Purpose
Anterior cruciate ligament reconstruction (ACLR) aims to restore knee function and stability, allowing patients to return to the activities they enjoy and minimize further injury to the ...meniscus and cartilage and their ultimate progression to osteoarthritis. This study aims to present the evolution of graft choice over the last three decades according to members of the ACL Study Group (SG).
Methods
Prior to the January 2020 ACL SG biannual meeting, a survey was administered consisting of 87 questions and 16 categories, including ACLR graft choice. A similar questionnaire has been administered prior to each meeting and survey results from the past 14 meetings (1992 through 2020, excluding 1994) are included in this work. Survey responses are reported as frequencies in percentages to quantify changes in practice over the surgery period.
Results
In 1992, the most frequent graft choice for primary ACLR was bone-patellar tendon-bone (BTB) autograft, at nearly 90%. Hamstring tendon (HT) autografts have increased in popularity, currently over 50%, followed by just under 40% BTB autograft. Recently, quadriceps tendon (QT) autograft has increased in popularity since 2014.
Conclusion
Autograft (HT, BTB, QT) is an overwhelming favorite for primary ACLR over allograft. The preference for HT autograft increased over the study period relative to BTB autograft, with QT autograft gaining in popularity in recent years. Graft selection should be individualized for each patient and understanding the global trends in graft choice can help orthopaedic surgeons discuss graft options with their patients and determine the appropriate graft for each case.
Level of evidence
Level V, Expert Opinion.
Multiple Myeloma is a typical example of a neoplasm that shows significant differences in incidence, age of onset, type, and frequency of genetic alterations between patients of African and European ...ancestry. This perspective explores the hypothesis that both genetic polymorphisms and spontaneous somatic mutations in the TP53 tumor suppressor gene are determinants of these differences. In the US, the rates of occurrence of MM are at least twice as high in African Americans (AA) as in Caucasian Americans (CA). Strikingly, somatic TP53 mutations occur in large excess (at least 4-6-fold) in CA versus AA. On the other hand, TP53 contains polymorphisms specifying amino-acid differences that are under natural selection by the latitude of a population and have evolved during the migrations of humans over several hundred thousand years. The p53 protein plays important roles in DNA strand break repair and, therefore, in the surveillance of aberrant DNA recombination, leading to the B-cell translocations that are causal in the pathogenesis of MM. We posit that polymorphisms in one region of the TP53 gene (introns 2 and 3, and the proline-rich domain) specify a concentration of the p53 protein with a higher capacity to repress translocations in CA than AA patients. This, in turn, results in a higher risk of acquiring inactivating, somatic mutations in a different region of the TP53 gene (DNA binding domain) in CA than in AA patients. Such a mechanism, by which the polymorphic status of a gene influencing its own "spontaneous" mutation frequency, may provide a genetic basis to address ethnicity-related differences in the incidence and phenotypes of many different forms of cancer.
Functional Territories of Human Dentate Nucleus Guell, Xavier; D’Mello, Anila M; Hubbard, Nicholas A ...
Cerebral cortex (New York, N.Y. 1991),
04/2020, Volume:
30, Issue:
4
Journal Article
Peer reviewed
Open access
Abstract
Anatomical connections link the cerebellar cortex with multiple sensory, motor, association, and paralimbic cerebral areas. The majority of fibers that exit cerebellar cortex synapse in ...dentate nuclei (DN) before reaching extracerebellar structures such as cerebral cortex, but the functional neuroanatomy of human DN remains largely unmapped. Neuroimaging research has redefined broad categories of functional division in the human brain showing that primary processing, attentional (task positive) processing, and default-mode (task negative) processing are three central poles of neural macroscale functional organization. This broad spectrum of human neural processing categories is represented not only in the cerebral cortex, but also in the thalamus, striatum, and cerebellar cortex. Whether functional organization in DN obeys a similar set of macroscale divisions, and whether DN are yet another compartment of representation of a broad spectrum of human neural processing categories, remains unknown. Here, we show for the first time that human DN are optimally divided into three functional territories as indexed by high spatio-temporal resolution resting-state MRI in 77 healthy humans, and that these three distinct territories contribute uniquely to default-mode, salience-motor, and visual cerebral cortical networks. Our findings provide a systems neuroscience substrate for cerebellar output to influence multiple broad categories of neural control.
