In Situ Radiation Hardness Study of Amorphous Zn-In-Sn-O Thin-Film Transistors with Structural Plasticity and Defect Tolerance.

Solution-processed metal-oxide thin-film transistors (TFTs) with different metal compositions are investigated for ex situ and in situ radiation hardness experiments against ionizing radiation exposure. The synergetic combination of structural plasticity of Zn, defect tolerance of Sn, and high electron mobility of In identifies amorphous zinc-indium-tin oxide (Zn-In-Sn-O or ZITO) as an optimal radiation-resistant channel layer of TFTs. The ZITO with an elemental blending ratio of 4:1:1 for Zn/In/Sn exhibits superior ex situ radiation resistance compared to In-Ga-Zn-O, Ga-Sn-O, Ga-In-Sn-O, and Ga-Sn-Zn-O. Based on the in situ irradiation results, where a negative threshold voltage shifts and a mobility increase as well as both off current and leakage current increase are observed, three factors are proposed for the degradation mechanisms: (i) increase of channel conductivity, (ii) interface-trapped and dielectric-trapped charge buildup, and (iii) trap-assisted tunneling in the dielectric. Finally, in situ radiation-hard oxide-based TFTs are demonstrated by employing a radiation-resistant ZITO channel, a thin dielectric (50 nm SiO2), and a passivation layer (PCBM for ambient exposure), which exhibit excellent stability with an electron mobility of ∼10 cm2/V s and aΔVth of <3 V under real-time (15 kGy/h) gamma-ray irradiation in an ambient atmosphere.

Influence of Intramuscular Injection Sites on Pharmacokinetics of Amoxicillin in Olive Flounder (Paralichthys olivaceus) and Its Implication for Antibacterial Efficacy.

This study aimed to investigate the effects of different injection sites, including dorsal, cheek, and pectoral fin muscles, on the pharmacological properties of amoxicillin (AMOX) in olive flounder (Paralichthys olivaceus) after a single intramuscular (IM) injection of 40 mg/kg. The AMOX concentration was measured using high-performance liquid chromatography-tandem mass spectrometry, followed by a non-compartmental model analysis. The peak serum concentrations (Cmax) achieved 3 h after dorsal, cheek, and pectoral fin IM injections were 202.79, 203.96, and 229.59 µg/mL, respectively. The area under the concentration-time curve (AUC) was 1697.23, 2006.71, and 1846.61 µg/mL·h, respectively. The terminal half-life (t1/2λZ) was prolonged for cheek and pectoral fin IM injections (10.12 and 10.33 h, respectively) compared to dorsal IM injection (8.89 h). In the pharmacokinetic-pharmacodynamic analysis, a higher T > minimum inhibitory concentration (MIC) and AUC/MIC values were observed after AMOX was injected into the cheek and pectoral fin muscles compared to the dorsal muscle. Muscle residue depletion was below the maximum residue level from day 7 after IM injection at all three sites. These findings suggest that the cheek and pectoral fin sites provide advantages regarding systemic drug exposure and prolonged action compared with the dorsal site.

Preoperative Epidural Steroid Injection Does Not Increase Infection Risk Following Posterior Cervical Surgery.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The purpose of this study was to characterize the infection risk of preoperative epidural steroid injection (ESI) in patients undergoing posterior cervical surgery. SUMMARY OF BACKGROUND DATA: ESI is a helpful tool for alleviating pain and is often used as a diagnostic tool before cervical surgery. However, a recent small-scale study found that ESI before cervical fusion was associated with an increased risk of postoperative infection. MATERIALS AND METHODS: Patients from 2010 to 2020 with cervical myelopathy, spondylosis, and radiculopathy who underwent posterior cervical procedure including laminectomy, laminoforaminotomy, fusion, or laminoplasty were queried from the PearlDiver database. Patients who underwent revision or fusion above C2 or who had a diagnosis of neoplasm, trauma, or preexisting infection were excluded. Patients were divided on whether they received an ESI within 30 days before the procedure and subsequently matched by age, sex, and preoperative comorbidities. The χ 2 analysis was used to calculate the risk of postoperative infection within 90 days. Logistic regression controlling for age, sex, Elixhauser Comorbidity Index, and operated levels was conducted within the unmatched population to assess infection risk for injected patients across procedure subgroups. RESULTS: Overall, 299,417 patients were identified with 3897 having received a preoperative ESI and 295,520 who did not. Matching resulted in 975 in the injected group and 1929 in the control group. There was no significant difference in postoperative infection rate in those who received an ESI within 30 days preoperatively and those who did not (3.28% vs. 3.78%, odds ratio=0.86, 95% CI: 0.57-1.32, P =0.494). Logistic regression accounting for age, sex, Elixhauser Comorbidity Index, and levels operated demonstrated that injection did not significantly increase infection risk in any of the procedure subgroups. CONCLUSIONS: The present study found no association between preoperative ESI within 30 days before surgery and postoperative infection in patients undergoing posterior cervical surgery.

