season, 34 were during games. Overall, 29% (19/65) of the preseason tears occurred in rookies and 100% (36/36) of the in-season tears affected nonrookies. Of the rookies with AT ruptures, 42.11% returned to play in the NFL, while 62.20% of the nonrookies came back to partake in future seasons. Despite an average age of 26.7 years, the tear distribution was bimodal with players aged 24 and 36 years exhibiting the highest rates of tear. Conclusion: In our review of AT tears in NFL athletes, a large percentage of the tears occurred in rookie players, especially during the preseason. We also found that tears during the season occurred in only nonrookies, suggesting that the preseason is when rookies experience the greatest risk for injury.