Abnormal eye gaze is a hallmark characteristic of autism spectrum disorder (ASD), and numerous studies have identified abnormal attention patterns in ASD. The primary aim of the present study was to ...create an objective, eye tracking-based autism risk index.
In initial and replication studies, children were recruited after referral for comprehensive multidisciplinary evaluation of ASD and subsequently grouped by clinical consensus diagnosis (ASD n = 25/15, non-ASD n = 20/19 for initial/replication samples). Remote eye tracking was blinded to diagnosis and included multiple stimuli. Dwell times were recorded to each a priori-defined region of interest (ROI) and averaged across ROIs to create an autism risk index. Receiver operating characteristic curve analyses examined classification accuracy. Correlations with clinical measures evaluated whether the autism risk index was associated with autism symptom severity independent of language ability.
In both samples, the autism risk index had high diagnostic accuracy (area under the curve AUC = 0.91 and 0.85, 95% CIs = 0.81-0.98 and 0.71-0.96), was strongly associated with Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) severity scores (r = 0.58 and 0.59, p < .001), and not significantly correlated with language ability (r ≤| -0.28|, p > .095).
The autism risk index may be a useful quantitative and objective measure of risk for autism in at-risk settings. Future research in larger samples is needed to cross-validate these findings. If validated and scaled for clinical use, this measure could inform clinical judgment regarding ASD diagnosis and track symptom improvements.
Purpose
Lateral patellar instability is a debilitating condition not only to athletes, but also to a wide range of highly active individuals. Many of these patients experience symptoms bilaterally, ...though it is unknown how these patients fair with return to sports following a second medial patellofemoral ligament reconstruction (MPFLR). The purpose of this study is to evaluate the rate of return to sport following bilateral MPFLR compared to a unilateral comparison group.
Methods
Patients who underwent primary MPFLR with minimum 2-year follow-up were identified from 2014 to 2020 at an academic center. Those who underwent primary MPFLR of bilateral knees were identified. Pre-injury sport participation and Tegner score, Kujala score, Visual Analog Score (VAS) for pain, satisfaction, and MPFL-Return to Sport after Injury (MPFL-RSI) scale were collected. Bilateral and unilateral MPFLRs were matched in a 1:2 ratio based on age, sex, body mass index, and concomitant tibial tubercle osteotomy (TTO). A sub-analysis was performed regarding concomitant TTO.
Results
The final cohort consisted of 63 patients, including 21 patients who underwent bilateral MPFLR, matched to 42 unilateral patients at mean follow-up of 47 ± 27 months. Patients who underwent bilateral MPFLR returned to sport at a rate of 62% at a mean of 6.0 ± 2.3 months, compared to a unilateral rate of 72% at 8.1 ± 4.2 months (n.s.). The rate of return to pre-injury level was 43% among bilateral patients and 38% in the unilateral cohort. There were no significant differences in VAS pain, Kujala, current Tegner, satisfaction, and MPFL-RSI scores between cohorts. Approximately half of those (47%) who failed to return to sport cited psychological factors and had significantly lower MPFL-RSI scores (36.6 vs 74.2,
p
= 0.001).
Conclusion
Patients who underwent bilateral MPFLR returned to sports at a similar rate and level compared to a unilateral comparison group. MPFL-RSI was found to be significantly associated with return to sport.
Level of evidence
III.
2D polymers (2DPs) are promising as structurally well‐defined, permanently porous, organic semiconductors. However, 2DPs are nearly always isolated as closed shell organic species with limited charge ...carriers, which leads to low bulk conductivities. Here, the bulk conductivity of two naphthalene diimide (NDI)‐containing 2DP semiconductors is enhanced by controllably n‐doping the NDI units using cobaltocene (CoCp2). Optical and transient microwave spectroscopy reveal that both as‐prepared NDI‐containing 2DPs are semiconducting with sub‐2 eV optical bandgaps and photoexcited charge‐carrier lifetimes of tens of nanoseconds. Following reduction with CoCp2, both 2DPs largely retain their periodic structures and exhibit optical and electron‐spin resonance spectroscopic features consistent with the presence of NDI‐radical anions. While the native NDI‐based 2DPs are electronically insulating, maximum bulk conductivities of >10−4 S cm−1 are achieved by substoichiometric levels of n‐doping. Density functional theory calculations show that the strongest electronic couplings in these 2DPs exist in the out‐of‐plane (π‐stacking) crystallographic directions, which indicates that cross‐plane electronic transport through NDI stacks is primarily responsible for the observed electronic conductivity. Taken together, the controlled molecular doping is a useful approach to access structurally well‐defined, paramagnetic, 2DP n‐type semiconductors with measurable bulk electronic conductivities of interest for electronic or spintronic devices.