Preoperative radiographic findings associated with postoperative spinopelvic risk factors for instability following total hip arthroplasty.

Postoperative spinopelvic changes are associated with increased dislocation risk following total hip arthroplasty (THA). The aim of this study was to identify preoperative patient and radiographic factors associated with high-risk postoperative spinopelvic parameters. A retrospective review of consecutive THA patients who received preoperative and postoperative sitting and standing lateral lumbar spine-hip radiographs with minimum radiographic and clinical follow-up of 10 months was performed. Patient demographics were recorded and preoperative standing and sitting sacral slope (SS), anteinclination, pelvic femoral angle (PFA), and combined sagittal index (CSI) were measured. High-risk patients were defined by decreased spinopelvic motion (∆SS from sitting to standing of >10°), increased hip motion (∆PFA from sitting to standing of >10°), or decreased CSI of >10° at final follow-up compared with preoperative measurements. Univariate and multivariate regression analyses were used to identify preoperative demographic and radiographic factors associated with these high-risk categories. One hundred and fifty-three patients were included with an average age of 62 years, average body mass index of 27.8 kg/m2 , and average follow-up of 16.2 months. At 1-year follow-up, 43 (28.1%) patients demonstrated a decreased ∆SS > 10° and 67 (43.7%) patients demonstrated an increased ∆PFA > 10° compared with preoperative values. Sitting CSI decreased by >10° in 17 (11.1%) patients. Preoperative increased sitting PFA (adjusted odds ratio [aOR] 1.057, p < 0.001) and decreased preoperative hip motion (∆PFA) were associated with decreased sitting CSI of >10° at 10-month follow-up. Increased spinopelvic motion (∆SS) and decreased hip motion (∆PFA) preoperatively are associated with postoperative radiographic changes that be associated with increased dislocation risk.

Safety and Efficacy of Rivaroxaban in Primary Total Hip and Knee Arthroplasty.

BACKGROUND: An optimal venous thromboembolism prophylaxis agent should balance efficacy and safety. While rivaroxaban provides effective venous thromboembolism prophylaxis after total joint arthroplasty, it may be associated with higher rates of bleeding. This study aimed to compare the safety and efficacy of rivaroxaban to aspirin and enoxaparin. METHODS: A large national database was queried for patients who underwent elective primary total hip (THA) or total knee arthroplasty (TKA) from January 2015 through December 2020 who received rivaroxaban, aspirin, or enoxaparin. Multivariate analyses were performed to assess the 90-day risk of bleeding and thromboembolic complications. Among TKA patients identified, 86,721 (10.8%) received rivaroxaban, 408,038 (50.8%) received aspirin, and 108,377 (13.5%) received enoxaparin. Among THA patients, 42,469 (9.5%) received rivaroxaban, 242,876 (54.5%) received aspirin, and 59,727 (13.4%) received enoxaparin. RESULTS: After accounting for confounding factors, rivaroxaban was associated with increased risk of transfusion (TKA: adjusted odds ratio [aOR] = 2.58, P < .001; THA: aOR 1.64, P < .001), pulmonary embolism (TKA: aOR = 1.25, P = .007), and deep vein thrombosis (TKA: aOR = 1.13, P = .022) compared to aspirin. Compared to enoxaparin, rivaroxaban was associated with an increased risk of combined bleeding events (TKA: aOR = 1.07, P < .001, THA: aOR = 1.11, P < .001), but decreased risk of combined prothrombotic events (THA: aOR = 0.85, P = .036). CONCLUSION: Rivaroxaban chemoprophylaxis following TKA and THA was associated with an increased risk of bleeding and prothrombotic complications compared to aspirin and enoxaparin.

