University Of California Research Articles

Outcomes of open reduction and internal fixation using 2.0/2.4 mm locking compression plate in isolated greater tuberosity fractures of humerus

Background: The purpose of this study was to retrospectively evaluate the radiographic and clinical results of a small single or double low-profile plate fixation of 2.0/2.4 mm locking compression plate (LCP) in treating isolated greater tuberosity (GT) fractures of the humerus. Methods: From June 2015 to October 2022, patients who underwent LCP in treating isolated GT fractures of the humerus were included in this study. The radiological and clinical results were analyzed in 15 patients who underwent open reduction and internal fixation used 2.0/2.4 mm LCP. Results: Bone union was achieved in 14 patients (93.3%) and one failed case was treated with a 2.4 mm single LCP fixation. Radiological union was achieved within 10–20 weeks. Complications occurred in two patients (13.3%), including the reduction failure and shoulder stiffness. At the final follow-up, the average clinical scores were as follows: a visual analog scale for pain of 2.1 (range, 0–5) and a University of California, Los Angeles score of 27.2 (range, 18–31). Regarding range of motion (ROM), the average active ROMs were 142° for forward flexion (range, 120°–150°), 147.1° for abduction (range, 120°– 180°), and 59.3° for external rotation (range, 45°–80°). For internal rotation, the average was observed to reach the 10th thoracic vertebra (range, 1st lumbar vertebra–7th thoracic vertebra). Conclusions: The clinical and radiologic outcomes of treating isolated GT fracture using 2.0/2.4 mm LCP were favorable, and double low-profile plate fixation may be beneficial for sufficient fracture stability if possible. Level of evidence: Level IV, case series.

Interpositional tricortical iliac bone graft in nonunion of midshaft clavicular fractures

Background: The purpose of this study was to investigate the radiological and clinical outcomes after interpositional tricortical iliac bone graft with plate fixation for the nonunion of clavicle midshaft fractures. Methods: Between 2007 and 2020, 17 cases who were treated by interpositional tricortical iliac bone graft with plate fixation for the clavicle midshaft nonunion combined with bone defect were investigated. The mean age was 53 years (range, 22–70 years). The mean follow-up period was 102.2 months (range, 18–193 months). Serial plain radiographs were used to evaluate radiological outcomes. The University of California, Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and Quick-disabilities of the arm, shoulder, and hand (DASH) score were used to evaluate clinical outcomes. Complications were also evaluated. Results: All cases achieved complete bony union with mean healing time of 17.6 weeks (range, 14–22 weeks). The mean clavicle length difference was significantly decreased from 9.1 mm preoperatively to 2.6 mm postoperatively (P<0.001). The mean UCLA and ASES scores were significantly improved from 18.1 and 52.2 before surgery to 30.6 and 88.6 after surgery (both P<0.001), respectively. The mean final Quick-DASH score was 18.0. Three cases (17.6%) developed postoperative complications including two cases of shoulder stiffness and one case of screw irritation. Conclusions: Interpositional tricortical iliac bone graft with plate fixation for the clavicle midshaft nonunion demonstrated excellent radiological and clinical outcomes. In cases of atrophic nonunion combined with bone defect, this technique is an effective option that can provide structural support and restore clavicle length. Level of evidence: Level IV, case series.

Research Hotspots of Interferon Gamma in the Treatment of Lung Cancer: A Bibliometric Analysis Based on CiteSpace.

