bluuebunny/crossref_metadata_2025 huggingface dataset:
A Minority of Athletes Pass Symmetry Criteria in a Series of Hop and Strength Tests Irrespective of Having an ACL Reconstructed Knee or Being Noninjured
Authors: Markström Jonas L. , Naili Josefine E. , Häger Charlotte K.
Published: June 2022

Background:

Between-leg symmetry in 1-leg hop and knee strength performances is considered important after anterior cruciate ligament reconstruction (ACLR) to facilitate a safer return to sport. While few athletes with ACLR demonstrate symmetry in test batteries, reference data for noninjured athletes are lacking, thus questioning how ACLR-specific poor symmetry is.

Hypothesis:

Athletes with ACLR (hamstring autograft) show lower symmetry and have a lower proportion of symmetric individuals than noninjured athletes for knee flexion strength but not for hop for distance, vertical hop, and knee extension strength.

Study design:

Cross-sectional.

Level of Evidence:

Level 3.

Methods:

A total of 47 athletes with ACLR (median 13.0 months post-ACLR) who had returned to their sport, and 46 noninjured athletes participated. Symmetry was calculated between the worse and better legs for each test and combinations of them using the limb symmetry index (LSIWORSE-BETTER, ranging from 0% to 100%). The 2 groups were compared for these values and the proportions of individuals classified as symmetric (LSIWORSE-BETTER ≥90%) using independent t-tests and Fisher’s exact tests, respectively.

Results:

Athletes with ACLR were less symmetric than noninjured athletes for knee flexion strength with a lower LSIWORSE-BETTER (83% vs 91%, P < 0.01) and a lower proportion of symmetric individuals (39% vs 63%, P = 0.04). No differences between groups were revealed for the hop tests, knee extension strength, or combinations of tests ( P > 0.05). Only 17% of the athletes with ACLR and 24% of the noninjured athletes demonstrated symmetric performances for all 4 tests.

Conclusion:

Athletes with ACLR (hamstring autograft) showed poorer symmetry in knee flexion strength than noninjured athletes, although both groups had few individuals who passed the test battery’s symmetry criteria.

Clinical relevance:

Symmetry is uncommon among athletes irrespective of ACLR and should be considered regarding expected rehabilitation outcomes and return-to-sport decisions post-ACLR.
Blood Flow Restriction Therapy Preserves Lower Extremity Bone and Muscle Mass After ACL Reconstruction
Authors: Jack Robert A. , Lambert Bradley S. , Hedt Corbin A. , Delgado Domenica , Goble Haley , McCulloch Patrick C.
Published: June 2022

Background:

Muscle atrophy is common after an injury to the knee and anterior cruciate ligament reconstruction (ACLR). Blood flow restriction therapy (BFR) combined with low-load resistance exercise may help mitigate muscle loss and improve the overall condition of the lower extremity (LE).

Purpose:

To determine whether BFR decreases the loss of LE lean mass (LM), bone mass, and bone mineral density (BMD) while improving function compared with standard rehabilitation after ACLR.

Study Design:

Randomized controlled clinical trial

Methods:

A total of 32 patients undergoing ACLR with bone-patellar tendon-bone autograft were randomized into 2 groups (CONTROL: N = 15 [male = 7, female = 8; age = 24.1 ± 7.2 years; body mass index [BMI] = 26.9 ± 5.3 kg/m2] and BFR: N = 17 [male = 12, female = 5; age = 28.1 ± 7.4 years; BMI = 25.2 ± 2.8 kg/m2]) and performed 12 weeks of postsurgery rehabilitation with an average follow-up of 2.3 ± 1.0 years. Both groups performed the same rehabilitation protocol. During select exercises, the BFR group exercised under 80% arterial occlusion of the postoperative limb (Delfi tourniquet system). BMD, bone mass, and LM were measured using DEXA (iDXA, GE) at presurgery, week 6, and week 12 of rehabilitation. Functional measures were recorded at week 8 and week 12. Return to sport (RTS) was defined as the timepoint at which ACLR-specific objective functional testing was passed at physical therapy. A group-by-time analysis of covariance followed by a Tukey’s post hoc test were used to detect within- and between-group changes. Type I error; α = 0.05.

Results:

Compared with presurgery, only the CONTROL group experienced decreases in LE-LM at week 6 (−0.61 ± 0.19 kg, −6.64 ± 1.86%; P < 0.01) and week 12 (−0.39 ± 0.15 kg, −4.67 ± 1.58%; P = 0.01) of rehabilitation. LE bone mass was decreased only in the CONTROL group at week 6 (−12.87 ± 3.02 g, −2.11 ± 0.47%; P < 0.01) and week 12 (−16.95 ± 4.32 g,−2.58 ± 0.64%; P < 0.01). Overall, loss of site-specific BMD was greater in the CONTROL group ( P < 0.05). Only the CONTROL group experienced reductions in proximal tibia (−8.00 ± 1.10%; P < 0.01) and proximal fibula (−15.0±2.50%, P < 0.01) at week 12 compared with presurgery measures. There were no complications. Functional measures were similar between groups. RTS time was reduced in the BFR group (6.4 ± 0.3 months) compared with the CONTROL group (8.3 ± 0.5 months; P = 0.01).