Stability analysis of tranexamic acid in the presence of various antiseptic solutions.

Tranexamic acid (TXA) effectively reduces blood loss and transfusion risk during total joint arthroplasty. Additionally, intraoperative irrigation with various antiseptic solutions is often utilized for the management and prevention of surgical site infection. However, interactions between various antiseptic solutions and TXA have not been investigated. The purpose of this in vitro study is to evaluate the stability of TXA in the presence of common orthopedic antiseptic solutions. Five antiseptic solutions-0.1% chlorhexidine (CHX) gluconate, 10% povidone-iodine (BTD), 0.5% sodium hypochlorite (Dakin's), 3% hydrogen peroxide (H2 O2 ), and 1.5% H2 O2 -and a 0.9% normal saline (NS) control were obtained. A stock 100 mg/ml TXA solution was diluted in each antiseptic solution to a concentration of 10.0 mg/ml to generate reference standard and stability samples. TXA stability in each solution was measured using high performance liquid chromatography at t = 0 and t = 120 min and reported as mean percent of theoretical concentration (MPT) with associated relative standard deviation (RSD). All experiments were performed in triplicate at room temperature. At t = 0 min, TXA remained stable when mixed with 0.9% NS, 0.1% CHX, 10% BTD, 3% H2 O2 , and 1.5% H2 O2 (MPT range: 102.0%-105.0%, RSD range: 0.80%-2.92%). Only 0.5% Dakin's led to significant degradation of TXA at t = 0 min (MPT: 14.3%, RSD:1.28%). At t = 120 min, TXA stability persisted for all compounds except Dakin's 0.5% (MPT: 18.4%, RSD: 28.7%). TXA efficacy may be significantly diminished when 0.5% Dakin's is used as an intraoperative irrigation solution. CHX, BTD, and H2 O2 do not degrade TXA.

Increased dislocation rates following total hip arthroplasty in patients with ankylosing spondylitis.

BACKGROUND: Patients with ankylosing spondylitis (AS) experience abnormal spinopelvic motion due to chronic inflammation of the axial skeleton, predisposing them to impingement and dislocation. The purpose of this study was to evaluate total hip arthroplasty (THA) dislocation rates in AS patients and evaluate the effects of age and gender on dislocation risk. METHODS: Patients who underwent primary THA from 2005 to 2014 were identified using the PearlDiver database. AS patients were compared to age- and gender-matched controls without AS. Patients with a history of spine pathology or spine surgery were excluded. Univariate analyses were performed based on age and sex to evaluate dislocation rates at 90 days, 6 months, 1 year, and 5 years postoperatively. RESULTS: A total of 2792 THA patients (59.6% male) with AS were identified and compared to an age- and gender-matched control group of 5582 THA patients (59.5% male) without AS or known spine pathology. At final follow-up, there were 96 dislocations (3.4%) in the AS group and 138 (2.5%) dislocations in the control group (OR 1.40; 95% CI, 1.08-1.83; p = 0.0118). AS patients ⩾70 years old had higher dislocation rates at all time points (OR range, 1.75-2.09; p < 0.05) compared to controls. At 5-year follow-up, dislocation-free survivorship was 95.7% (95% CI, 94.5-96.9%) for AS patients ⩾70 years old compared to 97.3% (95% CI, 96.6-98.0%) for patients ⩾70 years old without AS. CONCLUSIONS: Older AS patients have higher dislocation rates following THA. This effect is likely related to decreased spinopelvic motion in the sagittal plane, predisposing patients to impinge and dislocate.

Rotator Cuff Repair With Acromioplasty Is Associated With an Increased Rate of Revision and Subsequent Procedures.

