Epidemiology of insertional and midportion Achilles tendinopathy in runners:A prospective cohort study

Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence and risk factors between insertional AT and midportion AT,though they are considered distinct.This study aimed to assess incidence and risk factors of AT based on data from a large prospective cohort.The secondary aim was to explore differences in risk factors between insertional and midportion AT.Methods:Participants were recruited from among registered runners at registration for running events.Questionnaires were completed at baseline,1 month before the event,1 week before the event,and 1 month after the event.Information concerning demographics,training load,registered events,and running-related injuries were collected at baseline.The follow-up questionnaires collected information about new injuries.A pain map was used to diagnose midportion and insertional AT.The primary outcome was the incidence of AT.Multivariable logistic regression analysis was applied to identify risk factors for the onset.Results:We included 3379 participants with a mean follow-up of 20.4 weeks.The incidence of AT was 4.2%.The proportion of insertional AT was 27.7%and of midportion AT was 63.8%;the remaining proportion was a combined type of insertional and midportion AT.Men had a significantly higher incidence(5%,95%confidence interval(95%CI):4.1%-6.0%)than women(2.8%,95%CI:2.0%-3.8%).AT in the past12 months was the most predominant risk factor for new-onset AT(odds ratio(OR)=6.47,95%CI:4.27-9.81).This was similar for both subcategories of AT(insertional:OR=5.45,95%CI:2.51-11.81;midportion:OR=6.96,95%CI:4.24-11.40).Participants registering for an event with a distance of 10/10.55 km were less likely to develop a new-onset AT(OR=0.59,95%CI:0.36-0.97)or midportion AT(OR=0.47,95%CI:0.23-0.93).Higher age had a significant negative association with insertional AT(OR=0.97,95%CI:0.94-1.00).Conclusion:The incidence of new-onset AT among recreational runners was 4.2%.The proportion of insertional and midportion AT was 27.7%and 63.8%,respectively.AT in the past 12 months was the predominant risk factor for the onset of AT.Risk factors varied between insertional and midportion AT,but we could not identify clinically relevant differences between the 2 subtypes.

Leisure-time physical activity and all-cause mortality and cardiovascular disease in adults with type 2 diabetes:Cross-country comparison of cohort studies

Purpose:This study aimed to quantify the dose-response association and the minimal effective dose of leisure-time physical activity(PA)to prevent mortality and cardiovascular disease in adults with type 2 diabetes.Methods:Cross-country comparison of 2 prospective cohort studies including 14,913 and 17,457 population-based adults with type 2 diabetes from the UK and China.Baseline leisure-time PA was self-reported and categorized by metabolic equivalent hours per week(MET-h/week)according to World Health Organization recommendations:none,below recommendation(>0-7.49 MET-h/week);at recommended level(7.5-14.9 MET-h/week);above recommendation(>15 MET-h/week).Mortality and cardiovascular disease data were obtained from national registries.Results:During a median follow-up of 12.4 and 9.7 years,in the UK and China cohorts,repectively,higher levels of leisure-time PA were inversely associated with all-cause(1571 and 2351 events)and cardiovascular mortality(392 and 1060 events),mostly consistent with a linear dose-response relationship.PA below,at,and above recommendations,compared with no activity,yielded all-cause mortality hazard ratios of0.94(95%confidence interval(95%CI):0.79-1.12),0.90(95%CI:0.74-1.10),and 0.85(95%CI:0.70-1.02)in British adults and 0.87(95%CI:0.68-1.10),0.88(95%CI:0.74-1.03),and 0.77(95%CI:0.70-0.85)in Chinese adults.Associations with cardiovascular mortality were more pronounced in British adults(0.80(95%CI:0.58-1.11),0.75(95%CI:0.52-1.09),and 0.69(95%CI:0.48-0.97))but less pronounced in Chinese adults(1.06(95%CI:0.76-1.47),1.01(95%CI:0.80-1.28),and 0.79(95%CI:0.69-0.92)).PA at recommended levels was not associated with lower rates of major adverse cardiovascular events(2345 and 4458 events).Conclusion:Leisure-time PA at the recommended levels was not convincingly associated with lower mortality and had no association with risk of major adverse cardiovascular events in British or Chinese adults with type 2 diabetes.Leisure-time PA above current recommendations may be needed to prevent cardiovascular disease and premature mortality in adults with type 2 diabetes.

