PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers.

Platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) are orthobiologic therapies considered as an alternative to the current therapies for muscle, bone and cartilage. Different formulations of biomaterials have been used as carriers for PRP and BMAC in order to increase regenerative processes. The most common biomaterials utilized in conjunction with PRP and BMAC clinical trials are organic scaffolds and natural or synthetic polymers. This review will cover the combinatorial strategies of biomaterial carriers with PRP and BMAC for musculoskeletal conditions (MsCs) repair and regeneration in clinical trials. The main objective is to review the therapeutic use of PRP and BMAC as a treatment option for muscle, bone and cartilage injuries

Confidence in risky value-based choice

Risk engenders a phenomenologically distinct experience from certainty, often driving people to behave in ostensibly irrational ways, and with potential consequences for our subjective sense of confidence in having made the best choice. While previous work on decision confidence has largely focused on ambiguous perceptual decisions or value-based choices under certainty, it is unclear how subjective confidence reports are formed during risky value-based choice (i.e. those with uncertain outcomes). Accordingly, we sought to examine the effect of risky (versus certain) choice upon confidence ratings in a calibrated economic choice task and explore the well-documented interrelationships between confidence and subjective value (SV) as well as choice response time (RT) in the context of value-based choice. By jointly analyzing choices (risky versus certain), SV of the chosen option, confidence, and RT, we found a systematic effect of risk on subjective confidence: subjective confidence reports were significantly higher when selecting a certain prospect compared with a risky one. Interestingly, risk attenuated the strength of the relationships between confidence and both RTs and difference in subjective value (ΔSV), as well as the relationship between RT and ΔSV. Taken together, these results corroborate how choice, RT, confidence and SV relate in value-based choice under risk, informing both theories of confidence and risk preferences

Dengue encephalopathy or encephalitis? You decide

Awareness of neurological sequelae of dengue fever is increasing. However, as this case illustrates, there is a diagnostic conundrum in determining whether certain features are in keeping with dengue encephalopathy, or dengue encephalitis. Further consensus is required

Inferring urban polycentricity from the variability in human mobility patterns

The polycentric city model has gained popularity in spatial planning policy, since it is believed to overcome some of the problems often present in monocentric metropolises, ranging from congestion to difficult accessibility to jobs and services. However, the concept 'polycentric city' has a fuzzy definition and as a result, the extent to which a city is polycentric cannot be easily determined. Here, we leverage the fine spatio-temporal resolution of smart travel card data to infer urban polycentricity by examining how a city departs from a well-defined monocentric model. In particular, we analyse the human movements that arise as a result of sophisticated forms of urban structure by introducing a novel probabilistic approach which captures the complexity of these human movements. We focus on London (UK) and Seoul (South Korea) as our two case studies, and we specifically find evidence that London displays a higher degree of monocentricity than Seoul, suggesting that Seoul is likely to be more polycentric than London

Left-right breast asymmetry and risk of screen-detected and interval cancers in a large population-based screening population

OBJECTIVES: To assess the associations between automated volumetric estimates of mammographic asymmetry and breast cancers detected at the same ("contemporaneous") screen, at subsequent screens, or in between (interval cancers). METHODS: Automated measurements from mammographic images (N = 79,731) were used to estimate absolute asymmetry in breast volume (BV) and dense volume (DV) in a large ethnically diverse population of attendees of a UK breast screening programme. Logistic regression models were fitted to assess asymmetry associations with the odds of a breast cancer detected at contemporaneous screen (767 cases), adjusted for relevant confounders.Nested case-control investigations were designed to examine associations between asymmetry and the odds of: (a) interval cancer (numbers of cases/age-matched controls: 153/646) and (b) subsequent screen-detected cancer (345/1438), via conditional logistic regression. RESULTS: DV, but not BV, asymmetry was positively associated with the odds of contemporaneous breast cancer (P-for-linear-trend (Pt) = 0.018). This association was stronger for first (prevalent) screens (Pt = 0.012). Both DV and BV asymmetry were positively associated with the odds of an interval cancer diagnosis (Pt = 0.060 and 0.030, respectively). Neither BV nor DV asymmetry were associated with the odds of having a subsequent screen-detected cancer. CONCLUSIONS: Increased DV asymmetry was associated with the risk of a breast cancer diagnosis at a contemporaneous screen or as an interval cancer. BV asymmetry was positively associated with the risk of an interval cancer diagnosis. ADVANCES IN KNOWLEDGE: The findings suggest that DV and BV asymmetry may provide additional signals for detecting contemporaneous cancers and assessing the likelihood of interval cancers in population-based screening programmes

Are mammography image acquisition factors, compression pressure and paddle tilt, associated with breast cancer detection in screening?

Objectives: To assess the associations between objectively measured mammographic compression pressure and paddle tilt and breast cancer (BC) detected at the same (“contemporaneous”) screen, subsequent screens, or in-between screens (interval cancers). Methods: Automated pressure and paddle tilt estimates were derived for 80,495 mammographic examina-tions in a UK population-based screening programme. Adjusted logistic regression models were fitted to estimate the associations of compression parameters with BC detected at contemporaneous screen (777 cases). Nested case-control designs were used to estimate associations of pressure and tilt with: (a) interval cancer (148 cases/625 age-matched controls) and (b) subsequent screen-detected cancer (344/1436), via condi-tional logistic regression. Results: Compression pressure was negatively associated with odds of BC at contemporaneous screen (odds ratio (OR) for top versus bottom third of the pressure distribution: 0.74; 95% CI 0.60, 0.92; P-for-linear-trend (Pt) = 0.007). There was weak evidence that moderate pressure at screening was associated with lower odds of interval cancer (OR for middle versus bottom third: 0.63; 95% CI 0.38, 1.05; p = 0.079), but no association was found between pressure and the odds of BC at subsequent screen. There was no evidence that paddle tilt was associated with the odds of contemporaneous, subsequent screen or interval cancer detection. Conclusions: Findings are consistent with compression pressure, but not paddle tilt, affecting the performance of mammographic screening by interfering with its ability to detect cancers. Advances in knowledge: Inadequate or excessive compression pressure at screening may contribute to a reduced ability to detect cancers, resulting in a greater number of interval cancer cases

