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To define the criteria for coverage for a cartilage restoration procedure and osteochondral allograft (OCA) transplantation and to investigate coverage for OCA procedures among private payer medical policies.A systematic search of private payer websites was conducted to identify publicly available 2018 OCA medical policies. Medical criteria related to patient demographics, defect characteristics, and previous treatment were analyzed. Trends in coverage for treatment of talus and patella and the extent of restrictiveness of medical policies were evaluated from 2016 to 2018. The extent of restrictiveness of a policy was defined by number of medical criteria established by payer policies. Policies with5, 3-5, and3 specified criteria for OCAs were considered strongly, moderately, and weakly restrictive, respectively.In total, 49 private payer medical policies for OCA transplantation were identified. Extracted criteria varied greatly between medical policies. Ten different defect size ranges were reported across payer policies. Criteria for patient body mass index was specified in 63% of policies. Criteria for failed arthroscopic or traditional surgical procedure were identified in 20% of the policies. More than one half of policies (51%) specified knee defect location to load-bearing surfaces. Analysis of trends in positive coverage statements and restrictiveness showed an increase from 4.7% in 2016 to 39.5% for talus, 4.7% to 7.0% for patella, and a slight shift (4.7% of payers) toward weakly restrictive medical policies.This study demonstrates wide variability and inconsistencies in published criteria among OCA medical policies.This study informs clinicians of the current state of coverage for OCA transplantation, providing insights into the variability of payer policies and potential impact.

A digital, or virtual, collection is a value added service developed by libraries that curates information and resources around a topic, theme or organization. Adoption of the virtual collection concept as an Earth science data service improves the discoverability, accessibility and usability of data both within individual data centers but also across data centers and disciplines. In this paper, we introduce a methodology for systematically and rigorously curating Earth science data and information into a cohesive virtual collection. This methodology builds on the geocuration model of searching, selecting and synthesizing Earth science data, metadata and other information into a single and useful collection. We present our experiences curating a virtual collection for one of NASA's twelve Distributed Active Archive Centers (DAACs), the Global Hydrology Resource Center (GHRC), and describe lessons learned as a result of this curation effort. We also provide recommendations and best practices for data centers and data providers who wish to curate virtual collections for the Earth sciences.

New highly productive apple rootstocks resistant to fire blight and crown rot can improve orchard profitability. However, some of the most promising rootstocks appear to have weak or brittle graft unions that are susceptible to breakage in the nursery and in the field. Flexural strength of graft unions may be related to the amount of vascular connections between graft partners, and poor vascular connections may cause increased hydraulic resistance. We sought to determine if transpiration rate and hydraulic resistance were correlated with graft union strength by comparing Geneva® 41 with the strong graft-forming Malling 9 selection NIC™ 29. The primary goal of this study was to compare weak and strong graft unions between similarly vigorous rootstocks by measuring whole-tree transpiration, as well as hydraulic resistance using the pressure chamber method. The effects of rootstock and grafting method on xylem hormone concentrations were also compared. There was no correlation between graft union strength and whole tree transpiration rate or leaf area-specific transpiration rate. The hydraulic resistance of the weaker forming rootstock was not significantly different than the strong graft union rootstock and was more closely correlated with overall size of the root system. However, hydraulic resistance of the scion and graft union were small relative to root system resistance, making it difficult to detect differences in graft union resistance among scion-rootstock combinations. Conversely, we observed differences in the hormone profile of xylem exudate among rootstock genotypes and among graft types.

Fresh osteochondral allograft transplantation has been my preferred procedure for chondral and osteochondral lesions for many decades. This is particularly true for patients younger than 18 years of age, where diagnoses such as osteochondritis dissecans, osteochondral fractures, and osteonecrosis predominate, rendering the situation as much a "bone problem" as a "cartilage problem." In the universe of cartilage-repair techniques, osteochondral allografts are particularly useful when bone defects must be managed. Furthermore, allografts have stood the test of time for safety, efficacy, and durability, even in a young, active population. For me, I don't think twice about using fresh allografts in young patients. I might even have to admit that an osteochondral allograft transplantation procedure for an osteochondritis dissecans lesion in a patient younger than 18 years old is my favorite surgery!

