Clinical outcomes in patients with scaphoid non-union treated with the vascularized medial femoral condyle technique a case series.

INTRODUCTION: Non-union is a prevalent complication of scaphoid fractures. Late diagnosis is common and has a clinical impact due to functional limitations for the patient. Multiple treatments have been proposed to manage this complication, ranging from conservative (i.e., orthopedic) to surgical treatment. The vascularized medial femoral condyle technique has shown satisfactory clinical and paraclinical results, mainly in presence of avascular necrosis of the proximal pole but data regarding functional outcomes and patient satisfaction is scarce. This case series aims to describe the clinical and patient-reported outcomes in a consecutive series of patients with non-union of the proximal third of the scaphoid treated with vascularized medial femoral condyle technique. METHODS: Case series reporting results for a consecutive - initial cohort of patients who presented with a non united fracture of the proximal pole of the scaphoid, avascular necrosis of the proximal pole was documented by CT od MRI imaging preoperatively in all patients. Measurement instruments include the q-DASH and PRWE questionnaires, radiographic images, goniometry, and assessment of grip strength. RESULTS: Twelve consecutive patients are included and they represent the initial cases for all surgeons involved; bone union was obtained in 10 patients (83%) after a mean follow-up time of 31 months (6-72), successful improvement in the range of motion and grip strength was documented. A high rate of satisfaction expressed by the patient was obtained, with an average score in Q-DASH of 17.3 and 20.1 in PRWE. CONCLUSIONS: The vascularized medial condyle technique in cases of nonunion of scaphoid fracture is a reproducible treatment in clinical terms, both in imaging and functional terms, and in patient satisfaction. The learning curve is flat for a dedicated multi surgeon team.

Overproduce and select, or determine optimal molecular descriptor subset via configuration space optimization? Application to the prediction of ecotoxicological endpoints.

Predicting the likely biological activity (or property) of compounds is a fundamental and challenging task in the drug discovery process. Current computational methodologies aim to improve their predictive accuracies by using deep learning (DL) approaches. However, non-DL based approaches for small- and medium-sized chemical datasets have demonstrated to be most suitable for. In this approach, an initial universe of molecular descriptors (MDs) is first calculated, then different feature selection algorithms are applied, and finally, one or several predictive models are built. Herein we demonstrate that this traditional approach may miss relevant information by assuming that the initial universe of MDs codifies all relevant aspects for the respective learning task. We argue that this limitation is mainly because of the constrained intervals of the parameters used in the algorithms that compute MDs, parameters that define the Descriptor Configuration Space (DCS). We propose to relax these constraints in an open CDS approach, so that a larger universe of MDs can be initially considered. We model the generation of MDs as a multicriteria optimization problem and tackle it with a variant of the standard genetic algorithm. As a novel component, the fitness function is computed by aggregating four criteria via the Choquet integral. Experimental results show that the proposed approach generates a meaningful DCS by improving state-of-the-art approaches in most of the benchmarking chemical datasets accounted for.

Embedded-AMP: A Multi-Thread Computational Method for the Systematic Identification of Antimicrobial Peptides Embedded in Proteome Sequences.

Antimicrobial peptides (AMPs) have gained the attention of the research community for being an alternative to conventional antimicrobials to fight antibiotic resistance and for displaying other pharmacologically relevant activities, such as cell penetration, autophagy induction, immunomodulation, among others. The identification of AMPs had been accomplished by combining computational and experimental approaches and have been mostly restricted to self-contained peptides despite accumulated evidence indicating AMPs may be found embedded within proteins, the functions of which are not necessarily associated with antimicrobials. To address this limitation, we propose a machine-learning (ML)-based pipeline to identify AMPs that are embedded in proteomes. Our method performs an in-silico digestion of every protein in the proteome to generate unique k-mers of different lengths, computes a set of molecular descriptors for each k-mer, and performs an antimicrobial activity prediction. To show the efficiency of the method we used the shrimp proteome, and the pipeline analyzed all k-mers between 10 and 60 amino acids in length to predict all AMPs in less than 20 min. As an application example we predicted AMPs in different rodents (common cuy, common rat, and naked mole rat) with different reported longevities and found a relation between species longevity and the number of predicted AMPs. The analysis shows as the longevity of the species is higher, the number of predicted AMPs is also higher. The pipeline is available as a web service.