The bulk conductivity of naphthalene‐diimide‐based 2D polymers is increased by controlled stoichiometric n‐doping with cobaltocene. Following single‐electron reduction, these 2DPs retain their periodic structure and become paramagnetic. Substoichiometric doping leads to the highest bulk electronic conductivities, which is found to proceed through a hopping‐mechanism.
Purpose
The purpose of this study was to evaluate the mid-term results of posterior medial meniscal root tear (PMMRT) repair through assessment of functional outcome scores and magnetic resonance ...imaging (MRI).
Methods
This was a single-center, retrospective study evaluating patients that had undergone a PMMRT. This was a follow-up to a previously published 2-year outcome study (all original patients were invited to participate). Clinical outcomes included pre- and postoperative International Knee Documentation Committee (IKDC) and Lysholm scores. Root healing, meniscal extrusion, and cartilage degeneration via International Cartilage Repair Society Scale (ICRS) grades were assessed on MRI by two musculoskeletal fellowship-trained radiologists.
Results
10 of the original study’s 18 patients were able to participate. Mean age and BMI was 48.4 ± 12.0 years and 29.5 ± 4.5, respectively, with mean follow-up 65.5 ± 8.3 months (range 52.0–75.8) (60% female).
The IKDC significantly increased from 43 ± 13 preoperatively to 75 ± 16 at 5-year follow-up (
p
< 0.001). There was no significant change in IKDC score between 2-year and 5-year follow-up 75 ± 16 vs 73 ± 20, (n.s). The Lysholm also significantly increased between preoperative and 5-year follow-up (49 ± 7 vs 84 ± 11,
p
< 0.001). There was no significant change between Lysholm score at 2-year and 5-year follow-up 84.0 ± 11 vs 82 ± 13, (n.s).
Mean extrusion did not significantly change from the preoperative state to 5-year follow-up 4.80 mm ± 1.9 vs 5.0 mm ± 2.5, (n.s.). Extrusion also did not significantly change between 2-and 5-year follow-up 6.1 ± 3.2 mm vs 5.0 mm ± 2.5, (n.s.). No patients with > 3 mm of extrusion on preoperative MRI had < 3 mm of extrusion on postoperative MRI.
Both medial femoral condyle and medial tibial plateau ICRS grades significantly increased from preoperative to 2-year follow-up (
p
= 0.038,
p
= 0.023, respectively). Medial femoral condyle and medial tibial plateau ICRS grades again significantly increased between 2-year and 5-year follow-up (
p
= 0.014,
p
= 0.034).
Conclusion
Patients treated with the transtibial suture pullout technique with two locking cinch sutures had maintenance of clinical outcome improvements at 5-year follow-up. However, extrusion was widely prevalent, with worsening progression of femoral and tibial chondral disease.
Level of Evidence
Level 4.
The purpose of the current study is to compare the outcomes of open subpectoral biceps tenodesis (BT) to arthroscopic repair (AR) for SLAP tears in patients under the age of 30 years.
A retrospective ...review of patients under the age of 30 years who underwent either isolated BT or AR for a diagnosis of a SLAP tear between 2011 and 2019 was performed. Patients were included if they were >16 years old at the time of surgery, had an isolated SLAP tear involving instability of the biceps-labral anchor (types II-IV), were skeletally mature, and had a minimum follow-up of 12 months. The American Shoulder & Elbow Surgeons score, visual analog scale, Subjective Shoulder Value, patient satisfaction, willingness to undergo surgery again, revisions, and return to play (RTP) were evaluated. A P value of <.05 was considered statistically significant.
Our study included 103 patients in total; 29 patients were treated with BT, and 74 were treated with AR. The mean age was 24.8 years, and the mean follow-up duration was 60 months. At final follow-up, there was no difference between treatment groups in any of the functional outcome measures assessed (P > .05). Overall, there was no significant difference in the total rate of RTP (BT: 76.3%, AR: 85%; P = .53), timing of RTP (BT: 8.8 months, AR: 9.4 months; P = .61), and total rate of RTP among overhead athletes (BT: 84.2%, AR: 83.3%; P > .99). Among those undergoing AR, 9 required a revision procedure (11.5%) compared to none treated with BT (P = .11).
In patients under the age of 30 years with a symptomatic isolated SLAP tear, BT may be a reliable alternative to AR.
Level III, retrospective comparative study.