Hypervalent iodine (HVI) compounds are very important selective oxidants often employed in organic syntheses. Most HVI compounds are strongly associated in the solid state involving interactions ...between the electropositive iodine centers and nearby electron lone pairs of electronegative atoms. This study examines the impact of remote substituents on select families of HVI compounds as means to achieve predictable two-dimensional extended solid-state materials. Crystallographic analyses of 10 HVI compounds from several related classes of λ3 organoiodine(III) compounds, (diacetoxyiodo)benzenes, (dibenzoatoiodo)benzenes, bis(trifluoroacetoxy)iodobenzenes, and μ-oxo-(carboxylateiodo)benzenes, provide insights into how remote substituents and the choice of carboxylate groups can impact intermolecular interactions in the solid state.
ABSTRACT
Objective: To estimate risk and relative risk (RR) of acute pancreatitis among patients using incretin-based diabetes therapies (exenatide or sitagliptin) compared to patients treated with ...agents with established safety profiles (metformin or glyburide).
Research design and methods: The study population was derived from a large US commercial health insurance transaction database using an active drug safety surveillance system (i3 Aperio*). This analysis is based on data from June 2005 through June 2008. Cohorts of exenatide and sitagliptin initiators were each matched to an equal number of metformin or glyburide (met/gly) initiators using propensity scores to reduce confounding in the comparison of outcomes during follow-up. Patients with claims suggesting pancreatic disease in the 6 months prior to cohort entry were excluded.
*i3 Drug Safety, Waltham, MA 02451, USA, www.i3aperio.com
Main outcome measure: Claims for hospitalizations associated with a primary diagnosis of acute pancreatitis (ICD-9 577.0).
Results: There were 27 996 exenatide initiators and 16 276 sitagliptin initiators and approximately equal numbers of matched comparators. During follow-up of up to 1 year, acute pancreatitis occurred among 0.13% of patients treated with exenatide and 0.12% of patients treated with sitagliptin. The risk of acute pancreatitis was comparable for initiators of exenatide (RR 1.0; 95% confidence interval (CI) 0.6-1.7) and sitagliptin (RR 1.0; 95% CI 0.5-2.0) relative to the comparison cohorts.
Conclusions: These data do not provide evidence for an association of acute pancreatitis among initiators of exenatide or sitagliptin compared to met/gly initiators. These results are limited by the data available in an administrative, healthcare database.
Current approaches to inhibit nuclear receptor (NR) activity target the hormone binding pocket but face limitations. We have proposed that inhibitors, which bind to nuclear receptor surfaces that ...mediate assembly of the receptor's binding partners, might overcome some of these limitations. The androgen receptor (AR) plays a central role in prostate cancer, but conventional inhibitors lose effectiveness as cancer treatments because anti-androgen resistance usually develops. We conducted functional and x-ray screens to identify compounds that bind the AR surface and block binding of coactivators for AR activation function 2 (AF-2). Four compounds that block coactivator binding in solution with IC₅₀ almost equal to 50 μM and inhibit AF-2 activity in cells were detected: three nonsteroidal antiinflammatory drugs and the thyroid hormone 3,3',5-triiodothyroacetic acid. Although visualization of compounds at the AR surface reveals weak binding at AF-2, the most potent inhibitors bind preferentially to a previously unknown regulatory surface cleft termed binding function (BF)-3, which is a known target for mutations in prostate cancer and androgen insensitivity syndrome. X-ray structural analysis reveals that 3,3',5-triiodothyroacetic acid binding to BF-3 remodels the adjacent interaction site AF-2 to weaken coactivator binding. Mutation of residues that form BF-3 inhibits AR function and AR AF-2 activity. We propose that BF-3 is a previously unrecognized allosteric regulatory site needed for AR activity in vivo and a possible pharmaceutical target.
A bulky 1,4-di-iodobenzene having four adjacent
para
-
t
Bu-C
6
H
4
group (Ar′) substituents (
1
) was used to prepare the di-hypervalent iodine compound 1,4-I(OAc)
2
2
-2,3,5,6-Ar′
4
-C
6
(
2
). ...Despite the steric encumbrance of the iodine center by the flanking aryl substituents, compound
2
undergoes ready cyclization under mild conditions (excess CF
3
COOH at 55 °C, 30 min) to afford a dicyclic di-iodonium di-triflate salt
3
. The single crystal structures of compounds
2
and
3
were examined and compared to the formerly characterized precursor
1
. The
para-tert
-butyl groups on these compounds also render the compounds more soluble than multifunctional hypervalent iodine (HVI) compounds. HVI compounds having multiple iodine(
iii
) centers are increasingly of interest for applications as recyclable reagents, materials precursors, and as Lewis acids.