A Qualitative Evaluation of a Community-Based Intervention on Health-Related Behaviors in Disadvantaged Women.

Purpose: Grounded in social ecological model and self-determination theory, the aim of this study was to qualitatively evaluate the first and second year follow-ups of a community-based healthy lifestyle programme on health-related behaviors, and outcomes in disadvantaged adult women. Methods: Eleven disadvantaged adult women (M = 37.72; SD = 8.34) (seven of them from the Roma population) participated in this community-based participatory action research. Discussion groups, semi-structured interviews, and field notes were used to assess the effects of the intervention programme on health-related behaviors and health outcomes through thematic analysis. Results: Women perceived improvements in PA-related variables, healthy eating, and other health-related outcomes throughout two years. Most women mentioned these behavior changes in the first year, while others perceived them in the second year. Conclusions: These findings highlight the importance of developing contextual and culturally tailored interventions that address the specific problems and needs that emerge from ethnic groups. Given that some of these behavior changes were only mentioned by most of these women in the second year, long-term interventions seem to be ideally required in this population.

Ruptured subcapsular liver hematoma as a rare complication of HELLP syndrome. A therapeutic challenge.

HELLP syndrome (HS), a low-incidence condition of uncertain pathogenesis associated with pregnancy hypertensive syndromes, is characterized by hemolysis, elevated liver enzymes and low platelet count. Ruptured subcapsular liver hematoma complicated with hemoperitoneum is an uncommon but very serious condition where early recognition and multidisciplinary management are key to reduce its associated maternal, infant mortality rate. Symptoms are nonspecific, characterized by por epigastric pain, nausea and vomiting; clinical suspicion and appropriate imaging studies are of crucial importance. We report the case of a 36-year-old primiparous woman at 39 weeks of gestation. She was admitted for early membrane rupture, with delivery complicated by retained placenta. During the immediate puerperium she had blood pressure > 140/90 mmHg, epigastric pain and vomiting, which required respiratory and hemodynamic support. An exploratory laparotomy was performed that revealed a massive hemoperitoneum as well as CR in the RLL with multifocal active bleeding. The left liver lobe was macroscopically normal. The patient underwent hemoperitoneum drainage and hepatic packing (HP); biopsy findings were consistent with necrosis. Polytransfusion was initiated with blood products and antihemorrhagic agents.

Reproducibility and safety of the 30" sit to stand test in individuals with obesity and cardiovascular risk factors.

BACKGROUND: The 30″ sit to stand test is a submaximal exercise test that assesses functional capacity and it has been validated for various pathologies. Although it has been used in individuals with obesity, its reproducibility in this population has not yet been determined. The main objective of this study was to determine the reproducibility and safety of the 30″ sit to stand test in individuals with overweight or obesity and with cardiovascular risk factors. METHODS: A cross-sectional study was performed. Individuals with obesity or overweight who also presented cardiovascular risk factors were evaluated with the 30″ sit to stand test. The reproducibility and safety of the 30" sit to stand test were determined, as well as its association with other functional tests and anthropometric characteristics. RESULTS: 59 individuals (27 men, 32 women) with obesity or overweight and cardiovascular risk factors, aged 57.93 (9.62) years, were included in the study. The 30″ sit to stand test showed good overall reproducibility (0.907 ICC) and significant correlation with the 6-minute walk test, handgrip strength test, body fat percentage and waist - height index, with a similar hemodynamic response to the 6-minute walk test. CONCLUSION: The 30" sit to stand test is a highly reproducible and safe test for individuals with obesity and cardiovascular risk factors, with a significant correlation to anthropometric characteristics and other functional tests regularly used for the evaluation of individuals with obesity.

Handcrafted versus non-handcrafted (self-supervised) features for the classification of antimicrobial peptides: complementary or redundant?

