University Of California In Los Angeles Research Articles

Autologous micro-fragmented adipose tissue in the treatment of atherosclerosis patients with knee osteoarthritis in geriatric population: A systematic review and meta-analysis.

Atherosclerosis and osteoarthritis are closely related. However, no high-quality studies have investigated the potential of micro-fragmented adipose tissue to treat patients with atherosclerosis accompanied by osteoarthritis. PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, WANFANG DATA, and CQVIP were searched for potentially eligible studies published before October 13, 2022. Due to the statistical limitations of the existing relevant literature, it is not possible to make direct statistics on the patients with osteoarthritis accompanied by atherosclerosis treated by micro-fragmented adipose tissue. The primary outcome consisted of two parts: 1) Correlation between atherosclerosis and osteoarthritis; 2) Scores of the Knee injury and Osteoarthritis Outcome Score (KOOS). And secondary outcomes were pain assessed by visual analog scale (VAS) or numeric rating scale (NRS), quality of life (QoL) (assessed using tools apart from the KOOS), and adverse events (AEs). Random meta-analysis was conducted using STATA 14.0. Nineteen studies were included. The metaanalysis evidenced a positive association between atherosclerosis and osteoarthritis (OR 1.17, CI 1.01-1.36). The mean absolute difference in KOOS subscale scores between pre- and post-treatment (mean with 95% confidence interval [CI]) was 19.65 (13.66, 25.63), 14.20 (4.64, 23.76), 19.95 (13.02, 26.89), 25.23 (14.80, 35.66), and 26.01 (13.68, 38.35) for pain, symptoms, activities of daily living (ADL), sports/recreation, and quality-of-life (QOL), respectively. The mean differences in VAS, resting VAS, activity VAS, and NRS between pre- and post-treatment was -8.24 (-10.66, -5.82), -3.61 (-4.49, -2.72), -4.17 (-4.89, -3.44), and -2.17 (-4.06, and -0.28), respectively. The mean difference in score of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D, and University of California in Los Angeles (UCLA) between pre- and post-treatment was -24.81 (-40.80, -8.82), 0.07 (0.02, 0.12), and 0.30 (-0.42, 1.02), respectively. The mean difference in Tegner score and the International Knee Documentation Committee (IKDC) score between pre- and post-treatment was 0.67 (-0.62, 1.97) and 13.70 (6.35, 21.04), respectively. The use of micro-fragmented adipose tissue was associated with risk of bruising, bleeding, hematoma, drainage, infection, soreness, swelling, pain, and stiffness in harvest and injection sites. Atherosclerosis and osteoarthritis share common risk factors and comorbidity. And the use of micro-fragmented adipose tissue may benefit for improving symptoms of knee osteoarthritis accompanied by atherosclerosis although may lead to some mild adverse events. Randomized controlled trials with long-term follow-up are necessary for further evaluation because many limitations of this meta-analysis cannot be ignored.

Patient-reported outcome tools and baseline scores vary by country and region for arthroscopic repair of massive rotator cuff tears: a systematic review

Different patient-reported outcome (PRO) tools are used in patients with arthroscopic rotator cuff repair (ARCR) which complicates outcome comparisons. The purpose of this systematic review was to compare PRO usage and baseline scores across world regions and countries in patients with ARCR of massive rotator cuff tears (MRCT). A systematic review was performed on ARCR for MRCT. The search was conducted from September to November of 2022 using the MEDLINE database for articles published in the last 15 years. Thirty-seven articles were included after initial screening and full-text review. In each article, PRO usage, baseline scores, and country of origin were collected. PRO usage was reported in percentages and baseline scores were normalized for each region to facilitate comparisons. Normalization was performed using the PRO means from each article. These averages were converted to fractions using the worst and best possible scores. These were combined into a single numerical value, expressed as a decimal from 0 to 1, using the total sample size for each tool per region. Values closer to 0 represent worse functional outcomes. Thirty-two percent (n= 12) of articles were from Asia, 43.2% (n= 16) from Europe, 5.4% (n= 2) from the Middle East, and 18.9% (n= 7) from North America. The most commonly reported PRO tools were American Shoulder and Elbow Surgeons (ASES) in 19 papers, Constant-Murley Score (CMS) in 26 papers, Visual Analog Scale for pain (VAS) in 19 papers, and University of California in Los Angeles (UCLA) in 11 papers. ASES was reported in 51% of articles with 63% being from Asia (n= 12) compared to 21% from North America (n= 4). CMS was reported in 70% of studies with 58% being from Europe. Upon normalization, the preoperative score ranged from 0.30 to 0.44. Europe (0.39), and North America (0.40) showed similar scores. The lowest and highest scores were seen in the Middle East (0.3) and Asia (0.44) respectively. There is no standardized method to report outcomes in patients undergoing ARCR for MRCT. Great variation in usage exists in PROs which complicates data comparison between world regions. With normalization, baseline scores where similar among Asia, North America, and Europe, and lowest in the Middle East.

