Basic science of osteoarthritis

Osteoarthritis (OA) is a prevalent, disabling disorder of the joints that affects a large population worldwide and for which there is no definitive cure. This review provides critical insights into the basic knowledge on OA that may lead to innovative end efficient new therapeutic regimens. While degradation of the articular cartilage is the hallmark of OA, with altered interactions between chondrocytes and compounds of the extracellular matrix, the subchondral bone has been also described as a key component of the disease, involving specific pathomechanisms controlling its initiation and progression. The identification of such events (and thus of possible targets for therapy) has been made possible by the availability of a number of animal models that aim at reproducing the human pathology, in particular large models of high tibial osteotomy (HTO). From a therapeutic point of view, mesenchymal stem cells (MSCs) represent a promising option for the treatment of OA and may be used concomitantly with functional substitutes integrating scaffolds and drugs/growth factors in tissue engineering setups. Altogether, these advances in the fundamental and experimental knowledge on OA may allow for the generation of improved, adapted therapeutic regimens to treat human OA.(undefined

The Evolution of Vasectomy Reversal

In the USA, about 500,000 vasectomies are performed each year, with up to 6 % of men requesting reversal. The technique of vasectomy reversal has evolved from macrosurgical to the implementation of both microscopic and robotic technologies. The very earliest attempts at vasectomy reversal, the vasoepididymostomy and vasovasostomy, have remained central in the treatment of male infertility and will continue to be so for years to come. As seen throughout its history, urological microsurgery has consistently implemented advanced techniques and state-of-the art technology in its craft, and its continued refinement will allow for even more favorable outcomes in the lives of patients seeking restoration of fertility following vasectomy. Here, we review the evolution of vasectomy reversal and its current techniques

Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study

Introduction: The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure.  Methods: International experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance.  Results: Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control—Performance Monitoring; (3) Arousal and Regulatory Systems—Arousal; (4) Cognitive Control—Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control—Response Selection and Inhibition/Suppression; (6) Working memory—Flexible Updating; (7) Working memory—Active Maintenance; (8) Perception and Understanding of Self—Self-knowledge; (9) Working memory—Interference Control, and (10) Expert-suggested—Shifting.  Discussion: Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.</p