Background Driving under the influence of alcohol is a leading cause of injury and premature death among young adults, and college-educated individuals are at particularly high risk. Less is known about driving under the influence of other drugs, which is on the rise. Method This study describes prospective seven-year trends in alcohol and other drug (AOD)-involved driving among a young-adult sample beginning with their second year of college (i.e., Years 2–8), and documents the extent of continuity in such behaviors across time. Originally recruited as incoming first-year students at one large public university, participants ( n = 1194) were interviewed annually about how frequently they drove while drunk/intoxicated (DWI), after drinking any alcohol (DAD), and/or while under the influence of other drugs (DD). Follow-up rates were high (>75% annually). Results Among participants with access to drive a car, annual prevalence peaked in Year 4 (modal age 21) for both DWI (24.3% wt ) and DD (19.1% wt ) and declined significantly thereafter through Year 8 (both p s wt in Year 2 to 66.9% wt in Year 5, and plateauing thereafter. Among marijuana-using participants, likelihood of DD was consistently greater than the likelihood of DWI among Heavy Episodic and Light-to-Moderate drinkers, and it declined significantly during Years 5–8 ( p Conclusion Post-college declines in heavy drinking and DWI prevalence were encouraging but did not necessarily translate to reductions in likelihood of engaging in DWI, depending on drinking pattern. College-educated individuals represent an important target for AOD-involved driving prevention.

The properties of extruded chicken collagen sausage casings can be tailored by the addition of sodium chloride (NaCl) or proteins prior to extrusion in order to gain films with modified mechanical properties. In this study, 4% (w/w) chicken skin collagen and telopeptide-poor collagen from bovine hide were modified by the addition of 0.05 mol/kg NaCl and/or partial substitution of collagen by soy protein isolate, at 1.25% (w/w). The collagen formulations were extruded to films and characterized in terms of their microstructure (light microscopy and scanning electron microscopy) and rheological properties (storage and loss modulus and phase angle). Moreover, the tensile strength and film thickness were examined. The addition of NaCl to the gel allowed for telopeptide-poor and chicken collagen films with high tensile strengths and elasticities to be formed. In contrast, a substitution of collagens with soy proteins decreased gel and film strengths. The soy protein induced weakening of collagen networks could be compensated by again adding NaCl leading to more homogeneous gels yielding films with higher storage moduli upon extrusion. The compensating effect of NaCl was more pronounced for chicken skin than for telopeptide-poor collagen in the film state suggesting differences in molecular interactions and network formation between the two different collagen types. Overall, the modulation of chicken collagen interactions by NaCl and soy protein addition enables the production of functional chicken collagen films, in turn providing the food and pharmaceutical industry with a viable alternative to the increasingly scarce beef collagen.

Curation is traditionally defined as the process of collecting and organizing information around a common subject matter or a topic of interest and typically occurs in museums, art galleries, and libraries. The task of organizing data around specific topics or themes is a vibrant and growing effort in the biological sciences but to date this effort has not been actively pursued in the Earth sciences. In this paper, we introduce the concept of geocuration and define it as the act of searching, selecting, and synthesizing Earth science data/metadata and information from across disciplines and repositories into a single, cohesive, and useful collection. We present the Climate Data Initiative (CDI) project as a prototypical example. The CDI project is a systematic effort to manually curate and share openly available climate data from various federal agencies. CDI is a broad multi-agency effort of the U.S. government and seeks to leverage the extensive existing federal climate-relevant data to stimulate innovation and private-sector entrepreneurship to support national climate-change preparedness. We describe the geocuration process used in the CDI project, lessons learned, and suggestions to improve similar geocuration efforts in the future.

