Publications by authors named "Milner J"

Background: Anteroposterior (AP) and lateral radiographs often underestimate displacement in medial epicondyle fractures, further complicating the already debated operative indications. The radiocapitellar (RC) view is an alternative radiograph that allows for the separation of the humeroradial and humeroulnar joints. This study investigates the utility of the RC view in measuring displacement and identifying the need for operative intervention in pediatric medial epicondyle fractures.

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Background: Iliopsoas injuries are a common cause of anterior hip and groin pain and can be successfully managed with conservative treatment. Corticosteroid and local anesthetic injections can also be offered in conjunction with nonoperative management. Given the variability in reported injection guidelines, composition, and techniques, the purpose of this study was to systematically review the literature to assess progression to surgery and patient outcomes following iliopsoas injections.

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Chimeric antigen receptor T cells (CAR T cells) with T stem (T) cell-like phenotypic characteristics promote sustained antitumor effects. We performed an unbiased and automated high-throughput screen of a kinase-focused compound set to identify kinase inhibitors (KIs) that preserve human T cell-like CAR T cells. We identified three KIs, UNC10225387B, UNC10225263A and UNC10112761A, that combined in vitro increased the frequency of CD45RACCR7TCF1 T cell-like CAR T cells from both healthy donors and patients with cancer.

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  • Inborn errors of immunity (IEIs) are genetic disorders that increase the risk of infections, autoimmunity, and other health issues, and often show incomplete penetrance despite being caused by single gene mutations.
  • This study examines how autosomal random monoallelic expression (aRMAE)—where only one allele of a gene is actively expressed—contributes to the variability in disease outcomes among individuals within families with IEIs.
  • The findings reveal that specific gene expression patterns related to aRMAE can influence clinical phenotypes, suggesting that understanding both genetic and expression variations is crucial for analyzing the impact of monogenic disorders.
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  • PLCγ2 is a key signaling molecule involved in immune regulation, and its variants can lead to conditions like PLCγ2-associated immune dysregulation (PLAID), particularly PLAID with cold urticaria (PLAID-CU), caused by specific genetic mutations.
  • Researchers conducted a study combining RNA sequencing and whole genome sequencing to identify genetic lesions in patients with antibody deficiency and known PLAID-CU cases.
  • The study found that two probands had novel PLCG2 transcripts with in-frame deletions linked to splice site mutations and deletions, which resulted in impaired ERK phosphorylation in a model system, highlighting the role of these genetic alterations in PLAID-CU.
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We report the case of a 3-year-old boy who was diagnosed with childhood pemphigus vulgaris having developed oral lesions, gastrointestinal symptoms with esophageal involvement, and failure to thrive. He had a markedly increased total serum IgE level and peripheral blood eosinophilia. The pemphigus was recalcitrant to conventional therapies and, based on the coexisting characteristics of Th2 immune deviation, he was treated with dupilumab and has had sustained clinical improvement since starting treatment.

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Background: The current study aims to analyze the effect of pre-operative non-bisphosphonate anti-osteoporotic drugs on complication and revision rates following total joint arthroplasty (TJA).

Methods: A retrospective cohort analysis of the PearlDiver (PearlDiver Technologies, Colorado Springs, CO) database was performed. The database was queried to identify all patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) with history of hip or knee osteoarthritis and either osteopenia or osteoporosis.

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The interferon (IFN)-induced STAT1 signaling pathway is a canonical immune pathway that has also been implicated in regulating neuronal activity. The pathway is enriched in brains of individuals with autism spectrum disorder (ASD) and schizophrenia (SZ). Over-activation of the STAT1 pathway causes pathological transcriptional responses, however it is unclear how these responses might translate into behavioral phenotypes.

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Angiotensin II receptor blockers (ARBs) are commonly prescribed for hypertension and heart failure, and have well-described antifibrotic properties throughout medical literature. The etiology and pathogenesis of fibrosis is biologically complex with a multitude of factors playing a role in the process. Consequently, pathologic fibrosis may be significant within orthopaedics contributing to post-operative stiffness and, ultimately, negative patient outcomes.

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  • The world is nearing the critical threshold of 1.5°C warming, with 2023 recording an average temperature rise of 1.45°C since pre-industrial times, leading to severe climate-related impacts.
  • The Countdown collaboration, formed to assess the health impacts of climate change post-Paris Agreement, involves over 300 experts analyzing data and trends annually.
  • The 2024 report highlights troubling increases in climate-related health risks, such as a staggering 167% rise in heat-related deaths among seniors, indicating worsening conditions affecting wellbeing globally.
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Background: While acute compartment syndrome (ACS) is a well-reported complication after pediatric tibial shaft fractures, prior literature has suggested that pediatric patients with tibial tubercle fractures may be at increased risk of ACS due to the proximity of the tibial tubercle to the anterior tibial recurrent artery. However, this theory was largely based on a series of early case reports without substantiation in larger-scale studies.

Hypothesis/purpose: The purpose of this study is to conduct a population-level analysis of the incidence and risk factors of acute compartment syndrome following pediatric tibial tubercle and tibial shaft fractures.

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  • The ongoing GUARDIAN study aims to evaluate the feasibility and acceptability of genome sequencing as an addition to traditional newborn screening across diverse racial and ethnic groups in New York City.
  • As of the interim analysis covering 4,000 newborns, 72% of approached families consented to participate, reflecting a representative sample of various racial and ethnic demographics.
  • The study primarily assessed the screen-positive rate, enrollment rate, and successful sequencing completion, with a large majority of families opting to screen for both early-onset genetic conditions and additional neurodevelopmental disorders.
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Background: Understanding the interaction between environmental conditions, crop yields, and soil health is crucial for sustainable agriculture in a changing climate. Management practices to limit disease are a balancing act. For example, in potato production, dry conditions favour common scab (Streptomyces spp.