Interferon-gamma (IFN-γ) is an important cytokine associated with antitumor immunity and has been implicated in the pathogenesis and progression of lung cancer. Nevertheless, no bibliometric analyses have been published in this field to date, and thus we aim to address this gap in knowledge. A search of the Web of Science (WOS) for literature related to the treatment of lung cancer with IFN-γ was conducted from 2002 to 2024. The extracted information from the included articles was subjected to visual analysis, and network diagrams were generated using software such as CiteSpace and VOSviewer. In total, 589 articles related to the treatment of lung cancer with IFN-γ were included in WOS between 2002 and 2024. The number of articles and citation frequency generally showed an increasing trend year by year. The United States and the University of California are the countries and institutions with the largest number of articles. The researcher who made the largest contribution to this field was Xin Cai from China (6). The Journal for ImmunoTherapy of Cancer published the largest number of relevant papers in the field (16 papers, IF = 12.469). The research hotspots in the field of immune escape in recent years have been IFN-γ, mechanism, immune checkpoints, and microtumor inhibitors. The field of IFN-γ treatment of lung cancer is evolving at a rapid pace. The current research focus within this field is on elucidating the mechanism of IFN-γ treatment of lung cancer, investigating the role of immune checkpoint inhibitors, and examining the tumor microenvironment and other pertinent topics.

Uridine-cytidine kinase 2 is correlated with immune, DNA damage repair and promotion of cancer stemness in pan-cancer

BackgroundUCK2 (Uridine-Cytidine Kinase 2) is a promising prognostic marker for malignant tumors, but its association with immune infiltration and cancer stemness in pan-cancer remains to be fully understood. we find that gene UCK2 is closed related to RNA stemness scores (RNAss) and DNA stemness scores (DNAss), which is measured the tumor stemness. We also discover an association between UCK2 expression and immune cells by CIBERSORT algorithm, ESTIMATE algorithm and ssGSEA algorithm, especially, related to T cell, monocytes, mast cells, and macrophages. This study aims to shed light on the role and possible mechanism of UCK2 in pan-cancer.MethodsWe used the R programming language for pan-cancer bulk sequencing data analysis, which were obtained from the University of California, Santa Cruz (UCSC) datasets. UCSC database is a very useful for explore data from TCGA and other cancer genomics datasets, The data we explored at the UCK2 transcriptome level came from TCGA data in the UCSC database. We explored differential UCK2 expression between tumor and normal samples. Immunohistochemistry (IHC) was utilized to validate the expression of UCK2 in different types cancers using tumor tissue chips. The correlations of UCK2 with prognosis, genetic instability, DNA repair, cancer stem cell characteristics, and immune cell infiltration were investigated. Furthermore, single-cell datasets, acquired from the Gene Expression Omnibus (GEO) database, were used to validate the relationship between UCK2 and immune cells. GEO is a famous public genomics database supporting freely disseminates microarray data. Finally, we analyzed the correlation between UCK2 and drug sensitivity.ResultsUCK2 expression was observed to be high in most cancers and was remarkably related to the prognosis of pan-cancers. We found that the increased UCK2 expression was associated with higher genetic instability. Additionally, positive relationships were observed between UCK2 expression and mismatch repair genes, homologous recombination repair genes, and cancer stemness across different cancer types. There were significant correlations between UCK2 and T cells, monocytes, mast cells, and macrophages. Moreover, as expected, the immune checkpoint human leucocyte antigen (HLA) was found to be negatively related to UCK2. Similarly, UCK2 was also observed to have a negative association with major histocompatibility complex (MHC) genes. We noted that UCK2 had significant correlations with the sensitivity to various anti-cancer drug.ConclusionWe have observed that UCK2 plays pivotal roles in prognosis and tumor immunity, and it is associated with DNA repair and cancer stemness. The UCK2 gene exhibits a strong correlation with the immune checkpoints HLA. This study highlights its potential impact on drug sensitivity.

Multimodal Pain Recognition in Postoperative Patients: Machine Learning Approach.

