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0 fM to 1.0 μM with a low detection limit of 0.28 fM (S/N = 3) was obtained. More importantly, the residual diethylstilbestrol in water was detected by the developed aptasensor; this confirmed that this method has good performance and potential applications in real samples.An organoselenium-catalyzed N1- and N2-selective aza-Wacker reaction of alkenes with benzotriazoles is reported, which provides easy access to N1- and N2-olefinated benzotriazole derivatives. The wide substrate scope, good functional group tolerance, and facile scale-up of this method are expected to promote its potential application in synthetic chemistry. A preliminary mechanism is proposed to explain the N1- and N2-selectivities.We show that a water envelope network plays a critical role in protein-protein interactions (PPI). The potency of a PPI inhibitor is modulated by orders of magnitude on manipulation of the solvent envelope alone. The structure-activity relationship of PEX14 inhibitors was analyzed as an example using in silico and X-ray data.Due to their inherent ring strain, three-membered carbocyclic- and heterocyclic ring structures are versatile synthetic building blocks. Traditional ring-opening methods of these molecules require the use of thermolysis, acid catalysts or transition-metals via ionic reaction pathways. Recently, visible light-induced photoredox catalysis has emerged as a powerful platform for initiating new chemical transformations. In this tutorial review, the synthetic and mechanistic aspects of visible light-promoted ring-opening functionalization of three-membered carbo- and heterocycles are highlighted. By using these strategies, a variety of ring-opening functionalization products, including biologically important carbo- and heterocycles, can be efficiently accessed in a high chemo- and regioselective manner.Introduction Although educational attainment and income are protective against tobacco use, Marginalization-related Diminished Returns (MDRs) theory posits that the protective effects of socioeconomic status (SES) indicators may be smaller for marginalized groups than mainstream social groups. We aimed to compare the effects of educational attainment and income on current smoking status of Chinese American and European American adults. Methods Data came from the National Health Interview Survey (NHIS - 2015). A total number of 28081 individuals entered our analysis. This included 420 Chinese Americans and 27661 European Americans. The independent variables were educational attainment (years of schooling) and annual income. The dependent variable was current established smoking status. Age, gender, region, and marital status were covariates. Ethnicity (Chinese American vs. European American) was the moderator. Results Overall, educational attainment and income were inversely associated with the odds of current established smoking. Ethnicity showed a significant interaction with income but not educational attainment. This finding suggested that the protective effect of income, but not educational attainment, on odds of current established smoking might be smaller for Chinese Americans than European Americans. Conclusions While educational attainment reduces the odds of current established smoking, high-income Chinese Americans remain at high risk of smoking due to a phenomenon called MDRs. In fact, high income is associated with greater smoking prevalence in Chinese Americans, rather than less. To reduce ethnic disparities in tobacco use, we need to go beyond SES inequalities by addressing structural causes of higher than expected risk of smoking in high SES ethnic minorities.Hypothesis This study aimed to examine the reliability and diagnostic discriminative accuracy of 5 different methods that quantity the craniocaudal humeral position with respect to the scapula on conventional radiographs. Methods In this retrospective, cross-sectional diagnostic study, 2 observers randomly assessed the conventional anteroposterior shoulder radiographs of 280 subjects with rotator cuff imaging for the (1) acromiohumeral (AH) interval, (2) upward migration index (UMI), (3) glenohumeral center-to-center measurement (GHCC), (4) glenohumeral arc measurement (GHa), and (5) scapular spine-humeral head center method (SHC). Reliability was assessed by means of relative consistency (intraclass correlation coefficient) and absolute consistency. Discriminative accuracy for detecting a rotator cuff tear was calculated. Results Relative consistency (intraclass correlation coefficient) for the AH interval, UMI, GHCC, GHa, and SHC was 0.961, 0.913, 0.806, 0.924, and 0.726, respectively. The AH interval had the highest absolute consistency with a random residual measurement error of 0.58 mm compared with 1.0-3.2 mm for the other measurements. The discriminative accuracy of the AH interval did not significantly differ from that of the UMI (-0.010; 95% confidence interval [CI], -0.042 to 0.022; P = .545) but was significantly better than that of the GHCC (0.112; 95% CI, 0.043-0.181; P = .001), GHa (0.074; 95% CI, 0.009-0.139; P = .027), and SHC (0.178; 95% CI, 0.100-0.256; P less then .001). Conclusion Assessment of the craniocaudal humeral position is performed with good to excellent intraobserver and interobserver reliability. The discriminative accuracy for detecting a rotator cuff tear on a single radiograph was highest for the AH interval and UMI. We recommend using the AH interval or UMI as an indirect measure of the presence of a rotator cuff tear on conventional radiographs. © 2019 The Authors.Background Reverse shoulder arthroplasty (RSA) is frequently performed in the revision setting as a salvage procedure. Rapamycin The purpose of this study was to report the clinical outcomes