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Christopher S Ahmad,1 Justin E Hellwinkel,1 Rifat Ahmed,1 Frank J Alexander,1 Alan W Reynolds,1 Dana P Piasecki,2,3 Thomas S Bottiglieri,1 T Sean Lynch,1 Charles A Popkin,1 Bryan M Saltzman,2,3 David P Trofa1 1Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA; 2Sports Medicine Center, OrthoCarolina, Charlotte, NC, 28207, USA; 3Musculoskeletal Institute, Atrium Health, Charlotte, NC, 28207, USACorrespondence: David P Trofa, Columbia University Irving Medical Center, 622 West 168 St, PH-11, New York, NY, 10032, Email dpt2103@cumc.columbia.eduObjective: Social distancing protocols due to the COVID-19 pandemic resulted in premature ending of athletic seasons and cancellation of upcoming seasons, placing significant stress on young athletes. Inability to play or forced early retirement has significant consequences on athlete’s mental health, as demonstrated by an extensive body of injury literature. We hypothesize that premature suspension and cancellation of athletic events due to the COVID-19 pandemic leads to higher incidence of depressive symptoms among high-school and collegiate athletes. Further, athletes who strongly derive their sense of self-worth centered around athletics would have higher rates of depressive symptoms.Methods: High school and collegiate athletes were evaluated for depressive symptoms, emotional health and athletic identity measures through validated assessment instruments from May 2020 through July 2020. The Patient-Reported Outcomes Measurement Information System Depression Computer Adaptive Test (PROMIS-10 Depression CAT), Veterans RAND-12 (VR-12), which comprises both a physical and mental health component, and Athletic Identity Measurement Scale (AIMS) were utilized.Results: Mental health assessments were completed by 515 athletes (52.4% male, 47.6% female; .84.5% collegiate, 15.5% high school). Female athletes scored significantly worse than males on VR-12 mental health assessments, as well as PROMIS-10 Depression scores; however, males scored significantly lower than females on VR-12 physical health assessments, irrespective of education level. Athletes who had strong associations with athletics as central to their personal identity exhibited worse psychologic impact on VR-12 mental health and PROMIS-10 Depression measures and female athletes in this cohort reported greater depressive symptoms than males.Conclusion: Social distancing protocols due to the COVID-19 pandemic have limited athlete’s ability to participate in sports at the training and competition level. Higher rates of depressive symptoms in high school and college athletes have resulted among female athletes and those who identify strongly as an athlete.Keywords: COVID-19, mental health, return to play, involuntary retirement, psychological impact, depression

We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I–III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11º) versus 43 (SD 11º); wrist flexion, 32 (SD 10º) versus 36 (SD 11º); flexion-extension arc, 62 (SD 14º) versus 75 (SD 10º); radial deviation, 14 (SD 5º) versus 10 (SD 5º); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial deviation and post-operative hand grip strength (as a percentage of the contralateral side) were significantly better after four-corner arthrodesis. Four-corner arthrodesis gave significantly greater post-operative radial deviation and grip strength as a percentage of the opposite side. Wrist flexion, extension, and the flexion-extension arc were better after proximal row carpectomy, which also had a lower overall complication rate.Level of evidence: Level III (Level I-III studies), Systematic Review. Therapeutic. [ABSTRACT FROM PUBLISHER]

This review describes the development, advantages and disadvantages, and applications of the Patient-Reported Outcome Measurement Information System (PROMIS) in orthopaedic trauma. PROMIS is a useful tool for quantifying outcomes in orthopedic trauma. It allows measurement of outcomes across multiple domains while minimizing administration time. PROMIS also reliably identifies clinical, social, and psychological risk factors for poor outcomes across a variety of orthopaedic injuries and disease states. However, PROMIS lacks specificity for certain anatomic regions and validation for mental health outcomes. It also is limited by ceiling effects in certain active patient populations. Orthopaedic traumatologists should be familiar with PROMIS, as its use is increasing and it is a valuable tool that can aid in clinical decision making.

