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Total shoulder arthroplasty (TSA) is an effective procedure to treat end stage osteoarthritis of the shoulder. Outcomes in patients with neurologic disorders are not well documented. Previous studies have shown that TSA in patients with Parkinson's disease was successful in alleviation of pain, but the overall shoulder function results were poor. We would like to extend this to include more neurologic symptoms. The purpose of this study is to determine the perioperative and the early postoperative outcomes in patients with neurologic disorders undergoing TSA. The Nationwide Readmission Database was used to identify all available primary anatomic TSA (aTSA) and reverse TSA (rTSA) occurring the US from 2011 to 2019 resulting in a total of 428,761 cases of TSA, with 209,789 being aTSA and 218,972 being rTSA. Relevant ICD9 and ICD10 codes identified 3602 (0.8%) patients to have at least 1 neurological disease. Both one way analysis of variance and Chi-squared analyses were used for demographic and comorbidity comparisons. For outcomes analyses, a Chi-squared/Fisher's Exact Test and binary logistic regression were used, which accounted for patient age, sex, primary payer, and Charlson-Deyo comorbidity index. Fisher's Exact Test was used to confirm significance in all low sample size parameters. Significant differences in several demographic categories were found between patients with and without neurological disorders receiving TSA including age (P <.001), sex (P <.001), zip-code income quartile distribution (P <.001), and the primary payer distribution (P <.001). At 180 days, the presence of a neurological condition was significantly predictive of higher rates of extended hospital stay (aTSA: P <.001, rTSA: P <.001) and non–home discharge following both aTSA and rTSA (aTSA: P <.001, rTSA: <0.001). The presence of a neurologic condition was predictive of significantly higher 180-day all-cause complication (P <.001) and mortality rates (P <.001) in patients undergoing rTSA, however this was not seen in those undergoing aTSA. Regarding perioperative complications, in patients undergoing aTSA and rTSA the presence of a neurological condition was significantly predictive of increased complication rates. This study demonstrates that patients with neurologic disorders undergoing TSA are at increased risk for perioperative complications, extended hospital stay, non–home discharge, and mortality out to 180 days. This information is helpful for both patients and surgeons when making an informed decision regarding TSA. Identifying patients with preexisting neurologic disorders before TSA can assist in tailoring preoperative and postoperative management of these patients to improve both short-term and long-term outcomes. [ABSTRACT FROM AUTHOR]

In the beginning, Americans got it right. They did not fall for the false choice between the comfort of the least and the potential of the best, sometimes posed as a choice between the common good and individualism. Instead, the Founders envisioned a productive people who were at the same time a caring people. They identified social progress with realizing the potential of the best. More recently, social progress tends to be identified with the comfort of the least, which is a dumbing down of the idea of freedom. [ABSTRACT FROM AUTHOR]

The article discusses the impact of interbank deposits on excess reserves. Through a simple example the author illustrates how the mere shifting of funds from one bank to another can reduce overall required reserves, and hence increase excess reserves. The author discusses a proposal by the U.S. Federal Reserve whereby separate reserve requirements govern such interbank deposits. On a system-wide basis this would essentially absolve interbank deposits from reserve requirements. Implications are discussed and an alternative proposal presented.

Scientists overwhelmingly agree that the climate is changing and that the changes are largely due to increased levels of carbon emissions into the atmosphere that are caused by human activities. The recommended response from society to climate change involves two sets of activities: mitigation and adaptation. Adaptation includes activities that attempt to adjust or respond to changes to the environment caused by climate change. For wildlife, a consensus is forming around an approach to adaptation planning that would improve the ability of an ecosystem to resist dramatic changes to habitats; build resilience into the ecosystem to recover from extreme weather events and changes in temperature and precipitation that may cause increased floods, wildfires, insect outbreaks, etc.; and lastly build realignment into our ecosystems through wildlife corridors or other connections through matrix landscape types that allow species to shift their ranges and transition into new areas when the need becomes inevitable. This commentary outlines a climate change adaptation strategy for wildlife within an eight-state region (Minnesota, Iowa, Missouri, Wisconsin, Illinois, Michigan, Indiana, and Ohio) of the Midwest United States (US) focused on the design of an interconnected green infrastructure network of natural areas that helps refine future wildlife habitat conservation priorities while also providing other natural and human benefits to residents of the Midwest US. A landscape-scale green infrastructure network will be developed for this area within the next 18–24 months thanks to a grant from the US Fish and Wildlife Service to the eight Midwest states, and the strategy outlined here serves as the foundation for implementing effective wildlife habitat protection projects in response to climate change.Environmental Practice 14:45–56 (2012) [ABSTRACT FROM PUBLISHER]

