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Rotator cuff tears are one of the more frequent pathologies of the shoulder. Arthroscopic techniques and biologic augmentation have been developed to improve the rate and quality of healing. The crimson duvet procedure (CDP) theoretically provides mesenchymal stem cells through microfracture treatment of the footprint. The aim of this research was to evaluate the effect of CDP in patients who had undergone arthroscopic surgery for complete rotator cuff repair. A prospective randomized clinical trial was performed in a total of 123 patients, consisting of 59 women and 64 men, with a mean age of 58 years. We included patients with a clinical and radiologic diagnosis of a complete rotator cuff tear. All patients were treated with arthroscopic rotator cuff repair. In group 1, the surface of the footprint was débrided; in group 2, the footprint underwent microfracture. The primary outcome was the nonhealing rate, which was detected by magnetic resonance imaging (MRI) or ultrasonography, and the secondary outcome was the functional result. A Sugaya classification of I to III was considered to indicate healing. For clinical evaluation, the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Constant scores were evaluated, along with the range of motion. The functional evaluation was performed preoperatively and at 6 months and 1 year postoperatively. The radiologic (MRI or ultrasonography) evaluation was performed at 6 months. Neither the patients nor the radiologists and physical therapists who performed the postoperative evaluations were informed of the random selection. We observed a healing rate of 85.11% in the control group and 93.7% in the CDP group, which was not significant (P =.19). However, a significant improvement in function was observed in all patients. The ASES score improved from 68.9 (SD 13.8) preoperatively to 92.2 at 6 months and to 96.4 (SD 6.2) at 12 months (P <.05), but no difference was observed between the groups. A similar level of improvement was observed in the Constant score. The arthroscopic repair of complete rotator cuff tears presents good and excellent clinical results in most patients. Nevertheless, nonhealing occurs at a rate that depends mainly on the age of the patient and the size of the tear. The addition of CDP did not improve the functional results or the healing rate. [ABSTRACT FROM AUTHOR]

The use of routine imaging with 18F-FDG PET-CT (PET-CT) in melanoma surveillance is debated and evidence of its diagnostic value and yield in asymptomatic patients is limited. Denmark introduced nationwide routine surveillance with PET-CT in high-risk patients in 2016. The aim of this study was to examine the sensitivity, specificity, negative and positive predictive values, numbers-needed-to-scan and clinical impact of routine PET-CT in the surveillance of asymptomatic stage IIB-III melanoma patients. Data was retrieved from the population-based Danish Melanoma Database and patient records. All patients diagnosed with stage IIB-III melanoma at two University Hospitals in 2016 and 2017 were included. Patients underwent surveillance with clinical examinations and PET-CT scans at 6, 12, 24 and 36 months. In 138 patients, 243 routine PET-CTs were performed within a median follow-up time of 17.7 months. Routine PET-CT detected recurrence at least once in 25 patients (18.1%), including distant recurrence in 19 patients (13.8%). Stage IIB patients had the lowest recurrence rate (11.1%). Numbers-needed-to-scan to detect one distant recurrence was 12.8 patients and median time-to-recurrence was 6.8 months. Sensitivity was 100%, specificity was 94.7% and negative and positive predictive values were 100% and 74.4%, respectively. False positive findings prompted 22 additional investigations (of which ten invasive) in 17 patients (12.3%). Routine PET-CT has a high sensitivity and specificity when used in high-risk melanoma surveillance. Time-to-recurrence and stage-specific recurrence rates indicate high gain of early routine imaging at six months especially for stage IIC and III patients. • Sensitivity of routine PET-CT was 100% and specificity was 94.7% • Routine PET-CT detected recurrence in 18.1% of patients within 17.7 months • PET-CT detected asymptomatic distant recurrence in 13.8% of patients • Median time-to-recurrence was 6.8 months, indicating a gain of imaging at 6 months • Results indicate a lower yield of early routine PET-CT in stage IIB patients [ABSTRACT FROM AUTHOR]

