Imbalanced gut microbiota predicts and drives the progression of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in a fast-food diet mouse model.

Nonalcoholic fatty liver disease (NAFLD) is multifactorial in nature, affecting over a billion people worldwide. The gut microbiome has emerged as an associative factor in NAFLD, yet mechanistic contributions are unclear. Here, we show fast food (FF) diets containing high fat, added cholesterol, and fructose/glucose drinking water differentially impact short- vs. long-term NAFLD severity and progression in conventionally-raised, but not germ-free mice. Correlation and machine learning analyses independently demonstrate FF diets induce early and specific gut microbiota changes that are predictive of NAFLD indicators, with corresponding microbial community instability relative to control-fed mice. Shotgun metagenomics showed FF diets containing high cholesterol elevate fecal pro-inflammatory effectors over time, relating to a reshaping of host hepatic metabolic and inflammatory transcriptomes. FF diet-induced gut dysbiosis precedes onset and is highly predictive of NAFLD outcomes, providing potential insights into microbially-based pathogenesis and therapeutics.

Neutron Activation Analysis of Rare Earth Element Extraction from Solution through a Surfactant-Assisted Dispersion of Carbon Nanotubes.

We report the preparation of surfactant-assisted carbon nanotube dispersions using gum arabic, Triton X-100, and graphene oxide as dispersing agents for removing rare earth elements in an aqueous solution. The analytical tools, including (a) scanning electron microscopy and (b) neutron activation analysis, were utilized for qualitative and quantitative examinations, respectively. Neutron activation analysis was employed to quantitatively determine the percent of extraction of nuclides onto the carbon structure, while the images produced from the scanning electron microscope allowed the morphological structure of the surfactant-CNT complex to be analyzed. This report tested the effects responsible for nuclide removal onto CNTs, including the adsorbent to target mass ratio, the CNT concentration and manufacturing process, the pH, and the ionic radius. Observable trends in nuclide extraction were found for each parameter change, with the degree of dispersion displaying high dependency.

Predicting the effects of COVID-19 related interventions in urban settings by combining activity-based modelling, agent-based simulation, and mobile phone data.

Epidemiological simulations as a method are used to better understand and predict the spreading of infectious diseases, for example of COVID-19. This paper presents an approach that combines a well-established approach from transportation modelling that uses person-centric data-driven human mobility modelling with a mechanistic infection model and a person-centric disease progression model. The model includes the consequences of different room sizes, air exchange rates, disease import, changed activity participation rates over time (coming from mobility data), masks, indoors vs. outdoors leisure activities, and of contact tracing. It is validated against the infection dynamics in Berlin (Germany). The model can be used to understand the contributions of different activity types to the infection dynamics over time. It predicts the effects of contact reductions, school closures/vacations, masks, or the effect of moving leisure activities from outdoors to indoors in fall, and is thus able to quantitatively predict the consequences of interventions. It is shown that these effects are best given as additive changes of the reproduction number R. The model also explains why contact reductions have decreasing marginal returns, i.e. the first 50% of contact reductions have considerably more effect than the second 50%. Our work shows that is is possible to build detailed epidemiological simulations from microscopic mobility models relatively quickly. They can be used to investigate mechanical aspects of the dynamics, such as the transmission from political decisions via human behavior to infections, consequences of different lockdown measures, or consequences of wearing masks in certain situations. The results can be used to inform political decisions.

Fresh whole blood from walking blood banks for patients with traumatic hemorrhagic shock: A systematic review and meta-analysis.

BACKGROUND: Whole blood is optimal for resuscitation of traumatic hemorrhage. Walking Blood Banks provide fresh whole blood (FWB) where conventional blood components or stored, tested whole blood are not readily available. There is an increasing interest in this as an emergency resilience measure for isolated communities and during crises including the coronavirus disease 2019 pandemic. We conducted a systematic review and meta-analysis of the available evidence to inform practice. METHODS: Standard systematic review methodology was used to obtain studies that reported the delivery of FWB (PROSPERO registry CRD42019153849). Studies that only reported whole blood from conventional blood banking were excluded. For outcomes, odds ratios (ORs) and 95% confidence interval (CI) were calculated using random-effects modeling because of high risk of heterogeneity. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation system. RESULTS: Twenty-seven studies published from 2006 to 2020 reported >10,000 U of FWB for >3,000 patients (precise values not available for all studies). Evidence for studies was "low" or "very low" except for one study, which was "moderate" in quality. Fresh whole blood patients were more severely injured than non-FWB patients. Overall, survival was equivalent between FWB and non-FWB groups for eight studies that compared these (OR, 1.00 [95% CI, 0.65-1.55]; p = 0.61). However, the highest quality study (matched groups for physiological and injury characteristics) reported an adjusted OR of 0.27 (95% CI, 0.13-0.58) for mortality for the FWB group (p < 0.01). CONCLUSION: Thousands of units of FWB from Walking Blood Banks have been transfused in patients following life-threatening hemorrhage. Survival is equivalent for FWB resuscitation when compared with non-FWB, even when patients were more severely injured. Evidence is scarce and of relative low quality and may underestimate potential adverse events. Whereas Walking Blood Banks may be an attractive resilience measure, caution is still advised. Walking Blood Banks should be subject to prospective evaluation to optimize care and inform policy. LEVEL OF EVIDENCE: Systematic/therapeutic, level 3.