Acute pain management is critical in postoperative care, especially in vulnerable patient populations that may be unable to self-report pain levels effectively. Current methods of pain assessment often rely on subjective patient reports or behavioral pain observation tools, which can lead to inconsistencies in pain management. Multimodal pain assessment, integrating physiological and behavioral data, presents an opportunity to create more objective and accurate pain measurement systems. However, most previous work has focused on healthy subjects in controlled environments, with limited attention to real-world postoperative pain scenarios. This gap necessitates the development of robust, multimodal approaches capable of addressing the unique challenges associated with assessing pain in clinical settings, where factors like motion artifacts, imbalanced label distribution, and sparse data further complicate pain monitoring. This study aimed to develop and evaluate a multimodal machine learning-based framework for the objective assessment of pain in postoperative patients in real clinical settings using biosignals such as electrocardiogram, electromyogram, electrodermal activity, and respiration rate (RR) signals. The iHurt study was conducted on 25 postoperative patients at the University of California, Irvine Medical Center. The study captured multimodal biosignals during light physical activities, with concurrent self-reported pain levels using the Numerical Rating Scale. Data preprocessing involved noise filtering, feature extraction, and combining handcrafted and automatic features through convolutional and long-short-term memory autoencoders. Machine learning classifiers, including support vector machine, random forest, adaptive boosting, and k-nearest neighbors, were trained using weak supervision and minority oversampling to handle sparse and imbalanced pain labels. Pain levels were categorized into baseline and 3 levels of pain intensity (1-3). The multimodal pain recognition models achieved an average balanced accuracy of over 80% across the different pain levels. RR models consistently outperformed other single modalities, particularly for lower pain intensities, while facial muscle activity (electromyogram) was most effective for distinguishing higher pain intensities. Although single-modality models, especially RR, generally provided higher performance compared to multimodal approaches, our multimodal framework still delivered results that surpassed most previous works in terms of overall accuracy. This study presents a novel, multimodal machine learning framework for objective pain recognition in postoperative patients. The results highlight the potential of integrating multiple biosignal modalities for more accurate pain assessment, with particular value in real-world clinical settings.

Research hotspots and trends in gut microbiota and nonalcoholic fatty liver disease: A bibliometric study.

Recent research indicates that the intestinal microbial community, known as the gut microbiota, may play a crucial role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). To understand this relationship, this study used a comprehensive bibliometric analysis to explore and analyze the currently little-known connection between gut microbiota and NAFLD, as well as new findings and possible future pathways in this field. To provide an in-depth analysis of the current focus issues and research developments on the interaction between gut microbiota and NAFLD. In this study, all data were collected from the Web of Science Core Collection, and the related searches were completed on one day (February 21, 2024). The data were stored in plain text format to facilitate subsequent analysis. VOSviewer 1.6.20 and CiteSpace 6.1R6 Basic were used for knowledge graph construction and bibliometric analysis. The study included a total of 1256 articles published from 2013 to 2023, and the number of published papers demonstrated an upward trend, reaching a peak in the last two years. The University of California, San Diego held the highest citation count, while Shanghai University of Traditional Chinese Medicine in China led in the number of published works. The journal "Nutrients" had the highest publication count, while "Hepatology" was the most frequently cited. South Korean author Suk Ki Tae was the most prolific researcher. The co-cited keyword cluster labels revealed ten major clusters, namely cortisol, endothelial dysfunction, carbohydrate metabolism, myocardial infarction, non-alcoholic steatohepatitis, lipotoxicity, glucagon-like peptide-1, non-islet dependent, ethnicity, and microRNA. Keyword outbreak analysis highlighted metabolic syndrome, hepatic steatosis, insulin resistance, hepatocellular carcinoma, cardiovascular disease, intestinal permeability, and intestinal bacterial overgrowth as prominent areas of intense research. Through the quantitative analysis of relevant literature, the current research focus and direction of gut microbiota and NAFLD can be more clearly understood, which helps us better understand the pathogenesis of NAFLD, and also opens up innovative solutions and strategies for the treatment of NAFLD.

Loneliness, Social Isolation, and Digital Health Literacy Among Older Women Living Alone in South Korea During the COVID-19 Pandemic