There is abundant literature about the impact of residential insulation on energy consumption using different methods. However, ex-post evaluation methods have not been used yet, which are helpful when the participants in a program are not chosen randomly. Therefore, this study performs the first ex-post evaluation of a residential insulation program using the "matching with differences-in-differences" method. This non-experimental method allows obtaining the causal impact of the program since it controls for observable factors and non-observable factors that are invariable over time. The data comes from a unique survey that includes energy consumption for heating and control variables for households benefited and not benefited by the program, both in the year before and after the retrofit. The results show that the residential insulation program does not significantly reduce energy consumption or external PM 2.5 emissions in the treated dwellings. Still, there is a significant increase in the perception of thermal comfort associated with the rebound effect. Thus, it is concluded that the program has not been an effective tool to reduce air pollution, but it improves the quality of life through an increase in thermal comfort. • This is the first study using ex-post techniques to evaluate a residential insulation program. • The "matching with differences-in-differences" method is used. • The program does not reduce energy consumption or external PM 2.5 emissions. • The program increases the perception of thermal comfort associated with the rebound effect. [ABSTRACT FROM AUTHOR]

Objective: Pregestational maternal obesity (PGMO) associates with foetoplacental vascular endothelial dysfunction and higher risk for insulin resistance in the neonate. We characterised the PGMO consequences on the insulin response of the human foetoplacental vasculature.Methods: Umbilical veins were from pregnancies where the mother was with PGMO (body mass index 30-42.3 kg/m2, n = 33) or normal pregestational weight (PGMN) (body mass index 19.5-24.4 kg/m2, n = 21) with total gestational weight gain within the physiological range. Umbilical vein ring segments were mounted in a myograph for isometric force measurements. Primary cultures of human umbilical vein endothelial cells were used in passage 3. Vessel rings and cells were exposed to 1 nmol/L insulin (20 min) in the absence or presence of 100 μmol/L NG-nitro-l-arginine methyl ester (inhibitor of nitric oxide synthase, NOS).Results: Vessel rings from PGMO showed reduced nitric oxide synthase-activity dependent dilation to insulin or calcitonin-gene related peptide compared with PGMN. PGMO associated with higher inhibitor phosphorylation of the insulin receptor substrate 1 (IRS-1) and lower activator phosphorylation of protein kinase B/Akt (Akt). Cells from PGMO also showed lower nitric oxide level and reduced activator serine1177 but increased inhibitor threonine495 phosphorylation of endothelial nitric oxide synthase (eNOS) and saturable transport of l-arginine. HUVECs from PGMO were not responsive to insulin.Conclusion: The lack of response to insulin by the foetoplacental endothelium may result from reduced IRS-1/Akt/eNOS signalling in PGMO. These findings may result in higher risk of insulin resistance in neonates to PGMO pregnancies. [ABSTRACT FROM AUTHOR]

Abstract This study provides an optimization model that explicitly determines the 'optimal' level of pollution of fine particulate matter (PM 2.5) by analyzing various options for reducing emissions from industrial and residential sources in the second largest urban area in Chile. Several conclusions that had not been previously addressed or sufficiently highlighted in the literature were discerned. The most notable conclusions included the importance of regulating all emission sources and not just industrial sources (which are typically fewer in number and easier to monitor), the homogeneity in 'optimal' levels of pollution from urban districts when considering the long-term effects on human health (which would support the adoption of uniform regulations), and the asymmetry in confidence intervals associated to the 'optimal' level of pollution. [ABSTRACT FROM AUTHOR]

Anthropogenically induced global climate change has caused profound impacts in the world ocean. Climate change related stressors, like ocean acidification (OA) and warming (OW) can affect physiological performance of marine species. However, studies evaluating the impacts of these stressors on algae-herbivore interactions have been much more scarce. We approached this issue by assessing the combined impacts of OA and OW on the physiological energetics of the herbivorous snail Tegula atra , and whether this snail is affected indirectly by changes in biochemical composition of the kelp Lessonia spicata , in response to OA and OW. Our results show that OA and OW induce changes in kelp biochemical composition and palatability (organic matter, phenolic content), which in turn affect snails' feeding behaviour and energy balance. Nutritional quality of food plays a key role on grazers' physiological energetics and can define the stability of trophic interactions in rapidly changing environments such as intertidal communities. [Display omitted] • Ocean acidification (OA) and warming (OW) alter algae-herbivore interactions • OA and OW modify biochemical composition of the kelp Lessonia spicata. • Changes in kelp biochemical composition affect snail's feeding behaviour. • OW and OA conditions increased snail's metabolic stress. • Nutritional quality of food plays a key role on grazers' physiological energetics. [ABSTRACT FROM AUTHOR]

