bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of rocker-sole footwear on knee joint biomechanics while walking in people with ACL-reconstructed knees: a cross-sectional biomechanical study
Authors: Bagheri Azam , Saeedi Hassan , Jalali Maryam , Forghany Saeed 
Published: May 2020

Background:
Reinjury has occurred at a high rate after anterior cruciate ligament (ACL) reconstruction. Low knee flexion angles and high peak posterior ground reaction forces in landing tasks increase ACL loading. Some studies reported that rocker-sole shoes increased knee flexion angle in the early stance phase of the gait. The aim of this study was to investigate the biomechanics of walking with a custom-made heel-to-toe rocker shoe design, with special attention to the sagittal knee joint kinematics of patients after ACL reconstruction.

Methods:
This study examined 10 male participants with ACL-reconstruction participants. Three-dimensional gait analysis was performed under two conditions of level walking that were tested in random order using either modified footwear adapted with a heel-to-toe rocker sole or baseline footwear with a flat sole. The knee flexion angle at initial foot contact with the ground, average knee flexion angle from heel strike to 25% stance phase, and first peak knee flexion angle were compared across footwear conditions.

Results:
Walking with the heel-to-toe rocker shoes increased the knee flexion angle at the early stance phase of the gait cycle when compared with the baseline footwear.

Conclusions:
Rocker-shoe intervention was found to have potential as a rehabilitation tool to modify gait patterns in the sagittal plane of people with ACL-reconstructed knees and may protect against high reinjury rates. Further research is required to evaluate whether prolonged wear of rocker-sole shoes can modify lower extremity biomechanics of participants who have undergone ACL reconstruction.

Level of Evidence:
Level II.
Anterolateral ligament in pediatric knees: A radiographic study
Authors: Hegaze Adel , Khashoggi Khalid , Alqrache Abdulraof , Ashour Abdullah , Mustafa Hesham N. 
Published: May 2020

Background:
The anterolateral ligament (ALL) is a true well-defined ligament in the knee first described in 1879 by Segond. After the work of Claes et al., several studies were conducted about biomechanics and its role in stability of the knee. The anatomical existence of the ALL has been studied by and various radiographic diagnostic modalities and in cadavers. It originates from lateral femoral epicondyle and is inserted between Gerdy’s tubercle and the fibular head. There has been controversy about the existence of ALL in pediatric patients. The aim of this work was to confirm the presence of ALL in pediatric patients by using MRI.

Materials and Methods:
We reviewed the knee MRI scans of 100 pediatric patients (ages between one and 12 yr) who had no knee injury or congenital deformity and had been evaluated by an expert radiologist.

Results:
The ALL was detected in 90% of the pediatric patients with the use of MRI.

Conclusions:
The main finding of this study was that ALL can be seen in pediatric patients using MRI. Despite numerous studies, additional research is needed to further define the role of the ALL in knee function.

Level of Evidence:
Level IV.
Physical therapy in axial spondyloarthritis: guidelines, evidence and clinical practice
Authors: Martey Christopher , Sengupta Raj 
Published: May 2020

Purpose of review
Physical therapy is recommended for the management of axial spondyloarthritis (axSpA) with the focus of promoting physical activity and prescribing exercise within four domains, outlined recently by the European League against Rheumatism (EULAR): aerobic, resistance, flexibility and neuro-motor exercise. There is an increasing evidence base to support physical therapy interventions in axSpA.

Recent findings
We present evidence supporting the use of exercise as treatment for patients with axSpA, recent updates among different exercise modalities, and make clear its critical place in the management of this condition. Recent large, multicentre data have shown that high-intensity exercise can improve disease activity and also positively impact cardiovascular risk factors in these patients. Although international treatment guidelines advocate the inclusion of physical activity and exercise for the optimal management of axSpA, specific guidance about the amount of exercise required to produce a beneficial effect is lacking.

Summary
Exercise must be used in the management of axSpA, and whilst hydrotherapy and flexibility exercises are traditionally the main focus, other applications, such as strength training, may be underutilized domains. Further studies are needed to determine the dose–response relationship between exercise and axSpA patient subsets.
MRI of the sacroiliac joints: what is and what is not sacroiliitis?
Authors: Østergaard Mikkel 
Published: May 2020

Purpose of review
MRI has, as the only imaging modality, the ability to visualize both the inflammatory and destructive aspects of sacroiliitis and is a crucial element in the diagnosis and classification of axial spondyloarthritis (axSpA). However, the MRI appearance of several potential differential diagnoses may resemble axSpA sacroiliitis.