Several studies have linked marijuana use with a variety of health outcomes among young adults. Information about marijuana's long-term health effects is critically needed.Data are from a ten-year study of 1253 young adults originally recruited as first-year college students and assessed annually thereafter. Six trajectories of marijuana use during college (Non-Use, Low-Stable, Early-Decline, College-Peak, Late-Increase, Chronic) were previously derived using latent variable growth mixture modeling. Nine health outcomes assessed in Year 10 (modal age 27) were regressed on a group membership variable for the six group trajectories, holding constant demographics, baseline health status, and alcohol and tobacco trajectory group membership.Marijuana trajectory groups differed significantly on seven of the nine outcomes (functional impairment due to injury, illness, or emotional problems; psychological distress; subjective well-being; and mental and physical health service utilization; all ps.001), but not on general health rating or body mass index. Non-users fared better than the Late-Increase and Chronic groups on most physical and mental health outcomes. The declining groups (Early-Decline, College-Peak) fared better than the Chronic group on mental health outcomes. The Late-Increase group fared significantly worse than the stable groups (Non-Use, Low-Stable, Chronic) on both physical and mental health outcomes.Even occasional or time-limited marijuana use might have adverse effects on physical and mental health, perhaps enduring after several years of moderation or abstinence. Reducing marijuana use frequency might mitigate such effects. Individuals who escalate their marijuana use in their early twenties might be at especially high risk for adverse outcomes.

Background Nearly 14% to 39% TKA patients report dissatisfaction causing incomplete return of function. We proposed that the kinematics of knees implanted with patient-specific prostheses using patient-specific cutting guides would be closer to normal. Methods Eighteen matched cadaver lower limbs were randomly assigned to two groups: group A was implanted with patient-specific implants using patient-specific cutting guides; group B, the contralateral knee, was implanted with a standard design using intramedullary alignment cutting guides. Knee kinematics were measured on a dynamic closed-kinetic-chain Oxford knee rig, simulating a deep knee bend and in a passive rig testing varus–valgus laxity. Results The difference from normal kinematics was lower for group A compared to group B for active femoral rollback, active tibiofemoral adduction, and for passive varus–valgus laxity. Conclusions Our results support the hypothesis that knees with patient-specific implants generate kinematics more closely resembling normal knee kinematics than standard knee designs. Clinical Relevance Restoring normal kinematics may improve function and patient satisfaction after total knee arthroplasty.

Osteochondral graft failure, whether an autograft or allograft, can be a challenging condition for treatment, with revision surgeries showing inferior outcomes. Optimizing the primary procedure is of paramount importance and will require following well accepted guidelines that are outlined in this chapter. When a revision surgery is indicated, the preoperative plan must include an assessment of the mechanism of failure and careful evaluation of all associated pathologies, which will need to be recognized and addressed in the treatment plan. Osteochondral allografts is the preferred technique for most revision cases of cartilage repair procedures (when indicated) and will usually require replacing the failed cartilage repair tissue in its whole. A well performed preoperative evaluation, a complete treatment plan and a well-executed surgery are key components for a successful outcome.

Proper mechanical and rotational alignment plays an important role in achieving the success of the total knee arthroplasty (TKA). The purpose of the present study was to retrospectively determine with computed tomography (CT) the distal femoral valgus angle (DFVA) and femoral rotation angle (FRA). Our cohort included 13,546 CT scans of patients undergoing TKA. The average DFVA was 5.7 ± 2.3° (range from 1 to − 16°) with 13.8% of patients identified as outliers. The distal FRA angle average was 3.3 ± 1.5° (range from − 3 to 11°) with 2.8% of patients identified as outliers. These data can be useful in making orthopedic surgeons aware of the variability of femoral anatomy. Using the same cutting angle may lead to malposition of the femoral component.

