Citations

Abstract VanZile, AW, Jones, DD, McHugh, LJ, Clickovich, GL, Morales, MA, Reimschisel, RK, Widenhoefer, TL, Baughman, JT, Urquidi, MD, Conner, DJ, Dobbs, WC, Jagim, AR, Luedke, JA, and Almonroeder, TG. Examining countermovement jump performance and dynamic balance among male high school athletes with varying levels of sports specialization. J Strength Cond Res 39(11): 1163–1168, 2025—Specializing at a young age may limit an athlete's motor development, since focusing on a single sport potentially exposes athletes to less variety of movements and neuromuscular demands. However, there are few studies examining the association between sport specialization and movement performance/control. The purpose of this study was to compare countermovement jump performance and dynamic balance among high school athletes of varying levels of sports specialization. 110 male high school athletes completed countermovement jump testing and the Y-Balance Test (YBT). Ground reaction forces were recorded during countermovement jumps and used to derive peak force, peak velocity, peak power, jump height, and the modified reactive strength index. Y-Balance Test composite scores were calculated to assess dynamic balance across multiple directions, for the dominant and non-dominant limbs. Athletes were grouped into high ( n = 46), moderate ( n = 39), and low ( n = 25) specialization groups based on their sport participation habits. There were no between-group differences for any of the countermovement jump metrics ( p > 0.05). For the YBT composite scores, there was not a group-by-limb interaction effect ( p = 0.28); however, there was a main effect of group ( p = 0.03). Post hoc tests indicated that the high specialization group exhibited lower YBT composite scores compared to the moderate specialization group ( p = 0.01) and a trend toward lower scores compared to the low specialization group ( p = 0.05). In general, highly specialized male athletes exhibited poorer dynamic balance compared to less specialized athletes.

Background: Point-of-care ultrasonography (POCUS) is becoming an increasingly relevant tool in hospital medicine, but its effective application in inpatient perioperative medicine remains to be determined. Much of the POCUS literature describes its use by anesthesiologists to evaluate cardiac function, volume status, pulmonary findings, and gastric volume. Objective: To identify, evaluate, and synthesize all available literature investigating the use of point-of-care ultrasound and associated clinical outcomes in inpatient perioperative medical management. Patients and Methods: A systematic review was designed using the PRISMA guidelines with sources of literature including Ovid, PubMed, Scopus, and the Web of Science. Literature search was conducted for published works between 1 January 2002 to 8 February 2024. Results: Three hundred sixty-seven abstracts were identified in our search, and, ultimately, 24 studies were included in this review. Most studies were done by anesthesiology evaluating cardiopulmonary and gastric POCUS. Studies supported using POCUS to expedite cardiac examination, promptly diagnose postoperative pulmonary complications, and optimize surgical timing. Conclusions: POCUS is a versatile tool in the perioperative setting; however, few studies were powered to assess clinical outcomes, and even fewer showed conclusive evidence of improved clinical outcomes. Furthermore, only two studies evaluated the use of POCUS specifically by acute care providers; more extensive studies are needed from their perspective as they take on increasing perioperative responsibilities.