Recent findings
The appearances of sacroiliac joint (SIJ) MRIs of various diseased and healthy populations have recently been intensively studied. BME, the key requirement in the Assessment of Spondyloarthritis international Society (ASAS) definition of a ‘MRI positive of sacroiliitis’ may also be found in degenerative disease, athletes and healthy persons, and, particularly, postpartum women. Certain pattern of BME (high extent, large depth from articular surface, close relation to other lesion types) as well as the presence of structural lesions, particularly bone erosion, backfill or ankylosis increase the likelihood/specificity of being axSpA. Furthermore, old and novel MRI approaches to best distinguish the sacroiliitis of early axSpA from differential diagnoses have recently been tested and compared.

Summary
Significant new and clinically relevant knowledge has been gained, but further research is still needed to optimally distinguish what is and what isn’t sacroiliitis.
Increasing Fusion Rate Between 1 and 2 Years After Instrumented Posterolateral Spinal Fusion and the Role of Bone Grafting
Authors: Lehr A. Mechteld , Oner F. Cumhur , Delawi Diyar , Stellato Rebecca K. , Hoebink Eric A. , Kempen Diederik H.R. , van Susante Job L.C. , Castelein René M. , Kruyt Moyo C. 
Published: May 2020

Study Design.
Two-year clinical and radiographic follow-up of a double-blind, multicenter, randomized, intra-patient controlled, non-inferiority trial comparing a bone graft substitute (AttraX® Putty) with autograft in instrumented posterolateral fusion (PLF) surgery.

Objectives.
The aim of this study was to compare PLF rates between 1 and 2 years of follow-up and between graft types, and to explore the role of bone grafting based on the location of the PLF mass.

Summary of Background Data.
There are indications that bony fusion proceeds over time, but it is unknown to what extent this can be related to bone grafting.

Methods.
A total of 100 adult patients underwent a primary, single- or multilevel, thoracolumbar PLF. After instrumentation and preparation for grafting, the randomized allocation side of AttraX® Putty was disclosed. The contralateral posterolateral gutters were grafted with autograft. At 1-year follow-up, and in case of no fusion at 2 years, the fusion status of both sides of each segment was blindly assessed on CT scans. Intertransverse and facet fusion were scored separately. Difference in fusion rates after 1 and 2 years and between grafts were analyzed with a Generalized Estimating Equations (GEE) model (P < 0.05).

Results.
The 2-year PLF rate (66 patients) was 70% at the AttraX® Putty and 68% at the autograft side, compared to 55% and 52% after 1 year (87 patients). GEE analysis demonstrated a significant increase for both conditions (odds ratio 2.0, 95% confidence interval 1.5–2.7, P < 0.001), but no difference between the grafts (P = 0.595). Ongoing bone formation was only observed between the facet joints.

Conclusion.
This intra-patient controlled trial demonstrated a significant increase in PLF rate between 1 and 2 years after instrumented thoracolumbar fusion, but no difference between AttraX® Putty and autograft. Based on the location of the PLF mass, this increase is most likely the result of immobilization instead of grafting.

Level of Evidence: 1
The Intelligent Automated Pressure-Adjustable Orthosis for Patients With Adolescent Idiopathic Scoliosis
Authors: Lin Yangmin , Lou Edmond , Lam Tsz Ping , Cheng Jack Chun-Yiu , Sin Sai Wing , Kwok Wing Kwan , Wong Man Sang 
Published: May 2020

Study Design.
Randomized controlled trial.

Objective.
To compare the effectiveness of the automated pressure-adjustable orthosis (PO) and conventional orthosis (CO) for treatment of adolescent idiopathic scoliosis (AIS).

Summary of Background Data.
Orthosis wearing quality may influence its effectiveness for AIS. An automated PO aimed to provide a more optimized and consistent biomechanical environment. Clinical evaluation was conducted to study the effectiveness of this innovative orthosis.

Methods.
Patients with AIS who met the criteria (Age 10–14, Cobb 20°–40°, and Risser sign 0–2) were recruited from two clinics and randomly assigned to the PO and CO groups. Compliance sensors were embedded in both groups, while the PO group was set to adjust the interfacial pressure as prescribed automatically. Clinical assessments (radiology and quality of life, QoL) were conducted at the baseline, immediate after orthosis fitting and 1-year follow-up. Orthosis wearing compliance was tracked using thermo and pressure sensors.

