Reverse total shoulder arthroplasty (RTSA) has become a widely accepted surgical treatment for
various complex conditions. It has demonstrated excellent clinical outcomes in alleviating pain and
restoring function in challenging cases where traditional anatomic replacements are less effective.
Unfortunately, complications may occur, such as periprosthetic joint infection (PJI). PJIs could be
caused by Staphylococcus aureus, coagulase-negative staphylococci (CoNS), mainly S.
epidermidis, and Cutibacterium acnes. Several approaches, during hip and knee arthroplasties, have
been explored with the aim of reducing PJIs intraoperatively, particularly the use of intraoperative
iodopovidone irrigation. However, no data referred to its use after shoulder arthroplasty are still
available. Therefore, the aim of the present multidisciplinary research is to establish if an
intraoperative iodopovidone irrigation could be able to reduce microbial contamination in shoulder
arthroplasty and to determine the bacterial isolates’ virulence features. Fifty-five patients
undergoing RTSA were included. They were enrolled from 3 different hospitals, specifically 29
from San Luigi Gonzaga Hospital (Orbassano, Turin), 11 from Mauriziano-Umberto I Hospital
(Turin), and 5 from Presidio CTO, Città della Salute e della Scienza Hospital (Turin). Most of them
had various comorbidities. At the end of RTSA surgery, three different specimens were collected
from the surgical field before and after an irrigation with iodopovidone. The specimens were
cultured on various agar media suitable for the growth of aerobic and anaerobic bacteria and
incubated. Subsequently, bacteriological investigations were carried out, and the resulting
predominant bacterial types were identified and characterized to evidence resistant or biofilmproducing bacterial strains. The microbiological analysis revealed a reduction in both anaerobic
(75%) and aerobic (100%) bacterial load, as well as the positivity rate, in samples collected after the
post-operative irrigation compared to pre-operative ones. C. acnes was the predominant anaerobic
pathogen isolated, whereas the most representative aerobic strains were CoNS, and rarely Gramnegative bacteria. The virulence factor’s characterisation revealed that a low number of isolates
were resistant to the assayed antibiotics, and notably, among the biofilm producers both C. acnes
and CoNS isolates were strongly adherent. PJI is a devastating complication following total joint
arthroplasty, which significantly increases the risk of patient morbidity. These preliminary results
corroborate the efficacy of the intraoperative irrigation in reducing the bacterial load in the
operatory field, and in turn it might contribute to prevent the risk of PJIs in shoulder arthroplasty.
An appropriate prophylaxis therapy and a multifaceted microbiological approach could ensure a
significant reduction in patient infection rate and a potential decrease in associated economic costs.

In Mexico, mucormycosis is an emerging opportunistic fungal infection that is associated with a mortality rate of more than 50%. Rhizopus spp. are the most frequent etiologic agents in 59% of the cases of rhinocerebral mucormycosis reported in the country . The most frequently identified clinical forms are the rhino-orbito-cerebral form (75.9%), the cutaneous form (8.41%) and the pulmonary form (7.47%), according to a 35-year retrospective study conducted at a tertiary care center .

Multidisciplinary microsurgical treatment is essential to limit damage and allow a good response to antifungals. Resection of the injured tissue at the base of the skull involves management of neurovascular structures that compromise the patient’s life and neurological function. Adequate reconstruction of the base of the skull is essential to avoid cerebrospinal fluid fistulas, meningitis or some other neuroinfection. Assisting in adequate prosthetic reconstruction

Brucellosis is a zoonotic disease caused by Brucella, which infects a wide variety of vertebrate animals including human beings. The aim was to carry out a randomized survey to evaluate the frequency of Brucella positive-raw milk artisanal cheese (RMAC) in five traditional Brazilian microregions, as well as evaluating the associated factors and  to analyze the relationships between spatial clusters of Brucella positive-RMAC and those of human exposures and positive livestock. During the period from October/2017 to April/2018, 100 RMAC samples were collected from different rural family-based cheese-processing agroindustries (RFCPA) in four and one regions from the states of Minas Gerais and Piauí, respectively, and were analysed for Brucella by direct polymerase chain reaction (PCR) species-specific DNA detection and cultivation-based approaches. Among 100 RMAC that were analysed, we found 33 Brucella DNA-positive samples by PCR and, for the first time, from one Minas artisanal cheese, viable Brucella abortus was recovered by cultivation. RMAC with a lower ripening period and three of the five regions had higher concentrations of positive samples (p < 0.05), showing two clusters by Kernel density estimator, one being significant by Scan (p < 0.05). Links between clusters of high-density human expositions to Brucella and positive-RMAC were found. In conclusion, RMAC may be a source of Brucella for humans, since the positive samples were from batches that were sold by cheesemakers. This should be of concern and encourage cooperation between the health and agriculture sectors in order to mitigate this public health risk through One Health integrated approaches.

Drawing on theory and previous empirical findings, we attempted to shed some light on the relationship between modes of learning – both In-person and Online – and the successful placement of graduates in supply chains. We asked whether the mode of learning – whether remote learning or on-campus learning affects graduates’ success in the field. Of interest are four logistics areas of learning: knowledge of core course content, mastery of related technology, exposure to logistics driven hard and soft skills and the extent to which they are all sufficient and necessary for meeting firms’ needs across supply chains. Data concerning these variables were collected from 219 recent logistics and supply chain program graduates at a Southeastern University, and from 82 of their immediate supply chain certified managers. We employed Necessary Condition Analysis for testing necessity conditions amongst our variables. Findings suggest that a high level of knowledge in core logistics content and mastery of logistic related technology – that were studied in-person rather than online – emerge as statistically significant conditions for graduates’ success in the field. Surprisingly, identifiable hard and soft skills being taught that could help ensure successful graduates’ placement in their firms were found to be statistically insignificant conditions. None of the corresponding program variables that were studied online have emerged as statistically significant. Online learning as a mode of delivery appears to be a weak measure of overall student learning. Remote learning, in NCA terms, emerged as a poor necessary condition, and thus as a less relevant criterion for job placement in the logistics field. Our findings, although mixed, help ascertain and illuminate some facets of the academic-practitioner model suggesting, in part, a few necessary conditions that are still critical for aligning course content with the need in the field. Theoretical, practical, as well as methodological contributions are discussed, along with limitations and future research directions.