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Objective: To investigate the effect of diadynamic currents administered prior to exercises on pain and disability in patients with osteoarthritis of the knee. Design: A randomized-controlled trial. Setting: Special Rehabilitation Services in Taboão da Serra. Participants: Patients with bilateral knee osteoarthritis. Intervention: Participants were randomly allocated to Group I (diadynamic currents and exercises; n = 30, 60 knees) or Group II (exercises alone; n = 30, 60 knees) and were treated three times a week for 8 weeks. Main outcome measures: The primary outcome measures were change in knee pain evaluated by visual analog scale and disability Index Score (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscle strength (dynamometer), a composite score for pain and disability (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and a drug diary to measure consumption of rescue pain medication (paracetamol). All measurements were collected at baseline, 8 weeks, and 6 months from baseline (follow-up). Results: There were 60 participants with a mean (SD) age of 63.40 (8.20) years. Between-group differences in the follow-up (8 weeks and 6 months) were observed for pain at rest, pain during activities of daily living and disability. There was improvement in Group I that was maintained for the three variables 6 months after treatment. Mean difference for pain at rest was −3.08 points (95% confidence interval −4.13; −2.02), p < 0.01 with an effect size of 1.4; mean difference for pain during activities of daily living was −2.40 points (95% confidence interval −3.34; −1.45), p < 0.01 with an effect size of 1.24; and mean difference for disability was −4.08 points (95% confidence interval −5.89; −2.26), p < 0.01 with an effect size of 1.04. Conclusion: Patients with symptomatic knee osteoarthritis receiving 8 weeks of treatment with diadynamic currents as an adjunct to a program of exercises had significantly greater improvements in pain and disability than those receiving exercises alone. Beneficial effects were sustained for 6 months. [ABSTRACT FROM AUTHOR]

Our purpose in this study was to determine the effects of a virtual reality intervention delivering specific motivational motor learning manipulations of either autonomy support (AS) or enhanced expectancies (EE) on frontal plane single-leg squatting kinematics. We allocated 45 participants (21 male, 24 female) demonstrating knee, hip, and trunk frontal plane mechanics associated with elevated anterior cruciate ligament injury risk to one of three groups (control, AS, or EE). Participants mimicked an avatar performing five sets of eight repetitions of exemplary single-leg squats. AS participants were given the added option of choosing the color of their avatar. EE participants received real-time biofeedback in the form of green highlights on the avatar that remained on as long as the participant maintained pre-determined 'safe' frontal plane mechanics. We measured peak frontal plane knee, hip, and trunk angles before (baseline) and immediately following (post) the intervention. The control group demonstrated greater increases in knee abduction angle (Δ = +2.3°) than did the AS (Δ = +0.1°) and EE groups (Δ = −0.4°) (p =.003; η2p =.28). All groups demonstrated increased peak hip adduction (p =.01, ηp2 =.18) (control Δ = +1.5°; AS Δ = +3.2°; EE Δ = +0.7°). Hip adduction worsened in all groups. AS and EE motivation strategies appeared to mitigate maladaptive frontal plane knee mechanics. [ABSTRACT FROM AUTHOR]

Background: Cancer patients experience significant changes in their social roles along with various physical and psychological challenges. Despite the growing recognition of the importance of palliative care in Bangladesh, there is a notable gap in research focusing on the psychosocial issues faced by patients with advanced cancer. Aim: This study aims to explore the level of social support perceived by Bangladeshi cancer patients and determine how this support relates to their mental health status. Methods: This cross-sectional study was conducted among 115 advanced cancer (stages III and IV) patients admitted to the palliative medicine department of a tertiary care hospital in Bangladesh. Perceived social support was measured by the Multidimensional Scale of Perceived Social Support, and the mental health status of the patients was assessed by Depression, Anxiety, and Stress Scale-21. Data collection was done from June to November 2023. Relationships between perceived social support, depression, anxiety, and stress were assessed by the Spearman correlation test. The moderating effect of perceived social support on patients' mental health variables was determined by multiple linear regression and simple slope analysis. p Value <0.05 was considered to be statistically significant. Result: The study included an almost equal number of male (49.6%) and female (50.4%) patients, with a mean age of 50.7 ± 14.4 years. Overall, perceived social support was moderate to high for most (74.7%) of the participants. Among the participants, 78.3% experienced anxiety, 77.4% suffered from depression, and 70.5% experienced stress. Depression, anxiety, and stress were all negatively and significantly (p < 0.05) correlated with perceived social support. Younger patients reported higher levels of anxiety, stress, and depression. Perceived social support had a significant buffering effect on depression and anxiety among the younger patients. Conclusion: Perceived social support has a profound and significant effect on the mental health of advanced cancer patients. Integrating psychosocial support early in palliative care can be highly beneficial to the mental health of these patients. Plain language summary: Social support and mental health of cancer patients This cross-sectional study was conducted among 115 patients with advanced cancer (stages III and IV) admitted to the palliative medicine department of a tertiary care hospital in Bangladesh. The majority of the patients with advanced cancer suffer from depression and anxiety and experience high level of stress. Younger patients report more of these psychological issues. High level of perceived social support is associated with lower levels of depression, anxiety, and stress. It acts as a buffer against these negative emotions. Patients who experienced a high level of social support while dealing with physical pain reported less depression. [ABSTRACT FROM AUTHOR]

Background: Patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with radiation-based therapy suffer from short- and long-term toxicities that affect quality of life (QOL). Transoral robotic surgery (TORS) has an established role in the management of early OPSCC but adjuvant treatment is often indicated postoperatively due to the high incidence of nodal metastasis associated with advanced human papillomavirus (HPV)-related OPSCC. To overcome the need for adjuvant radiation therapy (RT), neoadjuvant chemotherapy followed by TORS and neck dissection (ND) is proposed. This study aimed to assess if QOL in HPV-associated OPSCC receiving neoadjuvant chemotherapy followed by TORS and ND returns to baseline within 12 months of completing treatment. Methods: A 12 month longitudinal study was carried out at McGill University Health Centre in Montreal, Canada, among a convenience sample of patients with American Joint Committee on Cancer Seventh Edition stage III and IVa HPV-related OPSCC who were treated with neoadjuvant chemotherapy followed by TORS and ND. QOL data were obtained pretreatment and at 1, 3, 6, and 12 months following treatment completion using the European Organisation for Research and Treatment of Cancer Core and Head and Neck extension modules. Paired t tests and mixed models for repeated measures analysis were used to assess changes in QOL from baseline to 12 months postoperatively and over time, respectively. Results: Nineteen of 23 patients (median age 58 years) who received the study treatment fulfilled the eligibility criteria. OPSCC subsites were palatine tonsil (n = 12) and base of tongue (n = 7). All 19 patients were treated per protocol and none required adjuvant RT as per pathology review and protocol requirements at a postoperative multidisciplinary team tumor board discussion. No significant differences were found when comparing 12 month QOL follow-up scores to pretreatment scores in measures that would likely be affected by RT [eg, swallowing (P =.7), social eating (P =.8), xerostomia (P =.9)]. Conclusion: In HPV-related OPSCC, neoadjuvant chemotherapy followed by TORS and ND as definitive treatment is associated with excellent QOL outcomes. Postoperative QOL scores returned to baseline by 3 months and were maintained for all measures, indicating a return to normal function. [ABSTRACT FROM AUTHOR]

Approximately 85% of children with autism spectrum disorder from the SPARK study receiving standard interventions such as speech-language and occupational therapies. In contrast, only 32%–13% of children with autism spectrum disorder received movement therapies such as physical and recreational therapies, respectively. Little is known about how service receipt changes as a function of children's motor difficulties. Parents of children with autism spectrum disorder completed online surveys to provide a report of their child's motor difficulties using the Developmental Coordination Disorder–Questionnaire as well as the various therapies their child received (speech-language therapy, occupational therapy, physical therapy, applied behavioral analysis, social skill interventions, recreational therapy) by location (at school, privately/in community, or both). While movement therapies (occupational therapy, physical therapy, recreational therapy) increased with increasing motor risk and severity, there continued to be large disparities in physical therapy (37%–55%) and recreational therapy (15%–19%) compared to occupational therapy (85%–92%) across various settings indicating clear unmet needs for specific motor services given that 88.3% of this sample of children with autism spectrum disorder is at risk for motor difficulties/Developmental Coordination Disorder. Developmental Coordination Disorder–Questionnaire fine- and gross-motor subscale scores were fairly comparably affected yet physical therapy/recreational therapy were less received versus occupational therapy. These findings explain the paucity of physical therapy/recreational therapy and physical activity programs for individuals with autism spectrum disorder and the need for movement experts to receive appropriate access and training to work with individuals with autism spectrum disorder. There are clear disparities in motor services provided to children with autism spectrum disorder (physical and recreational therapies) compared to their standard therapies (speech-language and occupational therapies). Children with autism spectrum disorder need greater access to and funding for motor services (physical and recreational therapies) and physical activity programs. Movement experts including PTs, adapted physical educators, and community exercise/sports coaches/professionals need basic, specialized, and continuing education training to meet the needs of children and adults with autism spectrum disorder not only for providing early developmental and school-based services but also for ensuring appropriate built environments and providing general physical therapy/adapted physical education services as well as physical activity programs. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy of injecting various amounts of fluid into the shoulder joints for capsule distension in patients with adhesive capsulitis. Design: A randomized controlled trial. Setting: Outpatient clinic of a tertiary care centre. Participants: Eighty-four patients with adhesive capsulitis underwent a baseline (time0), 6 weeks (time1), and 12 weeks (time2) follow-up after hydrodilitation. Intervention: Group 1 (n = 42) received 20 ml of lidocaine, steroid, and saline hydrodilatation via posterior glenohumeral recess, while Group 2 (n = 42) received 10 ml of lidocaine, steroid, and saline hydrodilitation. Main measures: The primary outcome was the visual analogue scale for pain. The secondary outcomes were shoulder pain and disability index (SPADI) and ROM of the shoulder. Results: There was a significant reduce in VAS scores for pain, SPADI scores, and increased shoulder ROM in both groups over time; however, the group-by-time interactions for any of the outcomes between groups were not significant except VAS pain in motion. Post-hoc pairwise analysis of the marginal effect of time and group showed that the significant difference of VAS in motion is due to time effect: time1 vs time0 (95% CI −4.09 to −2.68), time2 vs time0 (−4.21 to −2.77), and time2 vs time1 (−0.83 to 0.63), without between-group difference: group 1 vs group 2 (−0.38 to 0.59). Conclusion: Our study suggests hydrodilatation achieved an optimal effect at time1 for patients with adhesive capsulitis in both groups, and adding more saline offers additional benefits in flexion and external roatation until time2. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effects of acupuncture and therapeutic exercise alone and in combination on temporomandibular joint symptoms in tension-type headache and to evaluate the potential interaction of existing temporomandibular dysfunction on the success of headache treatment. Design: Pre-planned secondary analysis of a randomized controlled, non-blinded trial. Setting: Outpatient clinic of a German university hospital. Subjects: Ninety-six Participants with frequent episodic or chronic tension-type headache were randomized to one of four treatment groups. Interventions: Six weeks of acupuncture or therapeutic exercise either as monotherapies or in combination, or usual care. Follow-up at 3 and 6 months. Main measures: Subjective temporomandibular dysfunction symptoms were measured using the Functional Questionnaire Masticatory Organ, and the influence of this sum score and objective initial dental examination on the efficacy of headache treatment interventions was analyzed. Results: Temporomandibular dysfunction score improved in all intervention groups at 3-month follow-up (usual care: 0.05 [SD 1.435]; acupuncture: −5 [SD 1.436]; therapeutic exercise: −4 [SD 1.798]; combination: −3 [SD 1.504]; P = 0.03). After 6 months, only acupuncture (−6 [SD 1.736]) showed a significant improvement compared to the usual care group (P < 0.01). Subjective temporomandibular dysfunction symptoms had no overall influence on headache treatment. Conclusions: Only acupuncture had long-lasting positive effects on the symptoms of temporomandibular dysfunction. Significant dental findings seem to inhibit the efficacy of acupuncture for tension-type headache. [ABSTRACT FROM AUTHOR]