A study was made of the lead exposures to the ladle attendant in a brass foundry since this work involved the highest exposure levels. A preliminary time and motion study was used to define the major existing worker practices and four exposure-related segments. The study measured the lead exposure in these segments through 12 cycles on each of 5 days. It was concluded that the mould-pouring segment in this particular foundry was the one for which engineering controls or respiratory protection were essential. The lead exposure in the other three segments (tapping, ladle transfer and waiting) could probably be abated by inexpensive changes in work practices, administrative controls and/or local engineering controls. [ABSTRACT FROM PUBLISHER]

Purpose and Patients: Pyomyositis, a common disease in the tropics, is rare in the continental United States, with approximately 83 cases described in the literature in the past two decades. The occurrence of pyomyositis complicating human immunodeficiency virus (HIV) infection has been reported in 10 patients since 1986. We report six cases of this entity in patients with advanced HIV disease seen in our institution over a 20-month period. A common denominator in all of our patients was muscle injury, induced by either exercise or trauma. Unlike most previous reports of HIV-associated pyomyositis, the clinical picture in our cases was complicated by the development of abscesses in multiple muscle groups, requiring prolonged antimicrobial therapy and repeated drainage procedures for successful management. Interestingly, one patient developed concomitant rhabdomyolysis--an otherwise rare event in classical pyomyositis. Staphylococcus aureus was the predominant infecting organism in this as well as all other series. Of note, we also observed and report the first case, to our knowledge, of gram-negative pyomyositis in an HIV-infected individual. The pathogenic implications of this catalase-producing gram-negative isolate are discussed in the context of neutrophil abnormalities in HIV disease.Conclusion: Like tropical pyomyositis, its HIV-associated counterpart appears to be multifactorial in origin. Its recent recognition suggests that, in addition to underlying abnormalities of host defense, factors relating to the prolonged survival of patients with late-stage disease, including myopathy, might play an important contributory role. [ABSTRACT FROM AUTHOR]

Purpose. To determine the natural history of patients presenting with acute proximal biceps rupture (APBR) and concomitant rotator cuff disease. Methods. Prospective cohort study of patients with an APBR confirmed via magnetic resonance imaging (MRI) presenting to clinic within 8 weeks of injury. Visual Analog Scale (VAS) pain score, Simple Shoulder Test (SST) score, and the American Shoulder and Elbow Surgeons (ASES) score were the main outcome measures assessed at a minimum of two-years. Results. Twenty-seven patients were included in the final analysis: seven females (26%) and 20 males (74%) (mean age: 61 years, range 42-78 years). Rotator cuff tears were found in 25 patients (93%). At two-year follow-up (SD 0.28), nine patients (33%) without improvement or dis-satisfaction with conservative management opted to undergo shoulder surgery (all with rotator cuff tears), at a mean 4.5 months (range 1.2-24 months) after injury. Worker's Compensation and a history of diabetes were significantly associated with having surgery. At the two-year follow-up, the median patient reported outcomes (PROs) were as follows: VAS pain- 0.0 (IQR 0.0-3.0); Disability subscale- 48.3 (IQR 34.2-50.0); ASES total- 89.2 (IQR 70.0-98.3); and SST- 11.0 (IQR 9.0-12.0). There was no statistically significant difference in PROs between patients who went on to have surgery and those who did not. Conclusions. Satisfactory PROs and low levels of pain were reported at the two-year follow-up in patients with an APBR, with no difference between those patients who underwent surgical intervention and those who did not. [ABSTRACT FROM AUTHOR]