Antimicrobial peptides (AMPs) have received a great deal of attention given their potential to become a plausible option to fight multi-drug resistant bacteria as well as other pathogens. Quantitative sequence-activity models (QSAMs) have been helpful to discover new AMPs because they allow to explore a large universe of peptide sequences and help reduce the number of wet lab experiments. A main aspect in the building of QSAMs based on shallow learning is to determine an optimal set of protein descriptors (features) required to discriminate between sequences with different antimicrobial activities. These features are generally handcrafted from peptide sequence datasets that are labeled with specific antimicrobial activities. However, recent developments have shown that unsupervised approaches can be used to determine features that outperform human-engineered (handcrafted) features. Thus, knowing which of these two approaches contribute to a better classification of AMPs, it is a fundamental question in order to design more accurate models. Here, we present a systematic and rigorous study to compare both types of features. Experimental outcomes show that non-handcrafted features lead to achieve better performances than handcrafted features. However, the experiments also prove that an improvement in performance is achieved when both types of features are merged. A relevance analysis reveals that non-handcrafted features have higher information content than handcrafted features, while an interaction-based importance analysis reveals that handcrafted features are more important. These findings suggest that there is complementarity between both types of features. Comparisons regarding state-of-the-art deep models show that shallow models yield better performances both when fed with non-handcrafted features alone and when fed with non-handcrafted and handcrafted features together.

A Community-Based Participatory Action Research with Women from Disadvantaged Populations: Strengths and Weaknesses of a Multiple Health Behaviour Change Intervention.

Disadvantaged populations usually adopt risk behaviours, resulting in obesity and mental health-related disorders. Grounded in the socioecological model and self-determination theory, the aims were firstly to describe and implement a two-year multiple health behaviour change intervention, and secondly, to assess the strengths and weaknesses of the intervention. In total, 11 women from a disadvantaged population participated in this programme, which encompassed 117 sessions. Qualitative techniques were used to collect data and a thematic analysis was conducted. The variety of activities and the group-based intervention were the main strengths, and the decrease in attendance and the programme's tight schedule were the main weaknesses. This is the first intervention in a disadvantaged population mainly comprised of Roma women. The design described in detail and its assessment provide relevant knowledge to improve their health status and decrease inequalities. The practical implications for future research are useful for replicating interventions in similar contexts.

The Immune Response in Adipocytes and Their Susceptibility to Infection: A Possible Relationship with Infectobesity.

The current obesity pandemic has been expanding in both developing and developed countries. This suggests that the factors contributing to this condition need to be reconsidered since some new factors are arising as etiological causes of this disease. Moreover, recent clinical and experimental findings have shown an association between the progress of obesity and some infections, and the functions of adipose tissues, which involve cell metabolism and adipokine release, among others. Furthermore, it has recently been reported that adipocytes could either be reservoirs for these pathogens or play an active role in this process. In addition, there is abundant evidence indicating that during obesity, the immune system is exacerbated, suggesting an increased susceptibility of the patient to the development of several forms of illness or death. Thus, there could be a relationship between infection as a trigger for an increase in adipose cells and the impact on the metabolism that contributes to the development of obesity. In this review, we describe the findings concerning the role of adipose tissue as a mediator in the immune response as well as the possible role of adipocytes as infection targets, with both roles constituting a possible cause of obesity.

Do deep learning models make a difference in the identification of antimicrobial peptides?

In the last few decades, antimicrobial peptides (AMPs) have been explored as an alternative to classical antibiotics, which in turn motivated the development of machine learning models to predict antimicrobial activities in peptides. The first generation of these predictors was filled with what is now known as shallow learning-based models. These models require the computation and selection of molecular descriptors to characterize each peptide sequence and train the models. The second generation, known as deep learning-based models, which no longer requires the explicit computation and selection of those descriptors, started to be used in the prediction task of AMPs just four years ago. The superior performance claimed by deep models regarding shallow models has created a prevalent inertia to using deep learning to identify AMPs. However, methodological flaws and/or modeling biases in the building of deep models do not support such superiority. Here, we analyze the main pitfalls that led to establish biased conclusions on the leading performance of deep models. Also, we analyze whether deep models truly contribute to achieve better predictions than shallow models by performing fair studies on different state-of-the-art benchmarking datasets. The experiments reveal that deep models do not outperform shallow models in the classification of AMPs, and that both types of models codify similar chemical information since their predictions are highly similar. Thus, according to the currently available datasets, we conclude that the use of deep learning could not be the most suitable approach to develop models to identify AMPs, mainly because shallow models achieve comparable-to-superior performances and are simpler (Ockham's razor principle). Even so, we suggest the use of deep learning only when its capabilities lead to obtaining significantly better performance gains worth the additional computational cost.