Objective: To evaluate therapeutic footwear expectations and usability of individuals with diabetes and foot complications. Design: A prospective multicenter study was conducted on participants with a high risk of developing a diabetic foot ulcer. Setting: Participants were enrolled in 11 different specialized diabetic foot units in Spain between March 2022 and June 2023. Subjects: Patients with diabetes at moderate to high risk of foot ulceration receiving first therapeutic footwear prescription. Interventions: All the patients included in the research were prescribed with their first pair of therapeutic footwear. Main measures: Primary outcome measures were MOS-pre and MOS-post questionnaires evaluating use and usability of prescribed therapeutic footwear. Secondary outcome measures aimed to evaluate footwear clinical efficacy as ulceration rate and self-reported perceived walking distance per day. Results: The use of therapeutic footwear exceeded the patient's pre-provision prediction of their anticipated use in 94% of people (n = 126). Based on the visual analogic satisfaction scale, the median satisfaction of daily wearing their therapeutic footwear was 7 points, Interquartile Range (IQR) [5–8.25]. During the follow-up period, 39 participants (29.1%) experienced diabetic foot ulcer. Perceived walking distance participants reported an improvement in their perceived walking ability during various daily life activities. Conclusions: Diabetes patients at moderate to high risk of diabetic foot ulcer improved their perception of walking ability after therapeutic footwear prescription. Adherence to the therapeutic footwear prescription resulted in less ulcerations. [ABSTRACT FROM AUTHOR]

Background: Qualitative movement screening tools provide a practical method of assessing mechanical patterns associated with potential injury development. Biomechanics play a role in hamstring strain injury and are recommended as a consideration within injury screening and rehabilitation programs. However, no methods are available for the in-field assessment of sprint running mechanics associated with hamstring strain injuries. Purpose: To investigate the intra- and interrater reliability of a novel screening tool assessing in-field sprint running mechanics titled the Sprint Mechanics Assessment Score (S-MAS) and present normative S-MAS data to facilitate the interpretation of performance standards for future assessment uses. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Maximal sprint running trials (35 m) were recorded from 136 elite soccer players using a slow-motion camera. All videos were scored using the S-MAS by a single assessor. Videos from 36 players (18 men and 18 women) were rated by 2 independent assessors blinded to each other's results to establish interrater reliability. One assessor scored all videos in a randomized order 1 week later to establish intrarater reliability. Intraclass correlation coefficients (ICCs) based on single measures using a 2-way mixed-effects model, with absolute agreement with 95% CI and kappa coefficients with percentage agreements, were used to assess the reliability of the overall score and individual score items, respectively. T -scores were calculated from the means and standard deviations of the male and female groups to present normative data values. The Mann-Whitney U test and the Wilcoxon signed-rank test were used to assess between-sex differences and between-limb differences, respectively. Results: The S-MAS showed good intrarater (ICC, 0.828 [95% CI, 0.688-0.908]) and interrater (ICC, 0.799 [95% CI, 0.642-0.892]) reliability, with a standard error of measurement of 1 point. Kappa coefficients for individual score items demonstrated moderate to substantial intra- and interrater agreement for most parameters, with percentage agreements ranging from 75% to 88.8% for intrarater and 66.6% to 88.8% for interrater reliability. No significant sex differences were observed for overall scores, with mean values of 4.2 and 3.8 for men and women, respectively (P =.27). Conclusion: The S-MAS is a new tool developed for assessing sprint running mechanics associated with lower limb injuries in male and female soccer players. The reliable and easy-to-use nature of the S-MAS means that this method can be integrated into practice, potentially aiding future injury screening and research looking to identify athletes who may demonstrate mechanical patterns potentially associated with hamstring strain injuries. [ABSTRACT FROM AUTHOR]

Development of painful oxaliplatin-induced peripheral neuropathy (OIPN) is a major problem in people who receive oxaliplatin as part of cancer treatment. The pain experienced by those with OIPN can be seriously debilitating and lead to discontinuation of an otherwise successful treatment. Duloxetine is currently the only recommended treatment for established painful OIPN recommended by the American Society of Clinical Oncology, but its preventative ability is still not clear. This study examined the ability of duloxetine to prevent signs of chronic OIPN in female (n = 12) and male (n = 21) rats treated with the chemotherapeutic agent oxaliplatin. Using an established model of OIPN, rats were started on duloxetine (15 mg) one week prior to oxaliplatin administration and continued duloxetine for 32 days. Behavioral testing for mechanical allodynia and mechanical hyperalgesia was done with selected von Frey filaments. Significant posttreatment differences were found for allodynia in female (p =.004), but not male rats. Duloxetine was associated with significant differences for hyperalgesia in both female (p <.001) and male (p <.001) rats. These findings provide preliminary evidence of the preventative effects of duloxetine on both oxaliplatin-induced allodynia and hyperalgesia in male and female rats, with a difference noted in response between the sexes. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of lullabies and classical music on preterm neonates' cerebral oxygenation, vital signs, and comfort during orogastric (OG) tube feeding. Methods: This was a parallel-group pretest-posttest randomized controlled study. The research was conducted between December 2020 and May 2022. The sample consisted of 51 preterm neonates hospitalized in the neonatal intensive care unit (NICU) of Selçuk University Faculty of Medicine Hospital in Konya, Türkiye. Participants were randomized into three groups (17 preterm infants in each group). The first group listened to lullabies sung by their mothers and the second group listened to classical music during OG tube feeding. The control group received routine care with no music. Data were collected using a Neonatal Identification Information Form, Physiological Parameters and rSO2 Monitoring Form, and the Newborn Comfort Behavior Scale (Comfort-Neo). The study was registered on the ClinicalTrials database (NCT05333575). Results: The lullaby group had stable peak heart rates and oxygen saturation levels (p =.002). Both lullaby and classical music groups had significantly higher cerebral oxygenation levels than the control group. The classical music group had the highest cerebral oxygenation level (p =.001). Both lullaby and classical music groups had significantly higher mean Comfort-Neo scores than the control group. The classical music group had the highest mean Comfort-Neo score (p =.040). Conclusion: Preterm neonates who listen to lullabies and classical music are likely to have higher cerebral oxygen and comfort levels. Listening to lullabies helps stabilize vital signs. These results suggest that healthcare professionals should encourage parents to get their preterm neonates to listen to lullabies and classical music. [ABSTRACT FROM AUTHOR]

We investigated whether mood and lifestyle-related indicators of physical health are differentially expressed according to self-reported levels of depressive symptoms among young adults with a current episode of major depression. In a cross-sectional study, we recruited 94 young adults (females = 67, 71.3%; males = 27, 28.7%; aged 18–35 years) with a current episode of major depression. We assessed their mood with the Profile of Mood States (POMS), and Beck Anxiety Inventory-(BAI), sleep with the Pittsburgh Sleep Quality Index (PSQI), physical activity with the Simple Physical Activity Questionnaire (SIMPAQ), and their cardiorespiratory fitness. Participants' depression levels were classified as follows using established cut-points: (a) Mild Depressive Symptoms (MIDS, BDI-II 14-19 points, n = 17), (b) Moderate Depressive Symptoms (MODS, BDI-II 20–28 points, n = 37) or (c) Severe Depressive Symptoms (SEDS, BDI-II 29–63 points, n = 40). As expected, we found that young adults with SEDS, when compared to those with MODS and MIDS, showed higher depressive mood on the POMS, and they exhibited greater anxiety symptoms, lower reported 'vigor' on physical activity measures, worse sleep quality as expressed by their global score sleep; daytime dysfunction; and sleep disturbance, and they showed lower cardiorespiratory fitness. Those with moderate depressive symptoms only differed from those with mild symptoms with respect to hostility, fatigue and mood disturbance. Although there was a gradient whereby worse mental and physical health indicators were more closely related to the SEDS depression categorization, while healthier indicators were associated with the MIDS category, some parameters were not different between the MDD severity groups, particularly when comparing MIDS and MODS. Clinicians treating patients with MDD should consider these factors when designing lifestyle-based interventions. [ABSTRACT FROM AUTHOR]

Uric acid (UA) to albumin ratio (UAR) is an emerging marker to predict coronary artery disease (CAD)-related events. There is limited data on the relationship between UAR and the severity of the disease in chronic CAD patients. We aimed to evaluate UAR as an indicator for CAD severity using the Syntax score (SS). We retrospectively enrolled 558 patients with stable angina pectoris and underwent coronary angiography (CAG). Patients were divided into 2 groups, according to CAD severity: low SS (≤22) and intermediate-high SS (>22) groups. UA levels were higher and albumin levels were lower in the intermediate-high SS score group (P <.001). UAR levels were significantly higher in the intermediate-high SS group (P <.001). Also, there was a significant correlation between UAR levels and SS (r =.55, 95% confidence interval (CI):.49–.60, P <.001). In multivariable analysis, UAR >1.34 (Odds ratio, 3.8 [2.3–6.2]; P <.001) was an independent predictor of intermediate-high SS while albumin and UA levels were not. In conclusion, UAR predicted disease burden in chronic CAD patients. It may prove useful as a simple and readily available marker to select patients for further evaluation. [ABSTRACT FROM AUTHOR]