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  • Current research on the health impacts of fine particulate matter (PM) exposure typically focuses on individuals who stay in one location, but this study introduces a new method to analyze the effects on U.S. diplomats who often move to cities with varying PM levels.
  • By applying life table methods and World Health Organization data, the researchers estimated the days of life lost (DLL) due to PM exposure for diplomats over 20-year assignments, with results showing significant variability based on the cities assigned.
  • The findings indicate that using air purifiers and changing living conditions can significantly reduce DLL, and the sensitivity analysis highlights how time lags in exposure impact the health outcomes for older male diplomats.
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There are no published studies on pregnancy-related concerns, worries, and fears (CWFs) in primiparous and multiparous women and men in U.S. Air Force (USAF) families.

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Immune evasion by tumors is promoted by low T cell infiltration, ineffective T cell activity directed against the tumor, and reduced tumor antigen presentation. The TET2 DNA dioxygenase gene is frequently mutated in hematopoietic malignancies and loss of TET enzymatic activity is found in a variety of solid tumors. We showed previously that vitamin C (VC), a cofactor of TET2, enhances tumor-associated T cell recruitment and checkpoint inhibitor therapy responses in a TET2-dependent manner.

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Human natural killer T (NKT) cells have been proposed as a promising cell platform for chimeric antigen receptor (CAR) therapy in solid tumors. Here we generated murine CAR-NKT cells and compared them with CAR-T cells in immune-competent mice. Both CAR-NKT cells and CAR-T cells showed similar antitumor effects in vitro, but CAR-NKT cells showed superior antitumor activity in vivo via CD1d-dependent immune responses in the tumor microenvironment.

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  • * A study examined 131 female patients with X-linked dominant incontinentia pigmenti (IP), finding that 36% produced autoantibodies against IFN-α and/or IFN-ω, significantly higher than age-matched controls.
  • * The presence of these autoantibodies is linked to an abnormally small thymus and predisposes patients to life-threatening viral infections, while those without these autoantibodies do not face the same risk.
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  • Racial and ethnic health disparities significantly affect outcomes in orthopedic shoulder surgeries, influenced by socioeconomic factors like insurance status, ethnicity, and race.* -
  • A literature review identified 22 studies revealing disparities in access to care and outcomes in shoulder and elbow surgeries related to race, ethnicity, and social determinants of health.* -
  • To address these disparities, recommendations include enhancing access to high-quality care by focusing on high-volume outpatient centers and improving geographical reach for surgical and rehab services.*
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Purpose: To assess the ability of ChatGPT-4 and Gemini to generate accurate and relevant responses to the 2022 American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guidelines (CPG) for anterior cruciate ligament reconstruction (ACLR).

Methods: Responses from ChatGPT-4 and Gemini to prompts derived from all 15 AAOS guidelines were evaluated by 7 fellowship-trained orthopaedic sports medicine surgeons using a structured questionnaire assessing 5 key characteristics on a scale from 1 to 5. The prompts were categorized into 3 areas: diagnosis and preoperative management, surgical timing and technique, and rehabilitation and prevention.

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Food systems can negatively impact health outcomes through unhealthy diets and indirectly through ammonia emissions originating from agricultural production, which contribute to air pollution and consequently cardiovascular and respiratory health outcomes. In the UK, ammonia emissions from agriculture have not declined in the same way as other air pollutants in recent years. We applied a novel integrated modelling framework to assess the health impacts from six ammonia reduction scenarios to 2030: two agriculture scenarios - a "Current trends" scenario projecting current mitigation measures to reflect a low ambition future, and "High ambition mitigation" based on measures included in the Climate Change Committee's Balanced Pathway to Net Zero; three dietary scenarios - a "Business as usual" based on past trajectories, "Fiscal" applying 20% tax on meat and dairy and 20% subsidy on fruit and vegetables, and "Innovation" applying a 30% switch to plant-based alternatives; one combination of "High ambition mitigation" and "Innovation".

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Background: Cherubism is most commonly caused by rare heterozygous gain-of-function (GOF) missense variants in SH3BP2, which appear to signal through phospholipase C gamma 2 (PLCG2) to cause excessive osteoclast activity leading to expansile lesions in facial bones in childhood. GOF variants in PLCG2 lead to autoinflammatory PLCG2-associated antibody deficiency and immune dysregulation (autoinflammatory PLAID, or PLAID-GOF), characterized by variably penetrant autoinflammatory, autoimmune, infectious, and atopic manifestations. Cherubism has not been reported in PLAID to date.

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  • Research highlights a critical gap in understanding long COVID (PASC) in children and emphasizes the need for studies that define its characteristics in this age group.
  • The objective is to identify common prolonged symptoms in children aged 6 to 17 post-SARS-CoV-2 infection, examining differences between school-age kids and adolescents, as well as potential symptom clusters for future research.
  • A multicenter study involved nearly 5,000 participants, revealing that certain symptoms were significantly more prevalent in those with a history of COVID-19 compared to those without.
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Background: Assessment of readability and reliability of online resources for orthopedic patients is an area of growing interest, but there is currently limited reporting on this topic for patellar instability (PI) and medial patellofemoral ligament reconstruction (MPFLR).

Methods: Utilizing the Searchresponse.io dataset, we analyzed inquiries related to PI and MPFLR.

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