A multicenter study investigating factors that influence initiation of return to sport functional testing following ACL reconstruction

Despite advances in surgical technique and rehabilitation following anterior cruciate ligament (ACL) reconstruction, re-injury rates after return to play (RTP) are high. There remains controversy over the most effective criteria utilized to initiate RTP functional testing following ACL reconstruction. The purpose of this study is to investigate factors that influence provider decision to initiate RTP functional testing

Concussions in the National Basketball Association: Analysis of Incidence, Return to Play, and Performance From 1999 to 2018.

Background: The effect of concussions on professional athletes has been investigated in many sports. However, few studies have evaluated concussions in National Basketball Association (NBA) players. Hypothesis: We hypothesized that concussion incidence has increased, yet the return-to-play (RTP) rate will remain high following the institution of the NBA concussion policy (NBACP). We also hypothesized that the incidence of repeat concussions will be similar to first occurrences and that player performance and game availability will not be significantly affected by sustaining a concussion. Study Design: Descriptive epidemiology study. Methods: Publicly available records were searched to identify all concussions from NBA seasons 1999-2000 to 2017-2018. Player demographics and information regarding career history were tabulated. Incidence of concussion and RTP timing were evaluated before and after institution of the NBACP (2011). Minutes per game and game score per minute were evaluated pre- versus postconcussion. Player availability and performance were also compared with an age-, body mass index-, position-, and experience-matched control group of players who did not sustain a concussion. Results: A total of 189 concussions were reported in the NBA from 1999 to 2018, with a mean +/- SD incidence of 9.7 +/- 7.3 concussions per season. Following implementation of the NBACP, incidence significantly increased from 5.7 +/- 2.8 to 16.7 +/- 7.5 concussions per season (P = .007). All players returned to play following first-time concussion after missing 7.7 +/- 8.6 days and 3.5 +/- 4.1 games. RTP time was not significantly different after implementation of the NBACP (games missed, P = .24; days missed, P = .27), and there was no difference in concussion-free time interval (P = .29). Game score per minute and minutes per game were not significantly affected by sustaining a concussion (both P \u3e .05). Conclusion: Concussion incidence in NBA players is approximately 17 instances per season since the 2011 institution of a league-wide concussion policy. The number of reported concussions significantly increased following the policy, in line with trends seen in other professional sports leagues. Players have retained a high rate of RTP after 3 to 4 missed games. Player performance and availability are not affected by sustaining a concussion following successful RTP

Oral Contraceptive Pills Are Not a Risk Factor for Deep Vein Thrombosis or Pulmonary Embolism After Arthroscopic Shoulder Surgery

Background: Worldwide, more than 100 million women between the ages of 15 and 49 years take oral contraceptive pills (OCPs). OCP use increases the risk of venous thromboembolism (VTE) through its primary drug, ethinylestradiol, which slows liver metabolism, promotes tissue retention, and ultimately favors fibrinolysis inhibition and thrombosis. Purpose: To evaluate the effects of OCP use on VTE after arthroscopic shoulder surgery. Study Design: Cohort study; Level of evidence, 3. Methods: A large national payer database (PearlDiver) was queried for patients undergoing arthroscopic shoulder surgery. The incidence of VTE was evaluated in female patients taking OCPs and those not taking OCPs. A matched group was subsequently created to evaluate the incidence of VTE in similar patients with and without OCP use. Results: A total of 57,727 patients underwent arthroscopic shoulder surgery from 2007 to 2016, and 26,365 patients (45.7%) were female. At the time of surgery, 924 female patients (3.5%) were taking OCPs. The incidence of vascular thrombosis was 0.57% (n = 328) after arthroscopic shoulder surgery, and there was no significant difference in the rate of vascular thrombosis in male or female patients (0.57% vs 0.57%, respectively; P \u3e .99). The incidence of VTE in female patients taking and not taking OCPs was 0.22% and 0.57%, respectively (P = .2). In a matched-group analysis, no significant difference existed in VTE incidence between patients with versus without OCP use (0.22% vs 0.56%, respectively; P = .2). On multivariate analysis, hypertension (odds ratio [OR], 2.00; P \u3c .001) and obesity (OR, 1.43; P = .002) were risk factors for VTE. Conclusion: OCP use at the time of arthroscopic shoulder surgery is not associated with an increased risk of VTE. Obesity and hypertension are associated with a greater risk for thrombolic events, although the risk remains very low. Our findings suggest that patients taking OCPs should be managed according to the surgeon’s standard prophylaxis protocol for arthroscopic shoulder surgery