Ethnic and age differences in right-left breast asymmetry in a large population-based screening population

OBJECTIVE: Exposure to sex hormones is important in the pathogenesis of breast cancer and inability to tolerate such exposure may be reflected in increased asymmetrical growth of the breasts. This study aims to characterize, for the first time, asymmetry in breast volume (BV) and radiodense volume (DV) in a large ethnically diverse population. METHODS: Automated measurements from digital raw mammographic images of 54,591 cancer-free participants (aged 47-73) in a UK breast screening programme were used to calculate absolute (cm3) and relative asymmetry in BV and DV. Logistic regression models were fitted to assess asymmetry associations with age and ethnicity. RESULTS: BV and DV absolute asymmetry were positively correlated with the corresponding volumetric dimension (BV or DV). BV absolute asymmetry increased, whilst DV absolute asymmetry decreased, with increasing age (P-for-linear-trend <0.001 for both). Relative to Whites, Blacks had statistically significantly higher, and Chinese lower, BV and DV absolute asymmetries. However, after adjustment for the corresponding underlying volumetric dimension the age and ethnic differences were greatly attenuated. Median relative (fluctuating) BV and DV asymmetry were 2.34 and 3.28% respectively. CONCLUSION: After adjusting for the relevant volumetric dimension (BV or DV), age and ethnic differences in absolute breast asymmetry were largely resolved. ADVANCES IN KNOWLEDGE: Previous small studies have reported breast asymmetry-breast cancer associations. Automated measurements of asymmetry allow the conduct of large-scale studies to further investigate these associations

The mental health of elite athletes: A narrative systematic review

BACKGROUND: The physical impacts of elite sport participation have been well documented; however, there is comparatively less research on the mental health and psychological wellbeing of elite athletes. OBJECTIVE: This review appraises the evidence base regarding the mental health and wellbeing of elite-level athletes, including the incidence and/or nature of mental ill-health and substance use. METHODS: A systematic search of the PubMed, EMBASE, SPORTDiscus, PsycINFO, Cochrane and Google Scholar databases, up to and including May 2015, was conducted. RESULTS: The search yielded a total of 2279 records. Following double screening, 60 studies were included. The findings suggested that elite athletes experience a broadly comparable risk of high-prevalence mental disorders (i.e. anxiety, depression) relative to the general population. Evidence regarding other mental health domains (i.e. eating disorders, substance use, stress and coping) is less consistent. These results are prefaced, however, by the outcome of the quality assessment of the included studies, which demonstrated that relatively few studies (25 %) were well reported or methodologically rigorous. Furthermore, there is a lack of intervention-based research on this topic. CONCLUSION: The evidence base regarding the mental health and wellbeing of elite athletes is limited by a paucity of high-quality, systematic studies. Nonetheless, the research demonstrates that this population is vulnerable to a range of mental health problems (including substance misuse), which may be related to both sporting factors (e.g. injury, overtraining and burnout) and non-sporting factors. More high-quality epidemiological and intervention studies are needed to inform optimal strategies to identify and respond to player mental health needs

Oxidative stress in asthmatic and non-asthmatic adolescent swimmers - a breathomics approach

We hypothesize that oxidative stress induced by trichloramine exposure during swimming could be related to etiopathogenesis of asthma among elite swimmers. Aim: To investigate the effect of a swimming training session on oxidative stress markers of asthmatic compared to non‐asthmatic elite swimmers using exhaled breath (EB) metabolomics. Methods: Elite swimmers annually screened in our department (n=27) were invited and those who agreed to participate (n=20, of which 9 with asthma) had EB collected (Tedlar® bags) before and after a swimming training session. SPME fiber (DVB/CAR/PDMS) was used to extract EB metabolites followed by a multidimensional gas chromatography analysis (GC×GC‐ToFMS). Dataset comprises eight metabolites end products of lipid peroxidation: five aliphatic alkanes (nonane, 2,2,4,6,6‐pentamethylheptane, decane, dodecane, and tetradecane) and three aldehydes (nonanal, decanal, and dodecanal). To assess exercise impact on lipid peroxidation markers, data were analyzed using principle component analysis (PCA), which was run on the original data set and on the data set constructed using differences in the metabolite total areas before and after exercise session. Results: Heatmap representation revealed that metabolites content decreased after exercise, both for control and asthma groups; however, the greater decrease was observed for controls. Asthmatics and controls did not form separated clusters; however, control swimmers demonstrated a more varied response to the exercise being dispersed along all score plot. Conclusion: In well‐trained athletes, swimming is associated with a decrease in oxidative stress markers independently of the presence of asthma, although a more pronounced decrease was seen in controls.European Regional Development Fund FEDER through the Competitive Factors Thematic Operational Programme (COMPETE) and FCT, Portugal, under projects PEST-C/QUI/UI0062/2013 (Research Unit 62/94 QOPNA) and PTDC/QUI-QUI/117803/2010