Search

Introduction: The minimal clinically important difference (MCID) is a valuable tool for patient-based outcome analysis, for which limited data is available in the literature, especially after arthroscopic rotator cuff repair (ARCR). Although several studies have reported MCID after ARCR, few have studied the impact of various clinical factors such as Diabetes, pseudoparalysis, type of cuff repair, and retear over MCID. This study attempts to determine the MCID in shoulder functional scores after ARCR and the impact of various factors on MCID. Methods: 144 patients undergoing ARCR were prospectively evaluated at six and 12 months by ASES and UCLA scores. MCID for American Shoulder and Elbow Surgeons (ASES) and the University of California and Los Angeles (UCLA) scores were calculated using an anchor-based and distribution-based approach. MCID was also calculated for diabetic and non-diabetic patients, smokers vs. non-smokers, presence or absence of pseudoparalysis, type of cuff repair (single row vs. suture bridge), and presence of retears. Uni- and multivariate analysis was performed to identify factors affecting the MCID of both scores. Results: Mean MCID for ASES score was 13.3 and 16.6 using an anchor-based and distribution-based approach, respectively. For the UCLA score, the mean MCID was 10.0 and 12.6 by anchor-based and 12.6 by distribution-based approach, respectively. Patients with higher pre-operative ASES scores demonstrated lower MCID values. No significant difference was observed in MCID scores of diabetic vs. non-diabetic patients, smoker vs. non-smoker, patients with or without pseudoparalysis, and type of cuff repair. The age, gender, and presence of retear did not affect MCID values. Conclusion: This study establishes the MCID values of ASES and UCLA scores for rotator cuff repair by anchor and distribution methods. No patient or surgical factors appear to affect the MCID except pre-operative ASES scores. Study design: Prospective cohort, Level II. [ABSTRACT FROM AUTHOR]

The Netherlands and Denmark are the two biggest pig meat exporters in Europe, both with a strong focus on the German market. The structure of pig farms is very different: an average Danish pig farm has 3500 pigs, 170 ha of agricultural land on which a major part of the feed cereals are grown, whereas a typical Dutch pig farm has 2500 pigs with only 10 ha. As a consequence, Dutch pig farmers have to purchase all feedstuff and need to dispose nearly all the manure off-farm. A literature based study revealed that the main factors for the contrasting development were a stronger competition for land, resulting in higher land prices, and stimulation of intensive animal husbandry in the Netherlands, while in Demark environmental policies more strongly coupled manure production to land area. As a result the Dutch pig farmers have focused on intensification of livestock production on small holdings using external sources of feed supply, and Danish farmers on efficient production of feed cereals on large holdings. Due to a gradual lowering of manure and fertiliser application standards, Dutch farmers increasingly have to process manure and export manure, further increasing the total costs of pig production. Manure disposal costs per kg of slaughter weight in 2011 were on average 3.5 times higher in the Netherlands than in Denmark. Manure is exported mainly to Germany and France, which also supply the feed cereals. Therefore manure export contributes to closure of nutrient cycles. Danish pig farmers are less sensitive to nutrient policies and feed prices than those in the Netherlands, but the high debt rate makes the sector vulnerable to low pig prices. [ABSTRACT FROM AUTHOR]

Emphasizes the need for communicating scientific information to general public by researchers. Importance of the popularization of research in keeping the masses informed about various changes in science; Sources for disseminating information; Tips for scientists to enhance their writing skills.

In the context of public introductions to emerging technologies, this study examined effects of priming and Web site interactivity on adolescents' attitude development and information processing. In a four (priming) by three (interactivity levels) experiment, participants (N = 273) were required to search for and process Web-based information about ecogenomics. Results showed that priming ecogenomics as biotechnology, ecology, economy, or science in general did not affect attitude development. Interactivity levels, manipulated as low, medium, and high, were found to influence adolescents' time invested in the information-processing task, perceived cognitive load, and Web site evaluations. [ABSTRACT FROM AUTHOR]

Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group formed from a number of Dutch specialist societies, joined by the Dutch Orthopedic Association, has produced a guideline based on the available scientific evidence. This resulted in a new outlook for the treatment of subacromial pain syndrome. The important conclusions and advice from this work are as follows: (1) The diagnosis SAPS can only be made using a combination of clinical tests. (2) SAPS should preferably be treated non-oper-atively. (3) Acute pain should be treated with analgetics if necessary. (4) Subacromial injection with corticosteroids is indicated for persistent or recurrent symptoms. (5) Diagnostic imaging is useful after 6 weeks of symptoms. Ultrasound examination is the recommended imaging, to exclude a rotator cuff rupture. (6) Occupational interventions are useful when complaints persist for longer than 6 weeks. (7) Exercise therapy should be specific and should be of low intensity and high frequency, combining eccentric training, attention to relaxation and posture, and treatment of myofascial trigger points (including stretching of the muscles) may be considered. (8) Strict immobilization and mobilization techniques are not recommended. (9) Tendinosis calcarea can be treated by shockwave (ESWT) or needling under ultrasound guidance (barbotage). (10) Rehabilitation in a specialized unit can be considered in chronic, treatment resistant SAPS, with pain perpetuating behavior. (11) There is no convincing evidence that surgical treatment for SAPS is more effective than conservature management. (12) There is no indication for the surgical treatment of asymptomatic rotator cuff tears. [ABSTRACT FROM AUTHOR]

Crop-livestock production systems are the largest cause of human alteration of the global nitrogen (N) and phosphorus (P) cycles. Our comprehensive spatially explicit inventory of N and P budgets in livestock and crop production systems shows that in the beginning of the 20th century, nutrient budgets were either balanced or surpluses were small; between 1900 and 1950, global soil N surplus almost doubled to 36 trillion grams (Tg).y-1 and P surplus increased by a factor of 8 to 2 Tg.y-1. Between 1950 and 2000, the global surplus increased to 138 Tg.y-1 of N and 11 Tg.y-1 of P. Most surplus N is an environmental loss; surplus P is lost by runoff or accumulates as residual soil P. The International Assessment of Agricultural Knowledge, Science, and Technology for Development scenario portrays a world with a further increasing global crop (+82% for 2000-2050) and livestock production (+115%); despite rapidly increasing recovery in crop (+35% N recovery and +6% P recovery) and livestock (+35% N and P recovery) production, global nutrient surpluses continue to increase (+23% N and +54% P), and in this period, surpluses also increase in Africa (+49% N and +236% P) and Latin America (+75% N and +120% P). Alternative management of livestock production systems shows that combinations of intensification, better integration of animal manure in crop production, and matching N and P supply to livestock requirements can effectively reduce nutrient flows. A shift in human diets, with poultry or pork replacing beef, can reduce nutrient flows in countries with intensive ruminant production. [ABSTRACT FROM AUTHOR]