Conclusion:

After ACLR, BFR may decrease muscle and bone loss for up to 12 weeks postoperatively and may improve time to RTS with functional outcomes comparable with those of standard rehabilitation.
Subjective sleep quality among hospitalised adult patients: An observational, cross-sectional study
Authors: Binte Arman Siti Nadiah , Lee Ying Hui , Lopez Violeta , Lim Siew Hoon
Published: June 2022

Background

Inpatient sleep quality is influenced by multiple factors including medical conditions, use of medication and the ward environment. Without adequate rest, detrimental effects on patients’ physical and psychological performances may persist, inhibiting recovery and increasing length of stay.

Objective

This study examined the sleep quality of adult inpatients and its’ associations with sociodemographic, clinical and environmental factors.

Methods

An observational study was conducted in the medical wards of an acute care hospital in Singapore from July to December 2018. Patients completed the Pittsburgh Sleep Quality Index (PSQI) to establish baseline sleeping habits and the Richards-Campbell Sleep Questionnaire (RCSQ) to assess perception of sleep quality during hospitalisation. Noise levels were measured using the SL-4023SD sound level meter. Environmental factors affecting sleep were also recorded.

Results

52 patients were recruited reported a mean RCSQ score of 5.83 (SD = 2.31) and mean Global PSQI score was 6.06 (SD = 3.33), indicative of poor baseline sleep. The highest mean noise level presented with an average reading of 80 dB, surpassing the WHO recommended noise levels by two times. Subjective sleep quality was not affected by demographic, clinical factors and bed locations. Patients exposed to night lamps reported a reduction in sleep quality ( p = .04).

Conclusions

Recognising the importance of overall sleep quality and the identification of external factors influencing patients’ sleep quality during hospitalisation is a vital step towards developing successful interventions to promote good sleep hygiene in the general wards of the Asian context.
Current options and future perspectives in the treatment of patients with relapsed/refractory diffuse large B-cell lymphoma
Authors: Frontzek Fabian , Karsten Imke , Schmitz Norbert , Lenz Georg
Published: June 2022

Diffuse large B-cell lymphoma (DLBCL) represents the most common subtype of aggressive lymphoma. Depending on individual risk factors, roughly 60–65% of patients can be cured by chemoimmunotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). However, patients with primary refractory disease or relapse (R/R) after an initial response are still characterized by poor outcome. Until now, transplant-eligible R/R DLBCL patients are treated with intensive salvage regimens followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) which, however, only cures a limited number of patients. It is most likely that in patients with early relapse after chemoimmunotherapy, chimeric antigen receptor (CAR) T-cells will replace high-dose chemotherapy and ASCT. So far, transplant-ineligible patients have mostly been treated in palliative intent. Recently, a plethora of novel agents comprising new monoclonal antibodies, antibody drug conjugates (ADC), bispecific antibodies, and CAR T-cells have emerged and have significantly improved outcome of patients with R/R DLBCL. In this review, we summarize our current knowledge on the usage of novel drugs and approaches for the treatment of patients with R/R DLBCL.
Chemotherapy for patients with advanced lung cancer with interstitial lung disease: a prospective observational study
Authors: Koda Keigo , Enomoto Yasunori , Aoshima Yoichiro , Amano Yusuke , Kato Shinpei , Hasegawa Hirotsugu , Matsui Takashi , Yokomura Koshi , Mochizuki Eisuke , Matsuura Shun , Koshimizu Naoki , Morita Meiko , Kojima Suguru , Watanabe Ayano , Oyama Yoshiyuki , Ikeda Masaki , Kusagaya Hideki , Uto Tomohiro , Sato Jun , Imokawa Shiro , Kono Masato , Hashimoto Dai , Kamiya Yosuke , Toyoshima Mikio , Asada Kazuhiro , Morita Masako , Mikamo Masashi , Yasui Hideki , Hozumi Hironao , Karayama Masato , Suzuki Yuzo , Furuhashi Kazuki , Fujisawa Tomoyuki , Enomoto Noriyuki , Nakamura Yutaro , Inui Naoki , Suda Takafumi
Published: June 2022

Introduction:

Although recent advances in chemotherapy for lung cancer are remarkable, most clinical trials have excluded patients with interstitial lung disease (ILD) due to the concern of developing acute exacerbation (AE) of ILD. Hence, accumulating original evidence of cancer treatment for this population is important.

Methods:

Between 2016 and 2020, a prospective observational study was conducted across 11 Japanese hospitals. Patients with chemotherapy- naïve, inoperable, advanced lung cancer with ILD were included. The primary outcome was the frequency of AE-ILD after registration; the secondary outcomes were the risk factor of AE-ILD and the efficacy of chemotherapy.

Results:

Among 124 patients enrolled, 109 patients who received chemotherapy were analyzed. The median age was 72 years, and the majority showed usual interstitial pneumonia (UIP)/probable UIP pattern upon chest computed tomography. The median percent-predicted forced vital capacity (%FVC) was 81% (interquartile range: 66–95%). After registration, 23 patients (21.1%; 95% confidence interval [CI]: 14.4–29.7%) developed AE-ILD. The logistic analysis revealed that lower %FVC slightly but significantly increased the risk of AE-ILD (odds ratio per 10% decrease: 1.27; 95% CI: > 1.00–1.62). Overall response rates/median overall survival times in non-small-cell lung cancer and small-cell lung cancer for the first-line chemotherapy were 41% (95% CI: 31–53)/8.9 months (95% CI: 7.6–11.8) and 91% (95% CI: 76–98)/12.2 months (95% CI: 9.2–14.5), respectively.