Pflegeheim-sensitive Krankenhausfälle und Ansätze zur Verringerung der Hospitalisierung von Pflegeheimbewohnerinnen und -bewohnern

ZusammenfassungHintergrundInterventionen zur Vermeidung von potenziell risikobehafteten Krankenhauseinweisungen aus dem Pflegeheim sind von hoher Bedeutung für Patientensicherheit und Versorgungsqualität. Ein Katalog Pflegeheim-sensitiver Krankenhausfälle (PSK) bildet die Grundlage für die Entwicklung von Handlungsempfehlungen.MethodenIn zwei vorangegangenen Forschungsphasen entwickelte ein Expertenpanel einen Katalog mit 58 PSK mittels eines angepassten Delphi-Verfahrens (die RAND/UCLA Appropriateness Methode). Dieses Verfahren wurde von der Nord-Amerikanischen gemeinnützigen Research and Development Organisation (RAND) und Klinikern der Universität von Kalifornien in Los Angeles (UCLA) entwickelt. In der hier vorgestellten dritten Projektphase wurden zunächst in einem Expertenworkshop Interventionsansätze zu deren Reduktion entwickelt. Die Ergebnisse wurden anschließend durch sechs Gutachtende aus themenverwandten Sektoren bewertet, ergänzt und systematisch zur Erstellung von Handlungsempfehlungen verwendet. Mögliche Umsetzungshürden wurden berücksichtigt und der Zeithorizont der Wirksamkeit abgeschätzt.ErgebnisDie Handlungsempfehlungen betreffen Bereiche der Kommunikation, Kooperation, Dokumentation und Versorgungskompetenz sowie einrichtungsbezogene, finanzielle und rechtliche Aspekte. Einzelne Indikationsbündel demonstrieren die Relevanz für das deutsche Gesundheitswesen. Zur Erhöhung der Wirksamkeit empfehlen die Sachverständigen eine sinnvolle Kombination von Handlungsempfehlungen.DiskussionDurch eine Optimierung multidisziplinärer Kommunikation und Kooperation, kombiniert mit einem – auch digitalen – Ausbau der Infrastruktur bei Schaffung einrichtungsbezogener rechtlicher Voraussetzungen und Vergütungsstrukturen, könnten fast 35 % aller Hospitalisierungen aus dem Pflegeheim, rund 220.000 Krankenhausfälle in Deutschland, vermieden werden. Die für Maßnahmen erforderlichen Ausgaben könnten aus Einsparungen durch vermiedene Krankenhausaufenthalte in Höhe von 768 Mio. € refinanziert werden.

No Clinically Meaningful Differences in 1-Year Patient-Reported Outcome Measures between Hip Resurfacing and Total Hip Arthroplasty: An Age-Matched Prospective Cohort Study

AbstractThis study compared patient-reported outcome measures (PROMs), readmissions, and reoperations between hip resurfacing (HR) and total hip arthroplasty (THA) in a matched prospective cohort. Between 2015 and 2017, 4,268 patients underwent HR or THA at a single institution. A prospective cohort of 2,147 patients were enrolled (707 HRs, 1,440 THAs). PROMs were collected at baseline and 1-year follow-up. Exclusion criteria: females (n = 2,008), inability/refusal to complete PROMs (n = 54), and diagnosis other than osteoarthritis (n = 59). Each HR patient was age-matched to a THA patient. Multivariate regression models were constructed to control for race, body mass index, education, smoking status, Charlson Comorbidity Index, mental health, and functional scores. A significance threshold was set at p = 0.017. A total of 707 HRs and 707 THAs were analyzed and 579 HRs (81.9%) and 490 THAs (69.3%) were followed up at 1 year. There was no statistically significant difference for Hip Injury and Osteoarthritis Outcomes Score (HOOS) Pain subscale (p = 0.129) and HOOS-Physical Function Shortform (HOOS-PS) (p = 0.03). HR had significantly higher median University of California in Los Angeles (UCLA) activity scores (p = 0.004). Ninety-day readmissions for HR and THAs were 1.8 and 3.5%, respectively (p = 0.06), and reoperations at 1 year were 1.2 and 2.3%, respectively (p = 0.24). For male patients, differences in medians for UCLA activity scores were 0.383 points, which were statistically significant but may not be clinically relevant. No differences exist in 90-day readmissions, reoperations, and HOOSpain and HOOS-PS scores. Because patients undergoing HR are advised to return to full activity at 1-year postoperative, follow-up is required. Metal ion levels were not obtained postoperatively for either group.