Background: Anteromedial rotatory instability (AMRI) of the knee is a complex and severe condition caused by injury to the anterior cruciate ligament and/or the medial collateral ligament. Clinical studies dealing with AMRI are rare, and objective measurements are nonexistent. Purpose/Hypothesis: The objectives of this study were, first, to quantify anteromedial rotatory knee laxity in healthy individuals using a noninvasive image analysis software and, second, to assess intra- and interrater reliability and equivalence in measuring anteromedial knee translation (AMT). It was hypothesized that AMT could be reliably quantified using a noninvasive image analysis software. Study design: Cohort study; Level of evidence, 3. Methods: This prospective proof-of-concept study included healthy individuals aged 16 to 40 years with no history of knee injury or surgery. Three adhesive surface markers were placed on predefined landmarks on the medial side of the knee. Three independent investigators examined anteromedial rotatory knee laxity with an anterior drawer test in different tibial rotations (neutral tibial rotation, 15° of external tibial rotation, and 15° of internal tibial rotation). The entire examination of each knee was recorded, and AMT including the side-to-side difference (SSD) was assessed using a freely available and validated image analysis software (PIVOT iPad application). Group comparisons were performed using a 1-way analysis of variance with Bonferroni-adjusted post hoc analysis. Intraclass correlation coefficients (ICCs) were calculated to assess inter- and intrarater reliability of AMT measurements. Equivalence of measurements was evaluated using the 2 one-sided t -test procedure. Results: Anteromedial rotatory knee laxity was assessed in 30 knees of 15 participants (53% male) with a mean age of 26.2 ± 3.5 years. In all 3 raters, the highest AMT was observed in neutral tibial rotation (range of means, 2.2-3.0 mm), followed by external tibial rotation (range of means, 2.0-2.4 mm) and internal tibial rotation (range of means, 1.8-2.2 mm; P <.05). Intrarater reliability of AMT (ICC, 0.88-0.96) and SSD (ICC, 0.61-0.96) measurements was good to excellent and moderate to excellent, respectively. However, interrater reliability was poor to moderate for AMT (ICC, 0.44-0.73) and SSD (ICC, 0.12-0.69) measurements. Statistically significant equivalence of AMT and SSD measurements was observed between and within raters for almost all testing conditions. Conclusion: Anteromedial rotatory knee laxity could be quantified using a noninvasive image analysis software, with the highest AMT observed during neutral tibial rotation in uninjured individuals. Reliability and equivalence of measurements were good to excellent within raters and moderate between raters. [ABSTRACT FROM AUTHOR]

Background: It is well known that rotator cuff repair is associated with an overall retear rate of 21% to 26%. However, a cuff retear may not necessarily be associated with poor clinical outcomes. Hypothesis: There would be no difference in clinical outcomes between patients with a cuff retear and those with an intact repair at a midterm follow-up of 5 years. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective study was conducted involving patients who received arthroscopic complete repair of the supraspinatus tendon between January 2009 and December 2017. Patients who did not have a postoperative magnetic resonance imaging (MRI) scan or who had a follow-up of <5 years were excluded. Clinical outcomes, including the visual analog scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and active forward flexion (FF) of the involved shoulder were assessed at the 2-year and 5-year follow-up points. Results: The study group included 105 patients with a mean follow-up of 85 months. MRI scans were performed at a mean of 20 months. Fourteen full-thickness cuff retears and 91 intact repairs were identified using postoperative MRI scans. Significant improvement in VAS score, ASES score, and FF were found between the preoperative assessment and the 2 designated follow-up points (2 years and 5 years) in both the cuff retear and the intact repair groups (P <.001). The VAS and ASES scores at the 2-year follow-up for the intact repair group were 1.8 ± 2.0 and 80.7 ± 18.1, respectively. The corresponding values for the retear group were 2.3 ± 2.2 and 71.9 ± 19.5, respectively. No significant difference was found between the 2 groups in the VAS and ASES scores at the 2-year follow-up. However, patients with an intact repair had a better VAS score (1.4 ± 1.8; P =.049) and ASES score (81.7 ± 17; P =.019) than those with a cuff retear at the 5-year assessment (3.0 ± 2.8 and 67.1 ± 22.9, respectively). In the intact repair group, 91% of patients achieved the minimal clinically important difference for the 5-year VAS score, compared with 54% in the cuff retear group (P <.001). The corresponding values for the 5-year ASES score were 80% and 54%, respectively (P =.044). FF measurements at the 5-year follow-up in patients with intact repair and those with a cuff retear were 161°± 23° and 144°± 37°, respectively (P =.059). Continuous improvement in VAS score and FF between the 2-year and 5-year follow-up was observed in the intact repair group (P =.005 and P =.04, respectively). Conclusion: The patients with an intact repair had better VAS and ASES scores compared with those who had a cuff retear at a midterm follow-up of 5 years. Between the 2-year and the 5-year follow-up, some further improvement was observed in the VAS score and FF in the intact repair group. [ABSTRACT FROM AUTHOR]

The Structured Assessment of PROtective Factors for violence risk (SAPROF) is a widely used structured professional judgment (SPJ) tool. Its indices have predictive validity regarding desistance from future violence in adult correctional/forensic psychiatric populations. Although not intended for applied use with youth, SAPROF items lend themselves to an investigation of whether their operationalizations capture only strengths or also risks. With 229 justice-involved male adolescents followed for a fixed 3-year period, promotive, risk, and mixed effects were found. Most SAPROF items exerted a mixed effect, being associated with higher and lower likelihoods of violent and any reoffending at opposite ends of their trichotomous ratings. Summing items weighted using their promotive and risk odds ratios produced statistically significant improvements in predictive accuracy, improvements found also with a cross-validation sample of 171 justice-involved youth. The nature of strengths and implications for the development of SPJ tools and training in their use were discussed. [ABSTRACT FROM AUTHOR]

Social media and other technologies are being increasingly adopted as mechanisms to perpetrate abuse against dating partners. Using Ajzen's theory of planned behavior as a framework, a sample of 352 emerging adults completed a questionnaire that assessed the core constructs of the theory of planned behavior (i.e., attitudes, subjective norms, perceived behavioral control), as well as intentions to commit three types of digital dating abuse in the near future: digital monitoring and control, digital direct aggression, and digital sexual coercion. The models explained 44%, 34%, and 44% of the variance in intentions to commit digitally facilitated monitoring and control, direct aggression, and sexual coercion, respectively. Attitudes and subjective norms significantly predicted intentions, whereas perceived behavioral control did not. Given the increasing prevalence of digital dating abuse, prevention efforts should target attitudes toward digital dating abuse-related behaviors and perceptions of social acceptability and engagement. [ABSTRACT FROM AUTHOR]

Background: In the setting of femoroacetabular impingement (FAI), decompression osteoplasties reconcile deleterious loading patterns caused by cam and pincer lesions. However, native variations of spinopelvic sagittal alignment may continue to perpetuate detrimental effects on the labrum, chondrolabral junction, and articular cartilage after hip arthroscopy. Purpose: To evaluate the effect of pelvic incidence (PI) on postoperative outcomes after hip arthroscopy for acetabular labral tears in the setting of FAI. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective query of prospectively collected data identified patients ≥18 years of age who underwent primary hip arthroscopy for FAI and acetabular labral tears between February 2014 and January 2022, with 3-, 6-, 12-, and 24-month follow-ups. Measurements for PI, pelvic tilt (PT), sacral slope (SS), and acetabular version were obtained via advanced diagnostic imaging. Patients were stratified into low-PI (<45°), moderate-PI (45°≤ PI ≤ 60°), and high-PI (>60°) cohorts. Patient-reported outcome measures (PROMs), clinically meaningful outcomes (ie, minimal clinically important difference, Patient Acceptable Symptom State, substantial clinical benefit, and maximal outcome improvement), visual analog scale (VAS) pain scores, and patient satisfaction were compared across cohorts. Results: A total of 74 patients met eligibility criteria and were stratified into low-PI (n = 28), moderate-PI (n = 31), and high-PI (n = 15) cohorts. Correspondingly, patients with high PI displayed significantly greater values for PT (P =.001), SS (P <.001), acetabular version (P <.001), and acetabular inclination (P =.049). By the 12- and 24-month follow-ups, the high-PI cohort was found to have significantly inferior PROMs, VAS pain scores, rates of clinically meaningful outcome achievement, and satisfaction relative to patients with moderate and/or low PI. No significant differences were found between cohorts regarding rates of revision arthroscopy, subsequent spine surgery, or conversion to total hip arthroplasty. Conclusion: After hip arthroscopy, patients with a high PI (>60°) exhibited inferior PROMs, rates of achieving clinically meaningful thresholds, and satisfaction at 12 and 24 months relative to patients with low or moderate PI. Conversely, the outcomes of patients with low PI (<45°) were found to match the trajectory of those with a neutral spinopelvic alignment (45°≤ PI ≤ 60°). These findings highlight the importance of analyzing spinopelvic parameters preoperatively to prognosticate outcomes before hip arthroscopy for acetabular labral tears and FAI. [ABSTRACT FROM AUTHOR]

Multiple imputation (MI) is one of the recommended techniques for handling missing data in ordinal factor analysis models. However, methods for computing MI-based fit indices under ordinal factor analysis models have yet to be developed. In this short note, we introduced the methods of using the standardized root mean squared residual (SRMR) and the root mean square error of approximation (RMSEA) to assess the fit of ordinal factor analysis models with multiply imputed data. Specifically, we described the procedure for computing the MI-based sample estimates and constructing the confidence intervals. Simulation results showed that the proposed methods could yield sufficiently accurate point and interval estimates for both SRMR and RMSEA, especially in conditions with larger sample sizes, less missing data, more response categories, and higher degrees of misfit. Based on the findings, implications and recommendations were discussed. [ABSTRACT FROM AUTHOR]