Purpose: To evaluate the mid-term rate of revision arthroscopic rotator cuff repair as well as ipsilateral shoulder reoperations after index rotator cuff repair performed with or without acromioplasty in the United States. Methods: The Medicare Standard Analytic File, which encompasses the entire Medicare billing and payment data, was queried between 2005 and 2014. Patients undergoing arthroscopic rotator cuff repair were identified and stratified based on whether ipsilateral acromioplasty was concurrently performed using Current Procedural Terminology codes. Groups were matched by age, sex, year of index procedure, and Elixhauser index at a 2:1 ratio. Primary end point was defined as undergoing a repeat ipsilateral shoulder surgery related to the rotator cuff at 5 years of follow-up. Kaplan-Meier survival curves were constructed, and the 2 groups were compared using the log-rank test. Results: After matching, 54,209 shoulders in the rotator cuff repair with acromioplasty group and 26,448 shoulders in the rotator cuff repair without acromioplasty group were identified. Shoulders undergoing concurrent acromioplasty at index rotator cuff repair had a significantly increased rate of repeat ipsilateral cuff repair at 5 years postoperatively (8.5% vs 6.8%, P < .001). Similarly, there was an increased rate of reoperation of all types to the ipsilateral shoulder in cases where concurrent acromioplasty was performed (9.6% vs 9.1%, P < .001). Conclusions: Using a large, national database, concurrent acromioplasty at the time of rotator cuff tear was found to be associated with both an increase rate of overall subsequent procedures and revision rotator cuff repair. Level of Evidence: III, retrospective comparative study.

Development and Characterization of Solution-Processable Dithieno[3,2-b : 2',3'-d]thiophenes Derivatives with Various End-capped Groups for Organic Field-Effect Transistors.

In this paper, four organic materials based on dithieno[3,2-b : 2',3'-d]thiophene (DTT) core structure with end-capping groups (phenyl and thienyl) and linker (acetylenic and olefinic) between DTT-core and end-capping groups were synthesized and characterized as solution-processable organic semiconductors (OSCs) for organic field-effect transistors (OFETs). Thermal, optical, and electrochemical properties of the corresponding materials were determined. Next, all DTT-derivatives were coated by solution-shearing method, and the thin-film microstructures and morphologies were investigated. To investigate the electrical performance of four newly synthesized DTT-derivatives, bottom-gate/top-contact OFETs were fabricated and characterized in ambient condition. It was found that substitution of acetylenic for olefinic linkers between DTT-cores and end-capping groups enhanced device performance. Especially, the resulting OFETs based on the compound containing phenylacetylene exhibited the highest hole mobility of 0.15 cm2 /Vs and current on/off ratio of ∼106 , consistent with film morphology and texture showing long range interconnected crystalline grains and strong diffraction peaks.

Timing of treatment in osteosarcoma: challenges and perspectives - a scoping review.

BACKGROUND: The timing of events in the management of osteosarcoma may be critical for patient survivorship; however, the prognostic value of factors such as onset of symptoms or initiation of therapy in these patients has not been studied. This study sought to review the literature reporting treatment of osteosarcoma to determine the utility of event timing as a prognostic indicator. Due to significant heterogeneity in the literature, this study was conducted as a scoping review to assess the current state of the literature, identify strengths and weaknesses in current reporting practices, and to propose avenues for future improvement. MAIN BODY: This review screened 312 peer-reviewed studies of osteosarcoma in any anatomic location published in an English journal for reporting of an event timing metric of any kind in a population of 6 or more. Thirty-seven studies met inclusion/exclusion criteria and were assessed for level of evidence, quality, and event timing metric. Reviewers also collated: publication year, population size, population age, tumor site, tumor type, surgical treatment, and adjuvant medical treatment. Extracted event timing data were further characterized using nine standardized categories to enable systematic analysis. The reporting of event timing in the treatment of osteosarcoma was incomplete and heterogenous. Only 37 of 312 (11.9%) screened studies reported event timing in any capacity. The period between patient-reported symptom initiation and definitive diagnosis was the most reported (17/37, 45.9%). Symptom duration was the second most reported period (10/37, 27.0%). Event timing was typically reported incidentally and was never rigorously incorporated into data analysis or discussion. No studies considered the impact of event timing on a primary outcome. The six largest studies were assessed in detail to identify pearls for future researchers. Notable shortcomings included the inadequate reporting of the definition of an event timing period and the pooling of patients into poorly defined timing groups. CONCLUSIONS: Inconsistent reporting of event timing in osteosarcoma treatment prevents the development of clinically useful conclusions despite evidence to suggest event timing is a useful prognostic indicator. Consensus guidelines are necessary to improve uniformity and utility in the reporting of event timing.

