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OBJECTIVE: To summarize changes in recommendations for injection treatments for knee osteoarthritis (OA) in current clinical practice guidelines (CPGs) and to assess whether these changes have affected public interest according to Google data and content in YouTube videos. DESIGN: A literature search to identify CPGs revised since 2019 that provide recommendations regarding the five intra-articular injection treatments for knee OA (corticosteroid [CS], hyaluronic acid [HA], stem cell [SC], platelet-rich plasma [PRP], and botulinum toxin [BT]) was conducted to assess perspective changes for each treatment. Data from Google Trends were examined to identify changes in search volume from 2004 to 2021 using a join-point regression model. Relevant YouTube videos were divided into those uploaded before and after changes in CPGs and compared according to degrees of recommendation for each treatment to identify the effect of changes in CPGs on video production. RESULTS: All eight identified CPGs released after 2019 recommended HA and CS use. Most CPGs were the first to state a neutral or opposing stance concerning the use of SC, PRP, or BT. Interestingly, relative searches on Google for SC, PRP, and BT has increased greater than those for CS and HA. YouTube videos produced after CPGs changed continue to recommend SC, PRP, and BT as much as those produced before CPGs were revised. CONCLUSIONS: Although knee OA CPGs have changed, public interest and healthcare information providers on YouTube have not reacted to this shift. Improved methods to propagate updates to CPGs warrant consideration.
Assuntos
Osteoartrite do Joelho , Plasma Rico em Plaquetas , Mídias Sociais , Humanos , Osteoartrite do Joelho/tratamento farmacológico , Injeções Intra-Articulares , Ácido Hialurônico/uso terapêutico , Corticosteroides/uso terapêutico , Resultado do TratamentoRESUMO
We present the study of B[over ¯]^{0}âΣ_{c}(2455)^{0,++}π^{±}p[over ¯] decays based on 772×10^{6} BB[over ¯] events collected with the Belle detector at the KEKB asymmetric-energy e^{+}e^{-} collider. The Σ_{c}(2455)^{0,++} candidates are reconstructed via their decay to Λ_{c}^{+}π^{∓} and Λ_{c}^{+} decays to pK^{-}π^{+}, pK_{S}^{0}, and Λπ^{+} final states. The corresponding branching fractions are measured to be B(B[over ¯]^{0}âΣ_{c}(2455)^{0}π^{+}p[over ¯])=(1.09±0.06±0.07)×10^{-4} and B(B[over ¯]^{0}âΣ_{c}(2455)^{++}π^{-}p[over ¯])=(1.84±0.11±0.12)×10^{-4}, which are consistent with the world average values with improved precision. A new structure is found in the M_{Σ_{c}(2455)^{0,++}π^{±}} spectrum with a significance of 4.2σ including systematic uncertainty. The structure is possibly an excited Λ_{c}^{+} and is tentatively named Λ_{c}(2910)^{+}. Its mass and width are measured to be (2913.8±5.6±3.8) MeV/c^{2} and (51.8±20.0±18.8) MeV, respectively. The products of branching fractions for the Λ_{c}(2910)^{+} are measured to be B(B[over ¯]^{0}âΛ_{c}(2910)^{+}p[over ¯])×B(Λ_{c}(2910)^{+}âΣ_{c}(2455)^{0}π^{+})=(9.5±3.6±1.6)×10^{-6} and B(B[over ¯]^{0}âΛ_{c}(2910)^{+}p[over ¯])×B(Λ_{c}(2910)^{+}âΣ_{c}(2455)^{++}π^{-})=(1.24±0.35±0.10)×10^{-5}. Here, the first and second uncertainties are statistical and systematic, respectively.
