Higher body mass index at ages 16 to 20 years is associated with increased risk of a multiple sclerosis diagnosis in subsequent adulthood among men.

Background: Evidence for the association between body mass index (BMI) and multiple sclerosis (MS) among men remains mixed.

Objective And Methods: Swedish military conscription and other registers identified MS after age of 20 years and BMI at ages 16-20 years ( = 744,548).

Results: Each unit (kg/m) BMI increase was associated with greater MS risk (hazard ratio and 95% confidence interval = 1.

Strategies to Standardize Opioid Research and Improve Clinical Pain Management.

Opioid abuse results in poor pain control, poor outcomes, and addiction. Clinical recommendations to manage pain include identifying the problem, considering multimodal anesthesia, avoiding overprescribing, acknowledging that minimizing opioid use is not equivalent to undertreating pain, minimizing preoperative opioid use, managing patient expectations, and continuing to investigate outcomes of pain management while limiting opioid prescriptions or forgoing opioids altogether. Authors are directed to new Recommendations for Pain Management Research to highlight critical research parameters and standardize outcome reporting.

Need Room to Operate? Partial and Intentional Release of the Knee Medial Collateral Ligament for Medial Meniscal Surgery.

Cutting the medial collateral ligament (MCL), even in part, seems counterintuitive. However, medial meniscal surgery is not always easy, and iatrogenic articular cartilage damage can be a complication of partial meniscectomy, meniscus repair, and/or allograft transplantation in a tight knee. Fortunately, partial tears of the MCL tend to heal, and most patients do tolerate iatrogenic, partial MCL tearing without negative long-term sequelae.

Particulate multivalent presentation of the receptor binding domain induces protective immune responses against MERS-CoV.

Middle East respiratory syndrome coronavirus (MERS-CoV) is a WHO priority pathogen for which vaccines are urgently needed. Using an immune-focusing approach, we created self-assembling particles multivalently displaying critical regions of the MERS-CoV spike protein ─fusion peptide, heptad repeat 2, and receptor binding domain (RBD) ─ and tested their immunogenicity and protective capacity in rabbits. Using a "plug-and-display" SpyTag/SpyCatcher system, we coupled RBD to lumazine synthase (LS) particles producing multimeric RBD-presenting particles (RBD-LS).

Reliability of Radiographic Union Scoring in Humeral Shaft Fractures.

Objectives: To establish the reliability of 2 radiographic union scoring systems for nonoperative humeral shaft fractures.

Design: Retrospective medical record review. Patients identified had humeral shaft fractures and radiographs at various follow-up time points, which were graded according to the both the standard (RUST) and modified radiographic union scoring systems (mRUST).

Relationship between iHOT12 and HOS scores in hip pain patients.

To determine if scores of the International Hip Outcome Tool-12 (iHOT12) and the Hip Outcome Score (HOS) correlate with one another in hip pain patients. Patients reporting to an orthopedic clinic for their scheduled appointment for hip pain were given a paper survey consisting of the iHOT12 and the HOS. Demographic information [age, weight, height and body mass index (BMI)] was obtained by chart review.

The Patient-Reported Outcomes Measurement Information System (PROMIS): Can We Finally Compare Apples to Oranges?

Legacy patient-reported outcome mea`sures lack standardization, resulting in difficulty comparing the results of diverse clinical outcome studies: "You can't compare apples to oranges." To address this concern, the National Institutes of Health initiated the Patient-Reported Outcomes Measurement Information System (PROMIS) to assess common dimensions of a wide range of diseases. PROMIS uses computer adaptive testing: A fluid questionnaire chooses subsequent questions based on the responses to previous questions to efficiently characterize outcomes using only 4 to 6 questions.

Deep convolutional neural networks for automated segmentation of brain metastases trained on clinical data.

Introduction: Deep learning-based algorithms have demonstrated enormous performance in segmentation of medical images. We collected a dataset of multiparametric MRI and contour data acquired for use in radiosurgery, to evaluate the performance of deep convolutional neural networks (DCNN) in automatic segmentation of brain metastases (BM).

Methods: A conventional U-Net (cU-Net), a modified U-Net (moU-Net) and a U-Net trained only on BM smaller than 0.

Will flooding or erosion of historic landfills result in a significant release of soluble contaminants to the coastal zone?

Historically, solid wastes were commonly landfilled in the coastal zone in sites with limited engineering to isolate waste from adjacent coastal environments. Climate change is increasing the likelihood that these historic coastal landfills will be inundated or eroded resulting in the release of soluble contaminants to the coastal zone. Previously research has focussed on the environmental impacts of leaching from landfills in freshwater environments with little or no consideration being given to saline environments.

AANA20: The 2020 Annual Meeting of the Arthroscopy Association of North America.

Arthroscopy, Arthroscopy Techniques, and Arthroscopy, Sports Medicine, and Rehabilitation will be in attendance in force at the 2020 Annual Meeting of the Arthroscopy Association of North America (AANA20). Program highlights and innovations include surgery simulcasts, "Great Debates," award-winning papers, Feature Lectures, and sessions glimpsing what is On the Horizon-and perhaps over and beyond.