Evaluation of genetic response of mesenchymal stem cells to nanosecond pulsed electric fields by whole transcriptome sequencing

BACKGROUND Mesenchymal stem cells(MSCs)modulated by various exogenous signals have been applied extensively in regenerative medicine research.Notably,nanosecond pulsed electric fields(nsPEFs),characterized by short duration and high strength,significantly influence cell phenotypes and regulate MSCs differentiation via multiple pathways.Consequently,we used transcriptomics to study changes in messenger RNA(mRNA),long noncoding RNA(lncRNA),microRNA(miRNA),and circular RNA expression during nsPEFs application.AIM To explore gene expression profiles and potential transcriptional regulatory mechanisms in MSCs pretreated with nsPEFs.METHODS The impact of nsPEFs on the MSCs transcriptome was investigated through whole transcriptome sequencing.MSCs were pretreated with 5-pulse nsPEFs(100 ns at 10 kV/cm,1 Hz),followed by total RNA isolation.Each transcript was normalized by fragments per kilobase per million.Fold change and difference significance were applied to screen the differentially expressed genes(DEGs).Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were performed to elucidate gene functions,complemented by quantitative polymerase chain reaction verification.RESULTS In total,263 DEGs were discovered,with 92 upregulated and 171 downregulated.DEGs were predominantly enriched in epithelial cell proliferation,osteoblast differentiation,mesenchymal cell differentiation,nuclear division,and wound healing.Regarding cellular components,DEGs are primarily involved in condensed chromosome,chromosomal region,actin cytoskeleton,and kinetochore.From aspect of molecular functions,DEGs are mainly involved in glycosaminoglycan binding,integrin binding,nuclear steroid receptor activity,cytoskeletal motor activity,and steroid binding.Quantitative real-time polymerase chain reaction confirmed targeted transcript regulation.CONCLUSION Our systematic investigation of the wide-ranging transcriptional pattern modulated by nsPEFs revealed the differential expression of 263 mRNAs,2 miRNAs,and 65 lncRNAs.Our study demonstrates that nsPEFs may affect stem cells through several signaling pathways,which are involved in vesicular transport,calcium ion transport,cytoskeleton,and cell differentiation.

Comparative study of the clinical efficacy of all-inside and traditional techniques in anterior cruciate ligament reconstruction

BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction.

Impact of Sports Participation on Intelligence among Boys of Age 14 -17 Years

Sports are a meaningful context in which many young people participate,and youth sports teams may be a viable way to promote optimal development.Sports comprises all forms of physical activities that contribute to physical fitness,mental well-being and social interaction.Participation in sport improves the development of peer relationships,establishes the notion of trust and builds teamwork skills.The purpose of this study was to see the impact of sports participation on intelligence among boys.The present study was conducted on 300 male subjects between age group 14 and 17 years.Subjects were divided into following three groups(Group 1-Team Sports Group,Group 2-Individual Sports Group,Group 3-Non-participant Group)using a questionnaire for Sports Activity participation survey.Each group has 100 students.To assess intelligence of the selected subjects,verbal intelligence test prepared by Dr.P.Srinivasan was adopted.Appropriate tool was used to assess the parameters.The results show that majority i.e.64.7%of the subjects were found to be average intelligent and 22.7 superiorly intelligent.It was revealed that sports participation has no association withrelation to intelligence(IQ)and revealed that there was no significant effect found on intelligence level of the subjects who participated in sports as well as the non-participants.