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We study the processes e^{+}e^{-}âωχ_{bJ}(1P) (J=0, 1, or 2) using samples at center-of-mass energies sqrt[s]=10.701, 10.745, and 10.805 GeV, corresponding to 1.6, 9.8, and 4.7 fb^{-1} of integrated luminosity, respectively. These data were collected with the Belle II detector during special operations of the SuperKEKB collider above the Ï(4S) resonance. We report the first observation of ωχ_{bJ}(1P) signals at sqrt[s]=10.745 GeV. By combining Belle II data with Belle results at sqrt[s]=10.867 GeV, we find energy dependencies of the Born cross sections for e^{+}e^{-}âωχ_{b1,b2}(1P) to be consistent with the shape of the Ï(10753) state. These data indicate that the internal structures of the Ï(10753) and Ï(10860) states may differ. Including data at sqrt[s]=10.653 GeV, we also search for the bottomonium equivalent of the X(3872) state decaying into ωÏ(1S). No significant signal is observed for masses between 10.45 and 10.65 GeV/c^{2}.
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The dark photon A^{'} and the dark Higgs boson h^{'} are hypothetical particles predicted in many dark sector models. We search for the simultaneous production of A^{'} and h^{'} in the dark Higgsstrahlung process e^{+}e^{-}âA^{'}h^{'} with A^{'}âµ^{+}µ^{-} and h^{'} invisible in electron-positron collisions at a center-of-mass energy of 10.58 GeV in data collected by the Belle II experiment in 2019. With an integrated luminosity of 8.34 fb^{-1}, we observe no evidence for signal. We obtain exclusion limits at 90% Bayesian credibility in the range of 1.7-5.0 fb on the cross section and in the range of 1.7×10^{-8}-200×10^{-8} on the effective coupling ϵ^{2}×α_{D} for the A^{'} mass in the range of 4.0 GeV/c^{2}
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We study B^{+}âπ^{+}π^{0}π^{0} using 711 fb^{-1} of data collected at the Ï(4S) resonance with the Belle detector at the KEKB asymmetric-energy e^{+}e^{-} collider. We measure an inclusive branching fraction of (19.0±1.5±1.4)×10^{-6} and an inclusive CP asymmetry of (9.2±6.8±0.7)%, where the first uncertainties are statistical and the second are systematic, and a B^{+}âρ(770)^{+}π^{0} branching fraction of (11.2±1.1±0.9_{-1.6}^{+0.8})×10^{-6}, where the third uncertainty is due to possible interference with B^{+}âρ(1450)^{+}π^{0}. We present the first observation of a structure around 1 GeV/c^{2} in the π^{0}π^{0} mass spectrum, with a significance of 6.4σ, and measure a branching fraction to be (6.9±0.9±0.6)×10^{-6}. We also report a measurement of local CP asymmetry in this structure.
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Using the data sample of 980 fb^{-1} collected with the Belle detector operating at the KEKB asymmetric-energy e^{+}e^{-} collider, we present the results of an investigation of the Λπ^{+} and Λπ^{-} invariant mass distributions looking for substructure in the decay Λ_{c}^{+}âΛπ^{+}π^{+}π^{-}. We find a significant signal in each mass distribution. When interpreted as resonances, we find for the Λπ^{+} (Λπ^{-}) combination a mass of 1434.3±0.6(stat)±0.9(syst) MeV/c^{2} [1438.5±0.9(stat)±2.5(syst) MeV/c^{2}], an intrinsic width of 11.5±2.8(stat)±5.3(syst) MeV/c^{2} [33.0±7.5(stat)±23.6(syst) MeV/c^{2}] with a significance of 7.5σ (6.2σ). As these two signals are very close to the K[over ¯]N threshold, we also investigate the possibility of a K[over ¯]N cusp, and find that we cannot discriminate between these two interpretations due to the limited size of the data sample.
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The first simultaneous determination of the absolute value of the Cabibbo-Kobayashi-Maskawa matrix element V_{ub} using inclusive and exclusive decays is performed with the full Belle data set at the Ï(4S) resonance, corresponding to an integrated luminosity of 711 fb^{-1}. We analyze collision events in which one B meson is fully reconstructed in hadronic modes. This allows for the reconstruction of the hadronic X_{u} system of the semileptonic bâuâν[over ¯]_{â} decay. We separate exclusive Bâπâν[over ¯]_{â} decays from other inclusive BâX_{u}âν[over ¯]_{â} and backgrounds with a two-dimensional fit that utilizes the number of charged pions in the X_{u} system and the four-momentum transfer q^{2} between the B and X_{u} systems. Combining our measurement with information from lattice QCD and QCD calculations of the inclusive partial rate as well as external experimental information on the shape of the Bâπâν[over ¯]_{â} form factor, we determine |V_{ub}^{excl}|=(3.78±0.23±0.16±0.14)×10^{-3} and |V_{ub}^{incl}|=(3.88±0.20±0.31±0.09)×10^{-3}, respectively, with the uncertainties being the statistical error, systematic errors, and theory errors. The ratio of |V_{ub}^{excl}|/|V_{ub}^{incl}|=0.97±0.12 is compatible with unity.