Climate change impacts on conventional and flash droughts in the Mekong River Basin.

Recent drought events in the Mekong River Basin (MRB) have resulted in devastating environmental and economic losses, and climate change and human-induced alterations have exacerbated drought conditions. Using hydrologic models and multiple climate change scenarios, this study quantified the future climate change impacts on conventional and flash drought conditions in the MRB. The Soil and Water Assessment Tool (SWAT) and Variable Infiltration Capacity (VIC) models were applied to estimate long-term drought indices for conventional and flash drought conditions over historical and future periods (1966-2099), using two emission scenarios (RCP 4.5 and RCP8.5), and four climate models from the Coupled Model Intercomparison Project Phase 5 (CMIP5). For the conventional drought assessment, monthly scale drought indices were estimated, and pentad-scale (5 days) drought indices were computed for the flash drought evaluations. There were overall increases in droughts from the SWAT model for the conventional drought conditions and overall decreases from the VIC model. For the flash drought conditions, the SWAT-driven drought indices showed overall increases in drought occurrences (up to 165%). On the contrary, the VIC-driven drought indices presented decreases in drought occurrences (up to -44%). The conventional and flash drought evaluations differ between these models as they partition the water budget, specifically soil moisture differently. We conclude that the proposed framework, which includes hydrologic models, various emission scenarios, and projections, allows us to assess the various perspectives on drought conditions. Basin countries have differential impacts, so targeted future adaptation strategy is required.

Midterm Survivorship of Robotic-Assisted Lateral Unicompartmental Knee Arthroplasty.

BACKGROUND: Lateral unicompartmental knee arthroplasty (UKA) is a popular alternative to total knee arthroplasty (TKA) for patients with isolated lateral compartment osteoarthritis. Few studies have investigated outcomes following robotic-assisted lateral UKA. The purpose of this study is to evaluate mid-term survivorship and patient-reported outcomes of robotic-assisted lateral UKA. METHODS: A retrospective case series was conducted on all robotic-assisted lateral UKAs performed by a single surgeon between 2013 and 2019. Patient demographics, surgical variables, and Kozinn and Scott criteria were collected. Implant survivorship was estimated using the Kaplan-Meier method with all-cause reoperation and conversion to TKA as endpoints. Participating patients were assessed for patient satisfaction and the Forgotten Joint Score-12. Correlations between patient demographics and patient outcome scores were investigated. RESULTS: In total, 120 lateral UKAs were identified, 84 of which met inclusion criteria, with a mean follow-up of 4.0 years (range 2.0-7.0). Five-year survivorship was 92.9% (95% confidence interval [CI] 84.5-96.7) with all-cause reoperation as the endpoint, and 100% (95% CI 95.0-100) with conversion to TKA as the endpoint. One patient was converted to TKA after the 5-year mark, resulting in a 6-year survival for conversion to TKA of 88.9% (95% CI 44.9-98.5). Average Forgotten Joint Score-12 score was 82.7/100, and patient satisfaction 4.7/5. Mean coronal plane correction was 2.5° ± 1.9° toward the mechanical axis. Neither final postoperative alignment nor failure to meet classic Kozinn and Scott criteria for UKA resulted in differences in patient-reported outcomes. CONCLUSION: The current study demonstrates high mid-term survivorship and excellent patient-reported outcomes with robotic-assisted lateral UKA. Robotic-assisted lateral UKA is a viable treatment option for isolated lateral compartment arthritis even in patients who do not meet classic indications.

Conversion rates and timing to total knee arthroplasty following anterior cruciate ligament reconstruction: a US population-based study.

