The torques exerted by a locally isothermal disk on an embedded planet lead to rapid inward migration. Recent work has shown that modeling the thermodynamics without the assumption of local isothermality reveals regions where the net torque on an embedded planet is positive, leading to outward migration of the planet. When a region with negative torque lies directly exterior to this, planets in the inner region migrate outwards and planets in the outer region migrate inwards, converging where the torque is zero. We incorporate the torques from an evolving non-isothermal disk into an N-body simulation to examine the behavior of planets or planetary embryos interacting in the convergence zone. We find that mutual interactions do not eject objects from the convergence zone. Small numbers of objects in a laminar disk settle into near resonant orbits that remain stable over the 10 Myr periods that we examine. However, either or both increasing the number of planets or including a correlated, stochastic force to represent turbulence drives orbit crossings and mergers in the convergence zone. These processes can build gas giant cores with masses of order ten Earth masses from sub-Earth mass embryos in 2-3 Myr.

The aim of this paper was to determine the effect of acupuncture on perceived stress levels in women on the day of embryo transfer (ET), and to determine if perceived stress levels at embryo transfer correlated with pregnancy rates. The study was an observational, prospective, cohort study based at the University IVF center. Patient(s) 57 infertile patients undergoing IVF or IVF/ICSI Interventions(s) Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care Main outcome measure(s) Perceive Stress Scale scores, pregnancy rates Result(s) women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only non-donor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status. Conclusions(s) The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.

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Background:Latissimus dorsi transfers have been considered necessary to restore active external rotation following reverse shoulder arthroplasty (RSA). The purpose of this study was to assess the effectiveness of an RSA system that lateralizes the center of rotation in restoring active external rotation without a latissimus dorsi transfer in patients with a preoperative external rotation deficit (external rotation of <0°).Methods:We retrospectively reviewed the records of patients who had undergone RSA with a lateralized center of rotation without a latissimus dorsi transfer. All patients had had a preoperative external rotation deficit (active external rotation of <0°), and all were followed for a minimum of 2 years. Patients were stratified into 2 groups on the basis of the preoperative diagnosis: (1) those with a combined loss of active elevation and external rotation as a result of rotator cuff tear arthropathy (CLEER group) and (2) those with a combined loss of active elevation and external rotation as a result of other posttraumatic etiologies (non-CLEER group). The mean improvement of external rotation was analyzed. Subgroup analysis was performed on the basis of the Goutallier classification, glenosphere lateralization, and total prosthetic lateralization.Results:Thirty-three patients (24 in the CLEER group and 9 in the non-CLEER group) met the inclusion criteria. The average follow-up was 43.4 months (range, 24 to 77 months). External rotation improved significantly in both the CLEER group (from −21° preoperatively to 28° postoperatively; p < 0.001) and the non-CLEER group (from −19° preoperatively to 26° postoperatively; p = 0.001). Goutallier classification, glenosphere lateralization, and total prosthetic lateralization were not correlated with the degree of improvement of external rotation in either group (p > 0.05 for all).Conclusions:RSA with a lateralized center of rotation can effectively restore external rotation without the use of a latissimus dorsi transfer in patients with a preoperative external rotation deficit as a result of rotator cuff arthropathy or other posttraumatic etiologies.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.