Conclusion:

AE-ILD during chemotherapy is a frequent complication among patients with lung cancer with ILD, particularly those with lower %FVC. Conversely, even in this population, passable treatment response can be expected.
Repopulation of decellularised porcine pulmonary valves in the right ventricular outflow tract of sheep: Role of macrophages
Authors: Vafaee Tayyebeh , Walker Fiona , Thomas Dan , Roderjan João Gabriel , Veiga Lopes Sergio , da Costa Francisco DA , Desai Amisha , Rooney Paul , Jennings Louise M , Fisher John , Berry Helen E , Ingham Eileen
Published: June 2022

The primary objective was to evaluate performance of low concentration SDS decellularised porcine pulmonary roots in the right ventricular outflow tract of juvenile sheep. Secondary objectives were to explore the cellular population of the roots over time. Animals were monitored by echocardiography and roots explanted at 1, 3, 6 ( n = 4) and 12 months ( n = 8) for gross analysis. Explanted roots were subject to histological, immunohistochemical and quantitative calcium analysis ( n = 4 at 1, 3 and 12 months) and determination of material properties ( n = 4; 12 months). Cryopreserved ovine pulmonary root allografts ( n = 4) implanted for 12 months, and non-implanted cellular ovine roots were analysed for comparative purposes. Decellularised porcine pulmonary roots functioned well and were in very good condition with soft, thin and pliable leaflets. Morphometric analysis showed cellular population by 1 month. However, by 12 months the total number of cells was less than 50% of the total cells in non-implanted native ovine roots. Repopulation of the decellularised porcine tissues with stromal (α-SMA+; vimentin+) and progenitor cells (CD34+; CD271+) appeared to be orchestrated by macrophages (MAC 387+/ CD163low and CD163+/MAC 387−). The calcium content of the decellularised porcine pulmonary root tissues increased over the 12-month period but remained low (except suture points) at 401 ppm (wet weight) or below. The material properties of the decellularised porcine pulmonary root wall were unchanged compared to pre-implantation. There were some changes in the leaflets but importantly, the porcine tissues did not become stiffer. The decellularised porcine pulmonary roots showed good functional performance in vivo and were repopulated with ovine cells of the appropriate phenotype in a process orchestrated by M2 macrophages, highlighting the importance of these cells in the constructive tissue remodelling of cardiac root tissues.
Dietary knowledge and practice and its associated factors among type 2 diabetes patients on follow-up at public hospitals of Dire Dawa, Eastern Ethiopia
Authors: Gebeyehu Anneleye Fantahun , Berhane Fitsum , Yimer Robel Mekonnen
Published: June 2022

Objectives:

This study tried to assess the level of dietary knowledge and practice and associated factors among type 2 diabetes mellitus patients in public hospitals of Dire Dawa, Ethiopia.

Methods:

A facility-based cross-sectional study was conducted among 253 type 2 diabetes mellitus patients visiting follow-up clinic in public hospitals selected by systematic random sampling. Primary data were collected by face-to-face interview and checklist. The collected data were entered into SPSS version 22 and analyzed using proportion, percentage, and mean and standard deviation. Bivariate logistic regression analysis was used to identify candidate variables affecting dietary practice. Finally, all candidate independent variables were further adjusted on multivariate regression analysis with adjusted odds ratio and 95% confidence interval to identify factors independently associated with dietary practice. p-value ⩽0.05 declared as level of significance.

Results:

The level of poor dietary practice among type 2 diabetes mellitus patients was found to be 53.8%. Around 78.8% of participants had fasting blood sugar level ⩾130 mg/dL, and 52.8% found to have poor dietary knowledge. Moreover, there was no up-to-date nutritional guideline in follow-up clinic. Not getting nutrition advice from doctors/nurses, low duration of follow-up, lack of family support, and despondency were significantly associated with poor dietary practice ( p-value < 0.05).

Conclusion:

More than half of diabetes patients had poor dietary practice, which is in contrary with international recommendations of diabetic self-care. Habit of eating fruits and vegetables was poorly practiced and also patients’ knowledge of recommended nutrition was poor. Therefore, provision of robust nutritional education and counseling service, a system to strengthen family support as well as psychosocial support, is highly recommended.
“Who’s Going to be a Creep Today?” Understanding the Social Media Experiences of Women Broadcast Journalists
Authors: Davis Kempton Stefanie , Connolly-Ahern Colleen
Published: June 2022

Reports of the online harassment of journalists have continued to increase as more newsrooms place higher emphasis on social media engagement with audiences. However, this harassment is subject to gendered dynamics, as women journalists are most often the target of online abuse, and the attacks themselves are often gender-centric. This study employs a mixed-method approach to explore how gender influences broadcast journalists’ social media interactions with audiences. Qualitative interviews with US broadcast journalists, along with a social media discourse analysis of the journalists’ Twitter pages, reveal the sexist nature of these interactions. Specifically, findings show that women journalists are treated not only as sexual objects, but also as non-serious journalists. In response to this treatment, women journalists adjust their social media strategies by limiting what they post and blocking certain users. This puts women journalists in a difficult position: increase coveted audience engagement and deal with online harassment or block abusive social media users and suffer the career impacts of low audience engagement. Implications are discussed.
An Evaluation of the Relationship Between Everyday Life Rhythms and Urban Morphology: The Square Of Bursa Kent Meydani Shopping Center, Turkey
Authors: Gümüş İmran , Yılmaz Ebru
Published: June 2022