Neurotización del nervio circunflejo por vía axilar, estudio cadavérico / Neurotization of the circumflex nerve through an axillary approach, cadaveric study

Objetivo Confirmar factibilidad técnica de la neurotización del nervio axilar por la rama motora de la porción larga del tríceps con el fin de definir la anatomía quirúrgica de los nervios radial y axilar. Materiales y métodos Veinte hombros de cadáver fueron intervenidos para transferencia de la rama del Nervio Radial para la porción larga del tríceps a la rama anterior del Nervio Axilar por abordaje axilar. Se confirmó la escogencia correcta del nervio receptor por abordaje posterior. Resultados Se logró una disección adecuada de la primera rama motora del nervio radial del nervio axilar y de la rama anterior del Nervio Axilar. El origen de la rama motora se encontró en promedio a 3,8mm (+/- 7,3mm) distal al borde superior del tendón del dorsal ancho. El nervio axilar se encontró cefálico al borde superior del dorsal ancho a una distancia promedio de 11,3mm (+/-2,13mm) y distal al redondo menor 3.05mm (+/- 1,3mm), sutura con la primera rama del radial en el 100% de los casos sin tensión y se confirmó la adecuada transferencia en todos los casos. Conclusión La neurotización del nervio axilar con la primera rama del nervio radial se logró con éxito en el 100% por vía axilar. Este abordaje es adecuado, evitando tener que realizar cambios de posición a prono y doble abordaje, y si se requiere procedimientos adicionales de reconstrucción en el mismo tiempo quirúrgico tipo Oberlin y exploraciones supraclaviculares del plexo braquial se pueden realizar sin cambio de posición.

Objective To confirm the technical feasibility of neurotization of the axillary nerve by the motor branch of the long head of the triceps in order to define the surgical anatomy of the radial and axillary nerves. Materials and method Twenty cadaver shoulders were operated on for transfer of the radial nerve branch for the long head of the triceps to the anterior branch of the axillary nerve by axillary approach. The correct choice of the receiving nerve was confirmed by posterior approach. Results An adequate dissection of the first motor branch of the radial nerve of the axillary nerve and of the anterior branch of the Axillary Nerve was achieved, The origin of the motor branch was found on average at 3.8mm (+/−7.3mm) distal to the superior border of the latissimus dorsi tendon. The axillary nerve was found 11.3mm (+/−2.13mm) cephalad to the upper border of the latissimus dorsi and 3.05mm (+/−1.3mm) distal to the teres minor. A tensionless coaptation was obtained in all cases. Conclusion Neurotization of the axillary nerve with the first branch of the radial nerve was successfully achieved through the axillary approach. This approach is adequate, avoiding position change to prone and double approach, and if additional reconstruction procedures are required at the same surgical time, Oberlin type and supraclavicular explorations of the brachial plexus can be performed without changing position.

Diagnostic concordance of pathological methods and reports of hematopathologists compared to local nonspecialized pathologists in the diagnosis of lymphoma in Mexico.