Objective While using digital technologies for social health is widely acknowledged, the relationship between loneliness, social isolation, and digital health literacy remains unknown. This study aimed to assess the levels of loneliness, social isolation, and digital health literacy in older women living alone and to explore the associations between these factors.Methods In August 2021, a cross-sectional survey was conducted on 145 older women living alone, selected using convenience sampling. The study used the University of California, Los Angeles Loneliness Scale (version 3), Lubben Social Network Scale-6, and Digital Health Technology Literacy-Assessment Questionnaire. The collected data were analyzed using descriptive statistics, the Mann–Whitney U test, the Kruskal–Wallis test, Spearman’s rho correlation, and a generalized linear model (GLM).Results Of the participants, 22.8% (n=33) reported moderate loneliness, 20.7% (n=30) reported severe loneliness, and 36.6% (n=53) were at risk for social isolation. The mean digital health literacy score among participants was 4.85 (SD=6.92), which is relatively low. Importantly, our findings using a GLM to control for covariates revealed a significant association between loneliness (B=-0.013, p=0.018) and digital health literacy.Conclusion The increased loneliness experienced during the pandemic may contribute to low digital health literacy, alienating these individuals from the benefits of digital technologies. Therefore, in developing digital health programs or policies, it is imperative to consider the psychosocial status of individuals, including loneliness, while enhancing digital health literacy.

Barriers to and Facilitators of Implementing Team-Based Extracorporeal Membrane Oxygenation Simulation Study: Exploratory Analysis.

Extracorporeal membrane oxygenation (ECMO) is a critical tool in the care of severe cardiorespiratory dysfunction. Simulation training for ECMO has become standard practice. Therefore, Keck Medicine of the University of California (USC) holds simulation-training sessions to reinforce and improve providers knowledge. This study aimed to understand the impact of simulation training approaches on interprofessional collaboration. We believed simulation-based ECMO training would improve interprofessional collaboration through increased communication and enhance teamwork. This was a single-center, mixed methods study of the Cardiac and Vascular Institute Intensive Care Unit at Keck Medicine of USC conducted from September 2021 to April 2023. Simulation training was offered for 1 hour monthly to the clinical team focused on the collaboration and decision-making needed to evaluate the initiation of ECMO therapy. Electronic surveys were distributed before, after, and 3 months post training. The survey evaluated teamwork and the effectiveness of training, and focus groups were held to understand social environment factors. Additionally, trainee and peer evaluation focus groups were held to understand socioenvironmental factors. In total, 37 trainees attended the training simulation from August 2021 to August 2022. Using 27 records for exploratory factor analysis, the standardized Cronbach α was 0.717. The survey results descriptively demonstrated a positive shift in teamwork ability. Qualitative themes identified improved confidence and decision-making. The study design was flawed, indicating improvement opportunities for future research on simulation training in the clinical setting. The paper outlines what to avoid when designing and implementing studies that assess an educational intervention in a complex clinical setting. The hypothesis deserves further exploration and is supported by the results of this study.

Improved outcomes of proximal hamstring avulsion surgery in patients both under and over 50 years, with greater gains in the younger group: A matched comparative study of the PHAS cohort.

To evaluate the functional outcomes of surgical treatment for proximal hamstring avulsion injuries in patients aged over 50 years and to compare the results across another matched group of patients under 50. This was a retrospective analysis of prospectively collected data in a matched case-control design targeting patients with proximal hamstring avulsion injuries who underwent surgical treatment at a sports surgery referral centre. Patients over 50 years with complete avulsion or partial injury (>2 cm retraction) were included. Two age groups were formed (18-50 and over 50), matched by the following variables: gender, rupture type (complete or partial), injury chronicity (chronic: more than 4 weeks from the injury or acute) and the preinjury Tegner score. The primary outcome was the Parisian Hamstring Avulsion Score (PHAS), with secondary outcomes, including the Tegner Activity Scale, University of California, Los Angeles (scale) (UCLA) scale, return to sport and complication rates. The study included 298 patients, with a mean age of 41.8 (7.2) years for the younger group and 58.0 (5.7) years for the older group. The follow-up duration in the younger group, 4.7 years (3.2), was slightly longer than that of the older group, 4.1 years (2.5), (p < 0.001). At the last follow-up, significant improvements were observed in PHAS, UCLA and Tegner scores in both groups (p < 0.001) compared to preoperative scores. The differential gain was higher in the younger group in all three scores (p < 0.05). The rerupture rate was 8.1% in the younger group and 4.7% in the older group (p > 0.05), with no significant differences in complication and return to sports rates (p > 0.05). This study shows that surgical treatment of proximal hamstring avulsion injuries is associated with significant improvements in functional outcomes in both younger and older patients, with greater magnitude of improvements in younger patients. Complication rates were similar between the age groups. Level of evidence III, Cohort Study.