Clinical outcome of anterior cruciate ligament reconstruction with quadrupled hamstring tendon graft and bioabsorbable interference screw fixation.

BACKGROUND: To date, there has been no publication of clinical follow-up data on patients who have undergone quadrupled hamstring tendon autograft anterior cruciate ligament reconstruction with bioabsorbable screw fixation. PURPOSE: To report the results of quadrupled hamstring tendon autograft anterior cruciate ligament reconstruction with bioabsorbable interference screw fixation. STUDY DESIGN: Retrospective review. METHODS: Sixty-five patients (66 knees) were retrospectively identified by chart review as having undergone quadrupled hamstring tendon autograft anterior cruciate ligament reconstruction with bioabsorbable interference screw fixation with a minimum 2-year follow-up. RESULTS: Data were collected on 48 knees in 47 patients (73%) at an average 30.2 months (range, 24 to 43) after surgery. Thirty-six patients (37 knees) returned for clinical evaluation (56% return) and subjective follow-up only was obtained in 11 patients (17%). The mean Lysolm knee score was 91 (range, 45 to 98), with a mean of 97 for the uninvolved knee. The mean Tegner activity score was 5.7 (range, 3 to 7). The KT-1000 arthrometer mean side-to-side difference for manual maximum displacement was 2.03 mm (range, -1 to 8). The mean International Knee Documentation Committee knee score was 83 (range, 47 to 100). Patients who underwent associated partial meniscectomy or meniscal repair had significantly lower International Knee Documentation Committee scores than patients without associated procedures (P < 0.01). CONCLUSIONS: Quadrupled hamstring tendon autograft anterior cruciate ligament reconstruction with bioabsorbable interference screw fixation is comparable with other methods of anterior cruciate ligament reconstruction in terms of patient satisfaction, knee stability, and function.

Persistence of the olecranon physis in baseball players: Results following operative management.

The purpose of this study is to report the results of operative management for pain associated with persistence of the olecranon physis in baseball players. Five maturing adolescent baseball players (4 male and 1 female) with pain associated with persistence of the olecranon physis underwent operative stabilization and autogenous bone grafting with second-stage hardware removal. All 5 patients remained symptomatic after a variable length of conservative management. At a mean follow-up of 32 months (range, 7-84 months), all 5 were satisfied with their results. All returned to or surpassed their previous level of performance. Operative management is recommended for a symptomatic, persistent olecranon physis in the high-demand, skeletally mature overhead athlete in whom conservative management has failed. Operative stabilization with internal fixation and autogenous iliac crest bone grafting results in the resolution of symptoms and a high rate of return to previous throwing performance.

Complications associated with reimplantation after girdlestone arthroplasty.

Complications associated with reimplantation of a total hip arthroplasty after resection or Girdlestone arthroplasty for treatment of an infected hip are not well-documented. Forty-four hips in 44 patients with a minimum 2-year followup (range, 2-9 years) from the time of reimplantation total hip arthroplasty were evaluated retrospectively. The average Harris hip score changed from 40 preoperatively to 78 at the latest followup. One patient had persistent infection requiring rerevision surgery, and another patient had rerevision surgery for recurrent dislocation. Complications related to the prosthesis consisted of dislocations in five patients (11.4%), recurrent infection in one patient (2.3%), trochanteric nonunion in four patients (9.1%), hematoma in one patient, heterotopic ossification in one patient, and postoperative wound drainage in one patient. Resection arthroplasty of the hip is highly effective in eradicating infection. In the current series, 97.7% of patients were free of infection at the latest followup. However, with an 11.4% dislocation rate and 39% of patients having a persistent limp, alternative approaches need to be evaluated which might reduce these complications.

Differences in femoral notch anatomy between men and women: a magnetic resonance imaging study.

BACKGROUND: Research has shown that variations in femoral intercondylar notch morphometry may be a predisposing factor for noncontact anterior cruciate ligament injury. HYPOTHESIS: There are anatomic differences in the anterior cruciate ligament and femoral notch between men and women. STUDY DESIGN: Descriptive anatomic study. METHODS: Using magnetic resonance imaging, we performed a three-dimensional analysis of the femoral intercondylar notch morphometry to look for differences in femoral notch and anterior cruciate ligament volumes between men and women. Axial plane magnetic resonance imaging scans were performed on 96 knees in 48 asymptomatic subjects. Digital measurements were taken of femoral notch area, anterior cruciate ligament area, notch width, and bicondylar width, within defined parameters of the femoral notch. The notch and anterior cruciate ligament volumes were then calculated. Analysis of variance was performed using sex, height, and weight as covariates. RESULTS: The volume of the femoral notch was found to be statistically smaller in women compared with men; this difference was primarily related to height. A similar relationship was found for anterior cruciate ligament volume. A statistically significant correlation was found between femoral notch volume and anterior cruciate ligament volume; patients with smaller notches also had smaller anterior cruciate ligaments. CONCLUSIONS: Our results suggest that there is a difference in femoral notch and anterior cruciate ligament volume between men and women, which, in turn, is related to differences in height and weight.