and complication, reoperation, and revision rates after revision RSA (RRSA) stratified according to the primary shoulder procedure undergoing revision. Methods Four databases (Embase, MEDLINE, SPORTDiscus, and Cochrane Controlled Trials Register) were searched for eligible studies published between January 1985 and September 2017. The primary outcomes of interest included pain, active range of motion, and functional outcome scores. Secondary outcomes included complication, reoperation, and revision rates. Results A total of 43 studies (1041 shoulder arthroplasties) met the inclusion criteria, with a mean follow-up period of 43.8 months (range, 31.1-57.2 months). Pain scores improved in all groups; however, none reached statistical significance. Range of motion improved in all groups, except for external rotation in the RSA category. RRSA demonstrated significant improvements in the Simple Shoulder Test score and Constant score (CS) in the group undergoing hemiarthroplasty (HA) for fracture, CS in the group undergoing HA for other indications, and CS in the group undergoing anatomic total shoulder arthroplasty. Pooled complication rates were highest in the failed RSA group (56.2%), followed by the group undergoing HA for other indications (27.7%), total shoulder arthroplasty group (23.6%), soft-tissue repair group (20.6%), open reduction and internal fixation group (19.0%), and group undergoing HA for fracture (13.6%). Conclusions Compared with other revision indications, RRSA for failed HA demonstrated the most favorable outcomes, whereas the highest complication and revision rates were observed in the RSA subgroup. This information is useful when establishing patient expectations regarding the risks, benefits, and complication and revision rates of RRSA. © 2019 The Author(s).Background Reverse shoulder arthroplasty (RSA) has gained popularity in the treatment of proximal humeral fractures (PHFs), especially in elderly patients. The purpose of this study was to investigate the use of RSA implants for acute PHFs and risk of revision, as well as risk factors for revision. Methods RSA implants for acute PHFs were identified from the Nordic Arthroplasty Register Association registry data from 2004 to 2016. Kaplan-Meier survival analysis was used to calculate implant survival. Cox multiple regression analysis was used to calculate the adjusted revision rate for sex, age, country of operation, and year of surgery. Results The study included 1523 RSA implants for PHFs (84% women; average age, 77 years; average follow-up time, 2.5 years). The 5-year cumulative implant survival rate was 97% (confidence limits, 95.5% and 98%). Revision was performed for 33 implants (2%). The most common reason for revision was instability, occurring in 11 cases (0.7%), followed by fracture, occurring in 6 (0.4%), and infection, occurring in 5 (0.3%). Four different arthroplasty brands were used in this cohort, with the Delta Xtend in two-thirds of cases (n = 1025). Age younger than 60 years and male sex were associated with slightly higher rates of revision; however, these differences did not reach statistical significance (hazard ratio of 2.02 with P = .075 and hazard ratio of 3.23 with P = .057, respectively). Conclusion The use of RSA for acute PHFs is increasing in the Nordic countries. The short-term risk of revision is low. The main reason for revision of RSA for this indication is instability. © 2019 The Author(s).Background Glenoid baseplate and glenosphere positioning may affect scapular notching rates. The purpose of this study was to assess various radiographic parameters and correlate them with scapular notching after primary reverse total shoulder arthroplasty (RTSA) at a minimum follow-up time of 5 years. Methods The study sample included 147 primary RTSA with good-quality postoperative radiographs at least 5 years after implantation (mean follow-up 6.1 years, range 5-12 years). The center of rotation (COR) of the glenosphere in reference to the bone-baseplate interface was medialized in 71 and lateralized in 76 shoulders, with a varus polyethylene opening angle in 134 shoulders. Preoperative and immediate postoperative radiographs were measured to determine (1) glenoid baseplate inclination α, β, and the reverse shoulder arthroplasty (RSA) angles; (2) glenoid component inferiorization-peg glenoid rim distance (PGRD); and (3) sphere bone overhang distance (SBOD). Scapular notching was graded according to the Sirwith eccentric glenospheres. Moderate or severe notching was seen in only approximately 15% of the shoulders. Revision surgery was extremely low in this cohort, and it was not related to notching or instability. © 2019 The Author(s).Background Humeral stem loosening has gained attention as it has been identified as a cause of revision surgery in reverse shoulder arthroplasty (RSA). In RSA, humeral stem revision is very difficult if there is humeral bone loss because of stress shielding. Some studies of humeral bone resorption after anatomic shoulder arthroplasty have been published, but there are few detailed reports of humeral bone resorption after RSA. This study aimed to investigate the prevalence of humeral bone resorption after RSA procedures and to evaluate the risk factors for bone resorption. Methods This study included 48 shoulders that underwent RSA with an uncemented humeral stem from July 2014 to May 2017 and were followed up for more than 1 year. The prevalence of humeral bone resorption and risk factors were investigated. Logistic, multiple logistic, and multivariate logistic regression analyses were performed to evaluate the data. Results Grade 0 bone resorption, the most advanced grade, occurred in 8 shoulders (16.7%); grade 1, in 0 (0%); grade 2, in 17 (35.
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