Notes

Plastics in the Earth program.
Various transboundary river basins are facing increased pressure on water resources in near future. However, little is known ab out the future drivers globally, namely, changes in natural local runoff and natural inflows from upstream parts of a basin, as well as local and upstream water consumption. Here we use an ensemble of four global hydrological models forced by five global climate models and the latest greenhouse-gas concentration (RCP) and socioeconomic pathway (SSP) scenarios to assess the impact of these drivers on transboundary water stress in the past and future. Our results show that population under water stress is expected to increase by 50% under a low population growth and emissions scenario (SSP1-RCP2.6) and double under a high population growth and emission scenario (SSP3-RCP6.0), compared to the year 2010. As changes in water availability have a smaller effect when water is not yet scarce, changes in water stress globally are dominated by local water consumption-managing local demand is thus necessary in order to avoid future stress. Focusing then on the role of upstream changes, we identified upstream availability (i.e., less natural runoff or increased water consumption) as the dominant driver of changes in net water availability in most downstream areas. Moreover, an increased number of people will be living in areas dependent on upstream originating water in 2050. International water treaties and management will therefore have an increasingly crucial role in these hot spot regions to ensure fair management of transboundary water resources.
Biomechanical studies have demonstrated that arthroscopic rotator cuff repair using a linked double-row equivalent construct results in significantly higher load to failure compared with conventional transosseous-equivalent constructs.

To determine the patient-reported outcomes (PROs), reoperation rates, and complication rates after linked double-row equivalent rotator cuff repair for full-thickness rotator cuff tears.

Case series; Level of evidence, 4.

Consecutive patients who underwent linked double-row equivalent arthroscopic rotator cuff repair with minimum 2-year follow-up were included. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) score at final follow-up. Secondary outcomes included the Simple Shoulder Test (SST), shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, visual analog scale (VAS), reoperations, and complications. Clinical relevance was defined by the minimally clinically important difference (MCID). Comparisons on an individual l0.0%) or reoperations (0.0%) at final follow-up.

Arthroscopic repair of full-thickness rotator cuff tears with the linked double-row equivalent construct results in statistically significant and clinically relevant improvements in PRO scores with low complication rates (0.0%) and reoperation rates (0.0%) at short-term follow-up.
Arthroscopic repair of full-thickness rotator cuff tears with the linked double-row equivalent construct results in statistically significant and clinically relevant improvements in PRO scores with low complication rates (0.0%) and reoperation rates (0.0%) at short-term follow-up.
The tie-grip suture can fix radial tears more rigidly than simple conventional sutures. However, one shortcoming is the residual gap at the central margin of the tear. The tie-grip suture was modified to address this issue and named the "cross tie-grip suture."

The purpose of this study was to compare the suture stability and strength among 4 suturing techniques the original tie-grip, cross tie-grip, and 2 conventional sutures (double horizontal and cross). It was hypothesized that the cross tie-grip suture would show the least displacement and resist the greatest maximum load.

Controlled laboratory study.

A total of 40 fresh-frozen porcine knees were dissected to acquire 80 menisci; 20 menisci were tested in each suture group. A radial tear was created at the middle third of the meniscal body. Repair was performed with the following original tie-grip, cross tie-grip, double horizontal, and cross sutures. The mechanical strength of sutured menisci was evaluated using a tensile testing machine. All menhigh resistance to displacement after repair of radial tears and may be advantageous in healing for radial meniscal tears.
The cross tie-grip suture provided high resistance to displacement after repair of radial tears and may be advantageous in healing for radial meniscal tears.
Patellar chondral defects represent up to 34.6% of defects found during routine arthroscopy. Surgical management has evolved during the past 20 years in an effort to develop techniques to replace hyaline cartilage. Currently, the only technique that achieves this is osteochondral autologous transfer (OAT). Although good and excellent results have often been reported at midterm and long-term follow-up for femoral lesions, little is known about isolated patellar defects.

To assess clinical and imaging results of patients treated with OAT for high-grade patellar defects.

Case series; Level of evidence, 4.

This was a retrospective study on all patients who received OAT for high-grade symptomatic patellar chondral defects between 2010 and 2018 at our institution. The study included patients younger than 40 years of age with anterior knee pain and a grade 4 International Cartilage Repair Society patellar chondral defect between 1 and 2.5 cm
. Patients with surgery in other knee compartments, concomitant andge, this is the largest series to date regarding isolated patellar OAT. At midterm follow-up, most patients reported good and excellent results regarding symptoms and activity levels. Most autografts showed good osseous integration and excellent filling of the chondral surface, as evidenced on MRI. OAT is a good alternative to treat high-grade patellar chondral defects, especially among young patients.
To our knowledge, this is the largest series to date regarding isolated patellar OAT. INX-315 in vivo At midterm follow-up, most patients reported good and excellent results regarding symptoms and activity levels. Most autografts showed good osseous integration and excellent filling of the chondral surface, as evidenced on MRI. OAT is a good alternative to treat high-grade patellar chondral defects, especially among young patients.
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