OBJECTIVES: To assess the concordance between lymphoma diagnoses made via tissue biopsy by local pathologists and also to assess the after review of these specimens by more specialized hematopathologists. METHODS: A prospective, non-interventional and multicenter study was conducted at seven sites in Mexico from January 2017 to October 2017. Eligible biopsies were sampled from patients with a previous diagnosis of lymphoma on lymph node biopsy or a diagnosis of extranodal lymphoma, with adequate amount and tissue preservation for the review analysis. The biopsy tissues reviewed by local pathologists were also reviewed by hematopathologists participating in the study. The concordance in diagnosis results was classified into three categories: diagnostic agreement, minor discrepancy and major discrepancy. RESULTS: Out of 111 samples received, 105 samples met the eligibility criteria and were included for full analysis. The median patient age (range) was 54 (16-94) years. A diagnostic agreement was observed in 23 (21.9%) biopsies, minor discrepancies were observed in 32 (30.5%) biopsies and major discrepancies were observed in 50 (47.6%) biopsies. Diagnostic concordance varied across the seven study sites; the rate of major discrepancies ranged from 0% to 100% and the rate of diagnostic agreement ranged from 0% to 81.8%. Out of the 105 reviewed biopsies, a total of 89 cases were diagnosed as lymphoma by hematopathologists. CONCLUSIONS: This study showed that major discrepancies were observed following the review by hematopathologists compared with that of the local pathologist's initial diagnosis in nearly one-half cases. In addition, there was a wide variation in the percentage of diagnostic agreements and discrepancies among different study sites.

The Influence of the Coach's Autonomy Support and Controlling Behaviours on Motivation and Sport Commitment of Youth Soccer Players.

The coach is one of the most influential agents in the sport commitment of youth players. Grounded in self-determination theory (SDT), numerous studies have examined the influence of the coach's autonomy-supportive behaviours on athletes' motivation. However, fewer studies have examined the influence of the coach's controlling behaviours. The aim of this cross-sectional study was to analyse the influence of young soccer players' perception of their coach's autonomy-supportive and controlling behaviours on the satisfaction and frustration of their basic psychological needs (BPN) and sport commitment. A total of 203 soccer players (86% boys), aged 10-19 years (M = 14.88; SD = 1.54) participated. Coach autonomy support positively predicted BPN satisfaction which, in turn, positively explained sport commitment. Coach intimidation behaviours positively predicted BPN frustration, which, in turn, negatively explained sport commitment. In cross-relationships, autonomy support negatively explained BPN frustration, while intimidation behaviours and the controlling use of rewards negatively predicted BPN satisfaction. To conclude, these results suggest that it is important for the coach not only to support autonomy, but also to avoid the use of controlling behaviours, especially intimidation and controlling use of rewards, because of their influence on the motivational processes and sport commitment of youth soccer players.

Cross-Cultural Adaptation and Validation of the Translated Patient-Rated Wrist Evaluation Score.

Introduction The purpose of this study is to perform a cross-cultural adaptation and validation of the translated Patient-Rated Wrist Evaluation (PRWE) score exclusively for pathologies of the wrist. Materials and Methods A methodological study of cross-cultural validation of clinical scores was performed through a test-retest reliability analysis, internal consistency, response to change, and criterion validity assessment. Results The test was applied to 57 patients with 139 surveys. Stability evaluated through Lin's concordance correlation coefficient was 0.98, with 95% confidence interval (CI) = 0.97-0.99; Cronbach's alpha was > 0.91; the difference in score was 24.26 (standard deviation: 26.59); the standardized response mean was 0.912; the effect size was 0.924; the Spearman's coefficient between the differences of PRWE and DASH-Disabilities of the Arm, Shoulder, and Hand-scores was r = 0.899, with 95% CI = 0.811-0.947; Spearman's nonparametric correlation test between PRWE and DASH was 0.82, with 95% CI = 0.711-0.890. Conclusions We successfully validated the Spanish translation of the PRWE scale. It showed valid and reliable interpretation of functional status and response to treatment after distal radius fracture, for Colombian population. Level of Evidence This is a level II, methodological study for scale validation.

Molecular Characterization of Coxsackievirus A24v from Feces and Conjunctiva Reveals Epidemiological Links.

