Miracle-dz/UniFAR-FTUs huggingface dataset:
Disabling Synovitis Associated With LARS Artificial Ligament Use in Anterior Cruciate Ligament Reconstruction

The Ligament Augmentation Reconstruction System (LARS, Surgical Implants and Devices, Arc-sur-Tille, France) is a synthetic, nonabsorbable augmentation device made of polyethylene terephthalate (PET). It has rapidly gained popularity in Australia because of the lack of graft donor site morbidity and the perceived absence of risk permitting an earlier return to sporting activity. While autograft use in anterior cruciate ligament (ACL) reconstruction has demonstrated excellent clinical results, little has been published to support the use of artificial ligaments. Poor patient outcomes associated with graft failure, tunnel osteolysis, foreign body synovitis, and premature arthritis are among the reasons that artificial ligaments were abandoned over 2 decades ago. We present a case report of disabling synovitis after LARS artificial ligament implantation that required revision at 1 year. This case is a cautionary note to the implantation of LARS ligaments into young and active patients. The patient provided consent for the use of case information in this publication.
The FIFA 11+ Program Is Effective in Preventing Injuries in Elite Male Basketball Players

Background: Recently, structured training programs for sports injury prevention (“The 11” and “The 11+”) have been validated in soccer. The FIFA 11+ program has not been evaluated in basketball. Hypothesis: The FIFA 11+ program is effective in reducing the rates of injury in male basketball players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: The authors randomized 11 teams of the same club. Seven teams were allocated to the intervention group (80 players; mean [SD] age 13.5 [2.3] years), and 4 teams were allocated to the control group (41 players; mean [SD] age 15.2 [4.6] years). The authors conducted an injury surveillance program during a 9-month season. The primary outcome was any injury to the athletes. The secondary outcome was any injury to the lower extremity (foot, ankle, lower leg, knee, thigh, groin, and hip). They included an analysis of the type of exposure (match or training), injury location in the body, and type of injury (acute or overuse). Results: During the 9-month season, 23 (19%) of the 121 players included in the study sustained a total of 31 injuries (14 in the intervention group and 17 in the control group). In the intervention group, injury rates per 1000 athlete-exposures were lower than those in the control group, with statistical significance, for overall injuries (0.95 vs 2.16; P = .0004), training injuries (0.14 vs 0.76; P = .007), lower extremity injuries (0.68 vs 1.4; P = .022), acute injuries (0.61 vs 1.91; P < .0001), and severe injuries (0 vs 0.51; P = .004). The intervention group also had statistically significant lower injury rates for trunk (0.07 vs 0.51; P = .013), leg (0 vs 0.38; P = .007), and hip and groin (0 vs 0.25; P = .023) compared with the control group. There was no statistically significant difference in match injuries, knee injuries, ankle injuries, and overuse injuries between 2 groups. The most frequent acute injury diagnoses were ligament sprains (0.41 and 0.38 in the intervention and control groups, respectively; P < .006) and contractures (0.76 and 0.07 in the control and intervention groups, respectively; P < .003). Conclusion: The FIFA 11+ warm-up program is effective in reducing the rates of injuries in elite male basketball players.
Treatment of growth plate injury using IGF‐I‐loaded PLGA scaffolds

Growth plate fracture can lead to retarded growth and unequal limb length, which may have a lifelong effect on a person's physical stature. The goal of this research was to develop an in vivo tissue‐engineering approach for the treatment of growth plate injury via localized delivery of insulin‐like growth factor I (IGF‐I) from cell‐free poly(lactic‐co‐glycolic acid) (PLGA) scaffolds. Mass loss and drug release studies were conducted to study the scaffold degradation and IGF‐I release patterns. In vitro cell studies showed that rat bone marrow stromal cells seeded on the porous scaffolds colonized the pores and deposited matrix within the scaffolds. These in vitro evaluations were followed by a proof‐of‐concept animal study involving implantation of scaffolds in proximal tibial growth plate defects in New Zealand white rabbits. Histological analysis of tissue sections from the in vivo studies showed regeneration of cartilage, albeit with disorganized structure, at the site of implantation of IGF‐I‐releasing scaffolds; in contrast, only bone was formed in empty defects and those treated with IGF‐free scaffolds. The present findings show the potential for treating growth plate injury using in vivo tissue engineering techniques. Copyright © 2012 John Wiley & Sons, Ltd.
Chondrogenic potential of injectable κ‐carrageenan hydrogel with encapsulated adipose stem cells for cartilage tissue‐engineering applications