The article focuses on forecasts of gross domestic product (GDP) growth in the United States and Great Britain. Forecasts are a vital part of discretionary policy-making: the quality of the policy depends greatly on the quality of the forecasts. The article examines and compares the evolution of forecasts of GDP in the light of new information in the form of GDP outturns. The examination is based on published information about forecasts made in the U.S. by members of the Federal Open Market Committee, and in Great Britain by members of the Bank of England Monetary Policy Committee.

Explores the doctrinal problems in the standards of judicial review of the 1985 Delaware corporation law. Importance of corporation law; Development of the standards; Difference in the review of duty of care and duty of loyalty claims against fiduciaries; Evaluation of the standards that embody the fundamental policies underlying Delaware's approach to corporation law.

This study developed a marital typology based on a nonrandom, national sample of 415 African-American couples who took the Enriching Relationship Issues, Communication and Happiness (ENRICH) marital assessment inventory. Five types of African-American marriages were identified through cluster analysis using the positive couple agreement (PCA) scores in 10 relationship domains. Relationships between marital satisfaction, marital stability, and the five marital types were then analyzed. The five types (from highest marital satisfaction to lowest) were labeled as vitalized, harmonious, traditional, conflicted, and devitalized. The results were similar to findings in studies of ethnically mixed (predominantly European-American) marital samples including the number and characteristics of marital types. [ABSTRACT FROM AUTHOR]

Reports on attempts of biologists and conservationists to restore Hawaii's dry forests. How feral ungulates, or hooved animals, were introduced to the island and are destroying land; Endangerment of many native Hawaiian species; Details of research which attempted to restore a small amount of forest by keeping out ungulates, rodents and fountain grass.

ABSTRACT. Objectives. To conduct surveillance for neural tube defects (NTDs) in a high-risk region of the United States and to prevent occurrence and recurrence of NTDs through the periconceptional use of folic acid supplements. Design. Active and passive methods were used for surveillance of NTD-affected pregnancies and births during a 6-year period (October 1992-September 1998). Individual genetic counseling was used to prevent NTD recurrences and a public awareness campaign was used to reduce NTD occurrences. Setting. State of South Carolina. Patients. All cases of spina bifida, anencephaly, and encephalocele identified among 278 122 live births and fetal deaths to South Carolina residents during 1992-1998 were included. Main Outcome Measure. Changes in occurrence and recurrence rates during a 6-year period. Results. Over the 6 years of surveillance, the prevalence rates for NTDs decreased from 1.89 to .95 cases per 1000 live births and fetal deaths. The prevalence decrease is explained primarily by a decrease in cases of spina bifida. Isolated NTDs accounted for 297/360 (82%) NTDs and 63/360 (18%) had at least 1 other structural anomaly. Females predominated among isolated NTDs but the sex distribution was equal among NTD cases with other anomalies. Prevalence rates for whites (1.48 cases per 1000 live births and fetal deaths) were higher than rates for blacks (.87 cases per 1000 live births and fetal deaths). There were no NTD recurrences in 113 subsequent pregnancies to mothers of infants with isolated NTDs who took periconceptional folic acid. The rate of periconceptional folic acid use among women of childbearing years increased from 8% to 35% during the 6-year project period. Conclusion. The prevalence of NTDs in a high-risk region has declined coincident with the increased periconceptional use of folic acid supplements among women of childbearing age. Pediatrics 2000;106:677-683; neural tube defects, high-risk region, birth defects, folic acid, spi... INSET: ACCURACY OF RISK-ADJUSTED MORTALITY RATE AS A..., By T. Hofer. [ABSTRACT FROM AUTHOR]

Comments on an article which deals with the concepts of finality of judgments in class actions. United States Supreme Court and the demands of federalism; Basics of finality of judgments and full faith and credit; Details on a class action lawsuit.

