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British Medical Bulletin Sep 2023Transient bone osteoporosis (TBO) is characterized by persistent pain, loss of function, no history of trauma and magnetic resonance image (MRI) findings of bone marrow...
INTRODUCTION
Transient bone osteoporosis (TBO) is characterized by persistent pain, loss of function, no history of trauma and magnetic resonance image (MRI) findings of bone marrow edema.
SOURCE OF DATA
PubMed, Google scholar, EMABSE and Web of Science were accessed in February 2023. No time constrains were used for the search.
AREAS OF AGREEMENT
TBO is rare and misunderstood, typically affecting women during the third trimester of pregnancy or middle-aged men, leading to functional disability for 4-8 weeks followed by self-resolution of the symptoms.
AREAS OF CONTROVERSY
Given the limited evidence in the current literature, consensus on optimal management is lacking.
GROWING POINTS
This systematic review investigates current management of TBO.
AREAS TIMELY FOR DEVELOPING RESEARCH
A conservative approach leads to the resolution of symptoms and MRI findings at midterm follow-up. Administration of bisphosphonates might alleviate pain and accelerate both clinical and imaging recovery.
Topics: Male; Middle Aged; Pregnancy; Humans; Female; Osteoporosis; Magnetic Resonance Imaging; Diphosphonates; Bone Marrow Diseases; Edema
PubMed: 37328938
DOI: 10.1093/bmb/ldad012 -
Philosophical Transactions. Series A,... Apr 2024Geodiversity is a topical concept in earth and environmental sciences. Geodiversity information is needed to conserve nature, use ecosystem services and achieve...
Geodiversity is a topical concept in earth and environmental sciences. Geodiversity information is needed to conserve nature, use ecosystem services and achieve sustainable development goals. Despite the increasing demand for geodiversity data, there exists no comprehensive system for categorizing geodiversity. Here, we present a hierarchically structured taxonomy that is potentially applicable in mapping and quantifying geodiversity across different regions, environments and scales. In this taxonomy, the main components of geodiversity are geology, geomorphology, hydrology and pedology. We propose a six-level hierarchical system where the components of geodiversity are classified at progressively lower taxonomic levels based on their genesis, physical-chemical properties and morphology. This comprehensive taxonomy can be used to compile geodiversity information for scientific research and various applications of value to society and nature conservation. Ultimately, this hierarchical system is the first step towards developing a global geodiversity taxonomy. This article is part of the Theo Murphy meeting issue 'Geodiversity for science and society'.
PubMed: 38342205
DOI: 10.1098/rsta.2023.0060 -
Epigenomes Aug 2023Although reported in the literature, ribosome heterogeneity is a phenomenon whose extent and implications in cell and organismal biology is not fully appreciated. This... (Review)
Review
Although reported in the literature, ribosome heterogeneity is a phenomenon whose extent and implications in cell and organismal biology is not fully appreciated. This has been the case due to the lack of the appropriate techniques and approaches. Heterogeneity can arise from alternative use and differential content of protein and RNA constituents, as well as from post-transcriptional and post-translational modifications. In the few examples we have, it is apparent that ribosomal heterogeneity offers an additional level and potential for gene expression regulation and might be a way towards tuning metabolism, stress, and growth programs to external and internal stimuli and needs. Here, we introduce ribosome biogenesis and discuss ribosomal heterogeneity in various reported occasions. We conclude that a systematic approach in multiple organisms will be needed to delineate this biological phenomenon and its contributions to growth, aging, and disease. Finally, we discuss ribosome mutations and their roles in disease.
PubMed: 37606454
DOI: 10.3390/epigenomes7030017 -
Knee Surgery, Sports Traumatology,... Oct 2023After four weeks from injury, tears of the Achilles tendon are considered chronic. Their management is challenging, and the use of a graft is suggested when the gap... (Review)
Review
PURPOSE
After four weeks from injury, tears of the Achilles tendon are considered chronic. Their management is challenging, and the use of a graft is suggested when the gap between proximal and distal stumps is greater than 6 cm. The present study systematically reviews the outcome of free tendon grafts in chronic ruptures of the Achilles tendon, evaluating clinical outcomes, complications and return to sport.
METHODS
The present study was conducted according to the PRISMA 2020 guidelines. PubMed, Google Scholar, Embase, and Web of Science databases were accessed in February 2023. All the published clinical studies reporting clinical outcome, return to sport and complications of free tendon grafts used the treatment of chronic rupture of the midportion of the Achilles Tendon were accessed. The mean CMS (Coleman Methodology Score) of 65.7 suggested an overall good quality of the available published articles, attesting to the low risk of bias.