Due to the limited self‐repair capacity of cartilage, regenerative medicine therapies for the treatment of cartilage defects must use a significant amount of cells, preferably applied using a hydrogel system that can promise their delivery and functionality at the specific site. This paper discusses the potential use of κ‐carrageenan hydrogels for the delivery of stem cells obtained from adipose tissue in the treatment of cartilage tissue defects. The developed hydrogels were produced by an ionotropic gelation method and human adipose stem cells (hASCs) were encapsulated in 1.5% w/v κ‐carrageenan solution at a cell density of 5 × 106 cells/ml. The results from the analysis of the cell‐encapsulating hydrogels, cultured for up to 21 days, indicated that κ‐carrageenan hydrogels support the viability, proliferation and chondrogenic differentiation of hASCs. Additionally, the mechanical analysis demonstrated an increase in stiffness and viscoelastic properties of κ‐carrageenan gels with their encapsulated cells with increasing time in culture with chondrogenic medium. These results allowed the conclusion that κ‐carrageenan exhibits properties that enable the in vitro functionality of encapsulated hASCs and thus may provide the basis for new successful approaches for the treatment of cartilage defects. Copyright © 2013 John Wiley & Sons, Ltd.
Current Status of Diabetes Management in Korea Using National Health Insurance Database

Background: The prevalence of diabetes is steadily increasing in Korea. The increase in number of people with diabetes would ultimately result in premature death, poor quality of life, and increasing economic burden. However, in our country, researches regarding on the quality of diabetes management are lacking. This study was conducted in 2005 using National Health Insurance Database to know the current status of diabetes management in Korea.Methods: We have randomly selected 3,902 subjects out of 2,503,754 subjects who had claims with diagnosis of diabetes between January 2003 to December 2003 by using two staged cluster sampling method. Field survey with review of medical records and telephone survey was conducted with standardized record forms developed by Korean Diabetes Association; Task Force Team For Basic Statistical Study of Korean Diabetes Mellitus. Results: The age of diabetic subjects was 58.1 ± 12.6 years and the duration of diabetes was 6.2 ± 5.5 years. Hypertension was present in 54% of diabetic subjects. Among those with hypertension, 59% were controlled with blood pressure below 140/90 mmHg, but only 19% were controlled with blood pressure below 130/80 mmHg. Hyperlipidemia was present in 29% of diabetic subjects. Only 38% of those with hyperlipidemia were controlled with LDL-cholesterol below 100 mg/dL. For glycemic control, only 40% of diabetic subjects achieved the goal of HbA1c less than 7%, which was suggested by ADA. 접수일자: 2007년 3월 28일, 통과일자: 2007년 5월 23일, 책임저자: 김재용, 건강보험심사평가원 조사연구실Conclusion: We found that only 20~40% of diabetic subjects in Korea achieved the management goal for glucose, blood pressure, and lipids. It seems urgent to develop a quality management program for diabetes subjects in Korea. (J Kor Diabetes Assoc 31:362~367, 2007)
Estudo prospectivo observacional sobre a incidência de injúria renal aguda em unidade de terapia intensiva de um hospital universitário

OBJECTIVE: To compare the clinical characteristics and outcomes of patients with and without acute renal failure (ARF) admitted to the general intensive care unit (ICU) of a university-affiliated hospital. METHOD: Prospective observational study comprising 263 patients followed up daily during their stay at the general ICU of the Hospital das Clinicas of the Medical School of Botucatu, from July 2007 to April 2008. RESULTS: The incidence of ARF was 31.2%. The groups were similar regarding gender and differed regarding the following: cause of ICU admission (sepsis: 31.7% x 13.1%, p < 0.0001, post-operative period: 11% x 43%; p < 0.0001); age (59.6 ± 18.1 x 50.2 ± 18.6 years; p < 0.0001); APACHE II: (21 ± 11.1 x 11 ± 4.8; p = 0.002); oliguria (67.7% x 4.5%; p < 0.0001); presence of mechanical ventilation (81.7% x 57.7%; p = 0.0014); use of vasoactive drugs (62.2% x 32.6%; p < 0.0001); and site of origin inside hospital (emergency room: 22% x 14.5%; p = 0.02; operating room: 42.7% x 62.6%; p = 0.03). As for comorbidities, hypertension and chronic renal disease were more frequent among patients with ARF than among those without ARF (42.6% x 35.9%; p = 0.005 and 15.8% x 2.1%; p = 0.04, respectively), but the groups did not differ regarding diabetes and congestive heart failure (19.5% x 11%, and 6% x 1.1%, respectively). Mortality was higher in ARF patients (62.1% x 16.5%; p < 0.0001). CONCLUSION: The incidence of ARF is high in the ICU and among patients with worse clinical parameters and prognosis, justifying the greater mortality observed in such patients.
Treatment of Femoroacetabular Impingement in Athletes Using a Mini–Direct Anterior Approach

