Tag: nevin manimala

Eur J Orthop Surg Traumatol. 2023 Aug 13. doi: 10.1007/s00590-023-03679-8. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to compare radiological and functional outcomes and complication rates between intramedullary nailing (IMN) and plate fixation for diaphyseal forearm fractures in adolescents via an age-matched analysis.

METHODS: Data were collected from medical records at 11 hospitals from 2009 to 2019, and the age-matched study was conducted between IMN and plate fixation. Functional outcomes, radiographic outcomes, and postoperative complication rates were compared.

RESULTS: The IMN group (Group N) and plate fixation group (Group P) each comprised 26 patients after age matching. The mean age after matching was 13.42 years old. Bone maturities at the wrist of the radius and ulna were not significantly different between the two groups (p = 0.764 and p = 1). At the last follow-up period, functional outcomes using the Price criteria were over 90% in both groups, and the rotational range of motion was comparable to that of the healthy side. Over 70% of cases in Group N were performed by closed reduction, and operation time was half that of Group P. Postoperative neurological symptoms and refractures were more common in Group P than in Group N, although not statistically significantly so.

CONCLUSIONS: Treatment outcomes for age-matched adolescent diaphyseal forearm fractures were excellent with IMN, as well as with plate fixation in many cases despite fewer complications, better cosmesis, and shorter operative times with IMN. IMN for diaphyseal forearm fractures is a useful treatment option even in adolescents although the indications for the best procedure to perform should be considered depending on individual patient needs.

LEVEL OF EVIDENCE IV: Multicenter retrospective study.

PMID:37573542 | DOI:10.1007/s00590-023-03679-8

Spine Deform. 2023 Aug 13. doi: 10.1007/s43390-023-00748-0. Online ahead of print.

NO ABSTRACT

PMID:37573537 | DOI:10.1007/s43390-023-00748-0

Int J Bipolar Disord. 2023 Aug 13;11(1):28. doi: 10.1186/s40345-023-00308-5.

ABSTRACT

BACKGROUND: We tested the hypothesis that, after initial improvement with intravenous ketamine in patients with bipolar disorder (BD) with severe depression and acute suicidal thinking or behavior, a fixed-dose combination of oral D-cycloserine (DCS) and lurasidone (NRX-101) can maintain improvement more effectively than lurasidone alone.

METHODS: This was a multi-center, double-blind, twostage, parallel randomized trial. Adult BD patients with depression and suicidal ideation or behavior were infused with ketamine or saline (Stage 1); those who improved were randomized to a fixed-dose combination of DCS and lurasidone vs. lurasidone alone (Stage 2) to maintain the improvement achieved in Stage 1. Depression was measured by the Montgomery Åsberg Depression Rating Scale (MADRS), and suicidal thinking and behavior was measured by the Columbia Suicide Severity Rating Scale (C-SSRS); global improvement was measured by the clinical global severity scale (CGI-S).

CLINICALTRIALS: gov NCT02974010; Registered: November 22, 2016.

RESULTS: Thirty-seven patients were screened and 22 were enrolled, randomized, and treated. All 22 patients treated in Stage 1 (17 with ketamine and 5 with saline) were enrolled into Stage 2, and 11 completed the study. The fixed-dose combination of DCS and lurasidone was significantly more effective than lurasidone alone in maintaining improvement in depression (MADRS LMS Δ-7.7; p = 0.03) and reducing suicidal ideation, as measured by C-SSRS (Δ-1.5; p = 0.02) and by CGI-SS (Δ-2.9; p = 0.03), and with a non-statistically significant decrease in depressive relapse (0% vs. 40%; p = 0.07). This sequential treatment regimen did not cause any significant safety events and demonstrated improvements in patient-reported side effects.

CONCLUSIONS: Sequential treatment of a single infusion of ketamine followed by NRX-101 maintenance is a promising therapeutic approach for reducing depression and suicidal ideation in patients with bipolar depression who require hospitalization due to acute suicidal ideation and behavior. On the basis of these findings, Breakthrough Therapy Designation was awarded, and a Special Protocol Agreement was granted by the FDA for a registrational trial.

PMID:37573534 | DOI:10.1186/s40345-023-00308-5

Knee Surg Sports Traumatol Arthrosc. 2023 Aug 13. doi: 10.1007/s00167-023-07528-3. Online ahead of print.

ABSTRACT

PURPOSE: The long-term changes in the dynamics of the medial meniscus after transtibial pullout repair for medial meniscus posterior root tears (MMPRTs) are not completely understood. Thus, the aim of this study was to investigate the effects of transtibial pullout repair on MMPRTs and whether the effects would be sustained.

METHODS: Nineteen knees with MMPRTs that were treated by trans-tibial pullout repair were enrolled in this study. Medial meniscus extrusion (MME) was measured by ultrasonography during knee extension (no weight-bearing with the knee at 0° extension: NW0°) and 90° flexion (no weight-bearing with the knee at 90° flexion: NW90°) with the patient in the supine position and with full weight-bearing (FW0°) preoperatively and at 3 and 12 months postoperatively. The clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score, Lysholm score, and International Knee Documentation Committee score.