Results.
Twenty-four patients were enrolled with one drop-out (PO, n = 11; CO, n = 12). Significant immediate in-orthosis correction was observed in the PO (11.0° ± 6.5°, 42.0%, P < 0.001) and CO (10.3° ± 5.3°, 37.6%, P < 0.001) groups. After 1 year, no patient with PO progressed while two with CO had progression more than 5°. The mean daily wearing duration was 1.1 hours longer in the PO group as compared with the CO group (15.4 ± 4.5 vs. 14.3 ± 3.8 h). Moreover, the wearing quality within the targeted pressure was 33.9% higher in the PO group (56.5 ± 16.5% vs. 23.1 ± 12.1%, P < 0.001). No significant difference in the QoL results was observed between two groups nor within both groups during the study period.

Conclusion.
This study showed that the automated PO could enhance wearing quality when compared with the CO, thus offering a better biomechanical corrective effect in the study period without adverse effect on the patients’ wearing quantity and QoL.

Level of Evidence: 1
Congenital Ophthalmoplegia and Late-Onset Limb Weakness Caused by MUSK Mutations
Authors: Ostos Fernando , Alcantara Miranda Pilar , Hernández-Laín Aurelio , Domínguez-González Cristina 
Published: May 2020

Abstract
Congenital myasthenic syndromes are clinically and genetically heterogeneous disorders characterized by a neuromuscular transmission defect. Mutations in novel genes have been described in recent years. Among these, MUSK gene mutations are extremely rare, with only 8 families identified worldwide to date. We report a Spanish case, a carrier of one known hetero-allelic missense mutation and one newly identified MUSK gene variant. Our patient presented with congenital onset ophthalmoplegia and palpebral ptosis associated with limb–girdle weakness and exercise intolerance without prominent fatigability, developed during his twenties. He was misdiagnosed as mitochondrial myopathy because of paraclinic and histologic findings, but detailed clinical examination prompted us to reassess him with repetitive stimulation technique, demonstrating decremental response and suggesting myasthenic syndrome. A genetic study confirmed the clinical diagnosis allowing us to started treatment with excellent clinical response.
MiR-7-5p Enhances Cerebral Ischemia–Reperfusion Injury by Degrading sirt1 mRNA
Authors: Zhao Jing , Wang Bo 
Published: May 2020

Abstract:
Cerebral ischemia–reperfusion (I/R) is a kind of neurovascular disease that causes serious cerebral damage. MicroRNAs (miRNAs) have been widely reported to participate in multiple diseases, including cerebral I/R injury. However, the exact mechanisms of miR-7-5p in cerebral I/R injury was not fully elucidated. In this study, we explored the biological role and regulatory mechanism of miR-7-5p in cerebral I/R injury. We established an in vivo model of cerebral I/R by middle cerebral artery occlusion and an in vitro cellular model of cerebral I/R injury through treating neurons (SH-SY5Y cells) with oxygen-glucose deprivation (OGD). In addition, miR-7-5p expression was confirmed to be upregulated in the cerebral I/R rat model and OGD/R-treated SH-SY5Y cells. Moreover, miR-7-5p inhibition overtly suppressed cerebral injury, cerebral inflammation, and SH-SY5Y cells apoptosis. Sirtuin 1 (sirt1) is previously reported to alleviate I/R, and in this study, it was identified to be a target of miR-7-5p based on luciferase reporter assay. Reverse transcription-quantitative polymerase chain reaction revealed sirt1 expression was downregulated in the cerebral I/R rat model and OGD/R-treated SH-SY5Y cells. Besides, miR-7-5p negatively regulated sirt1. Finally, rescue assays delineated sirt1 overexpression recovered the miR-7-5p upregulation-induced promotion on cerebral I/R injury. In conclusion, miR-7-5p enhanced cerebral I/R injury by degrading sirt1, providing a new paradigm to investigate cerebral I/R injury.
LOXL1-AS1/miR-515-5p/STAT3 Positive Feedback Loop Facilitates Cell Proliferation and Migration in Atherosclerosis
Authors: Xie Qiong , Li Feng , Shen Kangjun , Luo Cheng , Song Guobao 
Published: May 2020

