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e few studies investigating the impact of preoperative opioid use on postoperative outcomes after shoulder surgery.

We studied variation in perioperative opioid use after total joint arthroplasty with respect to patient and procedure characteristics in order to inform initiatives to optimize pain relief.

We recorded perioperative opioid consumption for a cohort of total joint arthroplasty patients to identify factors underlying variation in perioperative opioid use.

Younger patient age, tobacco use, greater symptoms of depression, private insurance, and knee arthroplasty were associated with increased opioid consumption.

Awareness of the patient characteristics associated with increased perioperative opioid use can help inform implementation of targeted strategies for safe, optimal pain relief and satisfaction.

Awareness of the patient characteristics associated with increased perioperative opioid use can help inform implementation of targeted strategies for safe, optimal pain relief and satisfaction.

This study assessed implant survival and dislocation following proximal femur tumor endoprosthetic replacement.

Thirty-eight procedures were performed between 2005 and 2019. The cumulative incidence of implant revision was calculated with death as a competing risk.

The majority of endoprostheses were bipolar hemiarthroplasty (n=33, 86.8%). The cumulative incidence of revision was 14.6% (95% CI, 3.2%-34.1%) at five years. Dislocation occurred in 7.9% (n=3) of hips at a mean (SD) 44±35.2 days.

Proximal femur tumor endoprosthetic replacement is a durable option that tends to outlive patients. Strict postoperative bracing may lower dislocation rates.

III. Retrospective Study.

III. Retrospective Study.

To evaluate outcomes for a combined osteoligamentous reconstruction technique for Neer Type IIB clavicle fractures.

Patients with Neer Type IIB clavicle fractures treated with combined clavicular locking plate and coracoclavicular ligament suture reconstruction were identified. KU-55933 Demographics, clinical outcomes, and radiographic outcomes were collected.

Twenty-four patients with mean 13 months of follow-up were included. Bony union and normal radiographic coracoclavicular relationship were achieved in 23 (96%) patients. The mean UCLA Shoulder score was 33.3. Three (13%) complications occurred.

The combined osteoligamentous reconstruction approach as described is a successful option for treating Neer Type IIB clavicle fractures.

The combined osteoligamentous reconstruction approach as described is a successful option for treating Neer Type IIB clavicle fractures.

The purpose of this study is to evaluate the reliability of magnetic resonance imaging (MRI) in predicting the location of ACL tears in preoperative planning for anterior cruciate ligament (ACL) repair.

Thirty-four patients who underwent ACL repair were retrospectively analyzed to compare intraoperative arthroscopic findings with preoperative MRIs.

For identifying type I tears, the sensitivity of MRI was 9.0% and the accuracy of MRI was 8.8%. There was moderate interrater agreement between MRI findings for tear location and tear degree.

MRI alone may not necessarily be accurate in identifying which ACL tears are amenable to repair.

Retrospective case series; Level of Evidence IV.

Retrospective case series; Level of Evidence IV.

The aim of this study was to investigate risk factors for VTEs after HTO based on patient demographics, medical comorbidities, operative valuables, and clinical results.

A total of 137 patients were assessed VTEs using ultrasonography at 1 week after HTO. The risk factors for postoperative VTEs were to assessed.

The incidence of VTEs after HTO was 25.5%. Postoperative single leg standing test was independent predictors of VTEs after HTO.

The incidence of VTEs after HTO is relatively high and Postoperative knee function is important for preventing VTEs after HTO.

Ⅱ, Prospective comparative study.

Ⅱ, Prospective comparative study.

To study the intraoperative morphology of the glenoid labrum and capsule in recurrent shoulder dislocation and to study the relationship between the number of dislocations and the changes in the glenoid and labrum.

Over a period of 18 months, 108 patients with traumatic anterior dislocations were included in the study, of which 102 men and 6 women with mean age of 33.4yrs range from 18 to 45. The patients with bony bankart, other labral lesions, ligamentous laxity, SLAP tear were excluded from the study. All the patients underwent arthroscopic bankart repair. We have classified the morphology of labrum and capsule on their appearance intraoperatively. Labrum is named as Normal, Desiccated or Shredded and Capsule as Normal or Damaged.

Six varieties of appearances were observed. Namely, Normal capsule and Normal labrum (NN), Normal capsule and Desiccated labrum (ND), Normal capsule and Shredded labrum (NS), Damaged capsule and Normal labrum (DN), Damaged capsule and Desiccated labrum(DD), Damaged capsule and Shredded labrum(DS). Among them, DD (33.3%) and DS (29.6%) variety had highest number of dislocations suggesting the labrum and capsule lose normal anatomy with more recurrence of dislocations.

These findings support that reproducing normal anatomy after surgical repair is possible when the intervention is done sooner than later.

III.