Background: Aortic aneurysms represent a chronic degenerative disease with life-threatening implications. In order for patients to comprehend health related information, it must be written at a level that can be readily understood. Study Design: In January 2023, we searched "aneurisma aorta" and "endoprótesis aorta" terms on Google, Yahoo and Microsoft/Bing. The 31th websites provided by each search engine were analyzed. Four readability measures were used to evaluate websites regarding aortic aneurysm and their endovascular treatment in Spanish language: Flesch Index, Flesch-Szigriszt Index, Fernández-Huerta Index and grading Inflesz scale. The quality on information was evaluated by the HONcode seal, the DISCERN instrument and the JAMA benchmark criteria. Results: 180 websites containing the terms "aneurisma aorta" and "endoprótesis aorta" were analyzed. Among the websites retrieved, the mean Flesh index score (53.12 ± 6.09 and 47.48 ± 7.12, respectively; P =.019), the Flesch-Szigriszt index (56.39 ± 5.72 and 48.10 ± 8.33; P =.000), and the Fernández Huerta index (61.30 ± 5.59 and 53.19 ± 8.21; P =.000), corresponding to a "somewhat difficult" readability level. In addition, the Inflesz scale (2.62 ±.59 and 2.07 ±.61; P =.000) reported a "somewhat difficult" readability, higher for the websites regarding aortic aneurysm. The HONcode seal was only presented in websites regarding aortic aneurysm (16.7%), whereas none of the websites relating to aortic endoprostheses presented it (0%) (P =.000). Websites that presented the HONcode seal obtained higher DISCERN score (P =.000, 95% CI = 6.42-16.84) and JAMA score (P =.000, 95% CI = 3.44-11.32). Conclusion: Internet information on aortic aneurysms and aortic endoprostheses is too difficult to read for the general Spanish-speaking population and is lacking in quality. [ABSTRACT FROM AUTHOR]

Background: In baseball, youth athletes play on smaller fields with shorter distances between bases, shorter pitching distances, and smaller mounds. Despite this, youth athletes use baseballs weighing the same amount as those used at the professional level, possibly predisposing youth baseball players to injuries. Purpose: (1) To determine the effects of throwing a smaller, lighter, and both smaller and lighter baseball on throwing arm stress in youth athletes and (2) to also investigate how changing the ball size and weight would affect elbow varus torque, shoulder distraction force, and throwing arm internal rotation velocity during the throwing motion. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This cross-sectional cohort study analyzed the kinematics and kinetics of 38 youth baseball players (mean age, 8.3 ± 0.8 years) throwing a baseball modified in size and weight. Three-dimensional motion data were collected using a retroreflective marker set and a 12-camera motion analysis system. Full-body kinematics and kinetics were calculated using commercial software. Participants threw 5 different types of baseballs 3 times each, in random order, with full effort from a pitching mound to a target 14 m away. The balls used were a 5-oz regular baseball, 5-oz (0.142-kg) baseball with a 5% reduced circumference, 4-oz (0.113-kg) baseball, 4-oz baseball with a 5% reduced circumference, and 3-oz (0.085-kg) baseball. Analysis of variance was used to determine statistical differences in elbow varus torque, shoulder distraction force, and throwing arm internal rotation velocity among baseball types. The Tukey post hoc test was used to further investigate differences between the ball groups, considering P <.05 to be significant. Results: Analysis of variance detected a significant difference in elbow varus torque among ball groups (P =.024). The Tukey post hoc test revealed a moderate difference in elbow varus torque between the 5-oz baseball (4.73 ± 1.06 percentage body weight × height [%BW × H]) and 3-oz baseball (4.06 ± 0.83 %BW × H) (P =.017; d = 0.677 [95% CI, 0.08-1.27]). No significant differences were found in shoulder distraction force or throwing arm internal rotation velocity among ball groups. Conclusion: Compared with a 5-oz baseball, throwing a 3-oz baseball resulted in decreased elbow varus torque with a moderate effect size. [ABSTRACT FROM AUTHOR]

Background: Loneliness has a significant impact on the physical and psychological well-being of patients with cancer. However, the specific factors contributing to loneliness among patients with cancer within the context of Chinese culture remain poorly understood. Objective: The objective of this study was to identify the factors associated with loneliness among patients with cancer in China. Methods: A cross-sectional study was conducted using convenience sampling, involving a sample of 205 patients with cancer from a tertiary hospital in Guangzhou, China. Participants completed several validated questionnaires, including the Cancer Loneliness Scale (CLS), Hospital Anxiety and Depression Scale (HADS), Cancer-Related Negative Social Expectations Scale (C-rNSES), and Social Support Rating Scale (SSRS). Multiple linear stepwise regression analysis was employed to explore the relationships between loneliness and psychosocial factors. Results: The median score for loneliness among patients with cancer was 13, with an interquartile range of 8. The multiple linear stepwise regression analysis revealed that negative social expectations, social support, and depression were significantly associated with loneliness in this population. Collectively, these factors accounted for 50.1% (R 2 =.501) of the variance in loneliness. Conclusions: The findings of this study highlight the importance of addressing negative social expectations and depression and improving social support to prevent or reduce loneliness among patients with cancer. Health care providers should consider these factors when developing interventions aimed at preventing or alleviating loneliness in this population. [ABSTRACT FROM AUTHOR]

Child maltreatment (CM) is a major global public health issue, and a strong association exists between CM and aggression. However, the underlying mechanism of this association has not been understood to date. The objective of this study was to explore the mediating role of irritability in the association between CM and aggression in Chinese early adolescents. A cross-sectional study was conducted using a self-report questionnaire to evaluate the levels of CM, aggression, and irritability in 5,724 middle school students from the Anhui Province, China. Structural equation modeling was used to test the hypothesis of the mediating effect of irritability on the relationship between CM and aggression. We further investigated gender differences in this association using multiple group analyses. CM was positively related to both irritability and aggression, and irritability was positively associated with aggression (p <.01). The mediating effects of irritability between CM and aggression were significant (β =.107, 95% confidence intervals [CI]: 0.077–0.133, p <.05). Males had a higher indirect effect size of the pathway from CM to aggression via irritability compared with females. Overall, irritability was a crucial mediator in the relationship between CM and aggression in Chinese adolescents, and males were more prone to engage in aggression compared with females through the pathway of irritability. Therefore, early irritability characteristics should be carefully monitored in adolescents, and they should be provided adequate support to acquire critical emotion regulation skills. [ABSTRACT FROM AUTHOR]

Background: Impaired quadriceps muscle strength after anterior cruciate ligament reconstruction (ACLR) is associated with worse clinical outcomes and a risk of reinjuries. Yet, we know little about quadriceps muscle strength in patients reconstructed with a quadriceps tendon (QT) graft, which is increasing in popularity worldwide. Purpose: To describe and compare isokinetic quadriceps strength in patients undergoing ACLR with a QT, hamstring tendon (HT), or bone–patellar tendon–bone (BPTB) autograft. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We included patients with QT grafts (n = 104) and matched them to patients with HT (n = 104) and BPTB (n = 104) grafts based on age, sex, and associated meniscal surgery. Data were collected through clinical strength testing at a mean of 7 ± 1 months postoperatively. Isokinetic strength was measured at 90 deg/s, and quadriceps strength was expressed as the limb symmetry index (LSI) for peak torque, total work, torque at 30° of knee flexion, and time to peak torque. Results: Patients with QT grafts had the most impaired isokinetic quadriceps strength, with the LSI ranging between 67.5% and 75.1%, followed by those with BPTB grafts (74.4%-81.5%) and HT grafts (84.0%-89.0%). Patients with QT grafts had a significantly lower LSI for all variables compared with patients with HT grafts (mean difference: peak torque: −17.4% [95% CI, −21.7 to −13.2], P <.001; total work: −15.9% [95% CI, −20.6 to −11.1], P <.001; torque at 30° of knee flexion: −8.8% [95% CI, −14.7 to −2.9], P =.001; time to peak torque: −17.7% [95% CI, −25.8 to −9.6], P <.001). Compared with patients with BPTB grafts, patients with QT grafts had a significantly lower LSI for all variables (mean difference: peak torque: −6.9% [95% CI, −11.2 to −2.7], P <.001; total work: −7.7% [95% CI, −12.4 to −2.9], P <.001; torque at 30° of knee flexion: −6.3% [95% CI, −12.2 to −0.5], P =.03; time to peak torque: −8.8% [95% CI, −16.9 to −0.7], P =.03). None of the graft groups reached a mean LSI of >90% for peak torque (QT: 67.5% [95% CI, 64.8-70.1]; HT: 84.9% [95% CI, 82.4-87.4]; BPTB: 74.4% [95% CI, 72.0-76.9]). Conclusion: At 7 months after ACLR, patients with QT grafts had significantly worse isokinetic quadriceps strength than patients with HT and BPTB grafts. None of the 3 graft groups reached a mean LSI of >90% in quadriceps strength. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) disease activity, associated comorbidities, and therapy-related side effects impair the physical, social, and emotional dimensions of the patient's health. Presently, the ongoing COVID-19 pandemic has been associated with a broad range of psychosocial disorders in various populations. Patients with RA are especially vulnerable to such effects. Objectives: Detect the prevalence of recent COVID-19 infection among patients with RA, assess depression and anxiety in these patients and their associated factors during the COVID-19 pandemic and their potential relation to disease activity. Design and Methods: This is a cross-sectional study conducted on 120 adult Egyptian patients diagnosed with RA during the COVID-19 pandemic. The prevalence of recent COVID-19 infection among the patients was evaluated. The patients underwent psychological assessment using the Hamilton Depression Rating Scale (Ham-D) and the Hamilton Anxiety Rating Scale (Ham-A) to measure levels of depression and anxiety levels. The RA disease activity was assessed using Disease Activity Score (DAS) Das-28-ESR. Results: This study encompasses a total of 120 RA patients. The prevalence of patients with a recent history of COVID-19 infection was 40.8%. Both groups exhibited significantly elevated mean scores on the Das-28-ESR scale and also scored higher on measures of depression and anxiety. Interestingly, the COVID-19 group exhibited a higher percentage of unmarried individuals, had educational attainment below the university level, and were unemployed. Patients with recent COVID-19 had significantly lower numbers of children, higher disease duration, higher Das-28-ESR scores, and elevated depression and anxiety scores. The statistical analysis revealed that the COVID-19 infection and disease duration were significant predictors of depression and anxiety. The results also exhibited that the depression score was positively correlated with age and DAS scores. Conclusions: It was observed that patients diagnosed with RA revealed a higher prevalence of COVID-19 infection. The occurrence of depression and anxiety was observed to be widespread among patients diagnosed with RA and, more significantly, prevalent in RA patients who had a recent COVID-19 and had a higher level of disease activity. The occurrence of COVID-19 and disease duration were identified as factors that can anticipate the development of depression and anxiety. [ABSTRACT FROM AUTHOR]