RESULTS
Data from 22 articles (368 patients with a mean age of 47 years) were retrieved. The average time from rupture to surgery was 25.1 week. At last follow-up, the AOFAS (American Orthopaedic Foot and Ankle Surgery) and ATRS (Achilles Tendon Total Rupture Score) scores improved of 33.8 (P = 0.0004), and 45.1 points (P = 0.0001) respectively. Return to activity was reported in 105 patients, and 82 (78.1%) had no activity limitations, while 19 (18.1%) had limited recreational but not daily activity limitations, and 4 (3.8%) reported limitations in daily activities. Return to sport data was reported in six studies, and 45 of 93 (48.4%) patients returned to sport at an average of 22.6 weeks.
CONCLUSION
In chronic tears of the Achilles tendon, with a gap of at least 6 cm, free tendon grafts allow predictable return to sport and acceptable recovery function.
LEVEL OF EVIDENCE
Level IV.
Topics: Humans; Middle Aged; Achilles Tendon; Treatment Outcome; Tendon Injuries; Plastic Surgery Procedures; Sports; Rupture; Retrospective Studies
PubMed: 37193823
DOI: 10.1007/s00167-023-07446-4 -
Scientific Reports Sep 2023Patterning of two or more liquids, either homogeneous in each phase or mixed with particles (including biological matter, such as cells and proteins), by controlling...
Patterning of two or more liquids, either homogeneous in each phase or mixed with particles (including biological matter, such as cells and proteins), by controlling their flow dynamics, is relevant to several applications. Examples include dynamic spatial confinement of liquids in microfluidic systems (such as lab-on-a-chip and organ-on-a-chip devices) or structuring of polymers to modulate various properties (such as strength, conductivity, transparency and surface finishing). State-of-the-art strategies use various technologies, including positioners, shakers and acoustic actuators, which often combine limited versatility of mixing with significant inefficiency, energy consumption, and noise, as well as tendency to increase the temperature of the liquids. Here, we describe a new kind of robotic mixers of liquids, based on electro-responsive smart materials (dielectric elastomer actuators). We show for the first time how an efficient soft robotic device can be used to produce, via combinations of rotations and translations, various spatial patterns in liquids and maintain them stable for a few minutes. Moreover, we show that, as compared to a conventional orbital shaker, the new type of robotic device can mix liquids with a higher efficacy (~ 94% relative to ~ 80%, after 8 min of mixing) and with a significantly lower increase of the liquids' temperature (+ 1 °C relative to + 5 °C, after 6 h of mixing). This is especially beneficial when mixing should occur according to controllable spatial features and should involve temperature-sensitive matter (such as biological cells, proteins, pre-polymers and other thermolabile molecules).
PubMed: 37735476
DOI: 10.1038/s41598-023-41755-5 -
Clinics in Geriatric Medicine Nov 2023This article introduces core topics in health equity scholarship and provides examples of how diversity, equity, and inclusion impact the aging population and emergency... (Review)
Review
This article introduces core topics in health equity scholarship and provides examples of how diversity, equity, and inclusion impact the aging population and emergency care of older adults. It offers strategies for promoting diversity, equity, and inclusion to both strengthen the patient-clinician therapeutic relationship and to address operations and systems that impact care of the geriatric emergency department patient.
Topics: Humans; Aged; Geriatrics; Emergency Service, Hospital; Emergency Medical Services; Aging
PubMed: 37798072
DOI: 10.1016/j.cger.2023.04.009 -
Diabetes & Vascular Disease Research 2023To compare the cardiovascular and renal outcomes of GLP-1 RA versus DPP4i and basal insulin in the management of T2DM. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To compare the cardiovascular and renal outcomes of GLP-1 RA versus DPP4i and basal insulin in the management of T2DM.
METHODS
Data from 22 studies involving over 200,000 participants were pooled using the inverse variance method and random-effects meta-analysis. The review was reported in accordance with PRISMA.
RESULTS
Compared with DPP4i, treatment with GLP-1 RA was associated with a greater benefit on composite cardiovascular outcomes (HR:0.77, 95% CI:0.69-0.87), myocardial infarction (HR:0.82, 95% CI:0.69-0.97), stroke (HR:0.83, 95% CI: 0.74-0.93), cardiovascular mortality (HR:0.76, 95% CI:0.68-0.85) and all-cause mortality (HR:0.65, 95% CI:0.48-0.90). There was no difference in effect on heart failure (HR:0.97, 95% CI:0.82-1.15). Compared with basal insulin, GLP-1 RA was associated with better effects on composite cardiovascular outcomes (HR:0.62, 95% CI:0.48-0.79), heart failure (HR:0.57, 95% CI:0.35-0.92), myocardial infarction (HR:0.70, 95% CI:0.58-0.85), stroke (HR:0.50, 95% CI:0.40-0.63) and all-cause mortality (HR:0.31, 95% CI:0.20-0.48). Evidence from a small number of studies suggests that GLP-1 RA had better effects on composite and individual renal outcomes, such as eGFR, compared with either DPP4i and basal insulin.