Background: Femoroacetabular impingement (FAI) is an increasingly common diagnosis in active patients with hip pain. Surgical options for FAI include arthroscopy, open surgical dislocation, or mini–direct anterior approaches. Arthroscopic and open treatments of FAI have been commonly performed and have had promising results in athletes. Hypothesis/Purpose: We hypothesized that the mini–direct anterior approach would provide the advantages of a minimally invasive procedure and still allow adequate exposure of the hip joint to successfully treat FAI in an athletic population. The purpose of this study was to determine if a mini-open approach for the treatment of FAI in athletic patients would allow a return to preoperative activity. Study Design: Case series; Level of evidence, 4. Methods: A total of 234 patients (257 hips) with FAI were treated by a mini-open approach; 59 were athletic patients (66 hips) with a preoperative University of California, Los Angeles (UCLA) activity score of 7 or higher or Super Simple Hip (SUSHI) activity score of 70 or greater. Forty-four of the 59 athletic patients (47 hips) have reached 1-year minimum follow-up. No patients were lost to follow-up. The mini-open approach was performed through a 4-cm incision and modified Smith-Peterson approach with no muscle detachment. All patients were prospectively evaluated using the following outcome measures: preoperative and postoperative UCLA activity, Short-Form 36 Health Survey (SF-36), Western Ontario and McMaster Osteoarthritis Index (WOMAC), modified Harris Hip Score (HHS), and SUSHI scores. Results: The average age at the time of surgery was 32 years (range, 17-60 years), with an average follow-up of 22 months. Labral changes—whether tear, detachment, or ossification—were present in all patients, and 84% had chondral lesions. The mean HHS improved from 55 preoperatively to 79 postoperatively (P < .001). The WOMAC scores also improved from 47.9 to 8.3 (P < .001). Mean SF-36 scores improved from 65 to 85 postoperatively (P < .001). The mean preoperative SUSHI general score was 31.1, pain score was 26.6, and limitation score was 28.9. The mean postoperative SUSHI general score was 53.6, pain score was 47.5, and limitation score was 51.6 (P < .001). There was minimal change from preinjury to postoperative UCLA (8.0 to 8.7, respectively; P = .07) or SUSHI activity scores (76.3 to 67.7, respectively; P = .048), indicating a reliable return to preinjury activity levels. Twenty-four of 44 patients (55%) reported a return to their specific preoperative sports. Nine patients (20%) developed meralgia paresthetica postoperatively, which resolved within 1 year. Conclusion: The mini-open approach for the treatment of FAI is a safe and effective procedure that allows surgical treatment of FAI in athletic patients and a successful return to high activity levels. The outcome of the mini-open approach for athletes may be comparable with open and arthroscopic treatment of FAI.
mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists

Antidepressant Action of Ketamine In contrast to the weeks or months of treatment required for standard antidepressant medication, ketamine administration produces an antidepressant response within 4 to 6 hours in depressed patients. What lies behind the rapid actions of ketamine? Li et al. (p. 959; see the Perspective by Cryan and O'Leary) found that ketamine administration resulted in fast activation of mammalian target of rapamycin (mTOR) signaling and increased levels of synaptic proteins in the rat prefrontal cortex. Ketamine rapidly increased the density and function of the dendritic spines of layer V pyramidal neurons in the prefrontal cortex. Thus, the behavioral actions of ketamine in models of depression and antidepressant response are dependent on mTOR signaling. Ketamine, an anaesthetic and recreational drug, rapidly increases synaptic signaling and antidepressant behavioral responses. The rapid antidepressant response after ketamine administration in treatment-resistant depressed patients suggests a possible new approach for treating mood disorders compared to the weeks or months required for standard medications. However, the mechanisms underlying this action of ketamine [a glutamate N-methyl-d-aspartic acid (NMDA) receptor antagonist] have not been identified. We observed that ketamine rapidly activated the mammalian target of rapamycin (mTOR) pathway, leading to increased synaptic signaling proteins and increased number and function of new spine synapses in the prefrontal cortex of rats. Moreover, blockade of mTOR signaling completely blocked ketamine induction of synaptogenesis and behavioral responses in models of depression. Our results demonstrate that these effects of ketamine are opposite to the synaptic deficits that result from exposure to stress and could contribute to the fast antidepressant actions of ketamine.
Adipose‐derived stromal cells for the reconstruction of a human vesical equivalent

Despite a wide panel of tissue‐engineering models available for vesical reconstruction, the lack of a differentiated urothelium remains their main common limitation. For the first time to our knowledge, an entirely human vesical equivalent, free of exogenous matrix, has been reconstructed using the self‐assembly method. Moreover, we tested the contribution of adipose‐derived stromal cells, an easily available source of mesenchymal cells featuring many potential advantages, by reconstructing three types of equivalent, named fibroblast vesical equivalent, adipose‐derived stromal cell vesical equivalent and hybrid vesical equivalent – the latter containing both adipose‐derived stromal cells and fibroblasts. The new substitutes have been compared and characterized for matrix composition and organization, functionality and mechanical behaviour. Although all three vesical equivalents displayed adequate collagen type I and III expression, only two of them, fibroblast vesical equivalent and hybrid vesical equivalent, sustained the development of a differentiated and functional urothelium. The presence of uroplakins Ib, II and III and the tight junction marker ZO‐1 was detected and correlated with impermeability. The mechanical resistance of these tissues was sufficient for use by surgeons. We present here in vitro tissue‐engineered vesical equivalents, built without the use of any exogenous matrix, able to sustain mechanical stress and to support the formation of a functional urothelium, i.e. able to display a barrier function similar to that of native tissue. Copyright © 2013 John Wiley & Sons, Ltd.
Firefly Synchrony: A Behavioral Strategy to Minimize Visual Clutter

Female fireflies are more likely to respond to simulated male flashes that are synchronized than to unsynchronized flashes. Most firefly species (Coleoptera: Lampyridae) use bioluminescent flashes for signaling. In some species, the flashing between males occurs rhythmically and repeatedly (synchronically) with millisecond precision. We studied synchrony’s behavioral role in the North American firefly, Photinus carolinus. We placed a female in a virtual environment containing artificial males that flashed at varying degrees of synchrony. Females responded to an average of 82% of synchronous flashes compared with as few as 3% of asynchronous flashes. We conclude that one function of flash synchrony is to facilitate a female’s ability to recognize her conspecific male’s flashing by eliminating potential visual clutter from other flashing males.
The Prevalence of Low Back Pain Among Former Elite Cross-Country Skiers, Rowers, Orienteerers, and Nonathletes

Background: Some cross-sectional studies have suggested that the prevalence of low back pain (LBP) may be high among endurance athletes with repetitive back loading, but there are no large, prospective cohort studies addressing this issue. Purpose: To compare the prevalence of symptoms of low back pain (LBP) among former endurance athletes with different loading characteristics on the lumbar region: cross-country skiing (flexion loading), rowing (extension loading), and orienteering (no specific loading), as well as a nonathletic control group. Study design: Cohort study; level of evidence, 2. Methods: Self-reported questionnaire on LBP adapted for sports based on standardized Nordic questionnaires for musculoskeletal symptoms. Responders were 173 rowers, 209 orienteerers, 242 cross-country skiers, and 116 control subjects (88% of the original cohort). Results: There were no group differences between the athletic groups and the control group with regard to the 2 main outcomes: reported LBP the previous 12 months (P = .66) and frequent LBP the past year (>30 days with LBP) (P = .14). More rowers than orienteerers reported frequent LBP the past year (adjusted OR = 2.32; CI, 1.02-5.28). Occupational changes due to LBP were reported more often by rowers (13%) than skiers (7%) and orienteerers (3%) (P = .002). More rowers and skiers reported having received outpatient medical assistance than orienteerers or controls. A training volume >550 h/y was a risk factor for reporting LBP during the previous 12 months compared with a training volume <200 h/y (adjusted OR = 2.51; CI, 1.26-5.02). A previous episode with LBP was associated with LBP later in life (adjusted OR = 3.02; CI, 2.22-4.10). Conclusion: Low back pain was not more common among former endurance athletes with specific back loading compared with non-athletes. The results indicate that years of prolonged and repetitive flexion or extension loading in endurance sports does not lead to more LBP. However, a large training volume in the past year and previous episodes with LBP are risk factors for LBP. Comparing the sports of rowing, cross-country skiing, and orienteering, it appears that whereas orienteering is protective, rowing can provoke LBP.
Sequential development of intercellular junctions in bioengineered human corneas