Objectives: Childhood trauma is common and associated with mental ill health. While high rates of trauma are observed across individual disorders, there is evidence that trauma is associated with an admixture of affective, anxiety and psychotic symptoms in adults. Given that early onset of mental disorder and trauma exposure herald poor outcomes, it is important to examine trauma prevalence rates in youth mental health services and to determine whether this trauma-related clustering is present in help-seeking young people. Methods: We used data from the Transitions Study, a longitudinal investigation of young people attending headspace youth mental health services in Australia between January 2011 and August 2012. Participants were 775 young people aged 12–25. Childhood trauma was assessed using the Childhood Trauma Questionnaire. Multinomial regression was used to assess whether reported childhood trauma was more strongly associated with the co-occurrence of depression, anxiety, mania and psychosis symptoms than with any one in isolation. Results: Approximately 84% of participants reported some form of abuse (emotional: 68%; physical: 32%; sexual: 22%) or neglect (emotional: 65%; physical: 46%). Exposure to multiple trauma types was common. Childhood trauma was significantly associated with each symptom domain. More severe childhood trauma was more strongly associated with the co-occurrence of symptoms than with any one symptom domain in isolation, such that more severely trauma-exposed young people were more likely to experience increased symptom clustering. Conclusions: Childhood trauma is pervasive in youth mental health services and associated with a symptom profile that cuts across traditional diagnostic boundaries. [ABSTRACT FROM AUTHOR]

Objectives: The Nasal Polyposis Symptom Diary (NPSD) is a novel and short patient-reported outcome (PRO) tool specifically developed to assess important and relevant symptoms reported by patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). We evaluated the psychometric properties of 4 predefined NPSD-derived scores intended to support symptom-improvement assessments of investigational therapies for inclusion in product labeling. Methods: Five hundred eighteen patients with severe CRSwNP from a Phase III clinical trial (NCT03401229) completed the NPSD, comprising 11 items: 8 symptom-specific, 2 symptom-impact, and 1 optional medication-compliance. The psychometric characteristics of 3 single-item symptom scores (Nasal Blockage Score [NBS], Nasal Congestion Score [NCS], and Difficulty with Sense of Smell Score [DSS]) and a Total Symptom Score (TSS, summary of the 8 symptom-specific items) were evaluated for reliability, validity, and ability to detect change. Within-patient meaningful change thresholds (MCTs) were established using anchor- and distribution-based methods. Comparative PROs included the 22-item Sino-Nasal Outcome Test (SNOT-22) and Patient Global Impression of Severity (PGI-S). Results: The TSS exhibited strong internal consistency (Cronbach α =.88) and test-retest reliability (intraclass correlation coefficient >.80). Correlation between the TSS and SNOT-22 total score indicated good convergent validity (r =.70). All 4 NPSD scores demonstrated known-groups validity (significant differences among subgroups of patients with predetermined disease severity levels based on PGI-S categories) and were sensitive to detect change in patients' clinical status (significant differences among subgroups of patients with reported changes between 2 time-points in PGI-S and Patient Global Impression of Change scores). MCTs for improvement were established at 1.0 point for NBS, NCS, and DSS, and 4.0 points for TSS. Conclusion: These findings support the reliability, validity, and suitability of the 4 NPSD-derived scores for evaluating treatment effect on CRSwNP symptoms and their use in clinical trials with predetermined MCTs for improvement. [ABSTRACT FROM AUTHOR]

Background: Biomechanical studies have shown that an increased medial posterior tibial slope (MPTS) may affect anteroposterior knee laxity and tibial shear forces, ultimately increasing the risk for graft failure after anterior cruciate ligament (ACL) reconstruction. Previous clinical studies have, however, reported inconclusive results. Purpose: The purpose of this study was to evaluate the relationship between the MPTS and graft failure as well as functional outcomes after anatomic primary isolated ACL reconstruction using a hamstring tendon autograft. It was hypothesized that an increased MPTS would be associated with a higher ACL graft failure rate. Furthermore, a higher MPTS would negatively correlate with functional outcomes in patients without ACL graft failure. Study Design: Case-control study; Level of evidence, 3. Methods: Consecutive patients who underwent isolated primary ACL reconstruction with an anteromedial portal drilling technique between January 2011 and December 2019 were retrospectively reviewed. The MPTS was measured on preoperative lateral knee radiographs. At a minimum of 24 months postoperatively, the ACL graft failure rate and patient-reported outcome measures (PROM; International Knee Documentation Committee subjective knee form, Lysholm score, Tegner Activity Scale, visual analog scale for pain and subjective instability) were evaluated. Differences in the MPTS between patients with and without ACL graft failure as well as the frequency of graft failure between those with an MPTS <12° and those with an MPTS ≥12° were assessed for statistical significance. Binary logistic regression analysis was performed to stratify the risk of graft failure with the following variables: MPTS, age at surgery, and sex. Correlation analysis was performed to evaluate the relationship between the MPTS and PROM in patients without ACL graft failure. Results: In total, 326 patients were included (median follow-up, 71.0 months [IQR, 49.0-104.0 months]). There was no significant difference in the MPTS between patients with and without graft failure (10.6°± 3.2° vs 11.2°± 2.8°, respectively; P =.264). Additionally, there was no significant difference in the frequency of graft failure between patients with an MPTS <12° and those with an MPTS ≥12° (15.6% vs 16.5%, respectively; P =.835). Binary logistic regression showed that younger age at the time of surgery (odds ratio, 1.069 [95% CI, 1.031-1.109]) was associated with graft failure; sex and MPTS were not associated with graft failure. In patients without ACL graft failure, there was no significant correlation between the MPTS and PROM. Conclusion: In patients who underwent anatomic primary isolated ACL reconstruction, an increased MPTS was not associated with a higher rate of graft failure or inferior functional outcomes. Younger age was a significant nonmodifiable risk factor for ACL graft failure. [ABSTRACT FROM AUTHOR]

Background: Anterior cruciate ligament (ACL) injury increases risks for osteoarthritis (OA), a poorly modifiable and disabling condition. Joint changes of potentially reversible pre-OA have been described just 2 years after ACL reconstruction (ACLR) when early bone shape changes have also been reported. Purpose: This study evaluates relationships between interlimb differences in tibiofemoral bone shape derived from statistical shape modeling (SSM) of magnetic resonance imaging (MRI) and participant factors on patient-reported outcomes 2 years after unilateral ACLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: SSM-derived tibiofemoral bone shape and subchondral bone area were assessed from bilateral knee MRI scans of 72 participants with unilateral ACLR (mean age, 34 ± 11 years; 32 women) and compared with a reference cohort of 398 older individuals without OA (mean age, 50 ± 3 years; 213 women). Multivariable logistic regression models examined relationships between participant and surgical factors with interlimb differences in bone shapes or subchondral bone areas. Relationships between patient-reported outcomes and the interlimb differences in bone shape and subchondral area were examined using similar models. Results: Bone shape scores and subchondral bone areas were greater (more OA-like) in ACLR knees than uninjured contralateral knees in every bone metric tested (P ≤.001). Interlimb differences in femur shape scores of participants with ACLR were 65% greater (P <.001) than those of the significantly older reference cohort. Taller height, medial meniscal tears, and decreasing age were associated with larger interlimb differences in shape scores and subchondral areas (P <.05). Bone–patellar tendon–bone (BPTB) autograft recipients demonstrated greater interlimb subchondral area differences compared with allograft recipients (P <.05). Interlimb differences for hamstring autograft recipients did not differ from those with BPTB or allograft. Greater interlimb differences in medial femur subchondral areas were associated with worse patient-reported Knee injury and Osteoarthritis Outcome Score Symptoms (R = 0.27; P =.040). Conclusion: Even in the absence of radiographic OA, just 2 years after unilateral ACLR patients showed greater bone shape scores and subchondral areas consistent with pre-OA in their ACLR knees. Furthermore, greater medial femur bone areas were weakly associated with worse symptoms. Patients who are younger, are taller, have meniscal tears, or have BPTB grafts may be at increased risk for bony asymmetries 2 years after ACLR. [ABSTRACT FROM AUTHOR]

Background: Young baseball players with medial elbow injuries are known to have high forearm flexor-pronator muscle elasticity; however, the causal relationship between forearm muscle elasticity and the occurrence of medial elbow injuries remains unclear. Purpose/Hypothesis: The purpose of this study was to determine whether the forearm flexor-pronator muscle elasticity is a risk factor for medial elbow injury in young baseball players. It was hypothesized that high flexor carpi ulnaris (FCU) elasticity would be a risk factor for medial elbow injuries. Study Design: Cohort study; Level of evidence, 2. Methods: Young baseball players (aged 9-12 years) with no history of elbow injuries underwent examination during which the strain ratios (SRs) of the pronator teres, flexor digitorum superficialis, and FCU muscles were measured using ultrasound strain elastography as an index of elasticity. Additionally, the participants completed a questionnaire assessing age, height, weight, months of experience as a baseball player, position in baseball, number of training days per week, number of throws per day, and elbow pain during throwing; then the range of motion of the shoulder and hip internal/external rotation were measured. One year after the baseline measurements, the occurrence of new medial elbow injuries was evaluated. Multivariate logistic regression analysis was subsequently conducted to determine risk factors for medial elbow injuries. Cutoff points for significant SR values obtained from the multivariate logistic regression analysis were calculated using the receiver operating characteristic curve. Results: Of the 314 players, 76 (24.2%) were diagnosed with medial elbow injury. Multivariate logistic regression analysis showed that a 0.1 increase in the SR of the FCU muscle (odds ratio [OR], 1.211; 95% CI, 1.116-1.314) and number of throws per day (OR, 1.012; 95% CI, 1.001-1.022) were significantly associated with medial elbow injuries. Receiver operating characteristic curve analyses revealed that the optimal cutoff for the SR of the FCU muscle was 0.920 (area under the curve, 0.694; sensitivity, 75.0%; specificity, 56.7%). Conclusion: Increased FCU elasticity is a risk factor for medial elbow injury. Evaluation of the FCU elasticity may be useful in identifying young baseball players at high risk of medial elbow injuries and may facilitate prevention of medial elbow injury. As shown by the results of multivariate logistic regression analysis, FCU elasticity itself may be useful in identifying young baseball players at high risk of elbow injuries. However, we believe that other factors, such as the number of pitches per day, need to be considered to improve its accuracy. [ABSTRACT FROM AUTHOR]