Oxidation of a 1,4-di-iodobenzene having four adjacent
p
-
t
Bu-C
6
H
4
group (Ar′) substituents (
1
) yields the hypervalent iodine compound 1,4-I(OAc)
2
2
-2,3,5,6-Ar′
4
-C
6
(
2
), that undergoes cyclization to produce dicyclic di-iodonium salt (
3
).
Many organizational representatives review social media (SM) information (e.g., Facebook, Twitter) when recruiting and assessing job applicants. Despite this, very little empirical data exist ...concerning the SM information available to organizations or whether assessments of such information are a valid predictor of work outcomes. This multistudy investigation examines several critical issues in this emerging area. In Study 1, we conducted a content analysis of job seekers' Facebook sites (n = 266) and found that these sites often provide demographic variables that U.S. employment laws typically prohibit organizations from using when making personnel decisions (e.g., age, ethnicity, and religion), as well as other personal information that is not work-related (e.g., sexual orientation, marital status). In Study 2 (n = 140), we examined whether job seekers' SM information is related to recruiter evaluations. Results revealed that various types of SM information correlated with recruiter judgments of hireability, including demographic variables (e.g., gender, marital status), variables organizations routinely assess (e.g., education, training, and skills), and variables that may be a concern to organizations (e.g., profanity, sexual behavior). In Study 3 (n = 81), we examined whether structuring SM assessments (e.g., via rater training) affects criterion-related validity. Results showed that structuring SM assessments did not appear to improve the prediction of future job performance or withdrawal intentions. Overall, the present findings suggest that organizations should be cautious about assessing SM information during the staffing process.
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Stroke is a serious complication after transcatheter aortic valve replacement (TAVR), yet predictive models are not available. A new risk model for in-hospital stroke after TAVR was developed and ...used to estimate site-specific performance.
We included 97,600 TAVR procedures from 521 sites in The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry from July 2014 to June 2017. Association between baseline covariates and in-hospital stroke was estimated by logistic regression. Discrimination was evaluated by C-statistic. Calibration was tested internally via cross-validation. Hierarchical modeling was used to estimate risk-adjusted site-specific performance.
Median age was 82 years, 44,926 (46.0%) were women, and 1,839 (1.9%) had in-hospital stroke. Covariates associated with stroke (odds ratio) included transapical access (1.44), access excluding transapical and transfemoral (1.77), prior stroke (1.57), prior transient ischemic attack (1.50), preprocedural shock, inotropes or mechanical assist device (1.48), smoking (1.28), porcelain aorta (1.23), peripheral arterial disease (1.21), age per 5 years (1.11), glomerular filtration rate per 5 mL/min (0.97), body surface area per m2 (0.55 male; 0.43 female), and prior aortic valve (0.78) and nonaortic valvular (0.42) procedures. The C-statistic was 0.622. Calibration curves demonstrated agreement between observed and expected stroke rates. Hierarchical modeling showed 10 (1.9%) centers with significantly higher odds ratios for in-hospital stroke than their peers.
A risk model for in-hospital stroke after TAVR was developed from The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry and used to estimate site-specific stroke performance. This model can serve as a valuable resource for quality improvement, clinical decision making, and patient counseling.
Although human capital resources (HCR) can be important for organizational performance, researchers have defined and measured HCR in various ways. Consequently, it is unclear whether existing ...measures provide valid inferences about HCR or their relations with other constructs. We conducted this three-study research to address these issues. In Study 1, we reviewed HCR definitions (k = 84) and found that most definitions focus on collective knowledge, skills, and abilities. Recent definitions also tend to include other characteristics (e.g., personality). In Study 2, a content analysis of HCR measures (k = 127) revealed that only 23.6% of the measures focused solely on HCR and they tended to assess only one or two dimensions of the construct (i.e., were deficient). Many measures (46.5%) assessed both HCR and other constructs (i.e., were partially contaminated), and other measures (29.9%) assessed only non-HCR constructs (i.e., were fully contaminated). In Study 3 (k = 94), we found that HCR measures that were less deficient demonstrated stronger criterion-related validity for predicting unit and firm performance. Interestingly, partially contaminated measures were somewhat more predictive than uncontaminated measures (ρ = .35 vs. .25, respectively), mainly because they assessed both HCR and other constructs that are related to performance. Both types of measures demonstrated stronger validity than fully contaminated measures. Overall, findings suggest that extant HCR measures often are deficient and/or contaminated. We discuss implications, as well as offer guidance for measuring HCR in future research.
Full text
Available for:
CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ
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