Miracle-dz/UniFAR-FTUs huggingface dataset:
Histomorphochemical comparison of microfracture as a first‐line and a salvage procedure: Is microfracture still a viable option for knee cartilage repair in a salvage situation?

Microfracture is considered as the first‐line procedure for knee cartilage repair, but the results of microfracture seem less predictable and rather controversial in a salvage situation. Thus, the purpose of the study was to histomorphochemically compare microfracture as a salvage procedure with microfracture as a first‐line procedure in a rabbit model. We hypothesized that microfracture in a salvage situation would result in histomorphochemically inferior cartilage repair compared to microfracture as a first‐line procedure, and the inferiority would be attributed to less migration of reparable marrow cells to the defect due to destruction of microarchitecture of the subchondral bone. Thirty‐six New Zealand white rabbits were divided into three groups: (i) untreated full‐thickness chondral defect, (ii) single microfracture treatment (first microfracture group), and (iii) repeated microfracture in 8 weeks after the first procedure (second microfracture group). In each group, rabbits were sacrificed at the end of 8 weeks, and osteochondral specimens at the repair sites were obtained for histomorphochemical analysis. Results showed that microfracture as a salvage procedure resulted in overall inferior cartilage repair histomorphochemically compared with microfracture as a first‐line procedure, which correlated with deteriorative changes in the quality of underlying subchondral bone rather than intrinsic incapability to recruit the reparative cells in the defect area. In conclusion, although a comparable number of reparable cells and a mechanically weakened subchondral bone are anticipated, more study is necessary to clearly determine when a microfracture should be performed in a situation. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:802–810, 2014.
A comparison of intravenous and intradiscal delivery of multipotential stem cells on the healing of injured intervertebral disk

A major hurdle of cellular therapy for biological treatment of intervertebral disk (IVD) degeneration is the delivery method where current delivery methods are limited to intradiscal injection which can potentially cause further degeneration. Recent studies indicated that multipotential stem cells (MPSCs) from human umbilical cord blood home to injured sites and induce local therapeutic changes, thereby potentially addressing the drawbacks of direct delivery. We tested the effects of these cells on injured IVD using a mouse model of puncture‐induced degeneration via two delivery methods. Caudal IVD underwent needle puncture, and MPSCs were injected indirectly (intravenously), or directly (intradiscally) into the nucleus pulposus. IVD were harvested for histological, gene and protein analysis after 14 weeks. Our finding showed limited homing ability of the MPSCs. However, regardless of delivery method, no engraftment or expansion of MPSCs was observed at the injured site. Contrasting to direct injection, intravenous injection neither improved the degeneration status, nor preserve disk height, however, both delivery methods increased glycosaminoglycan (GAG) protein and Acan gene expression relative to controls, suggesting possible paracrine effects. Identifying the mechanisms by which MPSCs act on endogenous IVD cells would provide insights into the potential of these cells to treat IVD injuries and degeneration. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:819–825, 2014.
Effect of head diameter on passive and active dynamic hip dislocation

Hip dislocation is a major short‐term complication after total hip arthroplasty (THA). One factor thought to reduce the risk for dislocation is head size. We constructed subject‐specific computer models to study the effect of head size on risk for postoperative dislocation. Femoral and acetabular geometry was constructed after segmenting CT scans of nine hips. CAD models of THA components with four head diameters (28, 32, 36, and 44 mm) were virtually implanted. Hip capsular ligaments were simulated using rigid‐body ellipsoids connected by non‐linear springs. Posterior dislocation was simulated during a rise from a low chair; anterior dislocation was simulated during a pivot activity. Intraoperative stability tests were simulated for anterior or posterior dislocation. While rising from a low chair (posterior dislocation) and during the pivot activity (anterior dislocation), increasing head size significantly increased hip flexion angle at dislocation and generated higher dislocation moments. Larger heads reduced the risk for dislocation. Intraoperative stability tests detected the relative increased resistance to dislocation despite differences in the absolute magnitude of moments. This model can be useful preclinical tool for assessing design changes, the effect of component placement, and the activity‐based risk for dislocation. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1525–1531, 2014.
Treatment options for AIDS patients with progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is a demyelinating viral disease produced by the John Cunningham (JC) virus, which is ubiquitously distributed. Up to 80% of adults seroconvert to JC virus. Classically, PML is a life-threatening AIDS-defining disease of the CNS, usually occurring in severely immunocompromised individuals. Until now, and despite several therapeutic attempts, there is no specific treatment for PML. Soon after the widespread use of combination antiretroviral therapy (CART), several studies showed prolonged survival for patients with AIDS-associated PML who were treated with CART. The outcome of PML in patients receiving CART is unpredictable at disease onset. Prognostic markers are needed. The JC virus DNA detection in cerebrospinal fluid by nucleic acid amplification techniques and the CD4+ cell count are the most promising parameters. Higher levels of CD4+ cell counts were independently associated with an improved survival in different clinical observations. A summary of the main current knowledge about AIDS-related PML is presented. The most effective strategy is to optimize CART to completely suppress HIV-1 viral load and allow the best CD4+ T-cell immune recovery. Nowadays, AIDS-related PML is no longer an ultimately fatal disease. A substantial number of HIV-1-infected patients with this condition can improve with CART.
Hyperbaric oxygen therapy improves angiogenesis and bone formation in critical sized diaphyseal defects