Evidence of Rapid Infection of Four Sweetpotato Potyviruses in a Commercial Field in California.

Sweetpotato (Ipomoea batatas Lam.) is grown worldwide and is a staple food in many countries. One of the main constraints for sweetpotato production is cultivar decline, caused by the accumulation of viruses and subsequent losses of storage root yield and quality over years of vegetative propagation. Virus indexing using diagnostic molecular techniques is essential for the detection and identification of the major viruses to avoid cultivar decline, but little information is available on the fate of clean (virus-tested) plant materials after field propagation. In this study, cuttings of three sweetpotato cultivars (Beauregard, Bellevue, and Vermillion) were acquired from a clean propagative material program and planted in commercial field plots in Merced County, California, over multiple growing seasons. In 2021 and 2022, the phytosanitary status of storage roots from different generations of the materials were assessed by reverse transcription quantitative PCR (RT-qPCR) at harvest at the Foundation Plant Services, University of California, Davis. The results showed their rapid infection with four major potyviruses-sweet potato feathery mottle virus, sweet potato virus 2, sweet potato virus C, and sweet potato virus G-over the two seasons. The infection by two to four potyviruses was confirmed by RT-PCR, RT-qPCR, high-throughput sequencing, and biological indexing onto Ipomoea setosa plants for symptoms evaluation.

Strålende afhandling om sort racial isolation

Review of Elizabeth Löwe Hunter Black Racial Isolation: Understanding African Diaspora Subjectivity in Post-Racial Denmark, University of California,Berkeley, 2023, PhD Dissertation

A Scientist in Russia: My Story

Born on December 12, 1937, I remember the first bombing of Moscow by the Germans in 1941. My schooling began in 1944, and I soon became interested in chemistry, setting up a kind of makeshift chemical laboratory behind a high cupboard in my house. I enrolled in Moscow University in 1955 and published my first scientific paper in 1959. After entering graduate school in 1960, I produced dense silica with a rutile structure, a natural analog of which was later named stishovite. I received my doctorate in 1961 and got a job at the Institute of Crystallography in 1962, where I worked until 1993. My first visit to the West was in 1976. I was became a Fairchild Distinguished Scholar at Caltech in 1989–1990 and a member of the USSR Academy of Sciences in 1990. I was a Miller Professor at the University of California, Berkeley and an Orson Anderson Distinguished Scholar at Los Alamos National Laboratory. From 1993 to 2022, I was director of the Institute for High Pressure Physics. During that time, I was awarded the P. Bridgman Gold Medal and the Gold Medal of P. Kapitsa.

Emerging Trends on the Growing Rods in Scoliosis in the Last 20 Years: A Bibliometric Analysis from 2003 to 2024.

Growing rods is a distraction-based, growth-friendly method that is commonly used in the treatment of scoliosis. Studies on growing rods in scoliosis published from 2003 to 2024 were retrieved from the Web of Science Core Collection. VOSviewer, Microsoft Excel, and CiteSpace were applied for data analysis. We identified 742 publications on growing rods in scoliosis. The annual number of publications grew steadily. The United States was the most prolific country. University of California, San Diego was the most productive institution. Behrooz A. Akbarnia ranked first among authors regarding the number of articles and citations. The Journal of Pediatric Orthopedics was the most prolific journal. The research topics can be divided into 3 clusters as follows. 1) Complications of growing rods and magnetically controlled rods in early onset scoliosis; 2) growing rods in congenital scoliosis, focusing on pulmonary function and thoracic insufficiency syndrome; and 3) scoliosis management. The frontier directions of current research included magnetically controlled growing rods and growing rods fusion. This study drew a knowledge map of growing rods in scoliosis over the past 2 decades. The changes in research hotspots and current research directions have been summarized. The high costs and limited access to growing rods methodology in less-developed regions highlight the economic and technical challenges of globalizing these advanced treatments.