Osteochondral lesions of the talus is a common problem affecting the ankle, particularly in you active patients. Patients recalcitrant to conservative modalities may require surgical correction. While many lesions may respond to arthroscopic management, larger or recurrent lesions may require osteochondral transplantation for which autograft of allograft tissue can be used. This chapter reviews the basic science and biology of fresh talar allograft ostechondral transplnattaion. Two techniques are described in detail. The first utilized osteochondral plugs using a system similar to that used for autograft OATS procedures. The second utilized larger bulk allograft pieces inserted following a talar dome hemitalectomy for more massive lesions. The surgical techniques, indications, concerns and results are described in the chapter.

Fresh osteochondral allograft (OCA) transplantation has more than a 100-year clinical history. Many clinical and basic scientific studies have been performed with the result that allografting is now part of the cartilage repair paradigm for the treatment of chondral or osteochondral lesions. In the knee joint, allografting has also been successfully used in complex joint reconstruction for the treatment of osteonecrosis, fracture malunion, and selected cases of osteoarthritis. Unlike many other cartilage repair techniques, OCAs have the ability to restore mature, hyaline articular cartilage to the affected area. By virtue of their composite structure (cartilage and bone), allografts also can restore diseased or damaged bone often present in large or complex lesions. The surgical techniques of allografting are relatively straightforward, and many clinical studies have shown excellent results. OCAs do present the surgeon with unique and important differences from other cartilage repair techniques, such as limited allograft tissue availability and the potential for transmission of infectious disease from the graft or immunologic response by the recipient. Ongoing investigations continue to clarify the indications, surgical techniques, and clinical outcomes of fresh OCAs.

The efficacy of osteochondral allografts (OCAs) may be affected by osseous support of the articular cartilage, and thus affected by bone healing and remodeling in the OCA and surrounding host. Bone cysts, and their communication pathways, may be present in various locations after OCA insertion and reflect distinct pathogenic mechanisms. Previously, we analyzed the effect of OCA storage (FRESH, 4°C/14d, 4°C/28d, FROZEN) on cartilage quality in fifteen adult goats after 12months in vivo. The objectives of this study were to further analyze OCAs and contralateral non-operated (Non-Op) CONTROLS from the medial femoral condyle to (1) determine the effect of OCA storage on local subchondral bone (ScB) and trabecular bone (TB) structure, (2) characterize the location and structure of bone cysts and channels, and (3) assess the relationship between cartilage and bone properties. (1) Overall bone structure after OCAs was altered compared to Non-Op, with OCA samples displaying bone cysts, ScB channels, and ScB roughening. ScB BV/TV in FROZEN OCAs was lower than Non-Op and other OCAs. TB BV/TV in FRESH, 4°C/14d, and 4°C/28d OCAs did not vary compared to Non-Op, but BS/TV was lower. (2) OCAs contained "basal" cysts, localized to deeper regions, some "subchondral" cysts, localized near the bone-cartilage interface, and some ScB channels. TB surrounding basal cysts exhibited higher BV/TV than Non-Op. (3) Basal cysts occurred (a) in isolation, (b) with subchondral cysts and ScB channels, (c) with ScB channels, or (d) with subchondral cysts, ScB channels, and ScB erosion. Deterioration of cartilage gross morphology was strongly associated with abnormal μCT bone structure. Evidence of cartilage-bone communication following OCA repair may favor fluid intrusion as a mechanism for subchondral cyst formation, while bone resorption at the graft-host interface without affecting overall bone and cartilage structure may favor bony contusion mechanism for basal cyst formation. These findings suggest that cysts occurring after OCAs may result from aberrant mechanobiology due to (1) altered compartmentalization that normally separates overlying cartilage and subchondral bone, either from distinct ScB channels or more general ScB plate deterioration, and (2) bone resorption at the basal graft-host interface.