We have carried out a sequential study of intercellular junction formation and differentiation on human corneal substitutes consisting of an artificial corneal stroma and a corneal epithelium, developed by tissue engineering. To generate these artificial human corneas, we developed a corneal stroma substitute, using fibrin and agarose scaffolds with human keratocytes immersed within, then cultured the human corneal epithelium on top. Electron microscopy and immunofluorescence analyses revealed that artificial corneas with one or two epithelial cell layers did not show any formation of intercellular junctions. In contrast, several types of cell–cell junction, especially desmosomes, were found in multilayered mature corneal substitutes. Concomitantly, the expression of genes encoding for plakoglobin 3 (PKG3), desmoglein 3 (DSG3) and desmoplakin (DSP), zonula occludens 1 (ZO‐1) and 2 (ZO‐2) and connexin 37 (Cx37) was higher in multilayered artificial corneas than in immature artificial corneas, as shown by both microarray and immunofluorescence. Although expression of ZO‐1, ZO‐2 and Cx37 proteins was homogeneous, PKG3, DSG3 and DSP expression was restricted to the most apical cell layers in artificial corneas submerged in culture medium at all times, whereas expression was higher in intermediate cell layers, similar to normal human control corneas, when corneal substitutes are submitted to air–liquid culture techniques. These results suggest that cultured corneal substitutes submitted to air–liquid culture technique tend to form a well‐developed epithelium that is very similar to the epithelium of human native corneas, suggesting that these artificial corneas could eventually be used for clinical or in vitro purposes. Copyright © 2009 John Wiley & Sons, Ltd.
Evaluation of Different Methods for Measuring Lateral Tibial Slope Using Magnetic Resonance Imaging

Background: Since lateral tibial slope (LTS) affects the amount of anterior tibial translation and anterior cruciate ligament (ACL) strain during a dynamic maneuver, accurate measurements of LTS may be beneficial in screening people at a higher risk for ACL injury. Methods for measuring LTS on magnetic resonance imaging (MRI) scans of the proximal tibia include the midpoint and circle methods. No current studies have validated different LTS measurement methods using a proximal tibia MRI scan. Hypothesis: We tested the null hypotheses that (1) LTS measurements were independent of the length of tibia imaged using the midpoint method, and (2) LTS measurements calculated from different methods (midpoint, circle, and full tibia) would not differ significantly. Study Design: Controlled laboratory study. Methods: Blinded observers measured LTS from 3-tesla, 3-dimensional MRIs from 40 size-matched donors according to 1 circle method and 3 midpoint methods. Outcomes were then compared with the full-tibial anatomic axis (line connecting the center of 2 circles fit within the proximal and distal tibia) in 11 donors. Bonferroni-corrected paired t tests (significance, P < .005) were used to compare the 5 methods. Results: The circle and full-tibia methods had the lowest interobserver and intraobserver variability, whereas the midpoint method with 10-cm tibia was the most variable. The midpoint method with 10-cm and 15-cm proximal tibia closely resembled LTS measurements with the full-tibial anatomic axis. The circle method, although repeatable, provided smaller numerical LTS measurements than the full-tibia and midpoint methods. Conclusion: Although LTS measurements using the midpoint method can resemble measurements made using the full tibia, the reliability of the midpoint method depends on the length of proximal tibia used. The circle method may be the preferred method for future studies since it was the most repeatable method and is independent of proximal tibial length. Clinical Relevance: LTS measurements vary depending on the method used.