Increasing levels of A rtificial L ight A t N ight (ALAN) alter the natural diel cycles of organisms at global scale. ALAN constitutes a potential threat to the light-dependent functioning of symbiotic scleractinian corals, the habit-founders of warm, shallow water reefs. Here, we show that ALAN disrupts the natural diel tentacle expansion and contraction behaviour, a key mechanism for prey capture and nutrient acquisition in corals. We exposed four symbiotic scleractinian coral species to different ALAN treatments (0.4–2.5 μmol quanta m−2 s−1). Exposure to ALAN levels of 1.2 μmol quanta m−2 s−1 and above altered the normal tentacle expansion response in diurnal species (Stylophora pistillata and Duncanopsammia axifuga). The tentacle expansion pattern of nocturnal species (Montastraea cavernosa and Lobophyllia hemprichii) was less affected, which may indicate a greater capacity to tolerate ALAN exposure. The results of this work suggest that ALAN has the potential to affect nutrient acquisition mechanisms of symbiotic corals which may in turn result in changes in the coral community structure in shallow water reefs in ALAN-exposed areas. • Artificial light at night disrupts the natural diel tentacle expansion behaviour of symbiotic corals. • Diurnal corals were more affected by ALAN exposure compared to nocturnal corals. • ALAN exposure of ∼1.2 μmol quanta m−1 s−1 (∼10 lx) represents a critical threshold value for tentacle expansion behaviour. [ABSTRACT FROM AUTHOR]

We consider the problem of analyzing the structure of spectroscopic cubes using unsupervised machine learning techniques. We propose representing the target’s signal as a homogeneous set of volumes through an iterative algorithm that separates the structured emission from the background while not overestimating the flux. Besides verifying some basic theoretical properties, the algorithm is designed to be tuned by domain experts, because its parameters have meaningful values in the astronomical context. Nevertheless, we propose a heuristic to automatically estimate the signal-to-noise ratio parameter of the algorithm directly from data. The resulting light-weighted set of samples ( ≤ 1 % compared to the original data) offer several advantages. For instance, it is statistically correct and computationally inexpensive to apply well-established techniques of the pattern recognition and machine learning domains; such as clustering and dimensionality reduction algorithms. We use ALMA science verification data to validate our method, and present examples of the operations that can be performed by using the proposed representation. Even though this approach is focused on providing faster and better analysis tools for the end-user astronomer, it also opens the possibility of content-aware data discovery by applying our algorithm to big data. [ABSTRACT FROM AUTHOR]

Pinnatoxins (PnTXs) produced by the cosmopolitan dinoflagellate Vulcanodinium rugosum are highly potent cyclic imines that represent a risk for seafood consumers, artisanal fisheries, and the local aquaculture industry. Among the eight known PnTXs, pinnatoxin-G (PnTX-G) is the most frequent toxin analog detected in shellfish. Despite PnTX-G is still not internationally regulated, the French Agency for Food, Environmental and Occupational Health and Safety established that a risk for human consumers may exist when the accumulation of PnTX-G in shellfish exceeds 23 μg kg−1. This study reports the first detection of these fast-acting lipophilic toxins in localized shellfish banks (Mytilus chilensis) from the Chilean coast. Among 32 sentinel sampling stations monthly monitored for phytotoxins detection and quantification between 2021 and 2022 along the southern Chilean coast (from 36°25′ S to 54°57′S), PnTx-G was only detected in shellfish from the southernmost region of Magallanes in concentrations that ranged between 15 and 100 μg kg−1, highlighting the binational (Chile/Argentina) Beagle Channel as a 'hotspot'. As Chile is one of the major mussel producers worldwide, this result raises concern about the potential adverse effect of PnTXs for human health and point to the need of governmental actions for an enhanced monitoring of these emerging toxins. To date, the production of PnTXs has not yet been associated with any microalgae species in Chilean waters. • First localized detection of Pinnatoxin-G (PnTx-G) in the Chilean coast. • PnTx-G was only detected in shellfish banks from the Magallanes region. • The highest PnTx-G concentrations were detected in the Beagle channel. • PnTx-G has not yet been linked with any microalgae species in Chilean waters. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to compare open and arthroscopic surgical techniques for "cam-type" femoroacetabular impingement in terms of feasibility and reliability. Methods: We used 5 fresh-frozen cadaver specimens (10 hips). Anteroposterior and cross-table radiographs were taken for each. The head-neck union diameter was measured for each. The amount of bone resection at the anterolateral quadrant of the head-neck union was planned for each, with specific references to width, length, depth, and position. One side was randomly assigned to the open group and the other to the arthroscopic group. Surgical time, position of the osteotomy, and variation of the length, width, and depth of the final osteotomy with respect to the proposed dimensions were compared. Results: In all specimens partial resection of the anterior-lateral femoral head-neck junction with improvement of the femoral head-neck offset was accomplished. A statistically significant difference (P < .05) was observed for surgical time between the open and arthroscopic groups (shorter in open group). Conclusions: When comparing surgical precision, no statistically significant differences were found between the open and arthroscopic procedures in any of the measurements. The depth and width of the osteoplasty were reliably obtained by the arthroscopic technique. However, there was a tendency to underestimate the osteoplasty length with the arthroscopic procedure. Positioning the osteoplasty was also less reliable with the arthroscopic procedure than with the open procedure because of the tendency to place the osteoplasty more posterior and distally than intended. Clinical Relevance: Surgical resection of the femoral neck prominence and/or part of the anterolateral neck has been reported to improve femoral head offset and alleviate impingement. This study attempts to document the accuracy of this resection when done arthroscopically compared with an open procedure. [ABSTRACT FROM AUTHOR]