Nitrogen deficiency promotes lipid formation in many microalgae, but also limits growth and lipid productivity. In spite of numerous studies, there is poor understanding of the interactions of growth and lipid content, the time course of lipid accumulation and the magnitude of nitrogen deficiency required to stimulate lipid formation. These relationships were investigated in six species of oleaginous green algae, comparing high and low levels of deficiency. Nitrogen stress typically had disproportionate effects on growth and lipid content, with profound differences among species. Optimally balancing the tradeoffs required a wide range in nitrogen supply rate among species. Some species grew first and then accumulated lipids, while other species grew and accumulated lipids concurrently which resulted in increased lipid productivity. Accumulation of high lipid content generally resulted from a response to minimal stress. The data highlight the tremendous biodiversity that may be exploited to optimally produce lipids with precision nitrogen stress.

The size and shape of joints markedly affect their biomechanical properties, but the macroscopic 3-dimensional (3-D) mechanism and extent of cartilage and joint maturation during normal growth are largely unknown. This study qualitatively illustrates the development of the bone-cartilage interface in the knee during postnatal growth in humans and C57BL/6 wild-type mice, quantitatively defines the 3-D shape using statistical shape modeling, and assesses growth strain rates in the mouse distal femur. Accurate quantification of the cartilage-bone interface geometry is imperative for furthering the understanding of the macroscopic mechanisms of cartilage maturation and overall joint development.

Net radiation (Rn) is a key component of the surface energy balance, but it is expensive and difficult to measure accurately. For these reasons, Rn is often predicted in evapotranspiration (ET) calculations with a model requiring measurements of incoming shortwave radiation, air temperature, and vapor pressure. We compared Rn predictions from the Rn sub-model used in the American Society of Civil Engineers (ASCE) standardized reference ET equation to mean Rn measurements from five 4-component reference net radiometers. The radiometers were part of a recent comparison study of multiple net radiometer models conducted over irrigated and clipped turfgrass in northern Utah (Blonquist et al., 2009). In the Rn model, net shortwave radiation is determined by direct measurement of solar radiation and an assumed value of albedo for the surface (0.23 for fully vegetated surfaces), and net longwave radiation is calculated with a Brunt (1932, 1952) approach for predicting net surface emissivity, calculated from near surface vapor pressure. Additionally, the ratio of measured incoming shortwave radiation to predicted clear-sky shortwave radiation is used as a surrogate variable for cloud cover in the net longwave radiation calculation. Relative to the reference Rn measurements (average of five 4-component net radiometers), modeled Rn was high during the day by an average of 8.6% and high in magnitude (more negative) at night by an average of 13.4% over hourly time intervals. Daily total Rn calculated by summing the hourly model predictions was always higher than the reference measurements, by an average of 8.1%, whereas daily total Rn calculated from the model over daily time intervals was closer to the reference measurements, 2% high on average. The model Rn error during the day was partly caused by the assumption in the model that surface albedo is a constant value of 0.23. Measurements showed albedo ranged from approximately 0.21 at solar noon to 0.30 near the beginning and end of the day, with a mean value of 0.23. However, most of the model Rn error was due to the prediction of net longwave radiation, where the empirical equation in the model typically yielded values that were too low in magnitude (less negative), by approximately 20% on average, but the error was dependent on time of day. The Rn error at night was largely caused by the inability to measure the surrogate for cloud cover at night, which relies on measurement of solar radiation from a previous time period of sufficient solar zenith angle. All five of the net radiometer models tested in the comparison study matched the mean of the reference net radiometers better than the ASCE model. When modeled hourly Rn was used to calculate ET over hourly time intervals, or when hourly ET values were summed to yield daily ET, ET was typically high, by 6% on average, relative to ET calculated from measured reference Rn. When modeled Rn was calculated over daily time intervals and used to calculate ET over daily time intervals, ET was more accurate, 1% high on average, relative to ET calculated over daily time intervals from measured reference Rn. While new models for Rn are being developed, the sub-model in the ASCE standardized reference ET equation has been in use for the past two decades in thousands of ET stations. As newer models are developed we hope to use this data set to evaluate them