1995 CSREES Reports

The 1995 edition of the CSREES Reports was prepared for the Maine Wild Blueberry Commission and the University of Maine Wild Blueberry Advisory Committee by researchers at the University of Maine, Orono. Projects in this report include: 1. Factors Affecting the Quality of IQF Blueberries 2. Preventing the Bleeding of Blueberry Fruit in Bakery Products 3. Removing Water from Blueberries Before Freezing 4. Determination of Pesticide Residue Levels in Freshly Harvested and Processed Lowbush Blueberries 5. Industrial Ingredients from Cull Blueberries 6. Application of Heat as a Method of Controlling Secondary Pest Insects on Lowbush Blueberries 7. The Phenology and Biology of Bumble Bees, Bombus, spp., that Pollinate Lowbush blueberry, Vaccinium spp., in Maine 8. Pollination Ecology of Lowbush Blueberry in Maine 9. Effects of Irrigation on Lowbush Blueberry Yield 10. Effect of Brief Warming Treatments on Late Winter Low-Temperature Tolerance of Native Lowbush Blueberry 11. Correlation of Late-winter/Early-spring Cold Hardiness with Date of Flowering 12. Evaluation of Cold Tolerance of Opening Flowers of Lowbush Blueberry 13. Influence of Flower Delaying Sprays on Seasonal Variation of Low Temperature Tolerance in Lowbush Blueberry 14. Effect of Various Levels of Disbudding on Yield of Lowbush Blueberry 15. Effect of Boron and the Polyamine Putrescine on Lowbush Blueberry Fruit Set and Yield 16. Effect of Boron and the Polyamine Putrescine on Extending the Receptivity of Lowbush Blueberry Blossoms 17. Effect of Soil pH on Nutrient Uptake 18. Correcting Boron Deficiency - missing 19. Phosphorus Uptake 20. Evaluation of Hexazinone Formulation on Soil Movement and Weed Control 21. Effect of Time of Fall Pruning on Growth and Productivity of Blueberries 22. Hexazinone Ground Water Survey 23. Effect of hexazinone formulation on movement through the soil profile 24. Evaluation of Tribenuron Methyl for Bunchberry Control 25. Evaluation of Tribenuron Methyl Commercial Applications for Bunchberry Control 26. Effectiveness of Resin-Exchange Columns to Determine Efficacy in Removing Hexazinone from Well Water 27. Effect of Clopyralid for Vetch Control 28. Evaluation of Tribenuron Methyl/Velpar® Tank Mix for Bunchberry Control 29. Blueberry Extension Education Progra

Glucocorticoids Acutely Increase Brown Adipose Tissue Activity in Humans, Revealing Species-Specific Differences in UCP-1 Regulation

SummaryThe discovery of brown adipose tissue (BAT) in adult humans presents a new therapeutic target for metabolic disease; however, little is known about the regulation of human BAT. Chronic glucocorticoid excess causes obesity in humans, and glucocorticoids suppress BAT activation in rodents. We tested whether glucocorticoids regulate BAT activity in humans. In vivo, the glucocorticoid prednisolone acutely increased 18fluorodeoxyglucose uptake by BAT (measured using PET/CT) in lean healthy men during mild cold exposure (16°C–17°C). In addition, prednisolone increased supraclavicular skin temperature (measured using infrared thermography) and energy expenditure during cold, but not warm, exposure in lean subjects. In vitro, glucocorticoids increased isoprenaline-stimulated respiration and UCP-1 in human primary brown adipocytes, but substantially decreased isoprenaline-stimulated respiration and UCP-1 in primary murine brown and beige adipocytes. The highly species-specific regulation of BAT function by glucocorticoids may have important implications for the translation of novel treatments to activate BAT to improve metabolic health