Abstract: In the field of forensic toxicology, femoral blood is the most useful sample for the determination and quantification of drugs; however, cases in which blood is unavailable are common. In such cases, validated methodologies for drug determination in alternative matrices can be decisive in the investigation of a case. In particular, when femoral blood is unavailable for analysis for the presence of systemic exposure to cocaine and its principal metabolite, benzoylecgonine, validated methodologies from matrices other than blood that can be obtained in the autopsy room would be useful to the forensic toxicologist in the evaluation of a specific forensic case. To address this issue, we implemented and compared in our study the systematic evaluation of extraction, chromatographic separation, and quantification of cocaine and benzoylecgonine in different biological matrices (right and left cardiac blood, femoral arterial and venous blood, urine, vitreous humor, cerebrospinal fluid, brain accumbens nucleus, brain ventral tegmental area, and liver). The studied matrices were those most likely to be obtained from different autopsy rooms at the time of forensic testing in deceased individuals who are presumed of antemortem drug consumption. Solid phase extraction of analytes from the different matrices was performed using C-8/SCX mixed-phase columns, and gas chromatographic mass spectrometry separation was performed using detection in single-ion monitoring mode. The methodological validation was performed for all the studied matrices, and the results showed similar sensitivity and recoveries without statistical differences between the studied matrices. The methods were applied to evaluate a thanatological case using all the study matrices, showing unequal postmortem distribution of cocaine and benzoylecgonine throughout the different matrices tested. The present work opens the option of applying appropriate methodologies in the analysis of matrices, other than the usual blood, to obtain reliable results that may help clarify a forensic case. In addition, we present findings from different studies. This work affirms not only the potentiality of obtaining reliable data but also reaffirms the challenge of applying these data and taking into account the complexity of interpreting results in matrices other than blood. [Copyright &y& Elsevier]