Research progress on preparation of lateral femoral tunnel and graft fixation in anterior cruciate ligament reconstruction

Anterior cruciate ligament(ACL)injury is one of the most common types of sports injuries.People’s need to participate in sports and desire for a high quality of life promotes the continuous development of ACL reconstruction technology.Arthroscopic ACL reconstruction has been recognized as an effective method for the treatment of ACL injuries.This review analyses and summarizes the advantages and limitations of each surgical procedure for arthroscopic ACL reconstruction reported in the relevant literature so as to promote the future development of more relevant techniques.

Automatic Extraction of the Sparse Prior Correspondences for Non-Rigid Point Cloud Registration

Non-rigid registration of point clouds is still far from stable,especially for the largely deformed one.Sparse initial correspondences are often adopted to facilitate the process.However,there are few studies on how to build them automatically.Therefore,in this paper,we propose a robust method to compute such priors automatically,where a global and local combined strategy is adopted.These priors in different degrees of deformation are obtained by the locally geometrical-consistent point matches from the globally structural-consistent region correspondences.To further utilize the matches,this paper also proposes a novel registration method based on the Coherent Point Drift framework.This method takes both the spatial proximity and local structural consistency of the priors as supervision of the registration process and thus obtains a robust alignment for clouds with significantly different deformations.Qualitative and quantitative experiments demonstrate the advantages of the proposed method.

High doses of dextromethorphan induced shock and convulsions in a 19-year-old female:A case report

BACKGROUND Dextromethorphan is a prevalent antitussive agent that can be easily obtained as an over-the-counter medication.There has been a growing number of reported cases of toxicity in recent years.Generally,there are numerous instances of mild symptoms,with only a limited number of reports of severe cases necessitating intensive care.We presented the case of a female who ingested 111 tablets of dextromethorphan,leading to shock and convulsions and requiring intensive care that ultimately saved her life.CASE SUMMARY A 19-year-old female was admitted to our hospital via ambulance,having overdosed on 111 tablets of dextromethorphan(15 mg)obtained through an online importer in a suicide attempt.The patient had a history of drug abuse and multiple self-inflicted injuries.At the time of admission,she exhibited symptoms of shock and altered consciousness.However,upon arrival at the hospital,the patient experienced recurrent generalized clonic convulsions and status epilepticus,necessitating tracheal intubation.The convulsions were determined to have been caused by decreased cerebral perfusion pressure secondary to shock,and noradrenaline was administered as a vasopressor.Gastric lavage and activated charcoal were also administered after intubation.Through systemic management in the intensive care unit,the patient’s condition stabilized,and the need for vasopressors ceased.The patient regained consciousness and was extubated.The patient was subsequently transferred to a psychiatric facility,as suicidal ideation persisted.CONCLUSION We report the first case of shock caused by an overdose of dextromethorphan.

Bone marrow mesenchymal stem cell-derived exosomal microRNAs target PI3K/Akt signaling pathway to promote the activation of fibroblasts