Importance The effect of cornea donor diabetes on endothelial cell density (ECD) and morphometry after Descemet membrane endothelial keratoplasty (DMEK) is not known. Objective To determine whether endothelial cell loss (ECL) and morphometric changes 1 year after successful DMEK are related to cornea donor’s diabetes status. Design, Setting, and Participants This was a multicenter, double-masked, randomized clinical trial conducted from February 2022 to July 2024 at 28 US clinical sites (46 surgeons) and 13 eye banks. Included in the trial were the eyes of recipients (some of whom received tissue from donors without diabetes and others who received tissue from donors with diabetes) who underwent successful DMEK, primarily for Fuchs endothelial corneal dystrophy, and had at least 1 analyzable postoperative endothelial image. Intervention DMEK performed with a cornea from a donor without or with diabetes, assigned using a minimization procedure to achieve an approximate 2:1 distribution. Main Outcomes and Measures ECD, ECL, coefficient of variation in cell area (CV), and percentage of hexagonal cells (HEX) at 1 year from eye bank and postoperative specular central endothelial images. Results A total 1274 eyes of 982 recipients (mean [SD] age, 70 [8] years; 569 female [57.9%]; 816 [64.1%] with tissue from donors without diabetes and 458 [35.9%] with tissue from donors with diabetes) were included in the study. Preoperatively, mean (SD) central ECD in tissue from donors without diabetes and with diabetes were 2676 (290) cells/mm 2 and 2671 (286) cells/mm 2 , respectively. At 1 year, mean (SD) ECL was 28.3% (16.1%) and 28.0% (17.0%), in the donor groups without and with diabetes, respectively (adjusted mean difference = −0.4%; 95% CI, −2.3% to 1.4%), resulting in a mean (SD) 1-year ECD of 1927 (498) cells/mm 2 and 1920 (496) cells/mm 2 , respectively (adjusted mean difference = 10 cells/mm 2 ; 95% CI, −36 to 56; P = .95). No difference in ECD at 1 year associated with diabetes severity was noted ( P = .97). Mean (SD) CV did not differ at 1 year between the 2 groups of eyes (31.5% [4.1%] vs 31.4% [4.1%]; adjusted mean difference = −0.4%; 95% CI, −0.9% to 0.1%; P = .51), and mean (SD) HEX did not differ at 1 year between the 2 groups of eyes (57.7% [5.8%] vs 57.2% [5.8%]; adjusted mean difference = 0.1%, 95% CI, −0.8% to 0.9%; P = .33). Conclusions and Relevance This randomized clinical trial found that ECL and morphometry 1 year after DMEK were not affected by cornea donor diabetes status. With comparable 1-year graft success with tissue from donors with and without diabetes demonstrated in this trial, these findings support the use of corneas from donors with diabetes for endothelial keratoplasty procedures. Trial Registration ClinicalTrials.gov Identifier: NCT05134480

Importance If the success of Descemet membrane endothelial keratoplasty (DMEK) is not affected by whether the donor has diabetes, then the donor pool should expand. Objective To determine whether the 1-year DMEK success rate is affected by the presence of diabetes in the donor. Design, Setting, and Participants This was a multicenter, double-masked, randomized clinical trial conducted from February 2022 to July 2025 at 28 clinical sites (46 surgeons), with donor corneas provided by 13 eye banks in the US. Included in the study were individuals undergoing low to moderate risk DMEK (95% for Fuchs endothelial corneal dystrophy). Study data were analyzed from April to September 2025. Intervention DMEK performed with a cornea from a donor without or with diabetes, assigned using a minimization procedure (comparable with randomization) to achieve an approximate 2:1 distribution, respectively. Main Outcomes and Measures Graft success at 1 year Results A total of 1097 individuals (1421 study eyes; median [IQR] age, 71 [66-76] years; 631 female [57.5%]) were included in the study. The 1-year cumulative probability of graft success was 96.3% (95% CI, 95.0%-97.5%) among 912 study eyes (64.2%) receiving tissue from donors without diabetes and 97.1% (95% CI, 95.5%-98.4%) among 509 study eyes (35.8%) receiving tissue from donors with diabetes (difference between groups = 0.7 percentage points; 95% CI, −1.2 to 2.6; P = .63). The 1-year cumulative probability of graft success was 96.5% (95% CI, 93.6%-98.9%) in the mild donor diabetes severity subgroup (n = 173) and 97.3% (95% CI, 95.4%-98.8%) in the moderate to severe donor diabetes severity subgroup (n = 336), using a diabetes severity rating scale based on medical history. The rates of primary donor failure, early failure related to surgical complications, and subsequent failure were as follows: 2.5% (23 of 912), 0.7% (6 of 912), and 0.3% (3 of 912), respectively, in recipients of tissue from a donor without diabetes, and 2.6% (13 of 509), 0.4% (2 of 509), and 0%, respectively, among recipients of tissue from a donor with diabetes. There were no failures due to graft rejection. Conclusions and Relevance The 1-year success rate in eyes undergoing DMEK with successfully prepared tissue was very high regardless of donor diabetes status. These results, supported by the separately reported finding that endothelial cell loss and cornea morphometry after 1 year were not affected by donor diabetes status, provide strong support for having no restrictions on the use of tissue from donors with diabetes for DMEK. Trial Registration ClinicalTrials.gov Identifier: NCT05134480