Besides the use of autologous bone grafting several osteoconductive and osteoinductive methods have been reported to improve bone healing. However, persistent non‐union occurs in a considerable number of cases and compromised angiogenesis is suspected to impede bone regeneration. Hyperbaric oxygen therapy (HBO) improves angiogenesis. This study evaluates the effects of HBO on bone defects treated with autologous bone grafting in a bone defect model in rabbits. Twenty‐four New‐Zealand White Rabbits were subjected to a unilateral critical sized diaphyseal radius bone defect and treated with autologous cancellous bone transplantation. The study groups were exposed to an additional HBO treatment regimen. Bone regeneration was evaluated radiologically and histologically at 3 and 6 weeks, angiogenesis was assessed by immunohistochemistry at three and six weeks. The additional administration of HBO resulted in a significantly increased new bone formation and angiogenesis compared to the sole treatment with autologous bone grafting. These results were apparent after three and six weeks of treatment. The addition of HBO therapy to autologous bone grafts leads to significantly improved bone regeneration. The increase in angiogenesis observed could play a crucial role for the results observed. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:513–520, 2015.
Generation and characterization of osteochondral grafts with human nasal chondrocytes

We investigated whether nasal chondrocytes (NC) can be used to generate composite constructs with properties necessary for the repair of osteochondral (OC) lesions, namely maturation, integration and capacity to recover from inflammatory burst. OC grafts were fabricated by combining engineered cartilage tissues (generated by culturing NC or articular chondrocytes – AC – onto Chondro‐Gide® matrices) with devitalized spongiosa cylinders (Tutobone®). OC tissues were then exposed to IL‐1β for three days and cultured for additional 2 weeks in the absence of IL‐1β. Cartilage maturation extent was assessed (immune) histologically, biochemically and by delayed gadolinium‐enhanced magnetic resonance imaging of cartilage (dGEMRIC) while cartilage/bone integration was assessed using a peel‐off mechanical test. The use of NC as compared to AC allowed for more efficient cartilage matrix accumulation and superior integration of the cartilage/bone layers. dGEMRIC and biochemical analyzes of the OC constructs showed a reduced glycosaminoglycan (GAG) contents upon IL‐1β administration. Cartilaginous matrix contents and integration forces returned to baseline up on withdrawal of IL‐1β. By having a cartilage layer well developed and strongly integrated to the subchondral layer, OC tissues generated with NC may successfully engraft in an inflammatory post‐surgery joint environment. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1111–1119, 2015.
Hypoxia‐inducible factor 3‐alpha expression is associated with the stable chondrocyte phenotype

The hypoxia‐inducible factors HIF‐1α and HIF‐2α are important regulators of the chondrocyte phenotype but little is known about HIF‐3α in cartilage. The objective of this study was to characterize HIF‐3α (HIF3A) expression during chondrocyte differentiation in vitro and in native cartilage tissues. HIF3A, COL10A1, and MMP13 were quantified in mesenchymal stem cells (MSCs) and articular chondrocytes from healthy and osteoarthritic (OA) tissue in three‐dimensional cultures and in human embryonic epiphyses and adult articular cartilage. HIF3A was found to have an inverse association with hypertrophic markers COL10A1 and MMP13 in chondrogenic cells and tissues. In healthy chondrocytes, HIF3A was induced by dexamethasone and increased during redifferentiation. By comparison, HIF3A expression was extremely low in chondrogenically differentiated MSCs expressing high levels of COL10A1 and MMP13. HIF3A was also lower in redifferentiated OA chondrocytes than in healthy chondrocytes. In human embryonic epiphyseal tissue, HIF3A expression was lowest in the hypertrophic zone. Distinct splice patterns were also found in embryonic cartilage when compared with adult articular cartilage and redifferentiated chondrocytes. These in vitro and in vivo findings suggest that HIF3A levels are indicative of the hypertrophic state of chondrogenic cells and one or more splice variants may be important regulators of the chondrocyte phenotype. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1561–1570, 2015.
Repetitive jumping and sprinting until exhaustion alters hamstring reflex responses and tibial translation in males and females