BACKGROUND Fibroblast plays a major role in tendon-bone healing.Exosomes derived from bone marrow mesenchymal stem cells(BMSCs)can activate fibroblasts and promote tendon-bone healing via the contained microRNAs(miRNAs).However,the underlying mechanism is not comprehensively understood.Herein,this study aimed to identify overlapped BMSC-derived exosomal miRNAs in three GSE datasets,and to verify their effects as well as mechanisms on fibroblasts.AIM To identify overlapped BMSC-derived exosomal miRNAs in three GSE datasets and verify their effects as well as mechanisms on fibroblasts.METHODS BMSC-derived exosomal miRNAs data(GSE71241,GSE153752,and GSE85341)were downloaded from the Gene Expression Omnibus(GEO)database.The candidate miRNAs were obtained by the intersection of three data sets.TargetScan was used to predict potential target genes for the candidate miRNAs.Functional and pathway analyses were conducted using the Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)databases,respectively,by processing data with the Metascape.Highly interconnected genes in the protein-protein interaction(PPI)network were analyzed using Cytoscape software.Bromodeoxyuridine,wound healing assay,collagen contraction assay and the expression of COL I andα-smooth muscle actin positive were applied to investigate the cell proliferation,migration and collagen synthesis.Quantitative real-time reverse transcription polymerase chain reaction was applied to determine the cell fibroblastic,tenogenic,and chondrogenic potential.RESULTS Bioinformatics analyses found two BMSC-derived exosomal miRNAs,has-miR-144-3p and hasmiR-23b-3p,were overlapped in three GSE datasets.PPI network analysis and functional enrichment analyses in the GO and KEGG databases indicated that both miRNAs regulated the PI3K/Akt signaling pathway by targeting phosphatase and tensin homolog(PTEN).In vitro experiments confirmed that miR-144-3p and miR-23b-3p stimulated proliferation,migration and collagen synthesis of NIH3T3 fibroblasts.Interfering with PTEN affected the phosphorylation of Akt and thus activated fibroblasts.Inhibition of PTEN also promoted the fibroblastic,tenogenic,and chondrogenic potential of NIH3T3 fibroblasts.CONCLUSION BMSC-derived exosomes promote fibroblast activation possibly through the PTEN and PI3K/Akt signaling pathways,which may serve as potential targets to further promote tendon-bone healing.

Highly specific characterization and discrimination of monosodium urate crystals in gouty arthritis based on aggregation-induced emission luminogens

Existing technologies used to detect monosodium urate(MSU)crystals for gout diagnosis are not ideal due to their low sensitivity and complexity of operation.The purpose of this study was to explore whether aggregation-induced emission luminogens(AIEgens)can be used for highly specific imaging of MSU crystals to assist in the diagnosis of gout.First,we developed a series of luminogens(i.e.,tetraphenyl ethylene(TPE)-NH_(2),TPE-2NH_(2),TPE-4NH_(2),TPE-COOH,TPE-2COOH,TPE-4COOH,and TPE-Ketoalkyne),each of which was then evenly mixed with MSU crystals.Next,optimal fluorescence imaging of each of the luminogens was characterized by a confocal laser scanning microscope(CLSM).This approach was used for imaging standard samples of MSU,hydroxyapatite(HAP)crystals,and mixed samples with 1:1 mass ratio of MSU/HAP.We also imaged samples from mouse models of acute gouty arthritis,HAP deposition disease,and comorbidities of interest.Subsequently,CLSM imaging results were compared with those of compensated polarized light microscopy,and we assessed the biosafety of TPE-Ketoalkyne in the RAW264.7 cell line.Finally,CLSM time series and three-dimensional imaging were performed on MSU crystal samples from human gouty synovial fluid and tophi.As a promising candidate for MSU crystal labeling,TPE-Ketoalkyne was found to detect MSU crystals accurately and rapidly in standard samples,animal samples,and human samples,and could precisely distinguish gout from HAP deposition disease.This work demonstrates that TPE-Ketoalkyne is suitable for highly specific and timely imaging of MSU crystals in gouty arthritis and may facilitate future research on MSU crystal-related diseases.

Feasibility of the 2-point method to determine the load-velocity relationship variables during the countermovement jump exercise

