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Category: Ankle Arthritis; Ankle Introduction/Purpose: The TAA was originally introduced in the 1970s and each subsequent generation of implant has been improved upon. Innovative solutions led to second and third generation arthroplasties, which addressed the initial failures and incorporated new designs to improve patients’ lives through significant improvements in pain and function. The Inbone II Total Ankle System was made available in 2009. The successor to the Inbone I, it features pivotal changes to both the tibial stem and talar components. The purpose of this study is to gather intermediate (five or more year follow-up) data on the Inbone II Total Ankle Systems since it's approval in 2009. Methods: The study is retrospective, single-site cohort of patients who have undergone one or multiple surgeries involving the Inbone II Total Ankle System by the senior authors with at least 5 years of follow-up. For patients that are able to be reached, and choose to consent, a prospective clinical visit was conducted. This visit included physical and radiographic assessments, as well as patient-reported outcome measures. Results: Initially, 168 potential patients (77 females and 72 males) and were identified. The average patient was 62.5 years (range: 25 - 88) at surgery. Following retrospective data collection, these post-operative dispositions were noted: (19 (11.3%) declined prospective follow-up, 29 (15.5%) were lost to follow-up, 5 (3%) underwent amputations, 7 (4.2%) were explanted, and 2 (1.2%) expired). Of these, 59 (35%) patients (63 implants) have returned to the office for prospective assessments. Of these, 28 were female, and 31 were male. The mean time from surgery was 7.2 years (6.4 to 10.6). 15 reported complications following the procedure, most commonly noted as residual post-operative swelling (7 patients). Patient satisfaction was noted to be 93% overall, with an average AOFAS score of 84.2% (52 - 100). Conclusion: Preliminary data demonstrates that ankle replacement with the Inbone II device has the equivalent survival rate as that reported in the literature at 5 years post surgery.

A extensão universitária é pautada na relevância do contato dos estudantes de ensino superior com a sociedade, uma inter-relação capaz de gerar transformação social. Ela visa a proporcionar pedagogicamente o exercício e aprimoramento profissional, de forma a criar diálogo, troca de conhecimento e contato com desafios, advindos do compromisso social com quem circunda a academia. Nesse contexto, programas de extensão são ações permanentes e estruturantes que integram diferentes linhas da universidade de modo interdisciplinar, interprofissional e intersetorial; têm caráter orgânico-institucional, orientações para um objetivo comum e devem ser estruturantes na Universidade e pautar-se na indissociabilidade entre extensão, ensino e pesquisa. Para mais, por meio dos diversos programas e projetos de extensão que possui, a UFCSPA oferece aos estudantes vivências que fomentam uma formação crítica e responsável dos indivíduos. Destaca-se o “Programa de Extensão Contação de Histórias na Promoção da Saúde” que, há 15 anos, tem como propósito possibilitar vivências práticas humanizadas entre alunos e pacientes, utilizando-se da literatura para criar cuidados em saúde. Desse modo, o histórico da extensão brasileira evidencia sua importância e a necessidade de valorização dos programas e projetos universitários, por meio de investimento das IES na institucionalização dessas atividades, e gera uma união benéfica entre o meio acadêmico e social.

Laminate-thickness tapering opportunities of Double-Double (DD) laminates are unique, compared to conventional laminates (denoted as Quad) in aerospace, which are typically composed of 0°, 45°, −45°, 90°plies. The more aggressive tapering concept of DD, with drop-offs located on laminate’s outer surfaces, promises simplification in terms of manufacturing. However, the DD concept bears the risk to impede crack propagation after impacts negatively, as no full plies cover building-block run outs.The present article utilizes conventional CAI (AITM-1-0010) infrastructure to examine how the characteristics of DD and Quad laminates deviate, when laminate transition zones experience impact loads.Sample dimensions and the overall testing procedure was executed as close as possible to the AITM norm, which is usually intended for testing quasi-isotropic, 4 mm thick laminates. The study focuses on M21E/IMA UD carbon-fiber epoxy prepreg.A tapered sample represents the key object of the present experimental study. It features a laminate transition from 16- to a 32-ply region, with a 1:10 ramp. Both regions are quasi-isotropic. The individual ply run outs are distributed along the transition zone (staggering), as it is done in industry. The examined DD laminate represents a structural equivalent of the Quad laminate (identical [A] matrix). The transition zone shows 4-building-block run outs.The tapered samples are impacted from both sides, to assess the effects of the differences in laminate architecture. Constant-thickness, 16-ply and 32-ply, samples complement the tests of the tapered samples. The study features a delamination area assessment, based on ultra-sonic scans, as well as the analysis of CAI tests.