Background: Physical tests are commonly used in patellar tendinopathy to aid the clinical diagnosis, assess the prognosis, and monitor treatment. However, it is still unknown whether these physical measures are associated with patient-reported outcomes after exercise therapy. Purpose: To identify the prognostic value of baseline physical test results and to determine the association between physical response after exercise therapy and clinical improvement over 24 weeks. Study Design: Case-control study; Level of evidence, 3. Methods: This study recruited 76 consecutive athletes with patellar tendinopathy who were randomized to 2 different programs of exercise therapy for 24 weeks. Athletes underwent a range of physical tests before and during exercise therapy (12 and 24 weeks), including isometric muscle strength (quadriceps and hip abductors), muscle flexibility (quadriceps, hamstrings, soleus, and gastrocnemius), vertical jump height, and visual analog scale (VAS) scores by palpation, after 3 jump trials, and after single-leg squat (VAS-SLS). The Victorian Institute of Sports Assessment–Patella (VISA-P) questionnaire was used as the primary patient-reported outcome. Linear mixed-effect models were used to assess the prognostic value of baseline physical tests. The change in VISA-P score was further dichotomized into clinical responsiveness (≥14 points) and nonresponsiveness (<14 points). Multiple linear and logistic regression models were performed to evaluate associations between physical response and clinical improvement. Results: Of the 76 included patients, 67 (88%) had complete follow-ups. The estimated mean VISA-P score increased by 23 points (95% CI, 19-28 points) after 24 weeks. No association was found between any baseline physical test results and a 24-week change in VISA-P score (all P interaction >.2, using the likelihood ratio test). Improvement in VAS-SLS after exercise therapy was not associated with VISA-P improvement after adjustment (β = −1.76; P =.01; Bonferroni-corrected P =.10; R 2 = 36.3%). No associations were found between changes in other physical test results and clinical improvement (all P >.05). Conclusion: In patients with patellar tendinopathy, physical test results including strength and flexibility in the lower limb, jump performance, and pain levels during pain-provoking tests were not identified as prognostic factors for patient-reported outcomes after exercise therapy. Similarly, changes in physical test results were not associated with changes in patient-reported outcomes after adjustments. These results do not support using physical test results to estimate prognosis or monitor treatment response. Registration: NCT02938143 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

An abbreviated version of the Conformity to Masculine Norms Inventory, the CMNI-30, was developed with several strengths. However, its measurement invariance across men with different sexual orientations has not been examined in a U.S. sample, so it is unclear whether these different populations understand the items similarly. In addition, no studies have compared conformity to masculinity norms across sexual orientations. This would be important to understand sexual minority men's experience of masculinity and how it differs from heteronormative masculinity. This article explores the measurement invariance of the CMNI-30 among 882 heterosexual, gay, and bisexual+ men using confirmatory factor analysis, and compares their CMNI-30 subscale scores. Results indicated that the CMNI-30 demonstrated residual invariance between men of different sexual orientations, suggesting that men of different sexual orientations interpreted the items similarly. We also found higher levels of conformity to the masculine norms of Winning, Heterosexual self-presentation, and Power over women among heterosexual men relative to gay and bisexual+ men, and higher levels of Pursuit of status among gay men relative to the other groups. Results provide support for the use of the CMNI-30 in research with men of different sexual orientations. [ABSTRACT FROM AUTHOR]

Engaging adolescent males is a promising violence prevention strategy. This study explored primary versus secondary prevention effects of a gender-transformative program (i.e., Manhood 2.0) versus job-readiness training on multiple forms of violence perpetration. Adolescent males, ages 13 to 19 years, were recruited through youth-serving organizations in Pittsburgh, PA, between July 27, 2015, and June 5, 2017, to participate in an unblinded community-based cluster-randomized trial in 20 neighborhoods. The intervention curriculum, Manhood 2.0, focused on challenging norms that foster gender-based violence and building bystander skills. The control program was job-readiness training. We completed a planned secondary analysis of surveys from baseline and 9 months post intervention (follow-up), wherein we stratified participants based on any sexual violence/adolescent relationship abuse (SV/ARA) at baseline and examined risk of perpetration of SV/ARA, incapacitated sex, sexual harassment, cyber sexual abuse, peer violence, bullying, and homophobic teasing at follow-up. Among 866 participants, mean age was 15.6 years, 70% identified as Black, 6% as Hispanic, and 6% as multiracial. In both the Manhood 2.0 intervention group and job-readiness control groups, youth who reported SV/ARA at baseline were significantly more likely to report any form of SV/ARA, incapacitated sex, sexual harassment, cyber sexual abuse, bullying, and homophobic teasing at follow-up. Among participants who reported no SV/ARA perpetration at baseline, participating in the Manhood 2.0 intervention program was associated with increased risk of SV/ARA at follow-up compared to participating in the job-readiness control program. Among participants who reported SV/ARA perpetration at baseline, participating in the Manhood 2.0 intervention group was associated with lower risk of peer violence at follow-up. Synergizing gender-transformative approaches with job-readiness training may offer opportunities for crosscutting prevention programming to address multiple forms of violence. [ABSTRACT FROM AUTHOR]

Violence against women is considered as one of the most serious social problems in all the societies. It is common that the abused women experience physical, psychological, and health problems, as well as reproductive health issues. Domestic violence affects women's health behaviors and ability to seek any form of health care. This study aimed to investigate the relationship between health-promoting behaviors and reproductive health needs in women experienced domestic violence. This cross-sectional study was conducted from May 5 to September 21, 2021, on 380 abused women. Cluster sampling was performed in health centers of Karaj. Data were collected using demographic survey questions, Domestic Violence Survey, Reproductive Health Needs of Domestic Violated Women scale, and health-promoting behaviors questionnaire. The mean (standard deviation) scores for reproductive health needs and health-promoting behaviors were 158.88 (20.24) and 131.08 (20.53), respectively. Psychological violence had the highest (69.5%) prevalence among all types and 37.6% of women reported severe violence. The results of Spearman's rank correlation coefficient test indicated that all dimensions of the reproductive health needs of abused women (men's participation, self-care, support and health services, and sexual and marital relationships) positively and significantly related to the total score and various dimensions of health-promoting behaviors (interpersonal relationship, health responsibility, physical activity, spiritual growth, nutrition, and stress management). The dimensions of health-promoting behaviors together can explain 21.6% of the changes in reproductive health needs based on linear regression. Violence is a global public concern and paying attention to the various health dimensions in abused women is an important aspect of the health policies. Developing health-promoting behaviors in abused women improves their reproductive health state and society as a whole. [ABSTRACT FROM AUTHOR]

Background: The influence of bony morphology on the development of posterior shoulder instability is not well known. Purpose: To determine if acromial morphology, as measured on magnetic resonance imaging (MRI), is associated with posterior or anterior shoulder instability. Design: Cross-sectional study; Level of evidence, 3. Methods: MRI measurements of posterior acromial coverage (PAC), posterior acromial height (PAH), posterior acromial tilt (PAT), and anterior acromial coverage (AAC) were completed for 3 separate matched groups who underwent surgical intervention: posterior instability, anterior instability, and a comparison group of patients who underwent arthroscopic surgery for snapping scapula. Inclusion criteria were patients with recurrent instability <40 years of age without multidirectional instability, glenoid bone loss >13.5%, or glenoid retroversion >10%. Results: Overall, 37 patients were included in each group. PAC was significantly less in the posterior instability group than in the anterior instability and comparison groups (68.3° vs 88.7° vs 81.7°; P <.001). PAH was significantly greater in the posterior group than in the anterior instability group (11.0 mm vs −0.1 mm; P <.001) and comparison group (0.7 mm; P <.001). There was no difference between the posterior and anterior groups in terms of PAT or AAC (P =.45 and P =.05, respectively). PAT was significantly smaller in the posterior instability group than the comparison group (55.2° vs 62.2°; P =.026). The anterior and comparison groups were not significantly different in PAH or PAT (P =.874 and P =.067, respectively) but were significantly different in AAC (P =.026). Conclusion: A higher and flatter posterior acromion, as measured on preoperative MRI, appears to be associated with patients who require arthroscopic capsulolabral repair due to posterior shoulder instability. This information may help clinicians to both diagnose and predict the need for operative intervention for patients with posterior labral tears. [ABSTRACT FROM AUTHOR]

Background: Sports function and psychological readiness to return to sports (RTS) are important outcomes when evaluating rehabilitation after anterior cruciate ligament reconstruction (ACLR). It is, however, unclear which specific factors contribute most to these outcomes. Purpose: To determine associations between demographic characteristics, objective measurements of physical function, patient-reported outcome measure scores, sports-related function assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) Sport and Recreation subscale, and psychological readiness to RTS assessed with the Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale at 1 year after ACLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: At a mean of 12.5 ± 2.0 months after ACLR, 143 participants (50.3% female), with a mean age of 25.0 ± 5.7 years, were assessed for demographic characteristics, physical factors (hop performance, muscle strength, ankle and hip range of motion), and psychological factors (KOOS Pain and Symptoms subscales, Perceived Stress Scale, fear of reinjury) as well as the KOOS Sport and Recreation subscale and ACL-RSI scale. Backward linear regression models were used to evaluate factors associated with sports function and psychological readiness to RTS. Results: Lower isokinetic knee extension peak torque (limb symmetry index) (B = 18.38 [95% CI, 3.01-33.75]), lower preinjury activity level (B = 2.00 [95% CI, 0.87-3.14]), greater knee pain (B = 0.90 [95% CI, 0.70-1.10]), shorter time between injury and reconstruction (B = 0.16 [95% CI, 0.05-0.26]), and greater fear of reinjury (B = 0.11 [95% CI, 0.01-0.20]) were associated with a worse KOOS Sport and Recreation subscore (R 2 = 0.683). A shorter hop distance (B = 0.15 [95% CI, 0.00-0.29]) was associated with a lower ACL-RSI score (R 2 = 0.245). Conclusion: A combination of knee muscle strength, activity level, knee pain, timing of surgery, and fear of reinjury accounted for approximately 70% of the variation in sports function at 1 year after ACLR. In contrast, there was only 1 weak association between physical function and psychological readiness to RTS at this time point. Thus, factors associated with current sports function are much better known than features related to psychological readiness to RTS. [ABSTRACT FROM AUTHOR]