NaY zeolite, an ordered, large pore molecular sieve pertaining to the FAU zeolite structural group, was studied as a novel matrix for the efficient preparation of a supported isothiazolinone-based biocide, and the results were compared to those corresponding to mesoporous silicas. To analyze the possibility of reducing the biocide ecotoxicity by encapsulation, a commercial biocide used for latex preservation (CMIT/MIT) was incorporated in the NaY zeolite structure by using two different methodologies: equilibrium adsorption (Zeo/Bio sample) and impregnation by total wetting (Zeo/Impreg sample). In the corresponding release tests, despite the large difference in the initial biocide amount released, the shape of the curve is nearly the same for both methods. Microbiological tests against fungi and bacteria were performed. The obtained results were compared to those previously obtained using mesoporous ordered silica SBA-15 and mesoporous foam MCF matrices (mesoporous/biocide samples named SBA-15/Bio, SBA-15/Impreg and MCF/Bio and MCF/Impreg respectively). For the Staphylococcus aureus the results from agar well diffusion assay shows that the inhibition zone is about 64 mm for Zeo/Impreg and about 55 mm for Zeo/Bio. As regards all the other materials, the inhibition zone does not exceed 46 mm. In the case of Escherichia coli, Zeo/Bio and Zeo/Impreg have an inhibition zone of about 43 and 37 mm, respectively. No one of the other materials shows an inhibition zone larger than 30 mm. Zeo/Impreg showed a greater inhibition zone against fungi (47 mm versus Chaetomium globosum and 53 mm versus Alternaria alternata, respectively) than SBA-15 and MCF impregnated with biocide. [Display omitted] • Isothiazolinone was effectively incorporated onto zeolita NaY. • The biocide release depends on the method of biocide incorporation • The biocide-impregnated zeolite showed better inhibition properties against fungi than mesoporous materials [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Mesenchymal stem cells (MSCs) have been isolated from various tissues and expanded in culture. MSCs add osteogenic potential to ceramic scaffolds when used together. A spinal fusion rabbit model was used to evaluate whether a pellet of cultured, autologous bone marrow MSCs (BMSCs) with osteogenic differentiation could increase the fusion rate when co-grafted with an autologus bone graft compared to autograft alone. Thirty rabbits were randomly assigned to two groups. Group 1 received bone autograft alone and Group 2 received bone autograft plus a pellet of cultured and differentiated BMSCs. Group 2 rabbits had a bone marrow puncture, after which the BMSC were cultured and osteoblastic differentiation was induced. BMSC cultures were obtained from 12 of 15 rabbits. The 27 rabbits underwent a bilateral, L4–L5 intertransverse fusion with an autograft and in Group 2 rabbits a pellet of differentiated BMSCs was added to the autograft. In Group 1, the fusion rate was 53% (8 of 15 rabbits) and in Group 2 the fusion rate was 0% (p <0.05). Adding differentiated BMSCs in a pellet without a scaffold not only failed to increase fusion rate, but completely inhibited bony growth. [Copyright &y& Elsevier]

• R&D subsidies in Chile are simulated with an intersectoral approach. • IOT and Survey of R&D expenditure are merged to use the Leontief price model. • R&D sector has the lowest backward linkage and employment effect. • Most intensive sectors in the use of domestic R&D receive indirect benefits. • Links between R&D subsidies and environmental impacts are obtained. The present study simulates subsidies to the R&D in Chile with an intersectoral approach known as the Leontief price model. For this, it has been used information from the Input-Output Tables (IOT), R&D expenditures at the sector level collected from the Survey of R&D Expenditure and Research Personnel, and labor market data available from the National Socioeconomic Characterization Survey. Thus, the official IOT data are broken down into new sectors to represent monetary transactions carried out by the R&D sector. Then, it is possible to obtain changes on macroeconomic, intersectoral, and environmental variables for different subsidy rates throughout the simulations performed with the model. The results show that an increase in R&D subsidies reduces the prices slightly and increases production, employment, and emissions at the sectoral level. Additionally, it is determined that the fiscal expenditure required to finance this subsidy is greater than the stimulus on national production. Finally, it can be concluded that the positive effects appear to be more relevant than negative impacts, so it is recommended to increase the rate of R&D subsidy in the country according to the availability of fiscal resources. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine if the use of platelet concentrate (PC) and bone plug (BP) does accelerate the healing process in anterior cruciate ligament (ACL) reconstruction. Methods: One hundred and eight patients requiring ACL reconstruction were prospectively randomized into 4 groups: control (27 patients), PC (26 patients), BP (28 patients), and a combination of PC and BP (27 patients). Magnetic resonance imaging (MRI) studies were carried out at both 3 and 6 months postsurgery. Maturation of the graft was evaluated at the femoral tunnel using MRI maturation criteria defined by a low-intensity signal, absence of osteoligamentous interface, and no widening of the femoral tunnel. Results: Three months after surgery, no differences were found among the groups regarding MRI maturation criteria. Six months postsurgery, 78% of the patients in the control group had a low-intensity signal, while in the PC group the low-intensity signal was present in 100% of the patients (P = .036). No statistical differences were observed regarding the osteoligamentous interface between the various groups. Finally, tunnel widening was seen in 11% of the patients of the BP group versus 41% of the patients in the control group (P = .047), but no statistical difference was seen with the other groups. Conclusions: The use of PC had an enhancing effect on the graft maturation process evaluated only by MRI signal intensity, without showing any significant effect in the osteoligamentous interface or tunnel widening evolution. The use of a BP effectively prevented tunnel widening. The BP and PC combination did not show a synergic effect as compared to PC or BP individually. Level of Evidence: Level II, lesser quality randomized controlled trial. [Copyright &y& Elsevier]