Composite samples of Mississippi farm-raised channel catfish (FRCC) fillets were analyzed at four different seasons for the following: proximate composition, cholesterol, fatty acids, eight vitamins, eleven minerals, four heavy metals and eight chemical residues. Nutrients and other compounds did not vary appreciably with season. Mississippi FRCC were higher in fat, calories and thiamin compared with USDA and wild catfish data and had much less cholesterol than previously reported. Monounsaturates comprised over half the fatty acids in FRCC and omega-3 fatty acid content was low. Chemical residues were not detectable or present in extremely small amounts. [ABSTRACT FROM AUTHOR]

This article presented a performance evaluation of credit unions in the U.S. The criteria respect the unique organizational and institutional features of credit unions, without losing sight of the fact that they must compete with other financial intermediaries. Nonparametric, nonstochastic techniques were used to measure performance, and parametric stochastic techniques were used to attribute performance variation to features of credit unions and their operating environment. The sample consists of two-thirds of all active credit unions in 1990.

Comments on the school of thought patronized by economists in the University of Chicago, Illinois. Influence of economist Milton Friedman on quantity theorist; Preference on the growth rate rule price-stabilization rule; Works of economist Carl Snyder.

The article presents a discussion on the works of economists Bernard F. Haley, Keith Lumsden and Rendigs Fels by researchers Willian R. Allen, Donald W. Paden and Phillip Saunders. Fels provides a straightforward report on the preparation of a new college level test of economic understanding in the U.S. Doubtlessly, the task of preparation is being performed systematically and there is little point in quarreling over most of the conspicuous details of the planned test. But there are some matters, perhaps of a less obvious nature, which raise questions and qualms. Lumsden's research presents at least two aspects which deserve comment. For the orientation of the uninitiated, the programmed text is properly described in the study as one which incorporates logical sequencing, student participation, reinforcement, and a measure of self-pacing. Haley has done a commendable job of summarizing and reviewing a very unwieldy body of material related to the teaching of economics. But there is the general lack of systematic attempts at controls and evaluation in these experiments.

Economists and international trade theorists have not been permitted to make their maximum potential contribution to the formation of public policy in the U.S. In any case, the question whether economists should strive generally for a more active role in formulating policy is a difficult one. The article examines views of Cordell Hull, economist and statesman from Tennessee, on foreign trade during his years in the U.S. Congress. Hull's unusual interest and competence in the field of international economics made it possible for him to be both the spearhead of the movement towards a more liberal policy for the United States and a substantial part of its driving force. To Hull, commercial aspects of foreign policy were always of paramount importance. He traces his interest in the tariff and other problems of trade to his first excursion into politics. The history of the Trade Agreements Program, which has furnished the core of U.S. economic foreign policy since 1934, deserves great and exploring consideration of long-held views of this statesman from Tennessee.

This article discusses the effectiveness of the audio-visual materials as compared with conventional means of instruction in the U.S. Reports and discussions of wartime research led to important studies during the past decade and the organization after the war of two significant audio-visual research programs: the Instructional Film Research Program at the Pennsylvania State University and the Audio-Visual Research Division of the Air Force Human Resources Research Laboratories. A vast amount of research has accumulated during the past years demonstrating conclusively that audio-visual instructional materials, when properly used, can make significant contributions to learning over a wide range of conditions and subject matter content. Along with this empirical research has come the development of theory regarding the impact of instructional and persuasive communications and an increasing knowledge of the relationships of audience characteristics to the influences of these communications.

Presents a legal case against Hartford Hospital's drug therapy management in Hartford, Connecticut. Claims of the plaintiff; Court decision over the case; Distinction between innovative therapy and human experimentation.

Focuses on the efforts of biologists in the United States to study the basic principles of energetics and mechanics in animal. Applicability of research findings on robotics; Survey of experiments on animal locomotion.

Focuses on the bicentennial celebration of the establishment of the Delaware Court of Chancery. Description of the celebration; Pride of the Delaware lawyers; History of the Delaware judicial system.

In this article, the author discusses the testing of school efficiency in the U.S. in 1912. The author explores seven kinds of thinking that have kept towns, publics, and educators from testing school efficiency. He gives a sample of the application of each thinking. Moreover, the author states some factors needed in applying the thinking.

The article discusses several issues relevant to teachers colleges in the United States in 1922. Key issues examined include the salaries of faculty members of state normal schools, summer schools for teachers, teaching methods, a school high spot exhibit at a state teachers' convention and normal training in high schools.

The article reports on the use of high spot method in promoting educational progress in the United States. It states that high spots inspires others and encourage them to imitate forward steps and advancement in education. High spots contributes in informing schools about helpful suggestions and practices in teacher preparation, elementary & secondary school improvement.