1994 CSRS Research Reports/1994 Blueberry Tax Reports

The 1994 edition of the CSRS Research Reports/Blueberry Tax Reports was prepared for the Maine Wild Blueberry Commission and the University of Maine Wild Blueberry Advisory Committee by researchers at the University of Maine, Orono. Projects in this report include: CSRS Research Reports 1. Potential Uses for Green and Red Cull Blueberries 2. Preventing the Bleeding of Blueberry Fruit in Bakery Products 3. The Effect of Fertilization and Irrigation on Blueberry Fruit Quality 4. Determination of Pesticide Residue Levels in Freshly Harvested and Processed Lowbush Blueberries 5. The Effect of Mechanical Harvesting on Blueberry Fruit Quality 6. Removing Water from Blueberries Before Freezing 7. Application of Heat as a Method of Controlling Secondary Pest Insects in Lowbush Blueberries 8. Evaluation of Effectiveness of Eumenid Wasps for Biocontrol of Blueberry Pests 9. Pollination Ecology of Lowbush Blueberry in Maine 10. Fungicide Treatment for Control of Monilinia Blight 11. Field Sanitation for Control of Monilinia Blight 12. Cold-hardiness of Native Lowbush Blueberry 13. Phosphorus Dose/Response Curve 14. Multiple Cropping of Wild Blueberry Stands 15. Effect of Soil pH on Nutrient Uptake 16. Effect of Boron and Calcium on Lowbush Blueberry Fruit Set and Yield 17. Effect of Time of Fall Pruning on Growth and Productivity of Lowbush Blueberries 18. A Reinvestigation of the Economics of Mechanical Harvesting 19. Thresholds of Mechanical and Chemical Weed Controls in Wild Blueberries 20. Evaluation of Pressurized Rope Wick Master Wiper for Treating Weeds Growing Above Lowbush Blueberries 21. Evaluation of Infrared Burner for Selective Weed Control Blueberry Tax Reports 22. Control of Blueberry Pest Insects 23. Biology and Action Thresholds of Secondary Blueberry Pest Insects 24. Pollination Ecology of Low bush Blueberry in Maine 25. Nitrogen-Phosphorus Study 26. Evaluation of Pronone 10G for Control of Weeds in Lowbush Blueberries 27. Evaluation of Tribenuron Methyl for Bunchberry Control 28. Evaluation of Pendimethalin for Control of Annual Grasses in Lowbush Blueberries 29. Evaluation of Time of Application of Clopyralid for Control of Vetch, and Effect on Flowering of Lowbush Blueberries 30. Hexazinone Ground Water survey 31. Blueberry Extension Program Base 32. Blueberry ICM Program for Hancock Count

Cost of Community Integrated Prevention Campaign for Malaria, HIV, and Diarrhea in Rural Kenya

BACKGROUND: Delivery of community-based prevention services for HIV, malaria, and diarrhea is a major priority and challenge in rural Africa. Integrated delivery campaigns may offer a mechanism to achieve high coverage and efficiency. METHODS: We quantified the resources and costs to implement a large-scale integrated prevention campaign in Lurambi Division, Western Province, Kenya that reached 47,133 individuals (and 83% of eligible adults) in 7 days. The campaign provided HIV testing, condoms, and prevention education materials; a long-lasting insecticide-treated bed net; and a water filter. Data were obtained primarily from logistical and expenditure data maintained by implementing partners. We estimated the projected cost of a Scaled-Up Replication (SUR), assuming reliance on local managers, potential efficiencies of scale, and other adjustments. RESULTS: The cost per person served was $41.66 for the initial campaign and was projected at$31.98 for the SUR. The SUR cost included 67% for commodities (mainly water filters and bed nets) and 20% for personnel. The SUR projected unit cost per person served, by disease, was $6.27 for malaria (nets and training),$15.80 for diarrhea (filters and training), and $9.91 for HIV (test kits, counseling, condoms, and CD4 testing at each site). CONCLUSIONS: A large-scale, rapidly implemented, integrated health campaign provided services to 80% of a rural Kenyan population with relatively low cost. Scaling up this design may provide similar services to larger populations at lower cost per person

Organ Transplants From Deceased Donors With Primary Brain Tumors and Risk of Cancer Transmission

