Understanding the factors that predict return to sport (RTS) after anterior cruciate ligament reconstruction facilitates clinical decision making.
To develop a clinical decision algorithm that could ...predict RTS and non-RTS based on the differences in the variables after anterior cruciate ligament reconstruction.
Cross-sectional study.
University laboratory.
A total of 150 athletes in any sport involving deceleration, jumping, cutting, or turning enrolled in the study. All participants answered the International Knee Documentation Committee and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) questionnaires and performed balance and isokinetic tests.
The classification and regression tree (CART) was used to determine the clinical decision algorithm associated with RTS at any level and RTS at the preinjury level. The diagnostic accuracy of the CART was verified.
Of the 150 participants, 57.3% (n = 86) returned to sport at any level and 12% (n = 18) returned to sport at the preinjury level. The interactions among the peak torque extension at 300°/s >93.55 Nm, ACL-RSI score >27.05 (P = .06), and postoperative time >7.50 months were associated with RTS at any level identified by CART and were factors associated with RTS. An ACL-RSI score >72.85% was the main variable associated with RTS at the preinjury level. The interaction among an ACL-RSI score of 50.40% to 72.85%, agonist : antagonist ratio at 300°/s ≤63.6%, and anteroposterior stability index ≤2.4 in these participants was the second factor associated with RTS at the preinjury level.
Athletes who had more quadriceps strength tended to RTS at any level more quickly, even with less-than-expected psychological readiness. Regarding a return at the preinjury level, psychological readiness was the most important factor in not returning, followed by a better agonist : antagonist ratio and better balance.
This scoping review study aimed to map the evidence about solvents' use for gutta-percha dissolution and removal during endodontic retreatments. The study protocol followed the Joanna Briggs ...Institute guidelines, available online (https://osf.io/5vy8n/). Reporting was based on PRISMA Extension for Scoping Reviews. We selected dentistry studies that considered the effectiveness of solvents in gutta-percha dissolution in endodontic retreatments and compared their performance to the use of instrumentation techniques without solvents. The search and study screening were performed in PubMed and Scopus databases by two independent researchers. A descriptive analysis considered the study design, method/technique used for obturation, method/technique used for instrumentation during retreatment, solvent solutions tested, exposure time, and main findings. A total of 41 studies were included. Despite that, most studies suggested that solvents' use may complicate root canal cleanliness, regardless of the type of instrumentation used, and facilitate the presence of gutta-percha remnants in the root surface. Thus, the use of solvents should be avoided and its use should only be considered if the previous working length was not possible to access without it. Despite that, high heterogeneity was observed, further studies are still encouraged comparing the performance and effects of different solvents in different clinical scenarios.
Single‐atom catalysis is a field of paramount importance in contemporary science due to its exceptional ability to combine the domains of homogeneous and heterogeneous catalysis. Iron and manganese ...metalloenzymes are known to be effective in C─H oxidation reactions in nature, inspiring scientists to mimic their active sites in artificial catalytic systems. Herein, a simple and versatile cation exchange method is successfully employed to stabilize low‐cost iron and manganese single‐atoms in poly(heptazine imides) (PHI). The resulting materials are employed as photocatalysts for toluene oxidation, demonstrating remarkable selectivity toward benzaldehyde. The protocol is then extended to the selective oxidation of different substrates, including (substituted) alkylaromatics, benzyl alcohols, and sulfides. Detailed mechanistic investigations revealed that iron‐ and manganese‐containing photocatalysts work through a similar mechanism via the formation of high‐valent M═O species. Operando X‐ray absorption spectroscopy (XAS) is employed to confirm the formation of high‐valent iron‐ and manganese‐oxo species, typically found in metalloenzymes involved in highly selective C─H oxidations.
Low‐cost iron and manganese single‐atoms are stabilized on poly(heptazine imides) (PHI). The resulting materials are exploited as photocatalysts for the selective oxidation of toluene into benzaldehyde, and further applied to the conversion of alkylaromatics and benzyl alcohols into the corresponding carbonyl derivatives. Operando X‐ray absorption spectroscopy supports the intermediacy of metal‐oxo species under heterogeneous conditions.
In this study we analyse the climatic impact over South America due to Amazon deforestation for positive (PDO+) and negative (PDO−) PDO phases. The regional climatic model RegCM4 was run from 1968 to ...2003 for the domain including a great area of the Pacific Ocean and South America, using 50 km as spatial resolution. The Amazon deforestation scenario is that one extrapolated to the 2050 year. Under deforestation, the results show precipitation depletion over the extreme northern South America and precipitation increase over areas to the south, including deforested pixels and east‐southern sectors. These changes are more intense and occupy larger areas during the rainy season. Simulations also indicate that deforestation may impose a drier corridor following the Andes Mountains oriental slopes, from northwestern to south‐southeastern South America, in the rainy season. The impact from deforestation in distinct PDO phases presents the greatest signals over central‐southern South America, in a northwest–southeast direction. Over southeast Brazil, deforestation presents a slightly northeastward displacement of the PDO+ positive precipitation anomalies, intensifying the precipitation anomalies in the north sector and weakening over the south sector. The deforestation effects are more intense in the rainy season and have opposite signals between PDO+ and PDO−. Over the southeast South America, deforestation provides a weaker signal on PDO+ negative precipitation than in PDO−. The increased air temperature over the northern South America, near the northern coast, due to the joint effect of deforestation and PDO variability is more evident during PDO+ dry season than PDO− rainy season. This study illustrates the importance of considering long‐term climate simulations to better understand the role of deforestation in the lower frequency variability over South America.
