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Background: Spaceflight poses a unique set of challenges to humans and the hostile spaceflight environment can induce a wide range of increased health risks, including dermatological issues. The biology driving the frequency of skin issues in astronauts is currently not well understood., Methods: To address this issue, we used a systems biology approach utilizing NASA's Open Science Data Repository (OSDR) on space flown murine transcriptomic datasets focused on the skin, biochemical profiles of 50 NASA astronauts and human transcriptomic datasets generated from blood and hair samples of JAXA astronauts, as well as blood samples obtained from the NASA Twins Study, and skin and blood samples from the first civilian commercial mission, Inspiration4., Results: Key biological changes related to skin health, DNA damage & repair, and mitochondrial dysregulation are identified as potential drivers for skin health risks during spaceflight. Additionally, a machine learning model is utilized to determine gene pairings associated with spaceflight response in the skin. While we identified spaceflight-induced dysregulation, such as alterations in genes associated with skin barrier function and collagen formation, our results also highlight the remarkable ability for organisms to re-adapt back to Earth via post-flight re-tuning of gene expression., Conclusion: Our findings can guide future research on developing countermeasures for mitigating spaceflight-associated skin damage., (© 2024. The Author(s).)

The Functional Movement Screen (FMS TM ) is a nonspecific movement pattern assessment while the Landing Error Scoring System (LESS) is a screen for movement patterns associated with lower extremity injury. The purpose of this study was to determine if the LESS and FMS TM are correlated or if they can be used as complementary assessments of preseason injury risk for anterior cruciate ligament injury., Methods: FMS TM and LESS were used to conduct a cohort study of 126 male National Collegiate Athletic Association Division IA football players. One hundred and eleven players met the criteria for inclusion during data review. At risk and not at risk LESS scores of players and FMS TM exercise score status were compared using Welch's t-test. Associations between FMS TM composites and LESS scores were evaluated using linear regression., Results: The average LESS score was 5.51±1.34, and the average composite FMS TM score was 11.77±2.13 (max=15). A poor FMS TM squat score (≤1 or asymmetry present) was associated with a higher LESS score ( P <0.001). No other FMS TM individual exercise score was associated with an at-risk LESS score ( P >0.05). Composite FMS TM score was loosely associated with the LESS score (R-squared=0.0677, P =0.006). Prior history of an ACL injury and player position were not associated with LESS score on multivariate regression ( P >0.05)., Conclusions: The LESS and FMS TM are not well correlated and may serve as complementary assessments for preseason injury risk., Level of Evidence: Level III., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Aiming to minimize overtreatment of high-risk breast lesions (HRLs), including atypical ductal hyperplasia, and small breast cancers, including ductal carcinoma in situ (DCIS), we investigated a minimally invasive (MI) approach to definitive diagnosis and management of these conditions., Methods: In the prospective Intact Percutaneous Excision registry study, women aged 31-86 years had removal of small invasive cancers, DCIS, or HRLs using image-guided 12-20 mm radiofrequency basket capture (MI excision). Second-pass 20 mm basket capture obtained shaved margins in cancer patients. Standard imaging (specimen, breast) and histologic criteria were applied. Patient data were registered in an Institutional Review Board approved, Health Insurance Portability and Accountability Act-compliant registry., Results: Of 282 registered patients, 124 had DCIS (n = 52) or invasive cancer (n = 72) and 160 had HRLs. Among cancer patients, 101 (81%) had clear histologic margins [average lesion size was 11 mm for both invasive cancers (4-20 mm) and DCIS (1.5-20 mm)]; 29 patients had re-excision (six despite clear margins). Among 160 HRLs, two were upgraded to DCIS and had MI excision. Two other HRL patients had subsequent standard surgical excision (no cancer found)., Conclusion: For diminutive HRLs, DCIS, and invasive cancers, MI excision can achieve the same procedure goals as standard surgical excision. Because MI excision removes less tissue with small incisions, it may reduce the discomfort and expense associated with standard treatment.

Background: Intra-articular (IA) corticosteroid therapy has been used for the treatment of inflammation and pain in the knee since the 1950s., Purpose: To review the current literature on the effects of IA corticosteroids on articular cartilage., Study Design: Systematic review., Methods: A MEDLINE and SCOPUS database search was performed, and studies were selected for basic science and clinical trial research on corticosteroids with direct outcome measures of cartilage health. Preliminary searches yielded 1929 articles, and final analysis includes 40 studies., Results: Methylprednisolone, dexamethasone, hydrocortisone, betamethasone, prednisolone, and triamcinolone were reported to display dose-dependent deleterious effects on cartilage morphology, histology, and viability in both in vitro and in vivo models. The beneficial animal in vivo effects of methylprednisolone, hydrocortisone, and triamcinolone occurred at low doses (usually <2-3 mg/dose or 8-12 mg/cumulative total dose in vivo), at which increased cell growth and recovery from damage was observed; the single human clinical trial indicated a beneficial effect of triamcinolone. However, at higher doses (>3 mg/dose or 18-24 mg/cumulative total dose in vivo), corticosteroids were associated with significant gross cartilage damage and chondrocyte toxicity. Dose and time dependency of corticosteroid chondrotoxicity was supported in the in vitro results, however, without clear dose thresholds., Conclusion: Corticosteroids have a time- and dose-dependent effect on articular cartilage, with beneficial effects occurring at low doses and durations and detrimental effects at high doses and durations. Clinically, beneficial effects are supported for IA administration, but the lowest efficacious dose should be used.

Purpose: Routine use of ureteral stents before extracorporeal shock wave lithotripsy of kidney stones between 10 and 20 mm. is controversial. We conducted a prospective randomized clinical trial to evaluate the outcome of ureteral stents for treating solitary kidney stones between 10 and 20 mm. or solitary proximal ureteral stones less than 20 mm. with shock wave lithotripsy., Materials and Methods: A total of 97 patients who met the aforementioned criteria were randomized between March 1994 to July 1997 into group 1-no stent, group 2-a 4.7Fr multi-length stent and group 3-a 7Fr multi-length stent. The patients were treated with the Dornier HM3 lithotriptor (Dornier Medical Systems, Inc., Marietta, Georgia) and monitored for stone-free rate, number of days lost from work, number of patients requiring rehospitalization, emergency room visits, irritative voiding symptom score and pain symptom score., Results: Objective outcome was obtained from 91 patients based on a followup of at least 3 months. The overall stone-free rate was 80%, with a re-treatment rate of 7%. The number of days lost from work was approximately 2, with no significant differences among individual groups or subgroups. The hospitalization rate and number of emergency room visits in group 1 (22%) were statistically higher compared to groups 2 (7%) and 3 (7%). The irritative voiding symptom score was statistically higher in the stented groups 2 and 3 compared to the nonstented group 1., Conclusions: Although ureteral stents are associated with more irritative symptoms, their use resulted in fewer hospital readmissions and emergency room visits compared to when no stent was used to treat solitary kidney stones of 10 to 20 mm. or solitary proximal ureteral stones less than 20 mm. Size 4.7Fr stents may be preferable over 7Fr stents when used in conjunction with shock wave lithotripsy.