In Chile, the toxic dinoflagellate A. catenella shows an apparent oceanic range expansion from south to the north since its first detection in 1972 in the Magallanes Region (56° S). Until 2017, A. catenella detections were restricted to a geographic area between Magallanes to Los Rios Regions (40° S). The establishment of a monitoring program in the offshore Pacific coast allowed the detection of A. catenella between 2018 and 2019 in northern areas off the Bío-Bío Region (36°S). Monoclonal cultures established from the Bío-Bío coast were genetically identified, and PSTs screened. Phylogenetic analyses determined that the Bío-Bío isolates aggregated in Group I ribotype (previously A. tamarense or A. fundyense) and the presence of PSTs analogs were confirmed. It is the northernmost detection of the toxic dinoflagellate A. catenella in the Pacific coast of Chile. These results have important implications for species monitoring and governmental management in the Bío-Bío Region. • The detection of A. catenella off the Bío-Bío Region represents the northernmost record of this species on the Chilean coast. • Morphology and phylogeny of cultured A. catenella from the Bío-Bío coast confirmed species identification. • PSTs quantification in A. catenella isolates from the Bio-Bio region represents a potential PSP risk in the area. [ABSTRACT FROM AUTHOR]

Purpose: Our purpose was to develop an alternative method to divide the acetabulum and femoral head into different zones based on anatomic landmarks clearly visible during arthroscopy to facilitate reporting the geographic location of intra-articular injuries. Methods: Two vertical lines are positioned across the acetabulum aligned with the anterior and posterior limits of the acetabular notch. A horizontal line is positioned aligned with the superior limit of the notch perpendicular to the previous lines. The lines divide the acetabulum into 6 zones. Numbers are assigned to each zone in consecutive order. Zone 1 is the anterior-inferior acetabulum. The numbers progress around the notch until zone 5 is assigned to the posterior-inferior acetabulum. Zone 6 is the acetabular notch. The same method is applied to the femoral head. Six experienced hip arthroscopists were instructed in the zone and clock-face methods and were asked to identify and describe the geographic locations of lesions at the acetabular rim, acetabular cartilage, and femoral head in the same cadaveric specimen. Results: The zone method was more reproducible than the clock-face method in the geographic description of intra-articular injuries on the acetabulum and the femoral head. Conclusions: Among a group of expert hip arthroscopists, the zone method was more reproducible than the clock-face method. Clinical Relevance: The presented method divides the acetabulum into 6 different zones based on the acetabular notch. The zones are the same for right- and left-side hips. The same method is applied for the femoral head allowing, for the first time, a geographic description of pathology. [Copyright &y& Elsevier]

Summary: Background: Hantaviruses in Europe and Asia cause haemorrhagic fever with renal syndrome and epidemic nephritis (mortality rate <1–15%). New strains of Hantaviruses cause Hantavirus pulmonary syndrome (HPS) from Canada to South America. Andes virus mortality rate is about 30% in Chile. Method: Clinical charts of 54 patients were reviewed. Results: Inhalation of aerosolized urine, faeces or saliva of rodents is the principal cause of infection. The incubation period is between 8 and 43 days. The main prodromal symptoms are: myalgias, fever, fatigue, gastrointestinal disorders, dyspnoea, petechiae and coughing. After the 4th day pulmonary oedema, hypotension and renal failure appear. Haemorrhagic disorders may occur. The first laboratory tests presenting alterations are: haemoconcentration, leukocytosis, low platelet count <150μ/L, and presence of immunoblasts. The treatment is supportive: mechanical ventilation, vasopressor drugs, haemofiltration or haemodialysis, and extracorporeal membrane oxygenation. There is no specific treatment for HPS. Preventive measures must be empathised. Conclusion: The principal risk factors for tourists are: accommodation in abandoned or closed up facilities; failure to use indicated pathways when walking in forests; camping outside recommended areas; drinking water from natural sources and fishing in risk areas. The risk of infection for foreign tourists in Chile is low. [Copyright &y& Elsevier]