The aim of this study is to search for the relationship between the morphological character of urban space and the rhythms of everyday life. Initially, behavioral maps are created by observing daily life rhythms, video recordings are taken on weekend and weekday, the snapshot technique, video recordings, and the pedestrian count analysis are used. In the second step, morphological analyses of the study area are prepared by using space syntax approach. Connectivity, local, and global integration values are obtained through creating axial map, and, in addition, visibility graph analysis (VGA) is performed. Bursa Kent Meydanı Shopping Center (BKMSC) consists of a square and the shopping units surrounding it. This area was the main transportation point as Central Bus Station Complex until 2006. The area was selected within the scope of the study because its changing public use due to the functional transformation of the area plays a significant role in the identity of the Bursa. The behavioral maps obtained from the observational data give information about user mobility, various actions, and the activities’ locations on weekends and weekdays. By correlating and comparing behavioral and space syntax maps analyses, the relationship between the rhythmic character and the morphological structure of the urban space is tested. The study presents original data by revealing the effects of the morphological elements of Bursa on the daily rhythms of the square of BKMSC. The case study is limited to the surveys conducted in 2 days and three different times of the day. The relationship between observational data and space syntax data shows that daily life rhythms are not independent of the morphological factors.
The Relationship Between Compliance of Physiotherapeutic Scoliosis Specific Exercises and Curve Regression With Mild to Moderate Adolescent Idiopathic Scoliosis
Authors: Fan Yunli , To Michael KT , Kuang Guan-Ming , Cheung Jason Pui Yin
Published: June 2022

Study Design

Retrospective Case-control Study.

Objectives

To determine the requisite exercise compliance (EC) of physiotherapeutic scoliosis-specific exercise (PSSE) for achieving curve regression; to analyze whether the apical translation (AT), apical wedging (AW), and apical rotation (AR) of the major curve improve with regression effect.

Methods

Between 2019 and 2021, a total of 763 patients undertook a 6-month PSSE treatment. This resulted 426 compliable and 302 uncompliable patients remained available for analysis. For compliable patients, 213 with curve regression and 213 age-/sex-matched with curve stabilization/deterioration at the 6-month, were eligible for regression analysis to detect the relationship between EC and regression effect at the 6-month; receiver operating characteristic (ROC) curve analysis and Youden’s index were applied to identify the threshold of EC leading to curve regression at the 6-month. The AT, AW, and AR of the major curve were compared before and after 6-month PSSE to investigate the radiographic parameters that improved with regression effect.

Results

EC was correlated with regression effect (odds ratio: 19.9, 95% confidence interval: 11.3-35.0, P < .001) and the cutoff threshold of EC was 4.4 h/week for 6 months to realize such an effect. AT was improved by 47.6% with curve regression, in which 152 cases remained curve regression and no case progressed into the operative threshold at the 1.5- to 2-year.

Conclusions

A 6-month PSSE protocol of 4.4 hours per week was potentially leading to curve regression in treating mild to moderate scoliosis. An improvement in AT of the major curve was observed with the regression effect.
Beach Chair Versus Lateral Decubitus Surgical Positioning for Arthroscopic Anterior Shoulder Stabilization: A Retrospective Comparison of Clinical and Patient-Reported Outcomes
Authors: Paul Ryan W. , Streicher Sydney , Osman Alim , Ukekwe Chuka , Zareef Usman , Freedman Kevin B. , Erickson Brandon J. , Hammoud Sommer , Bishop Meghan E.
Published: June 2022

Background:

Surgical positioning can affect both perioperative and postoperative complication rates. It is unclear whether beach-chair versus lateral decubitus positioning affects outcomes in patients undergoing arthroscopic anterior shoulder stabilization surgery.

Purpose:

The purpose of this study was to compare recurrent instability, complications, and patient-reported outcomes between patients who underwent arthroscopic anterior shoulder stabilization in the beach-chair versus the lateral decubitus positions. It was hypothesized that recurrent instability, complications, and patient-reported outcomes would not be affected by surgical positioning.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The authors reviewed the medical records of patients who underwent shoulder stabilization ( Current Procedural Terminology codes 29806 and 29807) from 2015 to 2019. Patients were included only if anterior instability was confirmed, arthroscopic surgery was performed in response to shoulder instability, and a minimum of 2 years of follow-up data were available. Data collected for eligible patients included perioperative and postoperative complications, recurrent instability, reoperation, and revision. Patients also completed surveys for the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) score, Oxford Shoulder Instability (OSI) score, and a return to any level of sport (RTS) questionnaire.