(1) Background: Since the death of George Floyd, the social movement Black Lives Matter continues to dominate the American political psyche, not only advancing a public dialogue but also escalating the polarization of supported solutions for policing and systemic discrimination. (2) Methods: Using a qualitative context analysis approach, we assessed over 350 sources related to social justice literature and policy-relevant documents to identify key policy solutions supported by the American Black Lives Matter movement compared to the Blue Lives Matter movement. We applied Fearon’s bargaining range of war model to analyze the extent to which the policy recommendations of these two opposing movements may overlap. The purpose was to identify and categorize agreement alternatives across various sectors. This research presents top policy solutions, assessing their bargaining ranges. (3) Results: 32 of the 36 top policy reform alternatives at the national level have sufficient bargaining ranges. This analysis indicates the importance of supporting various sectors like mental health/psychosocial policies and programs, which can (1) serve as a focal point of agreement between contending movements, and (2) decrease racial injustice through strategic bargaining. (4) Conclusions: In a divisively political landscape, it is crucial to identify starting points for negotiation among contending actors. Identifying bargaining opportunities can help seed a dialogue that may benefit all parties involved.

Airborne in situ cloud measurements were carried out over the northern Fram Strait between Greenland and Svalbard in spring 2019 and summer 2020. In total, 811 min of low-level cloud observations were performed during 20 research flights above the sea ice and the open Arctic ocean with the Polar 5 research aircraft of the Alfred Wegener Institute. Here, we combine the comprehensive in situ cloud data to investigate the distributions of particle number concentration N, effective diameter Deff, and cloud water content CWC (liquid and ice) of Arctic clouds below 500 m altitude, measured at latitudes between 76 and 83∘ N. We developed a method to quantitatively derive the occurrence probability of their thermodynamic phase from the combination of microphysical cloud probe and Polar Nephelometer data. Finally, we assess changes in cloud microphysics and cloud phase related to ambient meteorological conditions in spring and summer and address effects of the sea ice and open-ocean surface conditions. We find median N from 0.2 to 51.7 cm−3 and about 2 orders of magnitude higher N for mainly liquid clouds in summer compared to ice and mixed-phase clouds measured in spring. A southerly flow from the sea ice in cold air outbreaks dominates cloud formation processes at temperatures mostly below −10 ∘C in spring, while northerly warm air intrusions favor the formation of liquid clouds at warmer temperatures in summer. Our results show slightly higher N in clouds over the sea ice compared to the open ocean, indicating enhanced cloud formation processes over the sea ice. The median CWC is higher in summer (0.16 g m−3) than in spring (0.06 g m−3), as this is dominated by the available atmospheric water content and the temperatures at cloud formation level. We find large differences in the particle sizes in spring and summer and an impact of the surface conditions, which modifies the heat and moisture fluxes in the boundary layer. By combining microphysical cloud data with thermodynamic phase information from the Polar Nephelometer, we find mixed-phase clouds to be the dominant thermodynamic cloud phase in spring, with a frequency of occurrence of 61 % over the sea ice and 66 % over the ocean. Pure ice clouds exist almost exclusively over the open ocean in spring, and in summer the cloud particles are most likely in the liquid water state. The comprehensive low-level cloud data set will help us to better understand the role of clouds and their thermodynamic phase in the Arctic radiation budget and to assess the performance of global climate models in a region of the world with the strongest anthropogenic climate change.