PURPOSE: To define the rate of subsequent TKA following ACLR in a large US cohort and to identify factors that influence the risk of later undergoing TKA after ACLR. METHODS: The California's Office of Statewide Health Planning and Development (OSHPD) database was queried from 2000 to 2014 to identify patients who underwent primary ACLR (ACL group). An age-and gender-matched cohort that underwent appendectomy was selected as the control group. The cumulative incidence of TKA was calculated and ten-year survival was investigated using Kaplan-Meier analysis with failure defined as conversion to arthroplasty. Univariate and multivariate analyses were performed to explore the risk factors for conversion to TKA following ACLR. RESULTS: A total of 100,580 ACLR patients (mean age 34.48 years, 66.1%male) were matched to 100,545 patients from the general population. The ACL cohort had 1374 knee arthroplasty events; conversion rate was 0.71% at 2-year follow-up, 2.04% at 5-year follow-up, and 4.86% at 10-year follow-up. This conversion rate was higher than that of the control group at all time points, with an odds ratio of 3.44 (p<0.001) at 10-year follow-up. Decreasing survivorship following ACLR was observed with increasing age, female gender, and worker's compensation insurance, while increased survivorship was found in patients of Hispanic and Asian Pacific Islander racial heritage and those who underwent concomitant meniscal repair. CONCLUSIONS: In this US statewide study, the rate of TKA after ACLR is higher than reported elsewhere, with significantly increased odds when compared to a control group. Age, gender, concomitant knee procedures and other socioeconomic factors influence the rate of conversion to TKA following ACLR.

Multifunctional Nanohybrid of Alumina and Indium Oxide Prepared Using the Atomic Layer Deposition Technique.

Developing new transparent conducting materials, especially those having flexibility, is of great interest for electronic applications. Here, our study on using the ozone-assisted atomic layer deposition (ALD) technique at a low temperature of 200 °C for making an ultrathin, transparent, flexible, and highly electroconducting nanohybrid of indium and aluminum oxides is introduced. Through various characterizations, measurements, and density functional theory-based calculations, excellent electrical conductivity (∼950 S cm-1), transparency (95% in the visible region), and flexibility (bendable angle of 130° for 10 000 cycles) of our nanohybrid oxide thin film with a total layer thickness below 15 nm (2-4 nm for alumina and 10 nm for indium oxide) have been revealed and discussed. Besides, potential sensing applications of our oxide films on a flexible substrate have been demonstrated, such as strain sensors, temperature sensors (25-100 °C, resolution of 0.1 °C), and NO2 gas sensors (0.35-3.5 ppm, optimum operation at 65-75 °C). With the great potential in not only transparent conducting oxide but also sensing applications, our multifunctional nanohybrid prepared using a simple ozone-assisted ALD route opens more room for the applicability of transparent and flexible electronics.

Utilization of technology-assisted total hip arthroplasty in the United States from 2005 to 2018.

BACKGROUND: Successful outcomes in total hip arthroplasty (THA) rely in part on accurate component positioning, which may be optimized through the use of computer navigation and robot-assistance. Therefore, we queried a large national database to characterize national trends in technology-assisted THA utilization, determine whether these technologies were associated with increased hospital charges, and identify demographic factors associated with technology-assisted THA. METHODS: Using the Nationwide Inpatient Sample database, patients that underwent conventional THA, computer-navigated THA, and robot-assisted THA from 2005 to 2018 were identified. Patient and hospital demographics, charge data, and payer characteristics were collected. Temporal trends in utilization were reported. Univariate analyses were performed to compare differences between groups with multiple logistic regression analysis to account for confounders. RESULTS: In total, 3,428,208 patients undergoing THA from 2005 to 2018 were identified, of which 63,136 (1.8%) used computer navigation and 32,660 (1.0%) used robot-assistance. National utilization of computer navigation in THA increased from 0.1% to 1.9% between 2005 and 2018, while utilization of robot-assisted THA increased from <0.1% to 2.1% from 2008 to 2018. On multivariate analysis, technology-assisted THA was most commonly performed in urban hospitals in the Northeastern United States. Median hospital charges were increased for technology-assisted THAs relative to conventional THAs ($66,089 ± $254 vs $55,418 ± $43). CONCLUSIONS: Computer navigation and robot-assistance in THA demonstrated a consistent increase in utilization during the period examined, representing 4.0% of THAs performed in 2018. Patient and hospital characteristics including risk of mortality, geographic region, and teaching status were associated with increased utilization. Utilization of computer navigation was associated with increased hospital charges.

Differentiating Upper Extremity Necrotizing Soft Tissue Infection From Serious Cellulitis and Abscess.