Results:

Overall, 294 patients (162 lateral decubitus and 132 beach-chair positions) were included, with an average follow-up of 2.4 ± 1.6 years. There were no significant differences in demographics between groups, nor were there differences in the rates of postoperative dislocations, subjective instability, reoperations, revisions, or complications. There was a trend toward a higher revision rate in the beach-chair group (beach-chair, 6.1% vs lateral decubitus, 1.9%; P = .069). There was no significant difference between groups regarding RTS rates or postoperative ASES, SANE, and OSI scores at 3.3 ± 1.1 years postoperatively.

Conclusion:

Surgical positioning for arthroscopic anterior shoulder stabilization did not significantly affect recurrent instability, complications, and patient-reported outcomes. Both beach-chair and lateral decubitus positioning provided good outcomes for anterior shoulder stabilization, with an overall recurrent dislocation rate of 7.8% at a mean of 3.3 years after surgery.
Investigation of the Physical Properties and Acoustic Performance of Composites Developed From Natural Fibres
Authors: Krithika S.M. Udaya , Mani K. , Thangavelu Sathish Kumar , Bharathi C. Mohan , Saravanan K. , Prakash C.
Published: June 2022

Noise pollution is one of the most pressing issues in our society today. Controlling noise has become one of the most essential and prevalent factors in the development of acoustic materials. Traditionally, numerous expensive and synthetic sound-absorption materials, such as glass fibre, carbon fibre and polymer fibres were utilised to suppress noise, posing additional harm to living organisms and the environment. Natural fibres derived from renewable resources can be utilised as sound-absorption materials that are inexpensive, bio-degradable, recyclable and readily available. Natural fibre-reinforced composites are currently exclusively used for diverse applications in the automobile industry, construction, building sectors, furniture and other industries. The risk of physical harm and health issues has been greatly reduced by adopting these natural fibre materials. In this research, an attempt has been made to manufacture composites from four natural fibres: hemp, bagasse, Arenga pinnata and bamboo. These four natural fibres were mixed in a 50:50 proportion along with polypropylene and developed into a textile composite using the thermal bonding method. The developed natural composite materials were tested for sound-absorption co-efficient using the impedance tube method and various physical properties, such as flexural rigidity, thickness, tensile strength, elongation, areal density, air permeability and thermal conductivity, were analysed for the composites using the standard testing procedures. All the possible influential factors that determine the acoustic characteristics property of the fibres are taken into consideration for the enhancement of the acoustic absorption of the composites. The sound-absorption co-efficient percent of the Arenga pinnata/polypropylene composite sample is higher than other fibres.
ECMO for Circulatory Support
Authors: Venturumilli Rakesh , Vala Pavan Kumar
Published: June 2022

Extracorporeal membrane oxygenation (ECMO) is a form of circulatory and respiratory support used for patients who have an almost complete loss of function of native lungs or heart. ECMO helps supplement organ function while treatment for the primary pathology is initiated. Initiation and maintenance of ECMO requires specialized skill, and knowledge of potential complications is necessary to ensure rapid and good return of organ function while minimizing patient morbidity and mortality. Weaning from ECMO requires complex studies to assess return of native cardiac function. Major complications include bleeding thrombosis and ischemia.
A Case of Patellar Instability and Lateral Facet Cartilage Defect
Authors: Garcia Grant H. , Haratian Aryan , Hasan Laith K. , Bolia Ioanna K. , Hatch George F. Rick , Petrigliano Frank A. , Weber Alexander E. , Liu Joseph N.
Published: June 2022

Background:

Concomitant cartilage injury is commonly associated with patellofemoral instability. While nonoperative treatment remains the gold standard for first time dislocators, there has been an increased trend toward addressing patellar instability when symptomatic cartilage disease is present.

Indications:

A healthy active 29-year-old woman >2 years of patellar instability and pain symptoms in the right knee. Imaging revealed tibial tubercle to trochlear groove (TT-TG) distance of 19.8 mm, and a Caton Deschamps Ratio of 1.54. Initial staging arthroscopy demonstrated a near full thickness cartilage defect of the lateral patellar facet measuring 2x2 cm.

Technique Description:

In the index procedure, a staging diagnostic arthroscopy is performed to evaluate the extent of the cartilage defect. Given the size of the lesion, a matrix-induced autologous chondrocyte implantation (MACI) biopsy is performed for later implantation. At the second stage procedure, a midline approach to the patella and tibial tubercle is performed. A 45° osteotomy is initiated with a cutting jig. The osteotomy is detached distally to allow for both anteromedialization and distalization to offload the cartilage defect and improve patellar articulation. The lateral patellar facet cartilage defect is prepared, and a combination of fibrin sealant and digital pressure is used to implant the pre-shaped MACI transplant. The osteotomy is then secured with 2 bicortical screws. A semitendinosus allograft is secured to the upper half of the medial border of the patellar and secured to its anatomometric point on the femur to reconstruct the medial patellofemoral ligament (MPFL).

Results:

Patient successfully returned to running and is currently working on return to other sports with no anterior knee pain or instability. Recent studies have demonstrated overall good clinical outcomes following MACI for patellofemoral lesions. Addressing underlying bony deformity and offloading patellofemoral cartilage lesions with tibial tubercle osteotomy in combination with MPFL reconstruction has improved patellar stability and good patient satisfaction.