Clinical and Radiological Outcome after Surgical Treatment in Displaced Clavicular Midshaft Fracture

Background: The first purpose of this study is to compare the clinical and radiological outcomes of surgical treatment for displaced midshaft clavicle fracture (Robinson type 2B1 vs. 2B2) with 3.5-mm low profile clavicular locking compression plate. The second purpose is to evaluate the difference of the results depending on the presence of accompanying injuries. Methods: Forty-nine patients who underwent an operation for the fractures were reviewed retrospectively. Fracture patterns were classified according to group 2B1 and 2B2 using Robinson’s classification. For radiological outcome, time to union after operation was evaluated and for clinical outcome, American Shoulder and Elbow Society (ASES) score, University of California in Los Angeles (UCLA) score, visual analogue scale (VAS), and range of motion (ROM) were evaluated from preoperative period to last follow-up period. Results: The mean time for union was not significantly different in the 2B1 group and 2B2 group (p=0.062). No statistically significant difference in ASES score, UCLA score, and VAS was observed between 2B1 and 2B2 (p=0.619, p=0.896, p=0.856, respectively). In ROM, significant higher mean forward flexion and abduction was observed in 2B2 (p=0.025, p=0.017, respectively) and there was no difference in external rotation and external rotation at shoulder 90o abduction position (p=0.130, p=0.180, respectively). There was no significant difference in clinical outcomes according to the accompanying injuries. Conclusions: There was no difference in clinical and radiological outcome between Robinson 2B1 and 2B2 type fracture after the operation. Accompanying injuries may not affect the clinical result of displaced midshaft clavicle fractures.

La Plaque Console Du Radius : Une Alternative Dans L’ostéosynthèse Des Fractures De L’extrémité Supérieure De L’humérus ?

The aim of this study was to report the results of our experience in the treatment of proximal fractures with distal radius plate. This prospective study was conducted between January 2010 and December 2014. It took into account patients with a body mass index (BMI) not more than 25 kg/m2 in which the indication of conservative surgical treatment was decided and who did not have enough financial means to fulfill the required implants. The Neer classification was used to characterize fracture. To assess treatment outcomes, we used UCLA (University of California in Los Angeles) slightly modified score. There were 17 patients including 10 men and 7 women with a mean age of 32 years. According to Neer classification, six patients (35,29%) had stage I lesions, 5 others (29,42%) stage II and 6 patients (35,29%), stage III. There was no open fracture. There were three cases (17, 66%) of fracture-dislocations with one posterior variety. The average time of care was 13, 7 days (with a range of 2 to 29 days). The average time of healing was 117, 4 days with extremes of 81 days and 4 months 10 days. All patients were consolidated. The results at a mean of 15.31 months revealed excellent results in 29.41% and 29.41% poor results. In young patients whose treatment should be as conservative as possible, the distal radius plate could be an alternative if patient BMI does not exceed 25 kg/m2 and the epiphyseal screws are not too long. In case of comminuted fracture, it seems more desirable to postpone the osteosynthesis of weeks. However, only other subsequent studies on larger samples and longer followup, may lead to some conclusions about the usefulness of the distal radius plate in these lesions.

New technology based on clamping for high gradient radio frequency photogun

High gradient rf photoguns have been a key development to enable several applications of high quality electron beams. They allow the generation of beams with very high peak current and low transverse emittance, satisfying the tight demands for free-electron lasers, energy recovery linacs, Compton/Thomson sources and high-energy linear colliders. In the present paper we present the design of a new rf photogun recently developed in the framework of the SPARC_LAB photoinjector activities at the laboratories of the National Institute of Nuclear Physics in Frascati (LNF-INFN, Italy). This design implements several new features from the electromagnetic point of view and, more important, a novel technology for its realization that does not involve any brazing process. From the electromagnetic point of view the gun presents high mode separation, low peak surface electric field at the iris and minimized pulsed heating on the coupler. For the realization, we have implemented a novel fabrication design that, avoiding brazing, strongly reduces the cost, the realization time and the risk of failure. Details on the electromagnetic design, low power rf measurements and high power radiofrequency and beam tests performed at the University of California in Los Angeles (UCLA) are discussed in the paper.