Abstract:
Existing research has elucidated the critical role of long noncoding RNAs (lncRNAs) in the progression of multiple human cardiovascular diseases, including atherosclerosis (AS). Nonetheless, whether long noncoding RNA LOXL1 antisense RNA 1 (LOXL1-AS1) regulates the biological functions in AS is exceedingly limited. In this research, we detected through reverse transcription-quantitative polymerase chain reaction that LOXL1-AS1 expression was markedly upregulated in patients with AS. The role of LOXL1-AS1 in vascular smooth muscle cells (VSMCs) and human umbilical vein endothelial cells (HUVECs) was unmasked by functional assays. Moreover, knockdown of LOXL1-AS1 exerted suppressive effect on proliferation and migration whereas accelerated apoptosis in VSMCs and HUVECs. Molecular mechanism assays revealed that signal transducer and activator of transcription 3 (STAT3) functioned as a transcription activator of LOXL1-AS1 in VSMCs and HUVECs. In addition, miR-515-5p was manifested to bind with LOXL1-AS1 (or STAT3) in VSMCs and HUVECs. Furthermore, LOXL1-AS1 could elevate STAT3 expression by sponging miR-515-5p in VSMCs and HUVECs. More importantly, rescue assays delineated that inhibited expression of miR-515-5p or elevated expression of STAT3 could reverse the restraining effect of LOXL1-AS1 depletion on the progression of AS in HUVECs. All these findings revealed the role of a LOXL1-AS1/miR-515-5p/STAT3 positive feedback loop in AS.
The Small Conductance Calcium-Activated Potassium Channel Inhibitors NS8593 and UCL1684 Prevent the Development of Atrial Fibrillation Through Atrial-Selective Inhibition of Sodium Channel Activity
Authors: Burashnikov Alexander , Barajas-Martinez Hector , Hu Dan , Robinson Victoria M. , Grunnet Morten , Antzelevitch Charles 
Published: May 2020

Abstract:
The mechanisms underlying atrial-selective prolongation of effective refractory period (ERP) and suppression of atrial fibrillation (AF) by NS8593 and UCL1684, small conductance calcium-activated potassium (SK) channel blockers, are poorly defined. The purpose of the study was to confirm the effectiveness of these agents to suppress AF and to probe the underlying mechanisms. Transmembrane action potentials and pseudoelectrocardiograms were recorded from canine isolated coronary-perfused canine atrial and ventricular wedge preparations. Patch clamp techniques were used to record sodium channel current (INa) in atrial and ventricular myocytes and human embryonic kidney cells. In both atria and ventricles, NS8593 (3–10 µM) and UCL1684 (0.5 µM) did not significantly alter action potential duration, suggesting little to no SK channel inhibition. Both agents caused atrial-selective: (1) prolongation of ERP secondary to development of postrepolarization refractoriness, (2) reduction of Vmax, and (3) increase of diastolic threshold of excitation (all are sodium-mediated parameters). NS8593 and UCL1684 significantly reduced INa density in human embryonic kidney cells as well as in atrial but not in ventricular myocytes at physiologically relevant holding potentials. NS8593 caused a shift of steady-state inactivation to negative potentials in atrial but not ventricular cells. NS8593 and UCL1684 prevented induction of acetylcholine-mediated AF in 6/6 and 8/8 preparations, respectively. This anti-AF effect was associated with strong rate-dependent depression of excitability. The SK channel blockers, NS8593 and UCL1684, are effective in preventing the development of AF due to potent atrial-selective inhibition of INa, causing atrial-selective prolongation of ERP secondary to induction of postrepolarization refractoriness.
Chronopharmacokinetics and Food Effects of Single-Dose LCP-Tacrolimus in Healthy Volunteers
Authors: Alloway Rita R. , Trofe-Clark Jennifer , Brennan Daniel C. , Kerr Janice , Cohen Elizabeth A. , Meier-Kriesche Ulf , Stevens Daniel R. , Moten Misbah A. , Momper Jeremiah D. 
Published: May 2020

Background:
A modified-release version of tacrolimus, LCP-tacrolimus (LCPT; Envarsus XR, Veloxis Pharmaceuticals, Cary, NC), has been licensed in the United States for prophylaxis of organ rejection in de novo kidney transplant patients. As tacrolimus has a narrow therapeutic window, the impact of circadian patterns on LCPT drug exposure, including food and chronopharmacokinetic effects, needs to be elucidated to optimize dosing.

Methods:
Two randomized, crossover, phase 1 studies were conducted in healthy volunteers. The first assessed the effect of morning versus evening dosing on the pharmacokinetic profile of LCPT 2 mg; the second assessed the effect of food on the pharmacokinetic profile of LCPT 5 mg. In both, blood samples were drawn from participants for up to 144 hours after administration of a single LCPT dose.