Purpose: Spermatozoa centriolar defects can result in abnormal zygote functions. Recently, a method to quantify spermatozoa centriolar defects was developed named Fluorescence-Based Ratiometric Analysis of Sperm Centrioles (FRAC). However, whether spermatozoa centriolar defects identified by FRAC can result in abnormal zygote functions was not tested., Methods: Here, we quantified spermatozoa centriolar defects using FRAC, and zygote centriole function was assessed by imaging Nucleolus Precursor Body (NPB) polarization which was based on the pattern of NPB polarization. Data was analyzed at couple and embryo levels. Subjects were divided into two groups: seven couples and 62 embryos with normal spermatozoa centrioles versus eight couples and 78 embryos with abnormal spermatozoa centrioles (140 embryos from 15 couples in total)., Results: Patterned NPB polarization was statistically significant in both couple- and embryo-level analyses (p < 0.0001 and p = 0.0024). These results suggest that the abnormal spermatozoa centrioles identified by FRAC may correlate with abnormal zygote centrosome function via NPB polarization scoring., Conclusions: This study provides a foundation for more extensive studies to test for FRAC's utility in assessing spermatozoa centriole quality., Competing Interests: Declarations. Ethics approval: The Collaborative Program for Translating Basic Research to Clinical Trial in Idiopathic Infertility (CPTBR) consortium was formed in November 2018 to study male infertility using multiparametric sperm analysis. The semen samples were collected from the Reproductive Subject Registry and Sample Repository (RSRSR) at the University of Michigan (UM IRB#-HUM00125627). This study was conducted in accordance with the Declaration of Helsinki, and approved by the University of Toledo Institutional Review Board (IRB) (UT IRB#300364; initial approval 10/11/2019; PI: Tomer Avidor-Reiss). The remaining members of the CPTBR consortium agreed to rely on the approval of the study by the University of Toledo by employing a SMART IRB Reliance system ( https://smartirb.org/reliance/ ; SMART IRB ID: 2683; initial approval 4/11/2020). The University of Toledo IRB reviewed the SMART IRB, and other consortium members relied on the University of Toledo IRB for compliance with human subject research protections. Informed consent: Informed consent was obtained from all subjects involved in the study. Patents: The University of Toledo has filed provisional patent application number 63/117,056, with TAR named on this patent based on the original article describing the FRAC method. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objectives: This study aimed to understand why breastfeeding and exclusive breastfeeding rates substantially decrease shortly after birth among mothers in the USA. Specifically, we aimed to illuminate the impact of stressful life events and racial discrimination on mothers' breastfeeding behaviors and duration., Methods: We conducted a qualitative analysis of semi-structured telephone interviews with women (N = 66; 47 White, 16 Black, and 3 Hispanic) who gave birth between 2019 and 2021 in Ohio. Interviews were conducted between March 2022 and May 2022. Interviews were digitally recorded, transcribed verbatim, analyzed, coded, and organized into themes., Results: After thematic analysis of the data, five key themes were identified: (1) stress, (2) breastfeeding barriers, (3) policy and system change to support breastfeeding mothers, (4) racial discrimination, and (5) breastfeeding motivators. Our study found that the breastfeeding experience was both a positive bonding experience and a challenging practice, characterized by physical, mental, and sociocultural struggles., Conclusion for Practice: Addressing stress during pregnancy, equitable access to culturally sensitive lactation support, improved parental leave, and enhanced workplace breastfeeding regulations are essential to increasing breastfeeding duration among racially marginalized women., (© 2023. W. Montague Cobb-NMA Health Institute.)

Background: The objective of this study is to evaluate the Respect YOU program's impact on students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. A total of 444 (intervention cohort n = 348, control cohort n = 96) underclassmen enrolled in health or physical education courses from 7 high schools in the Midwest participated in the study., Methods: A repeated measure research design was utilized to assess students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. More specifically, paired t-tests were conducted to compare outcome measurements to evaluate the efficacy of the intervention., Results: Among the students who received the intervention (n = 348), there was a statistically significant change in scores for eating expectancies (Z = -14.403, p < .001), body image satisfaction levels (Z = -14.114, p < .001), social media self-efficacy (Z = 14.868, p < .001), and knowledge scales (Z = -16.100, p < .001) at post-intervention and compared to the control group., Conclusions: Results indicate that the Respect YOU program was effective in improving body image scores, eating expectancies, self-esteem, and knowledge-related outcomes among students post-intervention. These results can be used to further develop educational programming to address body image concerns and disordered eating among adolescents., (© 2024, American School Health Association.)