Introduction Necrotizing soft tissue infection (NSTI) of the upper extremity (UE) is a rapidly progressing infection that requires early diagnosis and emergent treatment to decrease risks of loss of limb or life. Clinical presentation, particularly of early NSTI, can appear similar to serious cellulitis or abscess. The purpose of this study was to identify factors that are associated with NSTI rather than serious cellulitis and abscess to differentiate patients with similar clinical presentations. Methods This study uses a retrospective cohort design that compares patients ultimately diagnosed with UE NSTI versus those diagnosed with UE serious cellulitis or abscess. Cohorts were matched using the Laboratory Risk Indicators for Necrotizing Fasciitis (LRINEC) score in the setting of UE soft tissue infection. Laboratory values, vital signs, subjective symptoms, and social factors including substance abuse and domiciled status were recorded. Continuous variables were compared using the Mann-Whitney U test, whereas categorical variables were compared using the chi-squared test or the Fisher exact test (for expected values less than 5). A binary logistic regression for continuous and categorical variables was also performed. Significance was set at p<0.05. Univariate and multivariate analyses were performed. Results Multivariate statistical analysis and clinical interpretation of data identified four factors more associated with a diagnosis of NSTI than serious cellulitis or abscess: elevated lactate on hospital presentation, a patient-reported history of fever, male gender, and homelessness.  Conclusions In patients with upper extremity infections, the clinical presentation of NSTI and serious cellulitis or abscess may appear similar. In this retrospective cohort of patients matched with LRINEC scores, elevated lactate, subjective fever, male gender, and homelessness were significantly associated with NSTI rather than serious cellulitis or abscess.

Reliability of Plain Radiographs Versus Magnetic Resonance Imaging to Measure Tibial Slope in Sports Medicine Patients: Can They Be Used Interchangeably?

BACKGROUND: The slope of the tibial plateau has been proposed as a reason for failure of anterior cruciate ligament reconstruction. PURPOSE: To evaluate the interobserver reliability of measurements of tibial slope on radiographs versus magnetic resonance imaging (MRI) scans and to assess whether the modalities can be used interchangeably for this purpose. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: This retrospective study included 81 patients aged 18 to 30 years who were evaluated in a sports medicine setting for knee pain and who had lateral knee radiographs as well as knee MRI scans on file. Medial and lateral tibial plateau slope measurements were made by 3 blinded reviewers from the radiographs and MRI scans using graphic overlay software. The paired t test was used to compare measurements of the medial tibial plateau slope (MTPS) and lateral tibial plateau slope (LTPS) from radiographs and MRI scans. Intraclass correlation coefficients (ICCs) were calculated to determine intra- and interobserver reliability of measurements within each imaging modality, and Pearson correlation coefficients were calculated to determine the relationship between measurements on radiographs versus MRI scans. RESULTS: Imaging from 81 patients were included. The average MTPS was significantly larger on radiographs compared with MRI scans (8.7° ± 3.6° vs 3.7° ± 3.4°; P < .001), and the average LTPS was also significantly larger on radiographs compared with MRI scans (7.9° ± 3.4° vs 5.7° ± 3.7°; P < .001). ICC values indicated good to excellent intraobserver agreement for all imaging modalities (ICC, 0.81-0.97; P ≤ .009). The ICCs for interobserver reliability of MTPS and LTPS measurements were 0.92 and 0.85 for radiographs, 0.87 and 0.83 for MRI based off the subchondral bone, and 0.86 and 0.71 for MRI based off the cartilage, respectively (P < .001). Medium correlation was noted between radiographic and MRI measurements; Pearson correlation coefficients for radiographic versus subchondral MRI measurements were 0.30 and 0.37 for MTPS and LTPS, respectively. CONCLUSION: The average MTPS and LTPS were significantly larger on radiographs compared with MRI scans. Although tibial slope measurements using radiography and those using MRI are reliable between individuals, the measurements from radiographs and MRI scans cannot be used interchangeably, and caution should be used when interpreting and comparing studies using measurements of the tibial slope.

Compensatory Protection of Thioredoxin-Deficient Cells from Etoposide-Induced Cell Death by Selenoprotein W via Interaction with 14-3-3.