RESULTS: The difference in MME with NW0° was not statistically significant between the preoperative (3.4 ± 1.0 mm) and 12-month postoperative (3.7 ± 0.6 mm) time points. The MME with NW90° at 3 (2.1 ± 0.7 mm) and 12 months (2.9 ± 0.6 mm) postoperatively were significantly lower than the preoperative values (3.4 ± 0.8 mm) (P < 0.05). However, the value significantly increased from 3 to 12 months postoperatively (P < 0.05). The MME with FW0° at 12 months postoperatively (4.3 ± 0.6 mm) was significantly larger than that at pre-operatively (3.6 ± 0.9 mm) (P < 0.05). All the patients’ clinical conditions were significantly improved at 12 months postoperatively when compared to their preoperative clinical conditions.

CONCLUSION: Surgery did not reduce the extrusion in the no weight-bearing and weight-bearing positions at knee extension, and these values increased in the postoperative period. In addition, while the surgery reduced the extrusion in the knee flexion position, the restoration achieved by the surgery was not sustained in the long term.

LEVEL OF EVIDENCE: Level IV.

PMID:37573532 | DOI:10.1007/s00167-023-07528-3

Expert Rev Anticancer Ther. 2023 Aug 13:1-6. doi: 10.1080/14737140.2023.2247565. Online ahead of print.

ABSTRACT

INTRODUCTION: Up to 30% of patients with stage IIB and 50% of stage IIC melanoma experience recurrence within 5 years after radical surgery. Adjuvant treatment is expected to improve this prognosis.

AREAS COVERED: Pembrolizumab (MK-3475) is a humanized monoclonal antibody that acts against the programmed cell death 1 (PD-1) receptor. Pembrolizumab was first approved in monotherapy for the treatment of unresectable/metastatic melanoma based on the results of the prospective KEYNOTE-001, KEYNOTE-002, and KEYNOTE-006 trials. KEYNOTE-716 is the randomized phase III trial of pembrolizumab treatment in resected stage II melanoma. Treatment with pembrolizumab is statistically significant, reducing the risk of recurrence as well as distant metastases risk after primary tumor resection. Pembrolizumab treatment has a 24-month RFS rate of 81.2% (HR 0.64 vs placebo) and a DMFS rate of 88.1%.

EXPERT OPINION: 1-year adjuvant pembrolizumab treatment of stage IIB/C melanoma patients significantly reduces recurrence or death risk. The safety profile of adjuvant treatment is not different from previously reported and is manageable. Longer follow-up is required to fully understand the efficacy and safety of adjuvant therapy for stage II melanoma, as the number of patients needed to treat is twice as high as for stage III patients.

PMID:37573515 | DOI:10.1080/14737140.2023.2247565

Dev Neurorehabil. 2023 Aug 13:1-10. doi: 10.1080/17518423.2023.2242483. Online ahead of print.

ABSTRACT

AIM: Investigation of the perspectives of paediatric health care professionals (PHCPs) in Switzerland regarding factors that influence participation in physical activity programs for children and adolescents with disabilities or chronic conditions (CADCCs). Evaluation of self-reported exercise counselling behavior of those professionals.

METHOD: A cross-sectional survey was used to collect the opinions of 171 PHCPs working with CADCCs using a structured questionnaire. The information obtained was evaluated by performing a combined quantitative and qualitative statistical analysis.

RESULTS: PHCPs in Switzerland think that CADCC do not get enough physical activity and see the underlying reasons in lacking information/knowledge and organizational factors. We found that the level of knowledge about disability sports opportunities among PHCPs has a positive influence on their exercise counselling behaviour.

CONCLUSIONS: We propose three approaches to increase the level of physical activity in CADCC: Establishing personalized exercise counseling, intensifying information about disability sports programmes towards PHCPs, and improving inclusion and integration in PE lessons or regular sports clubs.

PMID:37573511 | DOI:10.1080/17518423.2023.2242483

Genet Epidemiol. 2023 Aug 13. doi: 10.1002/gepi.22535. Online ahead of print.

ABSTRACT

We propose structural equation models (SEMs) as a general framework to infer causal networks for metabolites and other complex traits. Traditionally SEMs are used only for individual-level data under the assumption that all instrumental variables (IVs) are valid. To overcome these limitations, we propose both one- and two-sample approaches for causal network inference based on SEMs that can: (1) perform causal analysis and discover causal relationships among multiple traits; (2) account for the possible presence of some invalid IVs; (3) allow for data analysis using only genome-wide association studies (GWAS) summary statistics when individual-level data are not available; (4) consider the possibility of bidirectional relationships between traits. Our method employs a simple stepwise selection to identify invalid IVs, thus avoiding false positives while possibly increasing true discoveries based on two-stage least squares (2SLS). We use both real GWAS data and simulated data to demonstrate the superior performance of our method over the standard 2SLS/SEMs. For real data analysis, our proposed approach is applied to a human blood metabolite GWAS summary data set to uncover putative causal relationships among the metabolites; we also identify some metabolites (putative) causal to Alzheimer’s disease (AD), which, along with the inferred causal metabolite network, suggest some possible pathways of metabolites involved in AD.