Purpose:This study aimed to examine the reliability and validity of load-velocity(L-V)relationship variables obtained through the 2-point method using different load combinations and velocity variables.Methods:Twenty men performed 2 identical sessions consisting of 2 countermovement jumps against 4 external loads(20 kg,40 kg,60 kg,and80 kg)and a heavy squat against a load linked to a mean velocity(MV)of 0.55 m/s(load_(0.55)).The L-V relationship variables(load-axis intercept(L_(0)),velocity-axis intercept(v_(0)),and area under the L-V relationship line(A_(line)))were obtained using 3 velocity variables(MV,mean propulsive velocity(MPV),and peak velocity)by the multiple-point method including(20-40-60-80-load_(0.55))and excluding(20-40-60-80)the heavy squat,as well as from their respective 2-point methods(20-load_(0.55)and 20-80).Results:The L-V relationship variables were obtained with an acceptable reliability(coefncient of variation(CV)≤7.30%;intra-class correlation coefficient>0.63).The reliability of L_(0)and v_(0)was comparable for both methods(CV_(ratio)(calculated as higher value/lower value):1.11-1.12),but the multiple-point method provided Al_(ine)with a greater reliability(CV_(ratio)=1.26).The use of a heavy squat provided the L-V relationship variables with a comparable or higher reliability than the use of a heavy countermovement jump load(CV_(ratio):1.06-1.19).The peak velocity provided the load-velocity relationship variables with the greatest reliability(CV_(ratio):1.15-1.86)followed by the MV(CV_(ratio):1.07-1.18),and finally the MPV.The 2-point methods only revealed an acceptable validity for the MV and MPV(effect size≤0.19;Pearson s product-moment correlation coefficient≥0.96;Lin's concordance correlation coefficient≥0.94).Conclusion:The 2-point method obtained from a heavy squat load and MV or MPV is a quick,safe,and reliable procedure to evaluate the lower-body maximal neuromuscular capacities through the L-V relationship.

Adherence to 24-hour movement guidelines in children with mental,behavioral,and developmental disorders:Data from the 2016-2020 National Survey of Children's Health

Background:Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens.However,the lifestyles of children with mental,behavioral,and developmental disorders(MBDDs)remains under-described within the literature of public health field.This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.Methods:Data were from the 2016-2020 National Survey of Children’s Health—A national,population-based,cross-sectional study.We used the data of 119,406 children aged 6-17 years,which included 38,571 participants with at least 1 MBDD and 80,835 without.Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity,screen time,and sleep duration.Results:Among children with MBDDs,20.3%,37.0%,60.7%,and 77.3%met the physical activity,screen time,sleep,and at least 1 of the 24-hour movement guidelines.These rates were lower than those in children without MBDDs(22.8%,46.2%,66.7%,and 83.4%,respectively;all p<0.001).Children with MBDDs were less likely to meet these guidelines(odds ratio(OR)=1.21,95%confidence interval(95%CI):1.13-1.30;OR=1.37,95%CI:1.29-1.45;OR=1.29,95%CI:1.21-1.37;OR=1.45,95%CI:1.35-1.56)than children without MBDDs.Children with emotional disorders had the highest odds of not meeting these guidelines(OR=1.43,95%CI:1.29-1.57;OR=1.48,95%CI:1.37-1.60;OR=1.49,95%CI:1.39-1.61;OR=1.72,95%CI:1.57-1.88)in comparison to children with other MBDDs.Among children aged12-17 years,the difference in proportion of meeting physical activity and screen time guidelines for children with vs.children without MBDD was larger than that among children aged 6-11 years.Furthermore,the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.Conclusion:Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs.In educational and clinical settings,the primary focus should be on increasing physical activity and limiting screen time in children aged 12-17 years who have MBDDs;and specifically for white children who have MBDDs,increasing physical activity may help.

Long head of biceps tendon transposition for massive and irreparable rotator cuff tears:A systematic review and meta-analysis

BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain unclear.AIM To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs.METHODS We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane Library.Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria.Biomechanical studies were assessed for main results and conclusions.Included clinical studies were evaluated for quality of methodology.Data including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical outcomes.RESULTS According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 patients.The results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for MIRCTs.CONCLUSION In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinical outcomes,with comparable clinical outcomes,improved ROM,AHD,and reduced the retear rates compared to conventional SCR and other established techniques.More high-quality randomized controlled studies on the long-term outcomes of SCR with LHBT transposition are required to further assess.