Functional evaluation of arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis

Objectiveto evaluate the functional result from arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis, defined as incapacity to actively raise the arm above 90°, while complete passive elevation was possible. Methodswe reevaluated 38 patients with a mean follow-up of 51 months (minimum of 24). We analyzed the pseudoparalysis reversion rate and the functional result obtained. Resultsaccording to the assessment criteria of the University of California in Los Angeles (UCLA), 31 (82%) patients had good and excellent results, two (5%) had fair results and five (13%) had poor results. The mean active elevation went from 39° before the operation to 139° after the operation (p<0.05); the mean active lateral rotation went from 30° to 48° (p<0.05) and the mean active medial rotation went from level L3 to T12 (p<0.05). Conclusionarthroscopic repair of rotator cuff injuries produced good and excellent results in 82% of the cases and a statistically significant improvement of active range of motion, with reversion of the pseudoparalysis in 97.4% of the cases. It is therefore a good treatment option.

Avaliação funcional do reparo artroscópico da lesão do manguito rotador em pacientes com pseudoparalisia

Objectiveto evaluate the functional result from arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis, defined as incapacity to actively raise the arm above 90°, while complete passive elevation was possible. Methodswe reevaluated 38 patients with a mean follow‐up of 51 months (minimum of 24). We analyzed the pseudoparalysis reversion rate and the functional result obtained. Resultsaccording to the assessment criteria of the University of California in Los Angeles (UCLA), 31 (82%) patients had good and excellent results, two (5%) had fair results and five (13%) had poor results. The mean active elevation went from 39° before the operation to 139° after the operation (p < 0.05); the mean active lateral rotation went from 30° to 48° (p < 0.05) and the mean active medial rotation went from level L3 to T12 (p < 0.05). Conclusionarthroscopic repair of rotator cuff injuries produced good and excellent results in 82% of the cases and a statistically significant improvement of active range of motion, with reversion of the pseudoparalysis in 97.4% of the cases. It is therefore a good treatment option.

To Explore Surroundings, Pseudomonas Cells “Walk” Upright

Pseudomonas aeruginosa uses two distinct type IV pili (TFP)-driven movements when foraging —the first, “crawling,” gets a cell from one place to another quickly, while the second, “walking” upright, enables it to explore its surroundings, according to Gerard C. L. Wong at the University of California in Los Angeles (UCLA) and colleagues there and at the University of Illinois in Urbana-Champaign, the University of Houston in Houston, Tex., and the University of Notre Dame in Notre Dame, Ind. The newly described walking behavior was identified by using particle-tracking algorithms to analyze movies of bacterial trajectories. Details appear in the 8 October 2010 Science, DOI: 10.1126/science.1194238.

Arthur L Rosenbaum

Innovative paediatric eye surgeon and target of animal rights extremists Arthur Rosenbaum discovered a plastic container of orange coloured liquid beneath his BMW parked in front of his Los Angeles...

Ancient Endosymbionts May Have Led to Double-Membrane Bacteria

Ancient clostridia and actinobacteria formed an endosymbiosis that eventually led to the double-membraned, or gram-negative, bacteria that we know today, according to James Lake from the University of California in Los Angeles (UCLA) and his collaborators. This endosymbiosis “developed over billions of years as the partners evolved, adapted, and exchanged genes through traditional gene-transfer mechanisms,” the UCLA researchers note in the 20 August 2009 Nature (460:967–971).