Selenoprotein W (SELENOW) is a 9.6 kDa protein containing selenocysteine (Sec, U) in a conserved Cys-X-X-Sec (CXXU) motif. Previously, we reported that SELENOW regulates various cellular processes by interacting with 14-3-3ß at the U of the CXXU motif. Thioredoxin (Trx) is a small protein that plays a key role in the cellular redox regulatory system. The CXXC motif of Trx is critical for redox regulation. Recently, an interaction between Trx1 and 14-3-3 has been predicted. However, the binding mechanism and its biological effects remain unknown. In this study, we found that Trx1 interacted with 14-3-3ß at the Cys32 residue in the CXXC motif, and SELENOW and Trx1 were bound at Cys191 residue of 14-3-3ß. In vitro binding assays showed that SELENOW and Trx1 competed for interaction with 14-3-3ß. Compared to control cells, Trx1-deficient cells and SELENOW-deficient cells showed increased levels of both the subG1 population and poly (ADP-ribose) polymerase (PARP) cleavage by etoposide treatment. Moreover, Akt phosphorylation of Ser473 was reduced in Trx1-deficient cells and was recovered by overexpression of SELENOW. These results indicate that SELENOW can protect Trx1-deficient cells from etoposide-induced cell death through its interaction with 14-3-3ß.

Effect of Mindfulness Yoga on Depression Severity, Self-Esteem, and Quality of Life in Middle-Aged Men.

BACKGROUND: We aimed to conduct a mindfulness yoga program to treat the psychological problems of middle-aged men by examining the effects of a mindfulness yoga program on depression, self-esteem, and quality of life in this population. METHODS: The participants included 50 middle-aged men (aged 40-60 yr) living in Seongnam-si, Korea. Twenty-five men were randomly assigned to the experimental group and 25 were assigned to the control group. The mindfulness yoga program was conducted twice a week for 12 weeks, and each session lasted approximately 75 min. Before the first session, a pre-test was conducted, after which the program began. Questionnaires were completed after the 4th, 8th, and 12th weeks of the program, and the control group underwent psychological tests at the same time points. A two-way (2 × 4) repeated measures analysis of variance was conducted, and when the interaction effect was significant, a post-hoc test (Bonferroni) was performed. RESULTS: In the intervention group, depression severity significantly decreased (P<0.001) and self-esteem significantly increased (P<0.01). Furthermore, the intervention group also showed a significant increase in psychological (P<0.001), social (P<0.001), and overall quality of life (P<0.001) among the sub-dimensions of quality of life. CONCLUSION: Middle-aged men should be made aware of the usefulness of mindfulness yoga and encouraged to participate in such programs. Mindfulness yoga may be considered as an alternative treatment strategy that promotes the natural healing and management of psychological issues faced by middle-aged men.

Self and Relative Effects of Competitive State Anxiety on Perceived Performance in Middle and High School Taekwondo Athletes: An Actor and Partner Interdependence Model Analysis.

BACKGROUND: The present study aimed to provide an empirical theoretical basis for the psychological phenomena that occur among competing athletes. To this end, we utilized the actor and partner interdependence model (APIM) to analyze the self- and relative effects of competitive state anxiety on perceived performance in middle and high school Taekwondo athletes. METHODS: Data were analyzed for 372 middle and high school athletes (red group=186, blue group=186) who participated in the first round of the 2020 Korea Taekwondo Association National Taekwondo Competition. Analysis based on the APIM was applied to the collected data, and a path analysis was conducted to verify the self- and relative effects of competitive state anxiety on perceived performance. RESULTS: Cognitive (red: P<0.01, blue: P<0.001) and physical state anxiety (red: P<0.01, blue: P<0.01) exerted a significant negative self-effect on perceived performance in both groups. In contrast, state confidence (red: P<0.001, blue: P<0.001) exerted a significant positive self-effect on perceived performance. Furthermore, cognitive (red: P<0.001, blue: P<0.01) and physical state anxiety (red: P<0.001, blue: P<0.001) exerted a significant positive relative effect on the opponent's perceived performance in both groups, while state confidence (red: P<0.01, blue: P<0.001) exerted a significant negative relative effect on the opponent's perceived performance. CONCLUSION: Sports psychologists should focus on developing a psychological training program that provides practical psychological support as well as self-regulatory and relative strategies for improving athletic performance in competitive scenarios.