South America precipitation impact due to Amazon deforestation on rainy season. The 850 hPa wind streamline climatology (1970–2003) is plotted.
Phantom limb pain (PLP) occurs after amputations and can persist in a chronic and debilitating way. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation method ...capable of influencing brain function and modulating cortical excitability. Its effectiveness in treating chronic pain is promising.
To evaluate the evidence on the efficacy and safety of using rTMS in the treatment of PLP, observing the stimulation parameters used, side effects, and benefits of the therapy.
This is a systematic review of scientific articles published in national and international literature using electronic platforms.
Two hundred and fifty two articles were identified. Two hundred and forty six publications were removed because they were duplicated or met the exclusion criteria. After selection, six studies were reviewed, those being two randomized clinical trials and four case reports. All evaluated studies indicated some degree of benefit of rTMS to relieve painful symptoms, even temporarily. Pain perception was lower at the end of treatment when compared to the period prior to the sessions and remained during patient follow-up. There was no standardization of the stimulation parameters used. There were no reports of serious adverse events. The effects of long-term therapy have not been evaluated.
There are some benefits, even if temporary, in the use of rTMS to relieve painful symptoms in PLP. High-frequency stimulation at M1 demonstrated a significant analgesic effect. Given the potential that has been demonstrated, but limited by the paucity of high-quality studies, further controlled studies are needed to establish and standardize the clinical use of the method.
Gut microbiota has been implicated in various clinical conditions, yet the substantial heterogeneity in gut microbiota research results necessitates a more sophisticated approach than merely ...identifying statistically different microbial taxa between healthy and unhealthy individuals. Our study seeks to not only select microbial taxa but also explore their synergy with phenotypic host variables to develop novel predictive models for specific clinical conditions.
We assessed 50 healthy and 152 unhealthy individuals for phenotypic variables (PV) and gut microbiota (GM) composition by 16S rRNA gene sequencing. The entire modeling process was conducted in the R environment using the Random Forest algorithm. Model performance was assessed through ROC curve construction.
We evaluated 52 bacterial taxa and pre-selected PV (
< 0.05) for their contribution to the final models. Across all diseases, the models achieved their best performance when GM and PV data were integrated. Notably, the integrated predictive models demonstrated exceptional performance for rheumatoid arthritis (AUC = 88.03%), type 2 diabetes (AUC = 96.96%), systemic lupus erythematosus (AUC = 98.4%), and type 1 diabetes (AUC = 86.19%).
Our findings underscore that the selection of bacterial taxa based solely on differences in relative abundance between groups is insufficient to serve as clinical markers. Machine learning techniques are essential for mitigating the considerable variability observed within gut microbiota. In our study, the use of microbial taxa alone exhibited limited predictive power for health outcomes, while the integration of phenotypic variables into predictive models substantially enhanced their predictive capabilities.
Depression in older adults with multiple medical comorbidities can contribute to clinical deterioration, and increased mortality. Electroconvulsive therapy (ECT) is the first-line treatment for these ...patients. This study aimed to evaluate the effectiveness and safety of subcutaneous (SC) ketamine as an alternative to ECT. We reviewed the medical records of all consecutive older inpatients with severe depression and multiple medical comorbidities who were referred for ECT but treated with SC ketamine over 1 year in our institution. Demographic data, DSM-5 diagnosis, MÅDRS score, and CGI score were analyzed. Twelve patients aged 67-94 years were included. All patients were rated as severely ill, 83% were women, with a mean of 12.6 (SD, 1.4) medical comorbidities. Remission was achieved in 75% of the intention-to-treat population and 100% of treatment completers. The number of sessions ranged from 1 to 6, and days until remission from 1 to 16. Patients remained without relapse for 8-28 months. SC ketamine was safe and well tolerated, and most adverse events were mild and transient. Although limited by the retrospective open-label design of the study and small sample size, our findings provide a potential new indication for ketamine: treatment of severe depression, not necessarily resistant to antidepressants, in older patients with multiple medical comorbidities, at risk of clinical deterioration, and referral for ECT. SC ketamine was highly effective in this population, with no relapse and good tolerance. Randomized controlled trials are needed to adequately test the use of ketamine in this specific group.
PDF