Minimal information exists regarding early complications after operatively treated proximal humeral fractures. Of the 82 shoulders that had osteosynthesis, 42 had a (nonmedical) complication, with 21 requiring further surgery. Of 42 shoulders with complications, 12 were related to incomplete reduction, 16 had loss of anatomic fracture fixation, 9 had delayed healing, 3 had an infection, 1 had rotator cuff failure, and 1 had loose bodies. Fixed-angle plates had lower rates of initial malpositioning and resultant malunion. Of the 22 shoulders requiring hemiarthroplasty, 14 had an early complication. Of these, 7 had complications relating to implant insertion or tuberosity malreduction at the index operation and 7 had problems with tuberosity healing. The rate of complications after operative treatment of proximal humeral fractures is high. All efforts at fracture fragment fixation with osteosynthesis and hemiarthroplasty should be directed at obtaining anatomic fracture fixation that resists displacement. [Copyright &y& Elsevier]

Endoplasmic reticulum (ER) stress and activation of the unfolded protein response (UPR) in hypothalamic neurons are common features of obesity, resulting in leptin and insulin resistance. In this issue, Williams et al. (2014) demonstrate, for the first time, cell-nonautonomous UPR signaling between brain and liver in the context of glucoregulation. [ABSTRACT FROM AUTHOR]

• Eucalyptus genotypes growth was compared at two sites under High vs. Low Irrigation. • Water availability was the largest determinant of GxE interactions. • Growth efficiency increase under High Irrigation for all taxas across sites. • Challenging climate changes require to evaluate genotypes GxE interactions. Predicting Eucalyptus plantation productivity in the face of climate change is a key challenge for intensively managed forest plantations around the world. Forest industry tree improvement and advanced silvicultural programs are charged with maximizing forest production but face challenging selection choices where Eucalyptus genotypes may be sensitive to genetic × environment interactions (GxE). Our study investigated the importance of GXE interactions by measuring the early (establishment to 2.6 years old) cumulative growth response of 30 selected genotypes of Eucalyptus globulus , E. nitens , E. badjensis , E. smithii, E. nitens × globulus and E. camaldulensis × globulus hybrid seedlings established across contrasting water availability conditions (High vs Low Irrigation). We compared the same genotypes at a low vapor pressure deficit (VPD) and clayey soil (North site) and a high VPD sandy soil (South site) in order to evaluate the stability of these genotypes across environmental gradients and thus evaluate the importance of genetic versus environmental impacts on growth. Stand growth was evaluated at 2.6 years when leaf area index (LAI) reached canopy closure in order to estimate a growth efficiency relationship (GE) with current annual increment (CAI). As expected, irrigation increased cumulative growth and LAI for all taxas, except for E. smithii at the North site. Genotypes showed large significant differences of performance within and across sites under each irrigation treatment. However, a strong relationship between North and South cumulative volume at age 2.6 years was observed for irrigated genotypes but not for non-irrigated genotypes. This suggests that a large GxE interaction may be expected under low water resource availability conditions associated with strong effects in ranking change of evaluated taxas and genotypes. Comparing taxas with at least two genotypes or more in our experiment, GE increased under High Irrigation for all taxas across sites. However, E. nitens × globulus hybrids showed small differences between High vs Low Irrigation treatments GE relationships compared to E. nitens and E. globulus genotypes. Our results suggest the need for strategic allocation of genotypes to contrasting drought risk environments and the need to assess our understanding of how particular genotypes interact with water stress conditions. [ABSTRACT FROM AUTHOR]