Discussion/Conclusion:

Combined tibial tubercle osteotomy, MPFL reconstruction, and MACI in a comprehensive approach can successfully address symptomatic patellofemoral cartilage disease in the setting of patellar instability with underlying bony abnormalities.
Whole-genome CRISPR screening identifies N-glycosylation as a genetic and therapeutic vulnerability in CALR-mutant MPNs
Authors: Jutzi Jonas S. , Marneth Anna E. , Ciboddo Michele , Guerra-Moreno Angel , Jiménez-Santos María José , Kosmidou Anastasia , Dressman James W. , Liang Hongyan , Hamel Rebecca , Lozano Patricia , Rumi Elisa , Doench John G. , Gotlib Jason , Krishnan Anandi , Elf Shannon , Al-Shahrour Fátima , Mullally Ann
Published: June 2022

Calreticulin (CALR) mutations are frequent, disease-initiating events in myeloproliferative neoplasms (MPNs). Although the biological mechanism by which CALR mutations cause MPNs has been elucidated, there currently are no clonally selective therapies for CALR-mutant MPNs. To identify unique genetic dependencies in CALR-mutant MPNs, we performed a whole-genome clustered regularly interspaced short palindromic repeats (CRISPR) knockout depletion screen in mutant CALR-transformed hematopoietic cells. We found that genes in the N-glycosylation pathway (among others) were differentially depleted in mutant CALR-transformed cells as compared with control cells. Using a focused pharmacological in vitro screen targeting unique vulnerabilities uncovered in the CRISPR screen, we found that chemical inhibition of N-glycosylation impaired the growth of mutant CALR-transformed cells, through a reduction in MPL cell surface expression. We treated Calr-mutant knockin mice with the N-glycosylation inhibitor 2-deoxy-glucose (2-DG) and found a preferential sensitivity of Calr-mutant cells to 2-DG as compared with wild-type cells and normalization of key MPNs disease features. To validate our findings in primary human cells, we performed megakaryocyte colony-forming unit (CFU-MK) assays. We found that N-glycosylation inhibition significantly reduced CFU-MK formation in patient-derived CALR-mutant bone marrow as compared with bone marrow derived from healthy donors. In aggregate, our findings advance the development of clonally selective treatments for CALR-mutant MPNs.
Gut microbiota differs in composition between adults with type 1 diabetes with or without depression and healthy control participants: a case-control study
Authors: Petrak Frank , Herpertz Stephan , Hirsch Julia , Röhrig Bonnie , Donati-Hirsch Iris , Juckel Georg , Meier Juris J. , Gatermann Sören
Published: June 2022

Background

Individuals with type 1 diabetes and those with depression show differences in the composition of the gut microbiome from that of healthy people. However, these differences have not yet been studied in patients with both diseases. Therefore, we compared the gut microbiome of people with type 1 diabetes with or without depression with matched healthy controls.

Methods

A case-control study was conducted in 20 adults with type 1 diabetes (group A), 20 adults with type 1 diabetes and depression (group B), and 20 healthy adults (group C). Gut microbiota composition was determined by sequencing of the V3-V4 region of the bacterial 16S rDNA and alpha and beta diversity was compared between the groups.

Results

Groups A and B both showed higher alpha diversity than the healthy control group (P < 0.001) but alpha diversity did not differ significantly between groups A and B. Participants having type 1 diabetes with (P < 0.05) or without comorbid depression (P < 0.001) differed regarding beta diversity from healthy controls but not between each other. Group B (diabetes with depression) had significantly higher abundance of Megaspaera than groups A and C. Both diabetes groups had a higher abundance of Christensenellaceae, Succinivibrionaceae, and Rhodospirillaceae than the healthy group but similar between-group abundances.

Conclusions

While differences in alpha and beta diversity and in some bacterial taxa occurred only between participants with diabetes and healthy controls, specific characteristics regarding the abundance of Megasphaera were observed in people with diabetes and comorbid depression. In summary, the study findings indicate a possible involvement of bacterial groups in depression in people with diabetes. The results suggest replication studies in larger samples to verify these findings.
Stress-induced HPA activation in virtual navigation and spatial attention performance
Authors: Richardson Anthony E. , VanderKaay Tomasulo Melissa M.
Published: June 2022

Background

Previous research has shown that spatial performance (e.g. navigation, visuospatial memory, attention) can be influenced by acute stress; however, studies have produced mixed findings sometimes showing an improvement after stress, other times showing impairment or no overall effect. Some of these discrepancies may be related to: the type of stress system activated by the stressor (sympathetic adrenal medulla [SAM] or hypothalamic-pituitary-adrenocortical [HPA]); whether cortisol responders vs. nonresponders are analyzed subsequent to main effects; and sex differences in stress responses. In the present study, we examine the influence of HPA activation from an acute laboratory stressor (Socially Evaluated Cold Pressor test [SECPT]) on performance during two spatial tasks: Useful Field of View (UFOV; a measure of spatial attention) and virtual reality (VR) navigation. We assigned 31 males and 30 females to either the SECPT or a Non-Stress condition prior to the two spatial tasks. Cardiovascular measures including heart rate and blood pressure, and salivary cortisol biosamples were obtained at specific time points.