The incidence of anterior cruciate ligament injuries is considerably higher in females than in males and the underlying mechanisms are still under debate. Research indicates that the neuromuscular system of females and males might respond differently to the same fatigue protocol due to differences in muscle activation during movement tasks. This study analyzed sex differences in hamstring reflex responses and posterior‐anterior tibial translation (TT) before and after fatiguing exercise. We measured the isolated movement of the tibia relative to the femur as a consequence of mechanically induced TT in standing subjects as well as muscle activity of the hamstrings before and after repetitive jumping and sprinting until exhaustion. Muscle fatigue delayed reflex onset latencies in females and males. A reduction in reflex responses associated with an increased TT was observed after fatiguing exercise for both sexes. Data indicate that the used fatigue protocol altered the latency and magnitude of reflex responses as well as TT in females and males. Based on the results of previous research and the outcome of this study, it might be that sex‐specific effects of fatigue on reflex activity and mechanical stability of the knee depend on the kind of fatiguing exercise. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1687–1692, 2015.
Intraoperative passive knee kinematics during total knee arthroplasty surgery

Surgical navigation systems for total knee arthroplasty (TKA) surgery are capable of capturing passive three‐dimensional (3D) angular joint movement patterns intraoperatively. Improved understanding of patient‐specific knee kinematic changes between pre and post‐implant states and their relationship with post‐operative function may be important in optimizing TKA outcomes. However, a comprehensive characterization of the variability among patients has yet to be investigated. The objective of this study was to characterize the variability within frontal plane joint movement patterns intraoperatively during a passive knee flexion exercise. Three hundred and forty patients with severe knee osteoarthritis (OA) received a primary TKA using a navigation system. Passive kinematics were captured prior to (pre‐implant), and after prosthesis insertion (post‐implant). Principal component analysis (PCA) was used to capture characteristic patterns of knee angle kinematics among patients, to identify potential patient subgroups based on these patterns, and to examine the subgroup‐specific changes in these patterns between pre‐ and post‐implant states. The first four extracted patterns explained 99.9% of the diversity within the frontal plane angle patterns among the patients. Post‐implant, the magnitude of the frontal plane angle shifted toward a neutral mechanical axis in all phenotypes, yet subtle pattern (shape of curvature) features of the pre‐implant state persisted. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1611–1619, 2015.
Strategies for parenting by mothers and fathers with a mental illness.

UNLABELLED WHAT IS KNOWN ON THE SUBJECT? : The combination of coping with their mental health problems and caring for children makes parents vulnerable. Family-centred practice can help to maintain and strengthen important family relationships, and to identify and enhance the strengths of a parent with a mental illness, all contributing to the recovery of the person with the mental illness. WHAT THIS PAPER ADDS TO THE EXISTING KNOWLEDGE? : Taking the strength and the opportunities formulated by parents themselves as a starting point is fairly new. Parents with severe mental illness find strength for parenting in several ways. They feel responsible, and this helps them to stay alert while parenting, whereas parenthood also offers a basis for social participation through school contacts and the child's friendships. Dedication to the parent role provides a focus; parents develop strengths and skills as they find a balance between attending to their own lives and caring for their children; and parenting prompts them to find adequate sources of social support. In this study these strategies were found to be the fundamentals of recovery related to parenting. WHAT ARE THE IMPLICATIONS FOR PRACTICE? : Nurses can support and coach patients who are identified as parents, and self-chosen parenting related goals are set and addressed. A family-focused approach by nurses can be used to prevent problems for children and their families, identify their strengths as well as vulnerabilities, and address the challenges to build resilience. INTRODUCTION Understanding of the problems of parents with mental illness is growing. Gaining insight into strategies for parenting, while taking the opportunities formulated by these parents themselves as a starting point is fairly new. QUESTION What are the strategies of parents with a mental illness to be successful? METHOD Experiences of 19 mothers and eight fathers with a mental illness were explored with in-depth interviews. Data were content analysed, using qualitative methods. RESULTS Next to feelings of inadequacy, interviewees also describe how children enrich and structure their lives and are not only a burden but serve as distraction from problems. Developing activities that interest both child and parent provides avenues for emerging strength. Mental illness constrains fathers, but also gives opportunities to develop a meaningful relation with their children. DISCUSSION Strategies like being fully dedicated to the parental role, finding a balance between attention for one's own life and parenting and finding adequate sources of support are found to be fundamental for recovery in the parent role. Implications for practice Peer groups can be of valuable help and mental health workers can support parents to set self-chosen parenting related goals.
Free will perceptions and psychiatric symptoms in patients diagnosed with schizophrenia.