Unhappy triad of the knee:What are the current concepts and opinions?

The association between injuries to the anterior cruciate ligament,medial collateral ligament,and medial meniscus(MM)has been known to orthopedic surgeons since 1936;O’Donoghue first used the term"unhappy triad"of the knee to describe this condition in 1950.Later studies revealed that involvement of the lateral meniscus is more common than MM in these cases,leading to a change in the definition.Recent studies have revealed that this triad may be primarily linked to knee anterolateral complex injuries.Although there is not a definite management protocol for this triad,we try to mention the most recent concepts about it in addition to expert opinions.

Subchondral fatigue fracture of the femoral head in young military recruits:Potential risk factors

BACKGROUND Subchondral fatigue fracture of the femoral head(SFFFH)mainly occurs in young military recruits and might be confused with osteonecrosis of the femoral head.However,less research focuses on the risk factor for SFFFH.AIM To evaluate the intrinsic risk factors for SFFFH in young military recruits.METHODS X-ray and magnetic resonance imaging data were used for analysis.Acetabular anteversion of the superior acetabulum,acetabular anteversion of the center of the acetabulum(AVcen),anterior acetabular sector angle(AASA),posterior acetabular sector angle,superior acetabular sector angle,neck-shaft angle(NSA),inferior iliac angle(IIA),and ischiopubic angle were calculated.Then,logistic regression,receiver operating characteristic curve analysis,and independent samples t-test were performed to identify the risk factors for SFFFH.RESULTS Based on the results of logistic regression,age[odds ratio(OR):1.33;95%confidence interval(95%CI):1.12-1.65;P=0.0031]and treatment timing(OR:0.86;95%CI:0.75-0.96;P=0.015)could be considered as the indicators for SFFFH.AVcen(P=0.0334),AASA(P=0.0002),NSA(P=0.0007),and IIA(P=0.0316)were considered to have statistical significance.Further,AVcen(OR:1.41;95%CI:1.04-1.95)and AASA(OR:1.44;95%CI:1.21-1.77),especially AASA(area under curve:66.6%),should be paid much more attention due to the higher OR than other indicators.CONCLUSION We have for the first time unveiled that AASA and age could be key risk factors for SFFFH,which further verifies that deficient anterior coverage of the acetabulum might be the main cause of SFFFH.

Combined medial patellofemoral ligament and medial patellotibial ligament reconstruction in recurrent patellar instability:A systematic review and meta-analysis

BACKGROUND The medial patellofemoral ligament(MPFL),along with the medial patellotibial ligament(MPTL)and medial patellomeniscal ligament,aid in the stabilization of the patellofemoral joint.Although the MPFL is the primary stabilizer and the MPTL is a secondary limiter,this ligament is critical in maintaining joint stability.There have been few studies on the combined MPFL and MPTL reconstruction and its benefits.AIM To look into the outcomes of combined MPFL and MPTL reconstruction in frequent patellar instability.METHODS By May 8,2022,four electronic databases were searched:Medline(PubMed),Scopus,Web of Science,and Google Scholar.General keywords such as"patellar instability,""patellar dislocation,""MPFL,""medial patellofemoral ligament,""MPTL,"and"medial patellotibial ligament"were co-searched to increase the sensitivity of the search.RESULTS The pooled effects of combined MPFL and MPTL reconstruction for Kujala score(12-mo followup)and Kujala score(24-mo follow-up)were positive and incremental,according to the findings of this meta-analysis.The mean difference between the Cincinnati scores was also positive,but not statistically significant.The combination of the two surgeries reduces pain.According to cumulative meta-analysis,the trend of pain reduction in various studies is declining over time.CONCLUSION The combined MPFL and MPTL reconstruction has good clinical results in knee function and,in addition to providing good control to maintain patellofemoral joint balance,the patient's pain level decreases over time,making it a valid surgical method for patella stabilization.