Results:
No significant differences were observed between evening and morning dosing in peak blood concentration (4.4 versus 4.0 ng/mL; P = 0.27), area under the time–concentration curve (AUC) from time 0 to time of the last concentration (89.1 versus 102.6 ng/mL; P = 0.20), AUC from time 0 to infinity (99.7 versus 114.3 ng·h/mL; P = 0.18), AUC from 0 to 24 hours post-dose (AUC0–24; 49.4 versus 51.6 ng·h/mL; P = 0.56), time to reach maximum blood concentration (median, 6.0 versus 6.0 hours; P = 0.91), total clearance (arithmetic mean = 21.5 versus 19.5 L/h; P = 0.50), or terminal half-life (arithmetic mean = 26.8 versus 28.1 hours; P = 0.26). After a high-calorie meal in the morning, the AUC0–24 reduced by 54% (ratio of geometric means = 45.6%; P < 0.0001) and peak blood concentration reduced by 22% (ratio of geometric means = 78.4%; P = 0.0006). However, the terminal half-life did not differ between fasted and fed states (33.3 versus 34.8 hours; P = 0.16), implying that these differences occurred because of altered bioavailability rather than modified clearance.

Conclusions:
For LCPT, no chronopharmacokinetic effects were observed, whereas food significantly reduced the 24-h exposure and the peak blood concentration.
Perioperative pain management in minimally invasive gynecologic surgery
Authors: Womack Ashley S. , Smith Rachael B. , Mourad Jamal , Mahnert Nichole D. 
Published: May 2020

Purpose of review
The purpose of this review is to summarize the most recent evidence-based interventions for perioperative pain management in minimally invasive gynecologic surgery.

Recent findings
With particular emphasis on preemptive interventions in recent studies, we found preoperative counseling, nutrition, exercise, psychological interventions, and a combination of acetaminophen, celecoxib, and gabapentin are highly important and effective measures to reduce postoperative pain and opioid demand. Intraoperative local anesthetics may help at incision sites, as a paracervical block, and a transversus abdominus plane block. Postoperatively, an effort should be made to utilize non-narcotic interventions such as abdominal binders, ice packs, simethicone, bowel regimens, gabapentin, and scheduled NSAIDs and acetaminophen. When prescribing narcotics, providers should be aware of recommended amounts of opioids required per procedure so as to avoid overprescribing.

Summary
Our findings emphasize the evolving importance of preemptive interventions, including prehabilitation and pharmacologic agents, to improve postoperative pain after minimally invasive gynecologic surgery. Additionally, a multimodal approach to nonnarcotic intraoperative and postoperative interventions decreases narcotic requirement and improves opioid stewardship.
Breast Reconstruction Combining Lipofilling and Prepectoral Prosthesis after Radiotherapy
Authors: Razzouk Kais , Fitoussi Alfred , Al Khori Noor , Pasquier Jennifer , Chouchane Lotfi , Tabrizi Arash Rafii 
Published: May 2020

Background:
Prosthetic reconstruction in previously irradiated breasts has been associated with a higher risk of complications. Here we describe the surgical and cosmetic outcome of our breast reconstruction process based on primary fat grafting combined with prosthetic placement.

Methods:
In this multicenter retrospective study, 136 patients who underwent mastectomy and external chest wall radiotherapy between 2014 and 2018 were benefited from chest wall lipofilling and silicone implant placement were chosen. Patients were assessed for skin trophicity, thickness, and mobility and were allowed to undergo several lipofilling sessions before implant placement, if required. No patient had >3 lipofilling sessions. Cosmetic outcome was evaluated by the patient, surgeon, and nurse, using a Likert-type ordinal scale.

Results:
We included 136 patients: 79 patients (58%) received only 1 session of lipofilling before implant placement, 33 (24.6%) had 2 sessions, and 24 (17.4%) had 3 sessions. The volume of the third lipofilling was significantly higher and the volume of the prosthesis of these patients was significantly lower than those of patients undergoing 1 or 2 lipofillings. Reconstruction failure rate was 2.2% (3 patients had explantation); however, all benefited from prosthesis reconstruction a year after the initial procedures. The average satisfaction score was 4.7 out of 5 as evaluated by patients, 4.8 out of 5 by surgeons, and 4.8 out of 5 by nurses.

Conclusions:
Primary lipofilling combined with prosthesis placement after radiotherapy is a reconstructive method that yields a satisfactory cosmetic outcome with a low complication rate. Such minimally invasive breast reconstruction approach can be an alternative to flap-based reconstruction.