UNLABELLED WHAT IS KNOWN ON THE SUBJECT? : Some research suggests that holding a free will perspective may offer mental health and physical health benefits. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE? : This study is the first to examine links between free will perceptions and psychiatric symptoms in patients diagnosed with schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE? : Study results suggest that helping people with a diagnosis of schizophrenia to recognize situations where they do have some freedom of choice over their actions and emotional reactions (free will) may assist them in improving their experiences and better managing their symptoms. ABSTRACT Introduction Some research indicates that having a strong sense that one possesses free will may be associated with better psychological and physical health. This study is the first to examine the relationship between free will perceptions and psychiatric symptoms in patients with a diagnosis of schizophrenia. Method Thirty-two participants were interviewed using the Brief Psychiatric Rating Scale to assess symptom severity and the Free Will Subscale of the Free Will and Determinism Scale to assess free will perceptions. Results As hypothesized, a negative association was found between free will perceptions and total symptom severity, though it appears that this was mainly accounted for by positive symptoms. A content analysis was also conducted to qualitatively examine how patients conceptualize the construct of free will and its role in coping with their own mental illness. Discussion Study results suggest that holding a free will perspective may mitigate psychiatric symptoms in patients with a diagnosis of schizophrenia. Thus, psychiatric nurses and other mental health clinicians may improve current treatments for schizophrenia by helping patients recognize situations where they do have some freedom of choice over their actions and emotional reactions (free will) to stressful life events.
Childhood adversities of populations living in low-income countries: prevalence, characteristics, and mental health consequences

Purpose of review Although an association between childhood adversity and psychiatric disorder has been documented, most research has centered upon those living in developed countries and the types of adversities those populations experience. Most of the world's youth, however, live in the poorest countries and face additional types of adversity for which limited data are available. The aim of this review is to synthesize recently published research and policy documents regarding the prevalence, characteristics, and mental health consequences of childhood adversity in low-income countries. Recent findings Many youth in low-income countries are exposed to war-related violence, are orphaned by AIDS, work long hours in dangerous conditions, and, among girls in Africa, undergo female genital mutilation. These children have more posttraumatic stress disorder and depression than unexposed youth. Family violence, discrimination, and poverty may exacerbate the effects of war-related trauma and AIDS orphanhood upon mental health. Conclusion Research on the psychological consequences of childhood adversity in low-income countries is increasing, but is limited by the range of mental health outcomes evaluated and by small nonrepresentative samples. Further research is warranted to inform child advocacy and to guide public policy and the actions of nongovernmental agencies involved in the protection and welfare of children.
Measuring psychosocial outcomes in schizophrenia patients

Purpose of review Improvement in psychosocial functioning is nowadays considered an important and achievable goal of schizophrenia treatment. Therefore, treatment interventions are expected to have a positive influence both on symptoms and on social integration. In this nonsystematic literature review, we describe some of the available measures to assess social outcomes in schizophrenia treatment and their inherent limitations, and discuss future directions for research and clinical practice. Recent findings The lack of consensus on the appropriate terminology and standards applied to index patients' level of functioning remains an obstacle in assessing psychosocial outcomes in schizophrenia. Although some scales appear advantageous in terms of ease of administration and reliability, they lack enough solid evidence that they are related to real-world outcomes or sensitive to change. Performance-based measures are being more widely used to assess functional capacity because they appear effective in predicting independent living and work, as compared with both self-report and clinical measures. Summary We argue that assessment of psychosocial functioning should be an integral part of schizophrenia patients' assessment, in both the research and clinical setting. Ultimately, there exists no gold standard measure, but, of those available, the Personal and Social Performance (PSP) Scale and the UCSD Performance-based Skills Assessment (UPSA) have literature supporting their usefulness for assessing psychosocial outcomes in schizophrenia patients.