Analysis of the USD/JPY and EUR/JPY Exchange Rates Using Multifractal Analysis and Extreme Value Theory

We performed a multifractal analysis using wavelet transform to detect the changes in the fractality of the USD/JPY and EUR/JPY exchange rates, and predicted their extreme values using extreme value theory. After the 1997 Asian financial crisis, the USD/JPY and EUR/JPY became multifractal, then the USD/JPY became monofractal and stable, and yen depreciation was observed. However, the EUR/JPY became multifractal and unstable, and a strong yen depreciation was observed. The coherence between the USD/JPY and EUR/JPY was strong between 1995 and 2000. After the 2007-2008 financial crisis, the USD/JPY became monofractal and stable, and yen appreciation was observed. However, the EUR/JPY became multifractal and unstable, and strong yen appreciation was observed. Various diagnostic plots for assessing the accuracy of the GP model fitted to USD/JPY and EUR/JPY are shown, and all the diagnostic plots support the fitted GP model. The shape parameters of USD/JPY and EUR/JPY were close to zero, therefore the USD/JPY and EUR/JPY did not have finite upper limits. We predicted the maximum return level for the return periods of 10, 20, 50, 100, 350, and 500 years and their respective 95% confidence intervals (CI). As a result, the 10-year and 100-year return levels for USD/JPY were estimated to be 149.6 and 164.8, with 95% CI [143.2, 156.0] and [149.4, 180.1], respectively.

Analyzing of the ENSO Index Using Extreme Value Theory

We predicted the extreme values of the ENSO index, the Niño3.4 index, and the Southern Oscillation Index (SOI) using extreme value theory. Various diagnostic plots for assessing the accuracy of the Generalized Pareto (GP) model fitted to the Niño3.4 index and SOI are shown, and all four diagnostic plots support the fitted GP model. Because the shape parameter of the Niño3.4 was negative, the Niño3.4 index had a finite upper limit. In contrast, that of the SOI was zero, therefore the SOI did not have a finite upper limit, and there is a possibility that a significant risk will occur. We predicted the maximum return level for the return periods of 10, 20, 50, 100, 350, and 500 years and their respective 95% confidence intervals, CI. The 10-year, and 100-year return levels for Niño3.4 were estimated to be 2.41, and 2.62, with 95% CI [2.22, 2.59], and [2.58, 2.66], respectively. The Niño3.4 index was 2.65 in the 2015/16 super El Niño, which is a phenomenon that occurs once every 500 years. The Niño3.4 index was 2.51 in the 1982/83, and 1997/98 super El Niño, which is a phenomenon that occurs once every 20 years. Recently, a large super El Niño event with a small probability of occurrence has occurred. In response to global warming, the super El Niño events are becoming more likely to occur.

Decoding hereditary spastic paraplegia pathogenicity through transcriptomic profiling

Hereditary spastic paraplegia(HSP)is a group of genetic motor neuron diseases resulting from length-dependent axonal degeneration of the corticospinal upper motor neurons.Due to the advancement of next-generation sequencing,more than 70 novel HSP disease-causing genes have been identified in the past decade.Despite this,our understanding of HSP physiopathology and the development of efficient management and treatment strategies remain poor.One major challenge in studying HSP pathogenicity is selective neuronal vulnerability,characterized by the manifestation of clinical symptoms that are restricted to specific neuronal populations,despite the presence of germline disease-causing variants in every cell of the patient.Furthermore,disease genes may exhibit ubiquitous expression patterns and involve a myriad of different pathways to cause motor neuron degeneration.In the current review,we explore the correlation between transcriptomic data and clinical manifestations,as well as the importance of interspecies models by comparing tissue-specific transcriptomic profiles of humans and mice,expression patterns of different genes in the brain during development,and single-cell transcriptomic data from related tissues.Furthermore,we discuss the potential of emerging single-cell RNA sequencing technologies to resolve unanswered questions related to HSP pathogenicity.