Functional results of conservative therapy accompanied by interscalane brachial plexus block and patient-controlled analgesia in cases with frozen shoulder

We evaluated the efficacy of simultaneous interscalene block and catheter analgesia applied as an aid to conservative treatment in improving shoulder functions in patients with frozen shoulder. Three patients (2 women, 1 man; mean age 47 years) with frozen shoulder underwent conservative treatment including manipulation under interscalene brachial plexus block and subsequent rehabilitation under catheter analgesia to improve shoulder range of motion and function. Following manipulation under interscalene block, the patients were hospitalized for 15 to 28 days (mean 21 days) for an exercise program performed by a physiotherapist and orthopedist at least twice a day under interscalene catheter analgesia. Thirty minutes before each rehabilitation session, patient-controlled analgesia was administered via a pain relief pump. Active and passive range of motion (ROM) were measured and the severity of pain was rated using a visual analog scale (VAS) prior to and following interscalene block, during the exercise program, and at the end of the treatment. Functional assessments were made before and after treatment using the University of California in Los Angeles (UCLA) Shoulder Scale. The exercise program under interscalene analgesia was performed until pain-free and sufficient active movements were obtained, with at least 80% improvement in active and passive motion, a VAS score of 0-2, and an UCLA score of >27. Compared to pretreatment values, the ROM values showed remarkable increases at the end of the treatment. Active ROM reached at least 30 degrees external rotation, 40 degrees internal rotation, 150 degrees flexion, 45 degrees extension, and 100 degrees abduction in all cases. On presentation, the VAS scores of all cases were 10 for both active and passive movements, whereas they ranged from 0 to 2 on discharge. The mean UCLA score increased from 12.3 to 30.3 after treatment. Immediately after the interscalene block, two patients exhibited signs of Horner's syndrome which resolved spontaneously within an hour without the need for treatment. No complications or catheter-related problems such as infection, break-off, or displacement developed throughout the treatment period. There was no requirement for additional analgesia. In patients with frozen shoulder, interscalene block and continuous patient-controlled analgesia via an interscalene catheter provided sufficient analgesia and contributed to the recovery of shoulder functions through an effective and safe exercise program, with no side effects or complications. However, further studies are needed to assess the feasibility of home applications of interscalene patient-controlled analgesia to increase cost-effectiveness and patient satisfaction.

MASE: Undergraduate Research and Outreach as Part of a Large Project

The MesoAmerican Subduction Experiment (MASE) is a collaboration between the Tectonics Observatory at the California Institute of Technology (Caltech), the Universidad Nacional Autonoma de Mexico (UNAM), and the Center for Embedded Networked Sensing (CENS) at the University of California in Los Angeles (UCLA). Its main objective is to model and understand the dynamics of the subduction of the Cocos plate under the North American plate. In the first stage of the project, 100 broadband seismometers were deployed along a line that crosses Mexico from Acapulco on the Pacific coast to Tempoal, close to the Gulf of Mexico (figure 1) (Perez-Campos, Clayton et al. 2006; Clayton et al. 2007). This line goes through six Mexican states, with the stations distributed among 84 different towns, including seven cities (Acapulco, Chilpancingo, Iguala, Cuernavaca, Mexico City, Pachuca, and Huejutla). Security was an important factor when selecting sites, and schools turned out to be nearly ideal in this respect. In total, 53 MASE stations are situated in schools that range from K–12 through university level, and another six were housed within cultural or educational centers. This situation presented an excellent opportunity to provide educational outreach, particularly to rural communities. Usually, the schools in small towns draw students from neighboring communities, which means that outreach impact is spread beyond the specific MASE sites. Figure 1. Station location and type. The symbol of each station represents the type of site (school/private property). Six states hosted MASE stations, indicated by outlined numbers. Major cities and key towns are indicated by a star. The lower pie chart indicates the percentage of each school level or type of site along the MASE line. Figure 2. MASE social service program (SSP). Upper panel shows outreach activities and lower panel shows those related to research. Dashed lines include activities that favor student's knowledge in seismology. …

Outcome assessment of hemiarthroplasty of the shoulder: A 5-year follow-up with 4 evaluation tools

Background Outcome measurement of shoulder arthroplasty is not standardized. We compared 3 scores and 1 evaluation form.Patients and methods We report on 35 hemiarthroplasties of the shoulder (32 cementless). Mean age of the patients was 62 (29–87) years. After a mean follow-up of 6 years (range 2–18 years) patients were evaluated with the Neer score, the Constant-Murley score, the score of the University of California in Los Angeles (UCLA) and the Society of Shoulder and Elbow Surgeons Basic Shoulder Evaluation Form. We also performed radiographic evaluation and sonographic evaluation of the rotator cuff.Results Although pain relief and patient satisfaction were promising, the overall results of the respective score showed low values (Neer score 56/100 points, Constant-Murley score 43/100 points, and UCLA score 19/35 points on average).Interpretation We recommend choice of a score with a high impact of pain and patient satisfaction. Furthermore, ability to cope with activities of daily living should be of more importance than strength.