Decreased water uptake closes stomates, which reduces transpiration and increases leaf temperature. The leaf or canopy temperature has long been used to make an empirical estimate of plant water stress. However, with a few supplemental measurements and application of biophysical principles, infrared measurement of canopy temperature can be used to calculate canopy stomatal conductance (gC), a physiological variable derived from the energy balance for a plant canopy. Calculation of gC requires an accurate measurement of canopy temperature and an estimate of plant height, but all of the other measurements are available on automated weather stations. Canopy stomatal conductance provides a field-scale measurement of daily and seasonal stomatal response to prevailing soil water and atmospheric conditions, and facilitates a comparison of models that scale conductance from single leaves (measured with porometers) to canopies. A sensitivity analysis of the input measurements/estimates showed gC is highly sensitive to small changes in canopy and air temperature, and less sensitive to the other required measurements (relative humidity, net radiation, wind speed, and plant canopy height). The measurement of gC becomes increasingly sensitive to all of the component factors as the conditions become cloudier, cooler, and more humid. We determined gC for alfalfa and turfgrass by making the necessary environmental measurements and coupling them with a two-source (plant canopy layer and soil layer) energy balance model. We then compared these gC values to maximum single leaf values scaled-up to the canopy level (gCP, defined as potential canopy stomatal conductance herein) for the two crops. For both crops, gC matched gCP within approximately 10% after irrigation. The turfgrass gC measurements were also compared to mean single leaf values measured with a porometer. At mid-day, gC values were typically about double the single leaf values. Because this approach for determining gC allows continuous, non-contact measurement, it has considerable potential for coupling with measurements of soil moisture to better understand plant–soil water relations. It also has potential for use in precision drought stress and irrigation scheduling.

Net radiation (Rn) is the sum of the radiant energy at the Earth's surface and is a major component of the surface energy balance. However, Rn is difficult to measure accurately, and multiple instruments are available to measure it. Two new instruments (Hukseflux Thermal Sensors B.V., model NR01; Kipp & Zonen B.V., model CNR 2) have been released within the past two years. We compared these models, two less-expensive older models (Kipp & Zonen B.V., model NR-Lite; Radiation and Energy Balance Systems, Inc., model Q*7.1), and a more expensive older model (Kipp & Zonen B.V., model CNR 1) over a uniform turfgrass surface for 33 days in mid-summer. Three replicates of each radiometer were included in the study (except for the CNR 1). The instruments that independently measure the four components of Rn (models CNR 1 and NR01) were typically the most accurate. Incoming shortwave measurements from the four component instruments were compared to a reference pyranometer, and outgoing longwave measurements were compared to infrared measurements of surface temperature. The differences from the reference pyranometer and surface temperature measurements were typically 2% or less. There was a difference of approximately 5% in incoming longwave measurements between these two radiometer models. This is likely due to differences in calibration approaches, which are discussed. This emphasizes the need for standardization of longwave calibration methods and establishment of a world reference for longwave radiation. The instruments that do not separate shortwave and longwave radiation into component measurements (net all-wave radiometers, models NR-Lite and Q*7.1) were generally the least accurate, and had offsetting day and night differences that reduced daily total Rn differences relative to the reference. The CNR 2 measures net shortwave and net longwave, and is an intermediate between a four component instrument and a net all-wave instrument. The Rn measurement accuracy of the CNR 2 typically fell between that of the two groups. Differences among radiometers tended to be larger at night than during the day, indicating higher variability in longwave measurements. An inversion (flip) test in the field showed the NR-Lites and Q*7.1s had well matched detectors, however two of the three replicate CNR 2s had mismatch errors greater than 5%. This becomes important for measurements over non-vegetated surfaces. The data presented here should be helpful in selecting the most cost effective instrument for a given application.