PMID:37573486 | DOI:10.1002/gepi.22535

NPJ Vaccines. 2023 Aug 12;8(1):119. doi: 10.1038/s41541-023-00724-9.

ABSTRACT

Neutralizing antibodies strongly correlate with protection for COVID-19 vaccines, but the corresponding memory B cells that form to protect against future infection are relatively understudied. Here we examine the effect of prior SARS-CoV-2 infection on the magnitude and phenotype of the memory B cell response to single dose Johnson and Johnson (Ad26.COV2.S) vaccination in South African health care workers. Participants were either naïve to SARS-CoV-2 or had been infected before vaccination. SARS-CoV-2-specific memory B-cells expand in response to Ad26.COV2.S and are maintained for the study duration (84 days) in all individuals. However, prior infection is associated with a greater frequency of these cells, a significant reduction in expression of the germinal center chemokine receptor CXCR5, and increased class switching. These B cell features correlated with neutralization and antibody-dependent cytotoxicity (ADCC) activity, and with the frequency of SARS-CoV-2 specific circulating T follicular helper cells (cTfh). Vaccination-induced effective neutralization of the D614G variant in both infected and naïve participants but boosted neutralizing antibodies against the Beta and Omicron variants only in participants with prior infection. In addition, the SARS-CoV-2 specific CD8+ T cell response correlated with increased memory B cell expression of the lung-homing receptor CXCR3, which was sustained in the previously infected group. Finally, although vaccination achieved equivalent B cell activation regardless of infection history, it was negatively impacted by age. These data show that phenotyping the response to vaccination can provide insight into the impact of prior infection on memory B cell homing, CSM, cTfh, and neutralization activity. These data can provide early signals to inform studies of vaccine boosting, durability, and co-morbidities.

PMID:37573434 | DOI:10.1038/s41541-023-00724-9

Sci Rep. 2023 Aug 12;13(1):13156. doi: 10.1038/s41598-023-40453-6.

ABSTRACT

The evolution of secondary sex-specific traits of dioecious species under abiotic stress conditions has received limited research, especially in the case of Amaranthus palmeri, a fast adapting and highly competing plant. Here, we have examined the interactive effects of abiotic stress on mineral accumulation, chlorophyll a and b content, and the operating capacity of Photosystem II (PSII) in both male and female A. palmeri plants grown under three different intensities of white light, and under N, K or P deficiency. Mineral profiling of the leaves and stems (with inflorescence) highlighted intra- and intersexual differences in their accumulation pattern and mineral associations. Chlorophyll a and chlorophyll b were different between the male and the female plants, being slightly lower in the latter, at high light intensity towards maturity, or under K or P deficiency. Further, slight, although statistically significant differences were recorded in the chlorophyll a/b ratio, which was lower at the higher light intensity in the female, over that in the male, plants towards maturity. Chlorophyll fluorescence parameters, i.e., steady state and maximum fluorescence increased under high light intensity, whereas the PSII operating efficiency decreased in the female plants, indicating reduced PSII capacity. Sex-specific differences in A. palmeri showed a differential response to stressful conditions because of differences in their ontogeny and physiology, and possibly due to the cost of reproduction. We suggest that the breeding system of dioecious species has weaknesses that can be used for the ecological management of dioecious weeds without relying on the use of herbicides.

PMID:37573387 | DOI:10.1038/s41598-023-40453-6

Sci Rep. 2023 Aug 12;13(1):13126. doi: 10.1038/s41598-023-40046-3.

ABSTRACT

Electromagnetic wave-based analogue computing has become an interesting computing paradigm demonstrating the potential for high-throughput, low power, and parallel operations. In this work, we propose a technique for the calculation of derivatives of temporal signals by exploiting transmission line techniques. We consider multiple interconnected waveguides (with some of them being closed-ended stubs) forming junctions. The transmission coefficient of the proposed structure is then tailored by controlling the length and number of stubs at the junction, such that the differentiation operation is applied directly onto the envelope of an incident signal sinusoidally modulated in the time domain. The physics behind the proposed structure is explained in detail and a full theoretical description of this operation is presented, demonstrating how this technique can be used to calculate higher order or even fractional temporal derivatives. We envision that these results may enable the development of further time domain wave-based analogue processors by exploiting waveguide junctions, opening new opportunities for wave-based single operators and systems.

PMID:37573358 | DOI:10.1038/s41598-023-40046-3