CONCLUSION
Available evidence suggests that treating T2DM with GLP-1 RA can yield better benefits on composite and specific cardiorenal outcomes than with DPP4i and basal insulin.
PROSPERO REGISTRATION NUMBER
CRD42022335504.
Topics: Humans; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Dipeptidyl-Peptidase IV Inhibitors; Glucagon-Like Peptide-1 Receptor Agonists; Heart Failure; Hypoglycemic Agents; Insulins; Myocardial Infarction; Stroke
PubMed: 38111352
DOI: 10.1177/14791641231221740 -
EMBO Reports Oct 2023To fuel accelerated proliferation, leukaemic cells undergo metabolic deregulation, which can result in specific nutrient dependencies. Here, we perform an amino acid...
To fuel accelerated proliferation, leukaemic cells undergo metabolic deregulation, which can result in specific nutrient dependencies. Here, we perform an amino acid drop-out screen and apply pre-clinical models of chronic phase chronic myeloid leukaemia (CML) to identify arginine as a nutrient essential for primary human CML cells. Analysis of the Microarray Innovations in Leukaemia (MILE) dataset uncovers reduced ASS1 levels in CML compared to most other leukaemia types. Stable isotope tracing reveals repressed activity of all urea cycle enzymes in patient-derived CML CD34 cells, rendering them arginine auxotrophic. Thus, arginine deprivation completely blocks proliferation of CML CD34 cells and induces significantly higher levels of apoptosis when compared to arginine-deprived cell lines. Similarly, primary CML cells, but not normal CD34 samples, are particularly sensitive to treatment with the arginine-depleting enzyme, BCT-100, which induces apoptosis and reduces clonogenicity. Moreover, BCT-100 is highly efficacious in a patient-derived xenograft model, causing > 90% reduction in the number of human leukaemic stem cells (LSCs). These findings indicate arginine depletion to be a promising and novel strategy to eradicate therapy resistant LSCs.
Topics: Humans; Arginine; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Apoptosis; Stem Cells; Neoplastic Stem Cells
PubMed: 37489735
DOI: 10.15252/embr.202256279 -
Biomolecules Sep 2023Serine protease inhibitors, SERPINS, are a highly conserved family of proteins that regulate serine proteases in the central coagulation and immune pathways,... (Review)
Review
Serine protease inhibitors, SERPINS, are a highly conserved family of proteins that regulate serine proteases in the central coagulation and immune pathways, representing 2-10% of circulating proteins in the blood. Serine proteases form cascades of sequentially activated enzymes that direct thrombosis (clot formation) and thrombolysis (clot dissolution), complement activation in immune responses and also programmed cell death (apoptosis). Virus-derived serpins have co-evolved with mammalian proteases and serpins, developing into highly effective inhibitors of mammalian proteolytic pathways. Through interacting with extracellular and intracellular serine and cysteine proteases, viral serpins provide a new class of highly active virus-derived coagulation-, immune-, and apoptosis-modulating drug candidates. Viral serpins have unique characteristics: (1) function at micrograms per kilogram doses; (2) selectivity in targeting sites of protease activation; (3) minimal side effects at active concentrations; and (4) the demonstrated capacity to be modified, or fine-tuned, for altered protease targeting. To date, the virus-derived serpin class of biologics has proven effective in a wide range of animal models and in one clinical trial in patients with unstable coronary disease. Here, we outline the known viral serpins and review prior studies with viral serpins, considering their potential for application as new sources for immune-, coagulation-, and apoptosis-modulating therapeutics.
Topics: Animals; Humans; Serpins; Serine Proteinase Inhibitors; Serine Endopeptidases; Serine Proteases; Mammals
PubMed: 37759793
DOI: 10.3390/biom13091393 -
The Lancet. Global Health Oct 2023Pandemic preparedness and response have relied primarily on market dynamics to drive development and availability of new health products. Building on calls for... (Review)
Review
Pandemic preparedness and response have relied primarily on market dynamics to drive development and availability of new health products. Building on calls for transformation, we propose a new value proposition that instead prioritises equity from the research and development (R&D) stage and that strengthens capacity to control outbreaks when and where they occur. Key elements include regional R&D hubs free to adapt well established technology platforms, and independent clinical trials networks working with researchers, regulators, and health authorities to better study questions of comparative benefit and real-world efficacy. Realising these changes requires a shift in emphasis: from pandemic response to outbreak control, from one-size-fits-all economies of scale to R&D and manufacture for local need, from de novo product development to last-mile innovation through adaptation of existing technologies, and from proprietary, competitive R&D to open science and financing for the common good that supports collective management and sharing of technology and know-how.
Topics: Humans; Public Health; Motivation; Pandemics; Research; Disease Outbreaks
PubMed: 37652070
DOI: 10.1016/S2214-109X(23)00328-5