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Frailty, as quantified by the modified frailty index (mFI), has emerged as a promising method to identify patients at high risk of complications after surgery. Several studies have shown that frailty, as opposed to age, is more predictive of adverse surgical outcomes. We hypothesized that a 5-item mFI could be used to identify patients at elevated risk of complications after total shoulder arthroplasty (TSA). We identified patients aged 50 years or older who underwent TSA in the American College of Surgeons National Surgical Quality Improvement Program database. Pearson χ2 analysis and linear regression were used to determine the association of the mFI score with 30-day postoperative complications, reoperation, readmission, length of stay (LOS), adverse hospital discharge, and mortality rate. The study included 9861 patients with a mean age of 70 years. As the mFI score increased from 0 to 2 or greater, the following rates increased: postoperative complications from 4.2% to 9.4%, readmission from 1.6% to 4.4%, adverse hospital discharge from 6.3% to 19.6%, and LOS from 1.88 days to 2.43 days (P <.001). Multivariate analysis showed that patients with an mFI score of 2 or greater were over twice as likely to sustain a postoperative complication (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.86-3.10), readmission (OR, 2.80; 95% CI, 1.88-4.17), reoperation (OR, 1.82; 95% CI, 1.02-3.25), and adverse hospital discharge (OR, 3.14; 95% CI, 2.51-3.92). These effects were all significantly higher compared with age. Frailty is associated with increased rates of 30-day postoperative complications, readmission, reoperation, adverse hospital discharge, and hospital LOS after TSA. Use of a simple frailty evaluation may help inform decision making and risk assessment when considering TSA. [ABSTRACT FROM AUTHOR]

Abstract: After decades of speculation and attempted synthesis, terminal metal-oxo compounds of the late transition metal elements have been prepared. Terminal Pt-, Pd-, and Au-oxo complexes have been made using polytungstate ligands that share geometrical and electronic structural features and chemical properties (acid-base and others) in common with the metal oxides used as supports for these metals in myriad industrial catalytic processes.Up to 17 techniques, many addressed in this review, have been used to confirm the Late Transition Metal Oxo (LTMO) species exist and arise from direct reaction with O2. Metal organic frameworks (MOFs) that catalyze the oxidation of organic substrates using O2/air as the terminal oxidant are also described. Molecules or materials with this capability could be used to make fabrics, surfaces, nanostructures and other materials that catalytically purify and decontaminate using only ambient air. [Copyright &y& Elsevier]