Stigmas and taboos surrounding male sexual violence, stating that men cannot be sexually victimized and would not experience many adverse effects as a result, continue to shroud the issue of male sexual victimization (SV). Male victims, therefore, remain under-recognized in research, policy, and treatment provisions. Furthermore, knowledge regarding male SV is severely compromised by studying male victims in convenience samples with a focus on hands-on forms of sexual violence. Finally, severity of SV is often described using a one-dimensional approach based on presumed severity leading to an oversimplified image. This study addresses these various gaps in scientific research by constructing severity profiles of male SV based on self-reported consequences, prevalence, and co-occurrence of SV. A total of 1,078 male victims were selected from a Belgian nationally representative sample collected between October 2019 and January 2021. Profiles are constructed using latent class analysis. Sociodemographic differences across the profiles are examined through multinomial regression analysis. Finally, differences in current mental health problems across the profiles are assessed. Four distinct male victim profiles are identified: (a) low severity—low victimization (58.3%), (b) medium severity—hands-off victimization (21.4%), (c) medium severity—poly-victimization (13.3%), and (d) high severity—poly-victimization (7.0%). Group comparisons show how male victims in the high-severity class report significantly higher rates of mental health problems such as depression, anxiety, and suicide and/or self-harm. Significant differences in class membership were found for age, occupational status, relationship status, sexual orientation, and financial status. This study provides new insights in the patterns of male SV and highlights the presence of poly-victimization among male victims. Additionally, we point out how the so-called minor forms of SV (i.e., hands-off SV) can have a large effect on male victims. The study ends with suggestions for care and future research. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the well-being of individuals who had a newborn child during the previous year and to compare their well-being with that of individuals who had children previously and with childless individuals. The sample consisted of 2008 respondents (81% women) who participated in an online survey. Respondents rated their life satisfaction, positive and negative affect, and flourishing in two time points spanning one year. 102 respondents experienced childbirth between the two time points, 673 had children before, and 1233 did not have children. The results show that life satisfaction increased between two time points in the subsample of individuals who had a child during the previous year; they also had higher life satisfaction compared to other parents and non-parents. There was no difference between the groups in affective well-being and flourishing. However, parents who had a newborn child showed a decrease in flourishing. [ABSTRACT FROM AUTHOR]

Introduction: Antibiotic resistance is a public health concern in Nigeria and the world, and healthcare workers contributed to the upsurge of antibiotic resistance in hospital settings. This study focused on the knowledge, attitude, and practice (KAP) of antibiotic use and the frequency of prescriptions of antibiotics from the list of WHO Model Essentials Antibiotics (AWaRe) (in the last 6 months) among healthcare workers and established the determining factors in six hospitals in Niger state, Nigeria. Methodology: A KAP survey was conducted in Niger State, Nigeria, from March to June 2022. A structured self-administered, pretested questionnaire was distributed to six hospitals in the state following a stratified random sampling considering the staff capacity, the population of the city, and patients' patronage. Results: A total of 350 questionnaires distributed, and 313 (89.4%) completed and returned from the six hospitals. The median scores were knowledge (75%), attitude (69%), practice (62%), and self-reported prescription (70%), and respondents with good scores were knowledge [195 (62.3%)], attitude [185 (59.1%)], practice [201 (64.2%)], and prescription [117 (37.4%)]. In multivariate analysis, older respondents are more likely to have a good prescription (p = 0.006), and prior antimicrobial training improved their knowledge (p < 0.001), attitude (p = 0.007), and prescription pattern (p = 0.009). All the study participants had prescribed one or more of the most prescribed antibiotics; Amoxicillin clavulanate (Access group, 96.5%), Amoxicillin (Access group, 95.9%), and Metronidazole (Access group, 95.7%). Conclusions: The study suggests that antibiotic education for healthcare workers and antimicrobial stewardship programs are significant interventions to mitigate antibiotic overuse in the state. [ABSTRACT FROM AUTHOR]

Background: Femoroacetabular impingement (FAI) is a common cause of hip pain, especially in young patients. When left untreated, it has been demonstrated to be a risk factor for the onset or progression of osteoarthritis (OA) and has been identified as one of the main contributors leading to the need for total hip arthroplasty (THA) at a young age. While the short-term therapeutic potential of hip arthroscopy is widely recognized, little is known regarding its potential mid- to long-term preventive effect on the progression of hip OA. Purpose: To (1) report clinical outcomes of arthroscopically treated FAI syndrome with a minimum 5-year follow-up and compare the results to a cohort with FAI treated nonsurgically and (2) determine the influence of hip arthroscopy on the onset and progression of hip OA in patients diagnosed with FAI. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who had hip pain and were diagnosed with FAI were included. Exclusion criteria were (1) previous or concomitant hip surgery, (2) <5 years of follow-up, and (3) insufficient radiographs. Patients treated with hip arthroscopy were compared with a cohort of patients with FAI who were treated nonsurgically. Kaplan-Meier estimates of failure (defined as conversion to THA) were performed. Bivariate analysis and Cox regression were used to identify factors associated with inferior clinical and radiographic outcomes. Results: A total of 957 patients (650 female, 307 male; 1114 hips) (mean age, 28.03 ± 8.9 years [range, 6.5-41.0 years]) with FAI were included. A total of 132 hips underwent hip arthroscopy and 982 hips were nonoperatively treated. The mean follow-up was 12.5 ± 4.7 years (range, 5.0-23.4 years). At the final follow-up, the rate of OA progression was 26.5% in the operative group and 35.2% in the nonoperative cohort (P <.01). Conversion to THA was performed in 6.8% of the surgical patients and 10.5% of the initially nonsurgical patients (P =.19). Additionally, there was no significant difference in the risk of failure between the operatively and nonoperatively treated patients. Male sex, increased age at initial diagnosis, presence of cam morphology, and increased initial Tönnis grade were risk factors for failure (male sex: hazard ratio [HR], 2.3; P <.01; per year of increased age: HR, 1.1; P <.01; presence of cam: HR, 3.5; P <.01; per Tönnis grade: HR, 4.0; P <.01). Conclusion: At a mean follow-up of nearly 13 years, 7% of patients of the surgical group experienced progression to THA, compared with 11% of the nonoperative control group. While most of the operative group showed little to no OA at final follow-up, moderate OA (Tönnis grade 2) was present in 12% of the cohort compared with 22% of nonsurgical patients. Increased age at diagnosis, male sex, presence of a cam morphology, and presence of initial arthritic joint changes were found to be risk factors for failure. The results of this study demonstrated evidence for a preventive effect of hip arthroscopy on the development and progression of OA in young patients with FAI at mid- to long-term follow-up. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of multidirectional elastic tape on pain and function in individuals with lateral elbow tendinopathy. Study Design: Randomised crossover trial. Setting: Biomechanics laboratory. Subjects: 27 participants (11 females, mean (SD) age: 48.6 (11.9) years) with clinically diagnosed lateral elbow tendinopathy of at least six weeks' duration. Interventions: Tensioned multidirectional elastic tape applied over the wrist, compared to control tape (untensioned), and no tape conditions. Main measures: Pain-free grip strength and pressure pain threshold were recorded at three timepoints for each condition: baseline, post-application, and following an exercise circuit. Change scores were calculated as the post-application or post-exercise value minus baseline. Repeated-measure analyses of variance were used to examine differences between conditions. Results: There were no statistically significant differences in pain-free grip strength between conditions (flexed position: F2,52 = 0.02, p = 0.98; extended position: F2,52 = 2.26, p = 0.12) or across timepoints (post-application vs post-exercise) (flexed position: F1,26 = 0.94, p = 0.34; extended position: F1,26 = 0.79, p = 0.38). Seven participants (26%) increased pain-free grip strength above the minimal detectable change following application of multidirectional elastic tape. There were no statistically significant differences in pressure pain threshold between conditions (affected lateral epicondyle: F1.51,39.17 = 0.54, p = 0.54) or across timepoints (affected lateral epicondyle: F1,26 = 0.94, p = 0.34). Conclusion: Tensioned multidirectional elastic tape may not immediately improve pain-free grip strength or pressure pain threshold in our lateral elbow tendinopathy population; however, individual variation may exist. [ABSTRACT FROM AUTHOR]

Acute stent thrombosis (AST) is associated with increased morbidity and mortality. The main aim of this study was to evaluate the prognostic value of the systemic immune-inflammation index (SII) and C-reactive protein (CRP) to albumin ratio (CAR) in predicting AST and high SYNTAX score in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The criteria of the Academic Research Consortium were used to determine definite stent thrombosis. A total of 2077 consecutive patients with ACS undergoing PCI were retrospectively enrolled. Platelet, white blood cell and neutrophil counts, as well as SII, CRP, CAR, and peak cardiac troponin I (cTnI) values were significantly higher, whereas the lymphocyte count and albumin values were significantly lower in the AST (+) group compared with the AST (−) group (P <.05). SYNTAX score showed significant positive correlations with SII (r =.429, P <.001) and CRP (r =.402, P <.001). Multivariate logistic regression analysis showed that SII and CAR, as well as age, diabetes mellitus, stent length, and peak cTnI are independent predictors of AST and high SYNTAX score. In conclusion, the SII and CAR are simple, relatively cheap, and reliable inflammatory biomarkers that can predict AST and high SYNTAX scores in ACS. [ABSTRACT FROM AUTHOR]