How, where, and why carbon (C) moves into and out of an ecosystem through time are long-standing questions in biogeochemistry. Here, we bring together hundreds of thousands of C-cycle observations at the Harvard Forest in central Massachusetts, USA, a mid-latitude landscape dominated by 80–120-yr-old closed-canopy forests. These data answered four questions: (1) where and how much C is presently stored in dominant forest types; (2) what are current rates of C accrual and loss; (3) what biotic and abiotic factors contribute to variability in these rates; and (4) how has climate change affected the forest’s C cycle? Harvard Forest is an active C sink resulting from forest regrowth following land abandonment. Soil and tree biomass comprise nearly equal portions of existing C stocks. Net primary production (NPP) averaged 680–750 g C·m−2·yr−1; belowground NPP contributed 38–47% of the total, but with large uncertainty. Mineral soil C measured in the same inventory plots in 1992 and 2013 was too heterogeneous to detect change in soil-C pools; however, radiocarbon data suggest a small but persistent sink of 10–30 g C·m−2·yr−1. Net ecosystem production (NEP) in hardwood stands averaged ~300 g C·m−2·yr−1. NEP in hemlock-dominated forests averaged ~450 g C·m−2·yr−1 until infestation by the hemlock woolly adelgid turned these stands into a net C source. Since 2000, NPP has increased by 26%. For the period 1992–2015, NEP increased 93%. The increase in mean annual temperature and growing season length alone accounted for ~30% of the increase in productivity. Interannual variations in GPP and NEP were also correlated with increases in red oak biomass, forest leaf area, and canopy-scale light-use efficiency. Compared to long-term global change experiments at the Harvard Forest, the C sink in regrowing biomass equaled or exceeded C cycle modifications imposed by soil warming, N saturation, and hemlock removal. Results of this synthesis and comparison to simulation models suggest that forests across the region are likely to accrue C for decades to come but may be disrupted if the frequency or severity of biotic and abiotic disturbances increases.

Measurement(s) navigation data • temperature of air • atmospheric humidity • radar reflectivity • brightness temperature • cloud properties • radiation • atmospheric wind Technology Type(s) GPS navigation system • dropsondes • radar • microwave radiometer • particle count and size analyzer • imager • noseboom sensors Factor Type(s) temporal • location Sample Characteristic - Environment atmosphere Sample Characteristic - Location Arctic Ocean region

One of the most serious challenges facing higher education today is the erosion of academic culture--a declining sense that faculty form a community whose members reflect, deliberate, and make decisions together in the name of a shared educational vision. Our experience with Gonzaga University's Scholarship of Teaching and Learning (SoTL) Initiative suggests that SoTL can be a powerful counter force to this erosion. What became increasingly evident as the initiative unfolded was that its most important result was the creation of a kind of alternative academic community that stands in opposition to many of the dis-integrative, disempowering forces at work in higher education. The scholarly examination of practice, done in a collaborative context, changed participants' perceptions of learning, of themselves as teachers, and of the larger endeavor of which they are a part. Thus, we came to see the SoTL initiative as a subversive activity in the sense used by Neil Postman and Charles Weingartner in their 1969 book, "Teaching as a Subversive Activity": one that invites critical questions about education's purposes, practices, and underlying assumptions, and in so doing reanimates core values.

(1) Background: Since the death of George Floyd, the social movement Black Lives Matter continues to dominate the American political psyche, not only advancing a public dialogue but also escalating the polarization of supported solutions for policing and systemic discrimination. (2) Methods: Using a qualitative context analysis approach, we assessed over 350 sources related to social justice literature and policy-relevant documents to identify key policy solutions supported by the American Black Lives Matter movement compared to the Blue Lives Matter movement. We applied Fearon's bargaining range of war model to analyze the extent to which the policy recommendations of these two opposing movements may overlap. The purpose was to identify and categorize agreement alternatives across various sectors. This research presents top policy solutions, assessing their bargaining ranges. (3) Results: 32 of the 36 top policy reform alternatives at the national level have sufficient bargaining ranges. This analysis indicates the importance of supporting various sectors like mental health/psychosocial policies and programs, which can (1) serve as a focal point of agreement between contending movements, and (2) decrease racial injustice through strategic bargaining. (4) Conclusions: In a divisively political landscape, it is crucial to identify starting points for negotiation among contending actors. Identifying bargaining opportunities can help seed a dialogue that may benefit all parties involved. [ABSTRACT FROM AUTHOR]