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We report on a search for a heavy Majorana neutrino in the decays τ^{-}âπ^{-}ν_{h}, ν_{h}âπ^{±}â^{∓}, â=e, µ. The results are obtained using the full data sample of 988 fb^{-1} collected with the Belle detector at the KEKB asymmetric energy e^{+}e^{-} collider, which contains 912×10^{6} ττ pairs. We observe no significant signal and set 95% CL upper limits on the couplings of the heavy right-handed neutrinos to the conventional standard model left-handed neutrinos in the mass range 0.2-1.6 GeV/c^{2}. This is the first study of a mixed couplings of heavy neutrinos to τ leptons and light-flavor leptons.
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We report the first measurement of the Michel parameter ξ^{'} in the τ^{-}âµ^{-}ν[over ¯]_{µ}ν_{τ} decay with a new method proposed just recently. The measurement is based on the reconstruction of the τ^{-}âµ^{-}ν[over ¯]_{µ}ν_{τ} events with subsequent muon decay in flight in the Belle central drift chamber. The analyzed data sample of 988 fb^{-1} collected by the Belle detector corresponds to approximately 912×10^{6} τ^{+}τ^{-} pairs. We measure ξ^{'}=0.22±0.94(stat)±0.42(syst), which is in agreement with the standard model prediction of ξ^{'}=1. Statistical uncertainty dominates in this study, being a limiting factor, while systematic uncertainty is well under control. Our analysis proved the practicability of this promising method and its prospects for further precise measurement in future experiments.
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The measurement of two-particle angular correlation functions in high-multiplicity e^{+}e^{-} collisions at sqrt[s]=10.52 GeV is reported. In this study, the 89.5 fb^{-1} of hadronic e^{+}e^{-} annihilation data collected by the Belle detector at KEKB are used. Two-particle angular correlation functions are measured in the full relative azimuthal angle (ΔÏ) and three units of pseudorapidity (Δη), defined by either the electron beam axis or the event-shape thrust axis, and are studied as a function of charged-particle multiplicity. The measurement in the thrust axis analysis, with mostly outgoing quark pairs determining the reference axis, is sensitive to the region of additional soft gluon emissions. No significant anisotropic collective behavior is observed with either coordinate analyses. Near-side jet correlations appear to be absent in the thrust axis analysis. The measurements are compared to predictions from various event generators and are expected to provide new constraints to the phenomenological models in the low-energy regime.
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We search for a light Higgs boson (A^{0}) decaying into a τ^{+}τ^{-} or µ^{+}µ^{-} pair in the radiative decays of Ï(1S). The production of Ï(1S) mesons is tagged by Ï(2S)âπ^{+}π^{-}Ï(1S) transitions, using 158×10^{6} Ï(2S) events accumulated with the Belle detector at the KEKB asymmetric energy electron-positron collider. No significant A^{0} signals in the mass range from the τ^{+}τ^{-} or µ^{+}µ^{-} threshold to 9.2 GeV/c^{2} are observed. We set the upper limits at 90% credibility level (C.L.) on the product branching fractions for Ï(1S)âγA^{0} and A^{0}âτ^{+}τ^{-} varying from 3.8×10^{-6} to 1.5×10^{-4}. Our results represent an approximately twofold improvement on the current world best upper limits for the Ï(1S)âγA^{0}(âτ^{+}τ^{-}) production. For A^{0}âµ^{+}µ^{-}, the upper limits on the product branching fractions for Ï(1S)âγA^{0} and A^{0}âµ^{+}µ^{-} are at the same level as the world average limits, and vary from 3.1×10^{-7} to 1.6×10^{-5}. The upper limits at 90% credibility level on the Yukawa coupling f_{Ï(1S)} and mixing angle sinθ_{A^{0}} are also given.