Measuring the predictability of life outcomes with a scientific mass collaboration.

How predictable are life trajectories? We investigated this question with a scientific mass collaboration using the common task method; 160 teams built predictive models for six life outcomes using data from the Fragile Families and Child Wellbeing Study, a high-quality birth cohort study. Despite using a rich dataset and applying machine-learning methods optimized for prediction, the best predictions were not very accurate and were only slightly better than those from a simple benchmark model. Within each outcome, prediction error was strongly associated with the family being predicted and weakly associated with the technique used to generate the prediction.

Research Pearls: Checklists and Flowcharts to Improve Research Quality.

To instill quality in published clinical research, reporting guidelines, consisting of checklists and flowcharts, were developed to protect against reporting poorly designed research, and researchers should be aware of the available instruments and their appropriate use. With the popularity of synthetic reviews, meta-analyses, and systematic reviews, there is a greater need to assess risk of bias and study quality. This review highlights the most frequently used guidelines and checklists, risk-of-bias scales, and quality rating scales that can assist researchers with improving their research and its eventual publication.

Open pronation abduction ankle fractures associated with increased complications and patient BMI.

Introduction: Pronation abduction (PA) ankle fractures are often associated with a medial tension failure wound. Though this injury pattern was defined based on the mechanism of injury, there is a paucity of literature evaluating risk factors for understanding which patients will sustain an open PA fracture. Furthermore, how patients with these types of fractures perform relative to other open ankle fractures has not been established.

Direct Measurements of Collisional Dynamics in Cold Atom Triads.

The introduction of optical tweezers for trapping atoms has opened remarkable opportunities for manipulating few-body systems. Here, we present the first bottom-up assembly of atom triads. We directly observe atom loss through inelastic collisions at the single event level, overcoming the substantial challenge in many-atom experiments of distinguishing one-, two-, and three-particle processes.

Do Some Patients Count More Than Others? Reporting Outcomes of the Same Patient in More Than One Study Requires Disclosure.

Clinical databases allow researchers to test multiple hypotheses. This could result in including outcomes on the same patient or patients in more than 1 study. When this occurs, it is vital for authors to clarify multiple reporting in their study methods to avoid having patients counted more than once in future systematic reviews or meta-analyses.

Journal Article Titles Impact Their Citation Rates.

A journal article's title gives authors one chance to make a first impression and communicate succinctly the findings from their important research. The goal of a research article rests in disseminating information. Both authors and academic journals benefit from increasing the number of times an investigation is cited.

[Neuromuscular complications of fractures of the extremities, part 2 : Nerve injuries and iatrogenic damage].

Lesions of peripheral nerves substantially influence the long-term prognosis and functional outcome. Approximately 70% of peripheral nerval lesions are associated with vascular injuries and occur more frequently with certain fractures and osteosynthesis types. The prognosis and treatment depend on the severity of the injury and the presence of axonal lesions, in particular, determines the further procedure.

Influenza A viruses are transmitted via the air from the nasal respiratory epithelium of ferrets.

Human influenza A viruses are known to be transmitted via the air from person to person. It is unknown from which anatomical site of the respiratory tract influenza A virus transmission occurs. Here, pairs of genetically tagged and untagged influenza A/H1N1, A/H3N2 and A/H5N1 viruses that are transmissible via the air are used to co-infect donor ferrets via the intranasal and intratracheal routes to cause an upper and lower respiratory tract infection, respectively.

Pharmacologic and Radiation Therapies for Cancer-Induced Bone Loss.

Advancements in medical and radiation oncology have improved the prognosis for many cancers during the past few decades. As a result, physicians are challenged with managing a greater burden of disease for a longer time. In orthopaedics, bone loss secondary to metastatic tumor places patients at risk of impending and pathologic fractures.

Maternal smoking during pregnancy and fractures in offspring: national register based sibling comparison study.

Objective: To study the impact of maternal smoking during pregnancy on fractures in offspring during different developmental stages of life.

Design: National register based birth cohort study with a sibling comparison design.

Setting: Sweden.

Measuring attentional bias to food cues in young children using a visual search task: An eye-tracking study.

Objective: Attentional bias to food cues may be a risk factor for childhood obesity, yet there are few paradigms to measure such biases in young children. Therefore, the present work introduces an eye-tracking visual search task to measure attentional bias in young children.

Methods: Fifty-one 3-6-year-olds played a game to find a target cartoon character among food (experimental condition) or toy (control condition) distractors.

Pulmonary surfactant lipids inhibit infections with the pandemic H1N1 influenza virus in several animal models.

The influenza A (H1N1)pdm09 outbreak in 2009 exemplified the problems accompanying the emergence of novel influenza A virus (IAV) strains and their unanticipated virulence in populations with no pre-existing immunity. Neuraminidase inhibitors (NAIs) are currently the drugs of choice for intervention against IAV outbreaks, but there are concerns that NAI-resistant viruses can transmit to high-risk populations. These issues highlight the need for new approaches that address the annual influenza burden.