IMPORTANCE: Cancer transmission is a known risk for recipients of organ transplants. Many people wait a long time for a suitable transplant; some never receive one. Although patients with brain tumors may donate their organs, opinions vary on the risks involved. OBJECTIVE: To determine the risk of cancer transmission associated with organ transplants from deceased donors with primary brain tumors. Key secondary objectives were to investigate the association that donor brain tumors have with organ usage and posttransplant survival. DESIGN, SETTING, AND PARTICIPANTS: This was a cohort study in England and Scotland, conducted from January 1, 2000, to December 31, 2016, with follow-up to December 31, 2020. This study used linked data on deceased donors and solid organ transplant recipients with valid national patient identifier numbers from the UK Transplant Registry, the National Cancer Registration and Analysis Service (England), and the Scottish Cancer Registry. For secondary analyses, comparators were matched on factors that may influence the likelihood of organ usage or transplant failure. Statistical analysis of study data took place from October 1, 2021, to May 31, 2022. EXPOSURES: A history of primary brain tumor in the organ donor, identified from all 3 data sources using disease codes. MAIN OUTCOMES AND MEASURES: Transmission of brain tumor from the organ donor into the transplant recipient. Secondary outcomes were organ utilization (ie, transplant of an offered organ) and survival of kidney, liver, heart, and lung transplants and their recipients. Key covariates in donors with brain tumors were tumor grade and treatment history. RESULTS: This study included a total of 282 donors (median [IQR] age, 42 [33-54] years; 154 females [55%]) with primary brain tumors and 887 transplants from them, 778 (88%) of which were analyzed for the primary outcome. There were 262 transplants from donors with high-grade tumors and 494 from donors with prior neurosurgical intervention or radiotherapy. Median (IQR) recipient age was 48 (35-58) years, and 476 (61%) were male. Among 83 posttransplant malignancies (excluding NMSC) that occurred over a median (IQR) of 6 (3-9) years in 79 recipients of transplants from donors with brain tumors, none were of a histological type matching the donor brain tumor. Transplant survival was equivalent to that of matched controls. Kidney, liver, and lung utilization were lower in donors with high-grade brain tumors compared with matched controls. CONCLUSIONS AND RELEVANCE: Results of this cohort study suggest that the risk of cancer transmission in transplants from deceased donors with primary brain tumors was lower than previously thought, even in the context of donors that are considered as higher risk. Long-term transplant outcomes are favorable. These results suggest that it may be possible to safely expand organ usage from this donor group

HMDB: the Human Metabolome Database

The Human Metabolome Database (HMDB) is currently the most complete and comprehensive curated collection of human metabolite and human metabolism data in the world. It contains records for more than 2180 endogenous metabolites with information gathered from thousands of books, journal articles and electronic databases. In addition to its comprehensive literature-derived data, the HMDB also contains an extensive collection of experimental metabolite concentration data compiled from hundreds of mass spectra (MS) and Nuclear Magnetic resonance (NMR) metabolomic analyses performed on urine, blood and cerebrospinal fluid samples. This is further supplemented with thousands of NMR and MS spectra collected on purified, reference metabolites. Each metabolite entry in the HMDB contains an average of 90 separate data fields including a comprehensive compound description, names and synonyms, structural information, physico-chemical data, reference NMR and MS spectra, biofluid concentrations, disease associations, pathway information, enzyme data, gene sequence data, SNP and mutation data as well as extensive links to images, references and other public databases. Extensive searching, relational querying and data browsing tools are also provided. The HMDB is designed to address the broad needs of biochemists, clinical chemists, physicians, medical geneticists, nutritionists and members of the metabolomics community. The HMDB is available at

Integrated HIV Testing, Malaria, and Diarrhea Prevention Campaign in Kenya: Modeled Health Impact and Cost-Effectiveness

Efficiently delivered interventions to reduce HIV, malaria, and diarrhea are essential to accelerating global health efforts. A 2008 community integrated prevention campaign in Western Province, Kenya, reached 47,000 individuals over 7 days, providing HIV testing and counseling, water filters, insecticide-treated bed nets, condoms, and for HIV-infected individuals cotrimoxazole prophylaxis and referral for ongoing care. We modeled the potential cost-effectiveness of a scaled-up integrated prevention campaign.We estimated averted deaths and disability-adjusted life years (DALYs) based on published data on baseline mortality and morbidity and on the protective effect of interventions, including antiretroviral therapy. We incorporate a previously estimated scaled-up campaign cost. We used published costs of medical care to estimate savings from averted illness (for all three diseases) and the added costs of initiating treatment earlier in the course of HIV disease.Per 1000 participants, projected reductions in cases of diarrhea, malaria, and HIV infection avert an estimated 16.3 deaths, 359 DALYs and $85,113 in medical care costs. Earlier care for HIV-infected persons adds an estimated 82 DALYs averted (to a total of 442), at a cost of$37,097 (reducing total averted costs to $48,015). Accounting for the estimated campaign cost of$32,000, the campaign saves an estimated $16,015 per 1000 participants. In multivariate sensitivity analyses, 83$20.A mass, rapidly implemented campaign for HIV testing, safe water, and malaria control appears economically attractive