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The first measurements of differential branching fractions of inclusive semileptonic BâX_{u}â^{+}ν_{â} decays are performed using the full Belle data set of 711 fb^{-1} of integrated luminosity at the Ï(4S) resonance and for â=e, µ. With the availability of these measurements, new avenues for future shape-function model-independent determinations of the Cabibbo-Kobayashi-Maskawa matrix element |V_{ub}| can be pursued to gain new insights in the existing tension with respect to exclusive determinations. The differential branching fractions are reported as a function of the lepton energy, the four-momentum-transfer squared, light-cone momenta, the hadronic mass, and the hadronic mass squared. They are obtained by subtracting the backgrounds from semileptonic BâX_{c}â^{+}ν_{â} decays and other processes, and corrected for resolution and acceptance effects.
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We present a search for the direct production of a light pseudoscalar a decaying into two photons with the Belle II detector at the SuperKEKB collider. We search for the process e^{+}e^{-}âγa, aâγγ in the mass range 0.2
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The experimental results on the ratios of branching fractions R(D)=B(B[over ¯]âDτ^{-}ν[over ¯]_{τ})/B(B[over ¯]âDâ^{-}ν[over ¯]_{â}) and R(D^{*})=B(B[over ¯]âD^{*}τ^{-}ν[over ¯]_{τ})/B(B[over ¯]âD^{*}â^{-}ν[over ¯]_{â}), where â denotes an electron or a muon, show a long-standing discrepancy with the standard model predictions, and might hint at a violation of lepton flavor universality. We report a new simultaneous measurement of R(D) and R(D^{*}), based on a data sample containing 772×10^{6} BB[over ¯] events recorded at the Ï(4S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. In this analysis the tag-side B meson is reconstructed in a semileptonic decay mode and the signal-side τ is reconstructed in a purely leptonic decay. The measured values are R(D)=0.307±0.037±0.016 and R(D^{*})=0.283±0.018±0.014, where the first uncertainties are statistical and the second are systematic. These results are in agreement with the standard model predictions within 0.2, 1.1, and 0.8 standard deviations for R(D), R(D^{*}), and their combination, respectively. This work constitutes the most precise measurements of R(D) and R(D^{*}) performed to date as well as the first result for R(D) based on a semileptonic tagging method.
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We report the first observation of the radiative decay of the Ï(1S) into a charmonium state. The significance of the observed signal of Ï(1S)âγχ_{c1} is 6.3 standard deviations including systematics. The branching fraction is calculated to be B[Ï(1S)âγχ_{c1}]=[4.7_{-1.8}^{+2.4}(stat)_{-0.5}^{+0.4}(sys)×10^{-5}]. We also searched for Ï(1S) radiative decays into χ_{c0,2} and η_{c}(1S,2S), and set upper limits on their branching fractions. These results are obtained from a 24.9 fb^{-1} data sample collected with the Belle detector at the KEKB asymmetric-energy e^{+}e^{-} collider at a center-of-mass energy equal to the Ï(2S) mass using Ï(1S) tagging by the Ï(2S)âÏ(1S)π^{+}π^{-} transitions.
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We quantify the chemistry-process-structure-property relationships of a Ti-6Al-4V alloy in which titanium-boron alloy (Ti-B) was added in a functionally graded assembly through a laser-engineered net shaping (LENS) process. The material gradient was made by pre-alloyed powder additions to form an in situ melt of the prescribed alloy concentration. The complex heterogeneous structures arising from the LENS thermal history are completely discussed for the first time, and we introduce a new term called "Borlite", a eutectic structure containing orthorhombic titanium monoboride (TiB) and titanium. The ß-titanium grain size decreased nonlinearly until reaching the minimum when the boron weight fraction reached 0.25%. Similarly, the transformed α-titanium grain size decreased nonlinearly until reaching the minimum level, but the grain size was approximately 2 µm when the boron weight fraction reached 0.6%. Alternatively, the α-titanium grain size increased nonlinearly from 1 to 5 µm as a function of the aluminum concentration increasing from 0% to 6% aluminum by weight and vanadium increasing from 0% to 4% by weight. Finally, the cause-effect relationships related to the creation of unwanted porosity were quantified, which helps in further developing additively manufactured metal alloys.