III.Stomach is a highly vascular organ in the gastrointestinal tract. It is very rare for a stomach to go in for gangrene even in cases of volvulus. Spontaneous gangrene due to acute necrotizing gastritis is a very rare and dreaded condition. This condition is usually not recognized preoperatively due to its rarity. Hence, early diagnosis and prompt expert management are necessary. Here, we present a case of acute necrotizing gastritis which was admitted in our emergency department which was diagnosed to be a case of gastric gangrene preoperatively with the help of radiological investigations.The COVID-19 pandemic has disrupted teaching in medical schools across the world. Online learning has become the core method of teaching during this pandemic. The aim of this study was to investigate the impact of this mode of education among medical students in India. A survey was conducted by distributing online questionnaires to medical students across India. Data gathered from the survey was analyzed using SPSS® version 16. The overall response rate of survey was 58.4%. Practical training was most severely affected by online classes (93.32%) as compared to theory classes (60.93%). A total of 71.98% students agreed that canceling of physical medical conferences adversely affected the building up of their resumes while only 28.79% agreed that virtual conferences and meetings enhanced their learning. A total of 56.81% agreed that online exams adversely affected their performance. A total of 46.79% feels that online classes using simulated patients and simulation technology is not useful but 41.90% think that simulated teaching should be a part of the medical curriculum. A majority of the students (87.66%) had technical issues with online classes and 89.72% complained of poor concentration during online teaching due to distractions. A total of ~75% felt that the pandemic has adversely affected the availability of research opportunities and development of skills, ethics, communication, and behavior. Online education has adversely affected all aspects of learning, performance in exams, research, and the overall future plans of students. Moving forward from this pandemic, in order to maximize the benefits of both face-to-face and online teaching, we suggest medical schools resort to a hybrid pattern.Cellulose nanocrystals (CNCs) have attracted tremendous attention because of their excellent chemical and physical properties and due to their renewability and sustainability. This material can be extracted from agricultural by-products such as rice straw, banana tree, or bagasse. Rice straw was selected as the raw material in this study. Initially, a large amount of lignin must be removed by an alkaline process to obtain a slurry. Thereafter, a green bleaching process can be used to remove the remaining lignin in the slurry. An UV-emitting diode with 365 nm wavelength assisted the oxidation reaction of the H2O2 solution without the use of chlorine-containing chemical bleach. The reaction required only 2.5 h to obtain high-purity cellulose and successfully enhanced the yield. Transmission electron microscopy images showed that the CNCs from rice straw were ~ 100 nm long and 10-15 nm wide. The crystalline index and degradation temperature of CNCs were 83.8% and 257 °C, respectively.Mathematical modeling of epidemic spreading has been widely adopted to estimate the threats of epidemic diseases (i.e., the COVID-19 pandemic) as well as to evaluate epidemic control interventions. The indoor place is considered to be a significant epidemic spreading risk origin, but existing widely-used epidemic spreading models are usually limited for indoor places since the dynamic physical distance changes between people are ignored, and the empirical features of the essential and non-essential travel are not differentiated. In this paper, we introduce a pedestrian-based epidemic spreading model that is capable of modeling indoor transmission risks of diseases during people's social activities. Taking advantage of the before-and-after mobility data from the University of Maryland COVID-19 Impact Analysis Platform, it's found that people tend to spend more time in grocery stores once their travel frequencies are restricted to a low level. In other words, an increase in dwell time could balance the decrease in travel frequencies and satisfy people's demands. Based on the pedestrian-based model and the empirical evidence, combined non-pharmaceutical interventions from different operational levels are evaluated. Numerical simulations show that restrictions on people's travel frequency and open hours of indoor places may not be universally effective in reducing average infection risks for each pedestrian who visit the place. Entry limitations can be a widely effective alternative, whereas the decision-maker needs to balance the decrease in risky contacts and the increase in queue length outside the place that may impede people from fulfilling their travel needs. The results show that a good coordination among the decision-makers can contribute to the improvement of the performance of combined non-pharmaceutical interventions, and it also benefits the short-term and long-term interventions in the future.In 2020, Brazil was the leading country in COVID-19 cases in Latin America, and capital cities were the most severely affected by the outbreak. Climates vary in Brazil due to the territorial extension of the country, its relief, geography, and other factors. Since the most common COVID-19 symptoms are related to the respiratory system, many researchers have studied the correlation between the number of COVID-19 cases with meteorological variables like temperature, humidity, rainfall, etc. Also, due to its high transmission rate, some researchers have analyzed the impact of human mobility on the dynamics of COVID-19 transmission. There is a dearth of literature that considers these two variables when predicting the spread of COVID-19 cases. In this paper, we analyzed the correlation between the number of COVID-19 cases and human mobility, and meteorological data in Brazilian capitals. We found that the correlation between such variables depends on the regions where the cities are located. We employed the variables with a significant correlation with COVID-19 cases to predict the number of COVID-19 infections in all Brazilian capitals and proposed a prediction method combining the Ensemble Empirical Mode Decomposition (EEMD) method with the Autoregressive Integrated Moving Average Exogenous inputs (ARIMAX) method, which we called EEMD-ARIMAX.