Results

Participants in the Stress condition showed increases in heart rate, systolic and diastolic blood pressure indicating sympathetic adrenal medulla (SAM) axis activation. Stress also led to increases in salivary cortisol, suggesting hypothalamic-pituitary-adrenocortical (HPA) activation. Stress did not influence overall performance in the spatial attention UFOV or the VR navigation task. However, a sex difference in spatial attention was detected when participants were divided into Stress-cortisol responders and non-responders in the UFOV task. Male Stress-cortisol responders (n = 9) showed better UFOV accuracy than female Stress-cortisol responders (n = 6); no sex differences were found among the Non-Stress control group. Furthermore, for females in the stress condition (n = 14), higher cortisol responses were associated with lower spatial attention performance.

Conclusions

Socially Evaluated Cold Pressor stress resulted in no change in speed or accuracy in a VR navigation task. For the spatial attention task, the SECPT led to a sex difference among Stress-cortisol responders with males showing improved accuracy over females. The relationship between HPA activation and prefrontal cortex activity may be necessary to understand sex differences in spatial attention performance.
Association between internet use and successful aging of older Chinese women: a cross-sectional study
Authors: Jiang Yao , Yang Fan
Published: June 2022

Background

The internet has become ubiquitous in contemporary human life. However, little is known about the association between internet use and older people’s aging process, especially that of older women.

Methods

Using the nationally representative dataset of the China Longitudinal Aging Social Survey 2016, we examined the relationship between internet usage and the successful aging of older Chinese women. The sample in this study consisted of 2713 respondents with an average age of 69.963 years. Successful aging was defined as no major diseases, no disability, high cognitive functioning, high physical functioning, and active engagement with life. Older women’s internet use behavior was represented by internet use frequency. Probit and instrumental variable models were employed to test the association between internet use frequency and successful aging of older women. The Karlson/Holm/Breen (KHB) mediation analysis was used to estimate the mediating effect of social capital on the relationship between internet use frequency and older women’s successful aging.

Results

Using a probit model (coefficient = 0.030, p < 0.001) and an instrumental variable probit model (coefficient = 0.287, p < 0.001), it was found that a successful aging status was significantly correlated with an increase in internet use frequency. The functional mechanism analysis suggested that social capital partially mediated the overall association between internet use frequency and successful aging.

Conclusions

This study suggests that the more frequently older Chinese women use the internet, the greater the possibility of successful aging. Our findings provide new evidence from China about the determinants of older women’s aging process and aid in formulating targeted aging policies for older women in developing countries and regions.
Self-reported difficulty in walking 400 meters: the “red flag” for probable sarcopenia
Authors: Salini Sara , Russo Andrea , Calvani Riccardo , Covino Marcello , Martone Anna Maria , Tosato Matteo , Damiano Francesco Paolo , Picca Anna , Marzetti Emanuele , Landi Francesco
Published: June 2022

Background

Sarcopenia is associated with adverse outcomes in older people. Several tools are recommended to assess muscle mass, muscle strength and physical performance, but are not always available in daily practice.

Objective

The aim of the present study is to evaluate if there is a correlation between the personal perception of physical performance (assessed through a question on personal functional status) and the effective presence of sarcopenia (according to the EWGSOP2 definition) using data from the Longevity Check-up 7 + project.

Design

Cross-sectional study.

Setting

The Longevity Check-up 7 + project is an ongoing study started in June 2015 and conducted in unconventional settings (i.e., exhibitions, malls, and health promotion campaigns).

Subjects

Candidate participants are eligible for enrollment if they are at least 18 years of age and provide written informed consent. For the present study subjects 65 years age old and older have been considered (n = 2901).

Methods

According to the most recent EWGSOP2 consensus definition, subjects were defined to be affected by probable sarcopenia when handgrip strength was less than 27 kg in male and less than 16 kg in female, respectively. Furthermore, a single question assessed the perceived health status regarding own physical performance: “Do you have any difficulty in walking 400 m?”.

Results

Using the EWGSOP2 algorithm, 529 (18,9%) participants were identified as affected by probable sarcopenia with a significant higher prevalence among subjects with self-reported difficulty in walking 400 m compared to participant without any difficulty (33.6% versus 13.1%, respectively; p < 0.001). Relative to participants without self-reported difficulty, those subjects with self-reported difficulty in walking 400 m showed a significantly higher risk of sarcopenia (odds ratio [OR]: 3.34; 95% confidence interval [CI]: 2.75–4.07).

Conclusions

A single “Red Flag” question such as “Do you have any difficulty in walking 400 m?” should be considered as a recommended method for screening probable sarcopenia risk.
Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis – a study based on high-resolution vessel wall imaging MRI
Authors: Che Fengli , Mi Donghua , Wang Anxin , Ju Yi , Sui Binbin , Geng Xiaokun , Zhao Xihai , Zhao Xingquan
Published: June 2022

Background

Intraplaque hemorrhage (IPH) is a hallmark of carotid plaque vulnerability. We aim to investigate the association between IPH and recurrent ipsilateral ischemic stroke.