Loneliness is associated with different structural brain changes in schizophrenia spectrum disorders and major depression.

Loneliness, distress from having fewer social contacts than desired, has been recognized as a significant public health crisis. Although a substantial body of research has established connections between loneliness and various forms of psychopathology, our understanding of the neural underpinnings of loneliness in schizophrenia spectrum disorders (SSD) and major depressive disorder (MDD) remains limited. In this study, structural magnetic resonance imaging (sMRI) data were collected from 57 SSD and 45 MDD patients as well as 41 healthy controls (HC). Loneliness was measured with the German version of the University of California, Los Angeles Loneliness Scale (UCLA-LS). We used FreeSurfer v7.2 for automated parcellation of cortical regions. SSD patients showed reduced cortical volume and thickness in fronto-parietal and temporal regions when compared to HC (p<0.05, Benjamini-Hochberg (BH) corr.). In SSD, volume of the right superior temporal gyrus was associated with UCLA-LS total score (p=0.030; BH corr.). MDD patients showed reduced cortical volume and thickness in fronto-parietal regions (p<0.05, BH corr.). In MDD, cortical thickness of the right superior parietal cortex was associated with UCLA-LS total score (p=0.038; BH corr.). Our study suggests a different neural signature of loneliness in patients with SSD and MDD, comprising temporal and parietal regions responsible for social and attentive processing. Identifying neurobiological mechanisms underlying loneliness is critical for understanding its role in severe mental illnesses and identifying potential therapeutic targets.

Reflections of Foster Youth Engaging in the Co-Design of Digital Mental Health Technology: Duoethnography Study.

Current research on digital applications to support the mental health and well-being of foster youth is limited to theoretical applications for transition-aged foster youth and support platforms developed without intentional input from foster youth themselves. Centering the lived expertise of foster youth in digital solutions is crucial to dismantling barriers to care, leading to an increase in service access and improving mental health outcomes. Co-design centers the intended end users during the design process, creating a direct relationship between potential users and developers. This methodology holds promise for creating tools centered on foster youth, yet little is known about the co-design experience for foster youth. Understanding foster youth's experience with co-design is crucial to identifying best practices, knowledge of which is currently limited. The aim of this paper is to reflect on the experiences of 4 foster youth involved in the co-design of FostrSpace, a mobile app designed through a collaboration among foster youth in the San Francisco Bay Area; clinicians and academics from the Juvenile Justice Behavioral Health research team at the University of California, San Francisco; and Chorus Innovations, a rapid technology development platform specializing in participatory design practices. Key recommendations for co-designing with foster youth were generated with reference to these reflections. A duoethnography study was conducted over a 1-month period with the 4 transition-aged former foster youth co-designers of FostrSpace via written reflections and a single in-person roundtable discussion. Reflections were coded and analyzed via reflexive thematic analysis. In total, 4 main themes were identified from coding of the duoethnography reflections: power and control, resource navigation, building community and safe spaces, and identity. Themes of power and control and resource navigation highlighted the challenges FostrSpace co-designers experienced trying to access basic needs, support from caregivers, and mental health resources as foster youth and former foster youth. Discussions pertaining to building community and safe spaces highlighted the positive effect of foster youth communities on co-designers, and discussions related to identity revealed the complexities associated with understanding and embracing foster youth identity. This duoethnography study highlights the importance of centering the lived expertise of co-designers throughout the app development process. As the digital health field increasingly shifts toward using co-design methods to develop digital mental health technologies for underserved youth populations, we offer recommendations for researchers seeking to ethically and effectively engage youth co-designers. Actively reflecting throughout the co-design process, finding creative ways to engage in power-sharing practices to build community, and ensuring mutual benefit among co-designers are some of the recommended core components to address when co-designing behavioral health technologies for youth.