Coxsackievirus A24 variant (CVA24v), the main causative agent of acute hemorrhagic conjunctivitis (AHC), can be isolated from both the eyes and lower alimentary tract. However, the molecular features of CVA24v in feces is not well-documented. In this study, we compared the VP1 and 3C sequences of CVA24v strains isolated from feces during AHC epidemics in Cuba in 1997, 2003, and 2008-2009 with those obtained from conjunctival swabs during the same epidemic period. The sequence analyses of the 3C and VP1 region of stool isolates from the three epidemics showed a high degree of nucleotide identity (ranging from 97.3-100%) to the corresponding conjunctival isolates. The phylogenetic analysis showed that fecal CVA24v isolates from the 1997 and 2003 Cuban outbreaks formed a clade with CVA24v strains isolated from conjunctival swabs in Cuba and other countries during the same period. There were three amino acid changes (3C region) and one amino acid change (VP1 region) in seven CVA24v strains isolated sequentially over 20 days from fecal samples of one patient, suggesting viral replication in the intestine. Despite these substitutions, the virus from the conjunctival swab and fecal samples were genetically very similar. Therefore, fecal samples should be considered as a reliable alternative sample type for the routine molecular diagnosis and molecular epidemiology of CVA24v, also during outbreaks of AHC.

Evaluation of a 20-Month Physical Activity Intervention to Improve Motivational and Affective Outcomes Among Disadvantaged Adult Women.

Grounded in self-determination theory, this study aimed to qualitatively examine women's perception of a set of motivational and affective consequences during and immediately after a physical activity intervention. In total, 11 disadvantaged adult women participated in this 20-month intervention. A total of 102 physical activity sessions based on need-supportive strategies were performed. Six discussion groups, 14 semi-structured interviews, and field notes were used to collect data. A thematic analysis was conducted based on self-determination theory. Findings highlighted that it might be advisable among these disadvantaged women to begin with relatedness-support strategies to increase group cohesion, followed by competence support strategies to increase self-confidence, and, finally, autonomy support strategies to empower women to be physically active. The development of a need-supportive environment in a physical activity intervention may have the potential to achieve motivational and affective consequences, which might promote the empowerment of these disadvantaged women to be physically active.

Evaluating the Psychometric Properties of a Scale to Measure Perceived External and Internal Faces of Controlling Teaching among Students in Physical Education.

There are no validated instruments to date that have examined the students' perceptions of externally and internally controlling teaching practices in physical education (PE). Grounded in self-determination theory, the objective of this research was to provide validity and reliability evidence of the Controlling Teaching Scale for Physical Education (CTS-PE) to assess the external and internal faces of controlling teaching in PE through two sequential studies. In Study 1 (n = 241 students), an exploratory factor analysis revealed an eight-item two-factor solution (four items per factor). In Study 2 (n = 968 students), a confirmatory factor analysis supported the eight-item two-factor correlated model (i.e., externally and internally controlling teaching) that was invariant across gender. Reliability coefficients indicated an acceptable level of reliability for the two factors of the CTS-PE. A structural equation modelling showed that externally and internally controlling teaching behaviours positively predicted need frustration, and negatively need satisfaction. The current study gathered evidence to consider the CTS-PE as a valid and reliable instrument to assess students' perceptions of PE teachers' externally and internally controlling teaching behaviours. The CTS-PE provides PE teachers with deeper insights into the negative psychological experiences associated with externally and internally controlling teaching behaviours in PE.

A Hybrid TGfU/SE Volleyball Teaching Unit for Enhancing Motivation in Physical Education: A Mixed-Method Approach.

Grounded in self-determination theory, this pre-experimental study analyzed the effects of a hybrid teaching games for understanding/sport education (TGfU/SE) volleyball teaching unit on students' motivational outcomes, using a mixed-method approach. It also examined whether the intervention was equally effective for boys and girls. Participants were 53 secondary school students (Mage = 15.50, SDage = 0.57) who were taught through a hybrid TGfU/SE unit. The structure of this unit was designed according to the characteristics of SE model, while learning tasks were designed by using the pedagogical principles of TGfU model. Both self-reported validated questionnaires and focus groups were used before and after intervention to assess students' motivational responses. After the hybrid TGfU/SE unit, both quantitative and qualitative findings showed improvements in students' perceptions of need-support from the physical education (PE) teacher, basic psychological needs satisfaction, novelty, and variety satisfaction, as well as intrinsic motivation compared to baseline values. Although the hybrid TGfU/SE unit was effective in both genders, a large effect size was found for girls. Despite the existence of social and cultural stereotypes in team sports such as volleyball in favor of boys, results highlight the importance of developing hybrid TGfU/SE units to improve students' motivational outcomes, especially in girls.