There is enough scientific evidence that associates air pollution by particulate matter (PM) with negative impacts on health. However, one-third of the world's population uses highly polluting fuels for cooking, heating, or lighting, especially in low- and middle-income countries. Due to the above, the environmental authorities of most of the countries have established different short-, medium-, and long-term regulations to reduce this pollution. It should be noted that it is challenging to identify the real effectiveness of this type of regulation since it is necessary to determine whether the pollution was reduced exclusively by the implementation of that regulation or due to other confusing factors. To address this issue, the present study performs an ex - post evaluation of the Critical Episodes Management program that imposes restrictions on the use of firewood heaters during pre-emergency and emergency episodes to reduce air pollution in the short-term in the city of Temuco, Chile (one of the most polluted cities in Latin America). Specifically, a fixed-effects panel data regression is applied to hourly concentrations of particulate matter data, controlling by meteorological and seasonal factors. The results show that restrictions on the use of firewood heaters generate a significant reduction in PM 10 and PM 2.5 concentrations during pre-emergency episodes (9.2% and 17.5%) and emergency episodes (5.9% and 16.3%). Thus, it can be concluded that this program is useful, but it must be complemented by others medium- and long-term environmental programs. • One-third of the world's population uses highly polluting fuels for cooking, heating, or lighting. • The main pollution source in southern Chile is the residential firewood combustion. • This study evaluates the impact of the hourly restrictions on the use of firewood heaters. • This program is effective in the short term based on the results obtained. • It is possible to suggest the implementation of this type of program in other cities with similar problems. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the failure mechanism, stiffness, and pullout strength of acetabular knotless suture anchors.Methods: Seven suture anchors were tested in high-density (0.48 g/cc) synthetic blocks. The anchors were implanted perpendicular to the bone block. The anchor's suture(s) were tied around a loop of 8 high-strength nonabsorbable sutures and pulled in line with the anchor at a rate of 1 mm/s until failure. The following knotless anchors were tested: Stryker Knotilus 3.5, Arthrex Pushlock 2.9, Linvatec PopLok 2.8, Linvatec PopLok 3.3, ArthroCare SpeedLock HIP (3.4-mm), and Smith & Nephew Bioraptor Knotless 2.9. The standard knot tying Smith & Nephew Bioraptor 2.9 mm served as a baseline for comparison.Results: Stiffness was highest in the Pushlock, the SpeedLock HIP, and Knotilus. At 1 mm displacement, the SpeedLock HIP exhibited significantly higher load than all other anchors, excluding the Pushlock and PopLok 3.3 (P ≤ .012 for all comparisons). Excluding the SpeedLock HIP and Knotilus, the Pushlock displayed significantly higher load than all other anchors at 2-mm displacement (P ≤ .015 for all comparisons). Maximum load was the highest for the Knotilus and Bioraptor knotted anchor (P < .001 compared with all other anchors).Conclusions: All knotless suture anchors used in hip arthroscopy, except for the Knotilus 3.5, failed by suture pullout from the anchor. The 2 anchors with the highest maximum load, the Knotilus 3.5 and knotted Bioraptor 2.9, failed by suture failure; however, these anchors displayed the lowest stiffness and load at 1 mm displacement among all anchors tested. Stiffness and loads at clinically relevant displacements, not maximum load alone, may be most important in predicting anchor clinical performance during the early phases of labral healing.Clinical Relevance: Knotless suture anchors tend to fail by suture pullout from the anchor, yet the stiffness of these constructs suggests that minimal displacement of the repair will occur under physiologic loads. [ABSTRACT FROM AUTHOR]

Abstract: One of the mechanisms by which epithelial cells regulate intracellular pH is exchanging bicarbonate for Cl−. We tested the hypothesis that in ameloblasts the anion exchanger-2 (Ae2) is involved in pH regulation during maturation stage amelogenesis. Quantitative X-ray microprobe mineral content analysis, scanning electron microscopy, histology, micro-computed tomography and Ae2 immuno-localisation analyses were applied to Ae2-deficient and wild-type mouse mandibles. Immuno-localisation of Ae2 in wild-type mouse incisors showed a very strong expression of Ae2 in the basolateral membranes of the maturation stage ameloblasts. Strikingly, zones of contiguous ameloblasts were found within the maturation stage in which Ae2 expression was extremely low as opposed to neighbouring cells. Maturation stage ameloblasts of the Ae2 a,b −/− mice failed to stain for Ae2 and showed progressive disorganisation as enamel development advanced. Maturation stage enamel of the Ae2 a,b −/− mice contained substantially less mineral and more protein than wild-type enamel as determined by quantitative X-ray microanalysis. Incisor enamel was more severely affected than molar enamel. Scanning electron microscopy revealed that the rod-inter-rod structures of the Ae2 a,b −/− mice incisor enamel were absent. Mineral content of dentine and bone of Ae2 a,b −/− mice was not significantly different from wild-type mice. The enamel from knockout mouse teeth wore down much faster than that from wild-type litter mates. Basolateral bicarbonate secretion via the anionic exchanger Ae2 is essential for mineral growth in the maturation stage enamel. The observed zonal expression of Ae2 in the maturation stage ameloblasts is in line with a model for cyclic proton secretion during maturation stage amelogenesis. [Copyright &y& Elsevier]