Relationality in Psychedelic Facilitation Training Programs: The UC Berkeley Case

Psychedelic medicine must embrace high-quality, culturally sensitive, relational, and community-based education of facilitators in order to reduce risks and increase benefits. The University of California, Berkeley Psychedelic Facilitation Certificate Program (UC Berkeley PFCP) aims to provide this training through a mindfully crafted program. This paper outlines the UC Berkeley training model, focusing particularly on the training program’s relational and culturally sensitive approach. This model is one we believe should be adopted by other psychedelic training programs to improve the quality of facilitation and create a robust network of skilled practitioners.

Efficacy of latissimus dorsi and teres major tendon transfer in anterosuperior irreparable rotator cuff tears and posterosuperior irreparable rotator cuff tears

BackgroundThere are various options of tendon transfer according to the different types of irreparable rotator cuff tears (IRCTs). However, there were no clear treatment options for the IRCTs involving the anterior, superior and posterior rotator cuff tears (global IRCTs). Latissimus dorsi and teres major (LDTM) could be transferred anteriorly or posteriorly in global IRCTs. The purpose of this study is to evaluate the efficacy of LDTM transfer in anterosuperior IRCTs (ASIRCTs) and posterosuperior IRCTs (PSIRCTs).MethodsThe patients who underwent anterior LDTM (aLDTM) transfer (aLDTM group, n = 35) for ASIRCTs or pLDTM transfer (aLDTM group, n = 33) for PSIRCTs between January 2017 and December 2020 were reviewed retrospectively. Clinical and functional outcomes were evaluated based on pain, patient-reported outcome scores, active range of motion (aROM) and strength of aROM. Radiological outcomes were evaluated using arthritic changes in the glenohumeral joint and transferred tendon integrity. Arthritic changes in the glenohumeral joint were evaluated using the acromiohumeral distance (AHD) and Hamada classification on the true anteroposterior radiograph.ResultsNo significant intergroup difference was confirmed in patient demographics except for preoperative fat infiltration grade of subscapularis and infraspinatus. The postoperative Constant score, and University of California and Los Angeles (UCLA) score of aLDTM group were significantly higher than that of pLDTM group (p < 0.001 and < 0.001, respectively). Moreover, the achievement of minimal clinically important difference (MCID) for American Shoulder and Elbow Surgeons score and UCLA score showed a significant difference between two groups (p = 0.021 and 0.042, respectively). The postoperative forward elevation (FE) was significantly higher in aLDTM group (p = 0.046). The postoperative FE strength and abduction strength were significantly higher in aLDTM group (p = 0.001 and 0.025, respectively). Moreover, the mean improvement of internal rotation strength in aLDTM group was significantly higher than mean improvement of external rotation strength in pLDTM group (p = 0.011). The progression of arthritic change was significantly higher in pLDTM group (p = 0.002).ConclusionAlthough LDTM transfer is an effective and safe treatment option for ASIRCTs and PSIRCTs, LDTM transfer is more effective for ASIRCTs than PSIRCTs due to its biomechanical advantage and tendon transfer principles.Level of studyLevel III.

Writing a case for policy debate: reflections on the loss of policy debate in the west and recommendations for addressing the activity’s ongoing accessibility challenges

This essay examines equity in intercollegiate policy debate through the lens of a forensics director at a public university in California. I present and explain many external factors that currently harm participation for some students and prevent programs from providing pedagogical goals and benefits of intercollegiate policy debate. These harms include decreasing budgets, increasing travel costs, tournament locations, past, current, and future university, state, or federal laws and policies (e.g. pandemic related travel bans, California’s Assembly Bill 1887, and laws impacting academic freedom), and characteristics and demographics of university student bodies. Although some of the harms are more relevant to programs at colleges and the universities in the west, others remain reminders of the ongoing and systemic challenges that have always limited policy debate’s accessibility. The second part of the essay provides suggestions to help the policy debate community navigate the current and emerging challenges. I argue that some “solutions” require more collective insight and work from the coaches, directors, and organizational leaders for resolution. To that end, I call upon our governing organizations and community members to give attention to these issues so programs can thrive, and policy debate can revive and grow throughout the United States.

Robotically Assisted vs. Manual Total Hip Arthroplasty in Developmental Hip Dysplasia: A Comparative Analysis of Radiological and Functional Outcomes.