Background: Physical fatigue and cognitive performance have been suggested as risk factors for an anterior cruciate ligament (ACL) injury, and fatigue has also been demonstrated to reduce cognitive processing. The combined effects of fatigue and lower cognitive function during cognitive-challenging movements may increase knee mechanics associated with the ACL injury risk. Hypotheses: We hypothesized that (1) knee mechanics would be detrimentally affected by fatigue and associated with baseline cognitive function and (2) fatigue-induced deleterious changes in cognitive performance and knee mechanics would be correlated. Study Design: Descriptive laboratory study. Methods: A total of 22 athletes completed baseline cognitive testing. After performing maximal vertical jumps, they performed a jump-land-jump task based on unanticipated visual cues. Then, they completed a fatigue protocol including countermovement jumps, among other tasks, until the jump height decreased below 90% of their assessed maximum. Immediately after reaching the first fatigue point, they performed another set of jump-landing tasks, followed by repeating the fatigue protocol until the jump height decreased below 85% of their assessed maximum. After reaching the second fatigue point, they performed a final set of jump-landing tasks and repeated the initial cognitive assessment battery. Results: Mixed-effects models revealed that knee flexion decreased through the fatigue protocol (baseline: 61.8°; midpoint: 61.1°; final: 60.1°; P =.003). Stepwise regression showed that fatigue-worsened attentional control corresponded to smaller knee abduction angles (R 2adjusted = 51.68%; βstandardized = 1.16; P =.001), and worse reaction time after fatigue correlated with increased knee abduction angles (βstandardized = 0.85; P =.006) after accounting for the role of attentional control. Conclusion: Fatigue induced incremental modifications in sagittal-plane knee mechanics during an unanticipated sports movement. In addition, fatigue induced changes in cognitive function related to ACL injury–relevant knee mechanics. Clinical Relevance: The novel findings regarding fatigue-dependent changes in injury-relevant biomechanics during cognitively challenging movements represent an extension of recent developments in understanding the role of cognition in the ACL injury risk. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is a chronic, progressive, and degenerative condition with limited therapy options. Recently, biologic therapies have been an evolving option for the management of osteoarthritis. Purpose: To assess whether allogenic mesenchymal stromal cells (MSCs) have the potential to improve functional parameters and induce cartilage regeneration in patients with osteoarthritis. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 146 patients with grade 2 and 3 osteoarthritis were randomized to either an MSC group or placebo group with a ratio of 1:1. There were 73 patients per group who received either a single intra-articular injection of bone marrow–derived MSCs (BMMSCs; 25 million cells) or placebo, followed by 20 mg per 2 mL of hyaluronic acid under ultrasound guidance. The primary endpoint was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score. The secondary endpoints were WOMAC subscores for pain, stiffness, and physical function; the visual analog scale score for pain; and magnetic resonance imaging findings using T2 mapping and cartilage volume. Results: Overall, 65 patients from the BMMSC group and 68 patients from the placebo group completed 12-month follow-up. The BMMSC group showed significant improvements in the WOMAC total score compared with the placebo group at 6 and 12 months (percentage change: −23.64% [95% CI, −32.88 to −14.40] at 6 months and −45.60% [95% CI, −55.97 to −35.23] at 12 months P <.001; percentage change, −44.3%). BMMSCs significantly improved WOMAC pain, stiffness, and physical function subscores as well as visual analog scale scores at 6 and 12 months (P <.001). T2 mapping showed that there was no worsening of deep cartilage in the medial femorotibial compartment of the knee in the BMMSC group at 12-month follow-up, whereas in the placebo group, there was significant and gradual worsening of cartilage (P <.001). Cartilage volume did not change significantly in the BMMSC group. There were 5 adverse events that were possibly/probably related to the study drug and consisted of injection-site swelling and pain, which improved within a few days. Conclusion: In this small randomized trial, BMMSCs proved to be safe and effective for the treatment of grade 2 and 3 osteoarthritis. The intervention was simple and easy to administer, provided sustained relief of pain and stiffness, improved physical function, and prevented worsening of cartilage quality for ≥12 months. Registration: CTRI/2018/09/015785 (National Institutes of Health and Clinical Trials Registry–India). [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is an extensive public health concern, largely affecting women aged 20 to 24 years. Research suggests that bisexual women are more likely than heterosexual and homosexual women to be victims of IPV. Bisexual women are also more likely to be blamed for their abuse experiences after disclosing, a phenomenon known as victim blame attribution (VBA). However, very little VBA research recognizes bisexuality as a separate category. Therefore, the main aim of this quasi-experimental study was to investigate the role of female victim sexuality (bisexuality, homosexuality, and heterosexuality) and observer sex in the attribution of blame to the victim and perpetrator of IPV. Participants (N = 232; aged 18–24 years, M = 21.05, SD = 1.73) were randomly assigned into one of four conditions (heterosexual victim, bisexual victim with same-sex partner, bisexual victim with different-sex partner, homosexual victim), each containing a vignette portraying IPV within a relationship. Randomization checks were performed to ensure that participants in the four conditions did not differ significantly on underlying attitudes (institutional heterosexism (IH), aversive heterosexism (AH), heterosexual privilege (HP), sexist attitudes, just world beliefs) that may have affected their responses on outcome measures. Main analyses demonstrated that bisexual victims with a same-sex partner received the highest attribution of blame, whereas perpetrators in this condition received the lowest blame attribution. Male participants attributed significantly higher blame to victims than did female participants, regardless of victim sexuality. These findings substantiate the role of victim sexuality and observer sex in IPV blame attribution patterns. This research aimed to promote equality and rightful treatment to all victims of IPV regardless of their sexuality. [ABSTRACT FROM AUTHOR]

Background: Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce. Aim/Objective: The aim of the present study was to compare outcomes between oncological patients and the general population with Clostridioides difficile infection (CDI) after 90 days of follow-up. Methods: A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case. Findings/results: The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08–2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, p = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% p = 0.04). Discussion: Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence [ABSTRACT FROM AUTHOR]

Objectives: We aimed to elucidate whether lower limb extra-fascial compartment and muscle areas affect the calf muscle pumping action on lower limbs. Method: This study included 90 patients (180 limbs) who underwent preoperative air plethysmography (APG) and preoperative non-contrast computed tomography (CT) of the lower limbs for diagnosis of unilateral or bilateral primary varicose veins. A correlation between cross-sectional CT images and preoperative APG was confirmed. Cross-sectional CT was used to measure the extra-fascial compartment and muscle areas of the calf. The lower limbs were divided into two groups: those that were normal and those with primary varicose veins. Results: The extra-fascial compartment area was significantly correlated with the ejection fraction in normal (r = 0.388, n = 53, p = 0.004) and varicose limbs (r = 0.232, n = 91, p = 0.027). Conclusions: In normal and varicose limbs, evaluation of ejection fraction, an indicator of muscle pumping, requires consideration of the extra-fascial compartment area. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) women are among the many victims killed by intimate partner homicide (IPH) each year, though the differences between different SGM groups (and how these groups compare to non-SGM IPH) have not been well established. The objective of this article was to identify practicable, correlated risk factors of IPH of SGM women that may have utility in prevention of future IPH among these populations in the U.S. Homicide data from the National Violent Death Reporting System spanning 2003 to 2017 were used to identify a profile of IPH specific to SGM women compared to women who were neither sexual nor gender minorities. Situational and individual characteristics significantly differentiated sexual minority (SM) women from non-SGM women victims of IPH, including substance abuse history (adjusted odds ratio [AOR] = 4.80 [2.42, 9.51]), having themselves used a weapon during the incident (AOR = 3.63 [1.44, 9.16]), and the type of weapon(s) used, such as firearms (AOR = 0.61 [0.40, 0.91]), with notably different differentiating characteristics for gender minority (GM) women (vs. non-SGM women) such as the likelihood that thevictim was known to have experienced interpersonal violence victimization in the previous month (AOR = 0.50 [0.07, 3.67]). Lesbian and bisexual women homicide victims were far more likely to have been killed via IPH than non-SGM women (AOR for Black SM women = 7.84 [3.65, 16.88], AOR for White SM women = 2.30 [1.03, 5.17]). There was no corresponding difference for GM women victims, whose likelihood of being killed by an intimate partner was similar to that of non-SGM women. Based on these findings, actionable public health recommendations--centered around evidence that neither "all women" nor "all LGBTQ people" are appropriate intimate partner violence prevention umbrellas--are proposed. [ABSTRACT FROM AUTHOR]

Background: There is a significant long-term risk of posttraumatic osteoarthritis (PTOA) after anterior cruciate ligament reconstruction (ACLR). Elucidating the risk factors and successfully identifying at-risk patients is challenging. Purpose/Hypothesis: The purpose of this study was to produce machine learning survival models that can identify (1) patients at risk of symptomatic PTOA and (2) patients who are at risk of undergoing total knee arthroplasty (TKA) after ACLR. It was hypothesized that these models would outperform traditional Kaplan-Meier estimators. Study Design: Case-control study; Level of evidence, 3. Methods: A geographic database was used to identify patients undergoing ACLR between 1990 and 2016 with a minimum 7.5-year follow-up. Models were used to analyze various factors to predict the rate and time to (1) symptomatic osteoarthritis and (2) TKA using random survival forest (RSF) algorithms. Performance was measured using out-of-bag (OOB) c-statistic, calibration, and Brier score. The predictive performances of the RSF models were compared with Kaplan-Meier estimators. Model interpretability was enhanced utilizing global variable importance and partial dependence curves. Results: A total of 974 patients with ACLR and a minimum follow-up of 7.5 years were included; among these, 215 (22.1%) developed symptomatic osteoarthritis, and 25 (2.6%) progressed to TKA. The RSF algorithms achieved acceptable good to excellent predictive performance for symptomatic arthritis (OOB c-statistic, 0.75; Brier score, 0.128) and progression to TKA (OOB c-statistic, 0.89; Brier score, 0.026), respectively. Significant predictors of symptomatic PTOA included increased pain scores, older age, increased body mass index, increased time to ACLR, total number of arthroscopic surgeries before the diagnosis of arthritis, positive pivot-shift test after reconstruction, concomitant chondral injury, secondary meniscal tear, early (<250 days) or delayed (>500 days) return to sports or activity, and use of allograft. Significant predictors for TKA included older age, increased pain scores, total number of arthroscopic surgeries, high-demand activity/occupation, hypermobility, higher body mass index, systemic inflammatory disease, increased time to surgery, early (<250 days) or delayed (>500 days) return to sports or activity, and midsubstance tears. The Brier score over time revealed that RSF models outperformed traditional Kaplan-Meier estimators. Conclusion: Machine learning survival models were used to reliably identify patients at risk of developing symptomatic PTOA, and these models consistently outperformed traditional Kaplan-Meier estimators. Strong predictors for the development of PTOA after ACLR included increased pain scores at injury and postoperative visit, older age at injury, total number of arthroscopic procedures, positive postoperative pivot-shift test, and secondary meniscal tear. [ABSTRACT FROM AUTHOR]

Objectives: Methamphetamine (METH) use has been associated with impairments in a variety of cognitive functions. In this study, it was aimed to assess the relation between cognitive measures and frequency of METH use. Methods: Ninety-eight participants with methamphetamine use disorder were assessed with Wisconsin Card Sorting Test (WCST), Victoria-Stroop Word Color Test (SWCT), Trail Making Test (TMT) A and B. Participants were followed up during 6-month period with multiple urine toxicology tests (at baseline, month 1, month 2, month 3 and month 6). Results: Participants who had their prescriptions regularly were more likely to have higher rates of METH-negative urine results (P =.003). Participants who had more correct numbers, completed more categories and had more conceptual level responses on WCST were more likely to use lower frequency of METH (OR = 0.006, P <.01; OR = 0.171, P <.001; OR = 0.024, P <.001; respectively). The higher error numbers and perseverative error rates on WCST were associated with more frequent METH use (OR = 0.023, P <.001; OR = 0.076, P <.001). Interference factor on SWCT was related with lower frequency of METH use whereas color naming factor on SWCT was related with higher rates of urine results (OR = 0.012, P <.001; OR = 3.628, P <.001; respectively). Higher TMT B-A score was related with more frequent METH use, although the significance disappeared after adjustment (OR = 0.002, P <.001). Having psychotic symptoms predicted less frequent use, but after adjustment for other significant variables, there was no significance. Conclusion: Lower frequency of METH use in the follow-up could be predicted by neurocognitive assessments. Deficits in executive functions, attention, set-shifting and mental flexibility seems to be the most effected domains and this effect may be independent from the severity of psychotic symptoms. [ABSTRACT FROM AUTHOR]