The mechanisms underlying male infertility are poorly understood. Most mammalian spermatozoa have two centrioles: the typical barrel-shaped proximal centriole (PC) and the atypical fan-like distal centriole (DC) connected to the axoneme (Ax). These structures are essential for fertility. However, the relationship between centriole quality and subfertility (reduced fertility) is not well established. Here, we tested the hypothesis that assessing sperm centriole quality can identify cattle subfertility. By comparing sperm from 25 fertile and 6 subfertile bulls, all with normal semen analyses, we found that unexplained subfertility and lower sire conception rates (pregnancy rate from artificial insemination in cattle) correlate with abnormal centriolar biomarker distribution. Fluorescence-based Ratiometric Analysis of Sperm Centrioles (FRAC) found only four fertile bulls (4/25, 16%) had positive FRAC tests (having one or more mean FRAC ratios outside of the distribution range in a group's high-quality sperm population), whereas all of the subfertile bulls (6/6, 100%) had positive FRAC tests (P = 0.00008). The most sensitive biomarker was acetylated tubulin, which had a novel labeling pattern between the DC and Ax. These data suggest that FRAC and acetylated tubulin labeling can identify bull subfertility that remains undetected by current methods and may provide insight into a novel mechanism of subfertility., (© 2023. The Author(s).)

Unexplained infertility affects about one-third of infertile couples and is defined as the failure to identify the cause of infertility despite extensive evaluation of the male and female partners. Therefore, there is a need for a multiparametric approach to study sperm function. Recently, we developed a Fluorescence-Based Ratiometric Analysis of Sperm Centrioles (FRAC) assay to determine sperm centriole quality. Here, we perform a pilot study of sperm from 10 fertile men and 10 men in couples with unexplained infertility, using three centriolar biomarkers measured at three sperm locations from two sperm fractions, representing high and low sperm quality. We found that FRAC can identify men from couples with unexplained infertility as the likely source of infertility. Higher quality fractions from 10 fertile individuals were the reference population. All 180 studied FRAC values in the 10 fertile individuals fell within the reference population range. Eleven of the 180 studied FRAC values in the 10 infertile patients were outliers beyond the 95% confidence intervals (P = 0.0008). Three men with unexplained infertility had outlier FRAC values in their higher quality sperm fraction, while four had outlier FRAC values in their lower quality sperm fraction (3/10 and 4/10, P = 0.060 and P = 0.025, respectively), suggesting that these four individuals are infertile due, in part, to centriolar defects. We propose that a larger scale study should be performed to determine the ability of FRAC to identify male factor infertility and its potential contribution to sperm multiparametric analysis., (Copyright © 2022 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Bilirubin is a signaling molecule that alters the immune response and metabolism. While bilirubin has been employed as a marker of renal and cardiovascular health, its role in renal transplant recipients is not known. In this study, we sought to determine the impact of bilirubin (total, direct and indirect) on the estimated glomerular filtration rate (eGFR) after renal transplantation. We conducted a retrospective review of pre- and postoperative bilirubin levels in 457 renal transplant recipients at a single center. Pre- and post-rejection bilirubin levels were also assessed in those patients who experienced a rejection episode. No statistically significant differences were found in bilirubin levels during the pre-transplant to post-rejection period among patients who experienced rejection with kidney allograft survival. No statistically significant associations were observed between baseline bilirubin and post-transplant eGFR in the full patient group or within the gender- or race-stratified groups. Baseline bilirubin was not correlated with time to rejection. Our results suggest that bilirubin may not offer renoprotection in renal transplant recipients., Competing Interests: None., (AJCEU Copyright © 2022.)