Methods

Patients with a recent stroke or transient ischemic attack (TIA) were prospectively recruited and underwent an ultrasonographic examination and carotid HR VWMRI on the side consistent with symptoms. Carotid plaque was defined as carotid intima-media-thickness (IMT) by ultrasound≥1.5 mm. IPH was determined that the ratio of the plaque signal intensity relative to that of adjacent muscle was > 1.5. All enrolled patients were clinically followed until an ipsilateral ischemic stroke, TIA, carotid endarterectomy (CEA)/carotid artery stenting (CAS), or death within 12 months. Univariate analysis was used to analyze the correlation between clinical characteristics and IPH. Kaplan-Meier survival analysis and a log-rank test were used to compare recurrence-free survival time between the IPH and non-IPH groups. Cox regression models evaluated IPH as the predictor of ipsilateral stroke recurrence.

Results

A total of 171 patients (mean age, 60.13 ± 10.04 years; 118 males) were included in the final analysis. Thirty-two patients (18.7%) showed carotid IPH. During the follow-up, patients with carotid IPH suffered 60.9% (14 of 23) of recurrent ipsilateral strokes and 60.0% (3 of 5) TIA. Multivariate Cox regression analysis proved IPH as a strong predictor of ipsilateral stroke; the adjusted hazard ratio (HR) was 6.64 (95% confidence interval [CI], 2.84–15.54, P < 0.001). Meanwhile, Cox regression analysis also proved that IPH could predict recurrent ischemic events; the adjusted HR was 8.08 (95% CI, 3.65–17.91, P < 0.001).

Conclusions

Carotid intraplaque hemorrhage is strongly associated with recurrent ischemic events and could predict recurrent ipsilateral stroke.
Measuring impact of a quality improvement initiative on glaucoma clinic flow using an automated real-time locating system
Authors: Musser John A. , Cho Juno , Cohn Amy , Niziol Leslie M. , Ballouz Dena , Burke David T. , Newman-Casey Paula Anne
Published: June 2022

Background

Lean methodology helps maximize value by reducing waste, first by defining what value and waste are in a system. In ophthalmology clinics, value is determined by the number of patients flowing through the clinic for a given time. We aimed to increase value using a lean-methodology guided policy change, then assessed its impact on clinic flow using an automated radiofrequency identification (RFID) based real-time locating system (RTLS).

Methods

A total of 6813 clinical visits occurred at a single academic institution’s outpatient glaucoma clinic between January 5, 2018 to July 3, 2018. Over that period, 1589 patients comprising 1972 (29%) of visits were enrolled, with 1031 clinical visits occurring before and 941 visits after a policy change. The original policy was to refract all patients that improved with pinhole testing. The policy change was not to refract patients with a visual acuity ≥20/30 unless a specific request was made by the patient. Pre-post analysis of an automated time-motion study was conducted for the data collected 3 months before and 3 months after the policy change occurred on March 30, 2018. Changes to process and wait times were summarized using descriptive statistics and fitted to linear mixed regression models adjusting for appointment type, clinic volume, and daily clinic trends.

Results

One thousand nine hundred twenty-three visits with 1588 patients were included in the analysis. Mean [SD] age was 65.9 [14.7] years and 892 [56.2%] were women. After the policy change, technician process time decreased by 2.9 min (p < 0.0001) while daily clinical patient volume increased from 51.9 ± 16.8 patients to 58.4 ± 17.4 patients (p < 0.038). No significant difference was found in total wait time (p = 0.18) or total visit time (p = 0.83).

Conclusions

Real-time locating systems are effective at capturing clinical flow data and assessing clinical practice change initiatives. The refraction policy change was associated with reduced technician process time and overall the clinic was able to care for 7 more patients per day without significantly increasing patient wait time.
Inequalities in short-acting reversible, long-acting reversible and permanent contraception use among currently married women in India
Authors: Das Milan , Anand Abhishek , Hossain Babul , Ansari Salmaan
Published: June 2022

Background

In India, the usage of modern contraception methods among women is relatively lower in comparison to other developed economies. Even within India, there is a state-wise variation in family planning use that leads to unintended pregnancies. Significantly less evidence is available regarding the determinants of modern contraception use and the level of inequalities associated with this. Therefore, the present study has examined the level of inequalities in modern contraception use among currently married women in India.

Methods

This study used the fourth round of National Family Health Survey (NFHS-4) conducted in 2015-16. Our analysis has divided the uses of contraception into three modern methods of family planning such as Short-Acting Reversible Contraception (SARC), Long-Acting Reversible Contraception (LARC) and permanent contraception methods. SARC includes pills, injectable, and condoms, while LARC includes intrauterine devices, implants, and permanent contraception methods (i.e., male and female sterilization). We have employed a concentration index to examine the level of socioeconomic inequalities in utilizing modern contraception methods.

Results

Our results show that utilization of permanent methods of contraception is more among the currently married women in the higher age group (40–49) as compared to the lower age group (25–29). Women aged 25–29 years are 3.41 times (OR: 3.41; 95% CI: 3.30–3.54) more likely to use SARC methods in India. Similarly, women with 15 + years of education and rich are more likely to use the LARC methods. At the regional level, we have found that southern region states are three times more likely to use permanent methods of contraception. Our decomposition results show that women age group (40–49), women having 2–3 children and richer wealth quintiles are more contributed for the inequality in modern contraceptive use among women.

Conclusions

The use of SARC and LARC methods by women who are marginalized and of lower socioeconomic status is remarkably low. Universal free access to family planning methods among marginalized women and awareness campaigns in the rural areas could be a potential policy prescription to reduce the inequalities of contraceptive use among currently married women in India.