Background:
It is unclear whether leukocyte-poor (LP) or leukocyte-rich (LR) varieties of platelet-rich plasma (PRP) as an adjuvant to arthroscopic rotator cuff repair (ARCR) result in improved ...tendon healing rates.
Purpose:
To perform a network meta-analysis of the randomized controlled trials in the literature to ascertain whether there is evidence to support the use of LP- or LR-PRP as an adjunct to ARCR.
Methods:
The literature search was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Randomized controlled trials comparing LP- or LR-PRP with a control alongside ARCR were included. Clinical outcomes, including retears and functional outcomes, were compared using a frequentist approach to network meta-analysis, with statistical analysis performed using R. The treatment options were ranked using the P-score.
Results:
There were 13 studies (868 patients) included, with 9 studies comparing LP-PRP with a control and 4 studies comparing LR-PRP with a control. LP-PRP was found to significantly reduce the rate of retear and/or incomplete tendon healing after fixation, even among medium-large tears; it also improved outcomes on the visual analog scale for pain, Constant score, and University of California Los Angeles score. LP-PRP had the highest P-score for all treatment groups. LR-PRP did not result in any significant improvements over the control group, except for visual analog scale score for pain. However, post hoc analysis revealed that LP-PRP did not lead to significant improvements over LR-PRP in any category.
Conclusion:
The current study demonstrates that LP-PRP reduces the rate of retear and/or incomplete tendon healing after ARCR and improves patient-reported outcomes as compared with a control. However, it is still unclear whether LP-PRP improves the tendon healing rate when compared with LR-PRP.
The Fire Bay Formation of Trettin (1998), Clements Markham belt, Ellesmere Island, Canada, includes volcanic rocks described as Silurian in age based on Llandovery graptolites in adjacent clastic ...rocks. New field observations suggest the Llandovery fossils are from packages of the Silurian Danish River and/or Lands Lokk formations that are fault-bounded rather than stratigraphically tied to Ordovician sections that contain a 470.0 ± 0.2 Ma lithic tuff, volcaniclastic units with maximum depositional ages (MDAs) of 466 ± 2 and 462 ± 2 Ma based on detrital zircon, volcanic clasts with ages of 498 ± 6, 478 ± 4, and 477 ± 8 Ma, and Ordovician conodonts and graptolites of Darriwilian and Sandbian age, respectively. Since the Fire Bay Formation of Trettin (1998) lacks a type section and is fault-bounded with ambiguous age relationships, Ordovician volcanic units and fault-bounded clastic rocks correlated with the Hazen Formation are both included in the Fire Bay assemblage following the original interpretations of Trettin and Nowlan (1990). The Fire Bay assemblage records juvenile Ordovician arc magmatism proximal to the Pearya terrane. The adjacent Lands Lokk Formation yields bimodal age peaks at 440-430 and 465 Ma, MDA of 424 ± 3 Ma, and εHf(t) values of -5 to +10. The signature matches Ordovician Pearya units and Silurian circum-Arctic arc sources but there is no evidence for Silurian arc magmatism between the Pearya terrane and Laurentian margin, compatible with Pearya accretion during oblique Ordovician arc collision and Silurian sinistral translation along the northern Laurentian margin.
The purpose of the current study is to systematically review the current evidence in the literature to ascertain rates of return to play after ACLR with extra-articular augmentation (EA).
A ...literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they evaluated and reported on return to play after ACLR + EA; case studies and review articles were excluded. The outcomes measured focused on (1) return to play, (2) return to play at the same or higher level, and (3) timing of return to play. Qualitative analysis and quantitative analysis were performed using SPSS.
Overall, 19 studies met our inclusion criteria. Among patients undergoing primary ACLR, 82.8% to 100% were able to return to play, with 64% to 100% able to return at the same or higher level of play. All professional athletes were able to return to play, and 85.7% to 100% were able to return to the same level of preoperative play. The mean time to return was 5 to 11 months in those undergoing primary ACLR + EA. Among those undergoing revision ACLR, 50% to 88.4% were able to return to play, with 41.5% to 77.8% able to return at the same or higher level of play. None of the 5 studies that compared rate of return to play (at any level) between ACLR + EA and ACLR alone found a significant difference between them. However, among the 6 studies that compared rate of return to play at the same level between ACLR + EA and ACLR alone, 2 studies found a significantly higher rate of return to play with ACLR + EA.
ACLR + EA resulted in high levels of return to play in those undergoing either primary or revision ACLR. Additionally, comparative studies of patients undergoing primary ACLR with or without EA reported similarly high rates of return to play.
Level IV, systematic review of level I to IV studies.
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