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Purpose: To identify factors predictive of a large labral tear at the time of shoulder instability surgery., Methods: As part of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort, patients undergoing open or arthroscopic shoulder instability surgery for a labral tear were evaluated. Patients with >270° tears were defined as having large labral tears. To build a predictive logistic regression model for large tears, the Feasible Solutions Algorithm was used to add significant interaction effects., Results: After applying exclusion criteria, 1235 patients were available for analysis. There were 222 females (18.0%) and 1013 males (82.0%) in the cohort, with an average age of 24.7 years (range 12 to 66). The prevalence of large tears was 4.6% (n = 57), with the average tear size being 141.9°. Males accounted for significantly more of the large tears seen in the cohort (94.7%, P = .01). Racquet sports (P = .01), swimming (P = .02), softball (P = .05), skiing (P = .04), and golf (P = .04) were all associated with large labral tears, as was a higher Western Ontario Shoulder Instability Index (WOSI; P = .01). Age, race, history of dislocation, and injury during sport were not associated with having a larger tear. Using our predictive logistic regression model for large tears, patients with a larger body mass index (BMI) who played contact sports were also more likely to have large tears (P = .007)., Conclusions: Multiple factors were identified as being associated with large labral tears at the time of surgery, including male sex, preoperative WOSI score, and participation in certain sports including racquet sports, softball, skiing, swimming, and golf., Level of Evidence: I, prognostic study., (Copyright © 2021 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

Trivalent inactivated poliovirus vaccine (IPV) (MK) was made, purified, and inactivated according to the amended Rijks Instituut (The Netherlands) protocol from primary monkey kidney tissue grown on microcarrier cultures. Losses of the type 2 component due to adsorption to the glass ampule occurred with the purified vaccine preparation. This problem was solved by changing the diluent, and the vaccine was submitted for evaluation in clinical trials at Johns Hopkins (Baltimore, Md.). Phase 2 of the development was to standardize production of IPV from MRC-5 (human diploid) cells on microcarriers and otherwise follow the Rijks Instituut 's method. Results of experimental trivalent vaccine production and testing showed that the number of effective doses harvested from MRC-5 cell cultures compared favorably with vaccine derived from monkey kidney. The yields could be further increased with stearyl tyrosine as adjuvant. Large-scale production using 200-liter fermenters is in progress. Poliovirus particles of various densities in cesium chloride can be found in any IPV preparation and give rise to different immunogenic responses. As shown in this paper, some of these virus fractions produce a low primary humoral antibody response but appear to be important for memory induction.