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We present a macroscale constitutive model that couples magnetism with thermal, elastic, plastic, and damage effects in an Internal State Variable (ISV) theory. Previous constitutive models did not include an interdependence between the internal magnetic (magnetostriction and magnetic flux) and mechanical fields. Although constitutive models explaining the mechanisms behind mechanical deformations caused by magnetization changes have been presented in the literature, they mainly focus on nanoscale structure-property relations. A fully coupled multiphysics macroscale ISV model presented herein admits lower length scale information from the nanoscale and microscale descriptions of the multiphysics behavior, thus capturing the effects of magnetic field forces with isotropic and anisotropic magnetization terms and moments under thermomechanical deformations. For the first time, this ISV modeling framework internally coheres to the kinematic, thermodynamic, and kinetic relationships of deformation using the evolving ISV histories. For the kinematics, a multiplicative decomposition of deformation gradient is employed including a magnetization term; hence, the Jacobian represents the conservation of mass and conservation of momentum including magnetism. The first and second laws of thermodynamics are used to constrain the appropriate constitutive relations through the Clausius-Duhem inequality. The kinetic framework employs a stress-strain relationship with a flow rule that couples the thermal, mechanical, and magnetic terms. Experimental data from the literature for three different materials (iron, nickel, and cobalt) are used to compare with the model's results showing good correlations.
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Antimicrobial resistance is a growing health threat, but standard methods for determining antibiotic susceptibility are slow and can delay optimal treatment, which is especially consequential in severe infections such as bacteremia. Novel approaches for rapid susceptibility profiling have emerged that characterize either bacterial response to antibiotics (phenotype) or detect specific resistance genes (genotype). GoPhAST-R is a novel assay, performed directly on positive blood cultures, that integrates rapid transcriptional response profiling with detection of key resistance gene transcripts, thereby providing simultaneous data on both phenotype and genotype. Here, we performed the first clinical pilot of GoPhAST-R on 42 positive blood cultures: 26 growing Escherichia coli, 15 growing Klebsiella pneumoniae, and 1 with both. An aliquot of each positive blood culture was exposed to 9 different antibiotics, lysed, then underwent rapid transcriptional profiling on the NanoString® platform; results were analyzed using an in-house susceptibility classification algorithm. GoPhAST-R achieved 95% overall agreement with standard antimicrobial susceptibility testing methods, with the highest agreement for beta-lactams (98%) and the lowest for fluoroquinolones (88%). Epidemic resistance genes including the extended spectrum beta-lactamase bla CTX-M-15 and the carbapenemase bla KPC were also detected within the population. This study demonstrates the clinical feasibility of using transcriptional response profiling for rapid resistance determination, although further validation with larger and more diverse bacterial populations will be essential in future work. GoPhAST-R represents a promising new approach for rapid and comprehensive antibiotic susceptibility testing in clinical settings.
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This study investigates the question of whether open repair of acute distal radioulnar joint instability at the time of volar plating of distal radius fractures would enable early mobilization of the wrist without the risk of distal radioulnar joint instability. We evaluated 29 patients of mean age 53 years with a distal radius fracture and acute distal radioulnar joint instability who underwent volar plating of the radius combined with surgical repair of the triangular fibrocartilage complex or an ulnar styloid base fracture, followed by active motion exercise of the wrist at 1 week after surgery. At 1 year after treatment, all patients had a stable distal radioulnar joint and grip strength averaged 90% of the normal side. This study demonstrates that surgical repair of the triangular fibrocartilage complex or ulnar styloid fracture followed by early mobilization did not result in distal radioulnar joint instability, and suggests that the surgical treatment of distal radioulnar joint instability may permit early mobilization of the wrist in patients who are considered suitable for rapid rehabilitation after surgery. Type of study: Therapeutic Level IV.