The article highlights several educational programs in the U.S. The slogan of the University of Interscholastic League leads to study the subjects in the field of Americanization. Josephine Corliss Preston, superintendent of public instruction for the state of Washington, issued bulletin number 31 which is about Parent-Teacher Associations in high school. The Chaffey Union High School has published an illustrated book "Building a Community High School."

The article reports developments related to education in the U.S. Hi-Spots, the name of a printed monthly issued by the public schools of LaCrosse, Wisconsin is printed by students of the vocational school who get it out as part of their class work. There are bills in the legislature to repeal the compulsory continuation act in the New York. Superintendent George F. Hall announced how Newburgh, New York, boys and girls go out into the byways and hedges and recruit elementary boys.

The author reflects on the Food Administration Grain Corp. (FAGC), the nationalized buyer of wheat in the U.S. The FAGC, financed by the public, would provide wheat and flour for emergency needs of various European countries. Its efforts are projected to benefit wheat growers in the U.S., allowing the country to save around $45 million or an estimated 22 million bushels of wheat and 5 million more barrels of flour for starving nations.

The article reports on the importance of the Durant school prize to school boards and school managers of public, private and parochial schools in the U.S. The school prize went to the winning school and to the winning student. An interesting feature of the contest was a reminder that youth's thinking has naturally changed in partial keeping with scientific progress.

The article addresses issues concerning the situation of rural teachers in the U.S. The author assets that rural teachers must be given more respect for their present jobs and for themselves. He adds that state departments of public instruction must be required to report more specific facts about the rural schools, establish higher standards for rural teaching, and recommend improvements in training methods.

The article discusses the problem of acquiring outside help from philanthropists and will-givers of public schools in the U.S. The first step to secure outside help is to list the needs of schools. It cites the flaws on the part of most cities as to why outside agencies fail to coordinate with them. It cites the actions to be taken in order to persuade local school superintendents to stimulate and guide outside cooperation in their interim and annual reports.

Describes a study conducted by scientists from the Monsanto Company in Saint Louis, Mo. on a genetically-engineered weapon to protect crops from insects. Production of cholesterol oxidase, a potent insecticide; Reduction in pesticide use as effect of the development.

The article focuses on the importance of the Constitution Day Week celebration in the U.S. The Institute for Public Service presented a statement regarding the importance of the U.S. Constitution, and stated that the Constitution Day Week is a week for learning it. The organization also added that schools will talk about the Constitution in classes and assemblies for the whole week.

The article describes several best practices in elementary education in the United States in 1922. Oklahoma schools have established special days for celebration. The book "Economic Civics," by R.O. Hughes of the Peabody High School in Pittsburgh, Pennsylvania is popular in the educational sector. Male teachers in elementary grades are employed at Cleburne, Texas to provide boys with role models.

The article describes several innovative high school programs and significant educational achievements in the United States in 1922. Students at the Junior High School at Seward Park in New York City participated in 48 extra-curricular activities. Teacher-directed teachers' meetings are undertaken at the Brunswick School in Greenwich, Connecticut. The Girls' Booster Club of the Allentown High School in Pennsylvania increased its membership.

Discusses factors to consider by city councils in the U.S. to meet school needs including the need to centralize the purpose of schools, demand that the public be continuously informed regarding school work and encourage school teachers, principals and superintendents to report what they want, need and dislike.

Expresses views on the efforts of the U.S. Bureau of Education to secure public support for health work in schools. Actions to be taken by legislators to educate communities to support health work for school children; Aims of the proposed small separate children's bureau; Materials that can be used to instruct the public about health works.

The author deals with out-of-school conferences on child welfare in United States. He states that majority of school children in the U.S. are in small cities and rural districts. He points out that the children are not benefited by any conference that does not focus on the schools.

The article reports on the failure of accomplishment of educational projects for the schools in the U.S. Abraham Flexner is the dominating member of the General Education Board. He prevented the modernizing of 600 schools for 800,000 children. He failed to function the educational duties expected of him and for overattention to school politics. He is unaware of the modern methods in teaching.

The article discusses the importance of defense-focused technical education for airmen in the U.S. It states that investment in science, technology, engineering, and mathematics (STEM) education must increase to meet the demand of highly educated and operationally focused airmen. It notes that air force leaders with a defense-focused technical education are important to maintain military supremacy.