Background and purpose: Implantable vagus nerve stimulation (VNS) paired with volitional upper extremity rehabilitation can improve impairment and function among moderately to severely impaired, chronic stroke survivors. This study is a retrospective analysis of the in-clinic rehabilitation phase of the blinded, placebo-controlled, randomized pivotal VNS-REHAB trial to determine whether dosing parameters during in-clinic paired VNS therapy were associated with responder status and whether covariates might impact that determination. Methods: Data were limited to 53 participants in the active VNS group who had received VNS implants prior to undergoing 6 weeks of in-clinic rehabilitation paired with VNS. Tasks were standardized across all participants. Dosing parameters included number of stimulations and task time. The primary outcome was the Fugl-Meyer Upper Extremity Assessment (FMA-UE), evaluated at the end of 6 weeks (Post-1). Participants were classified a priori as responders based on an improvement of ≥6 points on the FMA-UE from baseline to Post-1. Results: Dosing parameters were not associated with FMA-UE responder status at the end of 6 weeks. Covariates including age, gender, paretic hand, baseline severity, and chronicity of stroke were also not significant associations of response. Discussion and conclusions: While responders to VNS could be defined, therapy dosing and participant attributes did not provide greater specification for association of responder status. Limitations of this study include small sample size and non-linearity of the FMA-UE. Future studies will include reassessing responder categorization using more linear scales and examining stroke lesion characteristics to determine whether these measures are more sensitive to dosing parameters. Video abstract available: for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://www.w3.org/1999/xlink ). [ABSTRACT FROM AUTHOR]

Introduction:. Owing to the coronavirus 2019 pandemic limiting both applicants and residency programs in their ability to connect in-person, it is likely that a shift toward virtual connections was made. We aimed to query applicants regarding their perspectives of orthopaedic residency program social media use. Furthermore, we aimed to quantify the number of orthopaedic surgery residency programs with active social media accounts. Methods:. All applicants to a single orthopaedic surgery residency were surveyed regarding their perceptions of social media use by orthopaedic surgery residency programs. After this, we evaluated social media use by orthopaedic surgery residency programs. Results:. Of total, 54.3% of applicants indicated that an orthopaedic surgery residency program they followed on social media posted content that increased their interest in the program. Furthermore, 77.8% of the applicants believed that orthopaedic surgery residency programs should have social media accounts, specifically Instagram. Of the orthopaedic surgery residencies identified, 113 (58.9%) had Instagram, 84 (43.8%) had Twitter, and 21 (10.9%) had Facebook accounts. Discussion:. Applicants largely feel that orthopaedic surgery residencies should have social media accounts. Orthopaedic surgery residencies saw the value in connecting with students virtually, as shown by nearly 90% of the programs, with social media starting their accounts this year.

Data provenance is a machine-readable summary of the collection and computational history of a dataset. Data provenance confers or adds value to a dataset, helps reproduce computational analyses, or validates scientific conclusions. The people of the End-to-End Provenance Project are a community of professionals who have developed software tools to collect and use data provenance.

Mineral dust particles from deserts are amongst the most common ice nucleating particles in the atmosphere. The mineralogy of desert dust differs depending on the source region and can further fractionate during the dust emission processes. Mineralogy to a large extent explains the ice nucleation behavior of desert aerosol, but not entirely. Apart from pure mineral dust, desert aerosol particles often exhibit a coating or are mixed with small amounts of biological material. Aging on the ground or during atmospheric transport can deactivate nucleation sites, thus strong ice nucleating minerals may not exhibit their full potential. In the partner paper of this work, it was shown that mineralogy determines most but not all of the ice nucleation behavior in the immersion mode found for desert dust. In this study, the influence of semi-volatile organic compounds and the presence of crystal water on the ice nucleation behavior of desert aerosol is investigated. This work focuses on the deposition and condensation ice nucleation modes at temperatures between 238 and 242 K of 18 dust samples sourced from nine deserts worldwide. Chemical imaging of the particles' surface is used to determine the cause of the observed differences in ice nucleation. It is found that, while the ice nucleation ability of the majority of the dust samples is dominated by their quartz and feldspar content, in one carbonaceous sample it is mostly caused by organic matter, potentially cellulose and/or proteins. In contrast, the ice nucleation ability of an airborne Saharan sample is found to be diminished, likely by semi-volatile species covering ice nucleation active sites of the minerals. This study shows that in addition to mineralogy, other factors such as organics and crystal water content can alter the ice nucleation behavior of desert aerosol during atmospheric transport in various ways.