Background/Objectives: Developmental dysplasia of the hip (DDH), defined by the malalignment of the femoral head and acetabulum, is a major precursor to coxarthrosis, posing substantial challenges during total hip arthroplasty (THA). Patients with coxarthrosis secondary to DDH often exhibit acetabular bone insufficiency, which makes challenging surgical reconstruction difficult. This study aimed to compare the radiologic and functional outcomes of robotically assisted and conventional manual THA techniques in patients with coxarthrosis secondary to Crowe type III-IV DDH. Methods: This prospective study included 40 patients divided into robotically assisted (n = 20) and conventional manual (n = 20) THA groups. Evaluations encompassed hip pain (Visual Analogue Scale, VAS), function (Harris hip score and University of California, Los Angeles, activity scale), quality of life (Short Form-12), and prosthesis sensation (Forgotten Joint Score-12). Radiologic outcomes included acetabular inclination and anteversion angles. Femoral shortening, operative duration, and follow-up times were also analyzed. Results: Demographic characteristics did not differ between groups (p > 0.05). Robotically assisted THA exhibited a significantly longer operative time (171.40 ± 11.96 vs. 150.30 ± 14.67 min; p = 0.001) but a shorter follow-up (29.3 ± 8.51 vs. 52.95 ± 18.96 months; p = 0.001), without a difference in the amount of femoral shortening (p = 0.947). Despite the extended surgical duration, the two techniques achieved comparable radiologic outcomes, with no significant differences in acetabular inclination or anteversion angles (p > 0.05). Functional assessments, including Harris hip scores (73.85 vs. 73.95; p = 0.978), UCLA activity scores, and VAS, indicated similar efficacy between groups. SF-12 physical and mental quality of life and Forgotten Joint Score-12 prosthesis sensation did not differ between groups (p > 0.05). Conclusions: This study concludes that robotically assisted and conventional manual THA present similar radiologic and functional outcomes in patients with coxarthrosis secondary to Crowe type III-IV DDH, as displayed by comparable acetabular anteversion and inclination alignment, femoral shortening, hip function, pain, quality of life, and prosthesis sensation scores. While robotically assisted THA requires a longer operative time, its precision in implant placement may hold potential advantages for long-term outcomes, demanding further investigation in extended follow-up studies.

A Comparative Environmental Impact Analysis of Screening Tests for Colorectal Cancer.

Healthcare is a major contributor to global greenhouse gas emissions. Colorectal cancer (CRC) screening is one of the most widely used healthcare services in the US, indicated for approximately 134 million adults. Recommended screening options include fecal immunochemical tests (FITs) every year, CT colonographies (CTCs) every 5 years, or colonoscopies every 10 years. We compared the environmental impacts of these tests and identified opportunities for impact reduction. We conducted a comparative life cycle assessment of three CRC screening strategies at the University of California, San Francisco. We performed on site audits to document the materials and energy used for each screening test. We used the ReCiPe 2016 method to estimate the environmental impacts of these procedures, measured by global warming potential (GWP) and damage to human health. We estimated the 10-year cumulative impacts of each screening strategy using a Markov reward model. We accounted for model uncertainty using hierarchical Monte Carlo simulations. FIT-based screening had the lowest environmental impacts, with a roughly 20% margin of superiority over colonoscopies, and this finding was robust in sensitivity analyses. Across tests, the biggest cause of environmental harm was car-based transportation of patients and staff. Prioritizing FITs over screening colonoscopies in the US could enhance population health by roughly 5.2 million disability adjusted life years per decade. Transitioning to electric vehicles could reduce the GWP of all screening tests by 15-20%. Given the similar efficacy and safety of these tests, payors should prioritize FITs for low-risk patients. Government initiatives to decarbonize transportation, incentivize telehealth, and mandate environmental product declarations will help reduce the environmental impacts of healthcare more generally. Our results call for a closer look at resource-intensive preventative health strategies, which could result in more harm than good if applied to a low-risk population. NIH, UCSF.