Abstract Transcription factors and their cofactors are major and selective nononcogene dependencies in multiple myeloma cells. By performing a gain-of-function perturbation screen in human multiple myeloma cell lines, we identified the inhibitor of DNA binding (ID) genes as putative suppressors of multiple myeloma cell fitness. Among them, ID2 was found to be downregulated in multiple myeloma patient cells and acted as a tumor suppressor by directly binding and repressing the basic helix-loop-helix factor TCF3, also known as E2A. Lower ID2 expression in multiple myeloma cells conferred a proliferative advantage by increasing TCF3 activity, leading to a dependency on this transcription factor. In contrast, ID2 overexpression reduced TCF3 binding to DNA, which resulted in cell-cycle arrest and a halt in multiple myeloma cell proliferation. The myeloma bone marrow milieu supported this process by further decreasing the expression of ID2 and enhancing TCF3 activity, partly via IL6, revealing a mechanism by which the tumor microenvironment affects multiple myeloma cell behavior. Significance: Multiple myeloma cells exploit the oncogenic and proliferative potential of TCF3 by downregulating the transcriptional regulator ID2, a process facilitated by the bone marrow microenvironment.

Variations in liver allocation systems worldwide are presented, with a specific focus on regional differences and their potential impact on outcomes, with the goal of serving as a reference for future policy development. Summaries of liver allocation across multiple European, Scandinavian, and Asian systems, as well as the combined allocation system of Australia plus Canada, the United States, and the systems in Central America, South America, and the Caribbean are reviewed. A comprehensive comparison of how different regions address MELD exceptions, primarily focusing on hepatocellular carcinoma, along with the most common etiologies of liver disease requiring transplantation is presented. In addition, the adoption of living donation and donation after circulatory death is discussed. The study involves contributions from a diverse group of world experts in liver transplantation and may serve as an essential resource to foster international dialogue as countries strive to optimize organ allocation policies, including MELD exceptions.

Abstract Our inability to obtain nerve samples from the vast majority of neuropathic pain patients impedes our ability to understand the disease, creates challenges in understanding mechanisms in specific patient populations, and limits our ability to make treatment decisions based on quantifiable molecular data. Fields like oncology have overcome these problems to take advantage of the insight that sequencing offers for understanding mechanisms of disease and have leveraged these molecular insights to dramatically change the treatment landscape in the past decade. Here we tested the hypothesis that skin biopsies could be used to gain insight into neuronal transcriptomic changes in patients with paclitaxel-induced peripheral neuropathy (PIPN). Our analysis reveals that hundreds of differentially expressed genes (DEGs) found through bulk RNA sequencing in these skin biopsies are likely contributed by dorsal root ganglion (DRG) neuronal axons and/or terminals. Up-regulated genes were representative of broad class of nociceptors whereas down-regulated genes were associated with putative injured DRG neurons expressing the PDIA2 gene. DEGs that could be confidently associated with specific subsets of skin cells were mostly expressed by keratinocytes supporting a growing literature tying keratinocyte-neuron communication abnormalities to pain in PIPN. We validated these findings by analyzing additional previously published datasets and through prospectively conducted spatial transcriptomics experiments on human skin biopsies. Our findings warrant further assessment of skin biopsies in additional neuropathic pain populations to gain insight into DRG neuron changes that have previously been thought to be inaccessible in routine clinical or scientific assessments in most patients.

Abstract Background After high‐level spinal cord injury (SCI), motor recovery of wrist extensors has significant functional consequences as it can facilitate grasp through tenodesis. A small seminal study from 1993 established widely used prognostic rules for wrist extensor recovery, though these have not been replicated with larger, real‐world samples since inception. Objective To determine the prognostic value of initial C5 sharp‐dull discrimination, C5 motor strength, and C6 motor strength on predicting 1‐year ipsilateral wrist extensor motor recovery for patients with SCI with neurological level of C4 or C5. Design Retrospective cohort replication study. Setting SCI Model Systems. Participants 35,675 total individuals with acute traumatic SCI with 219 cases of initial wrist extensor weakness (0/5–2/5) meeting inclusion criteria. Intervention Not applicable. Main outcome measure Recovery of wrist extensor strength to ≥3/5 at 1 year. Results The positive predictive and negative predictive values were 57% (95% CI, 47.4%–66.1%) and 66% (56.0%–75.1%) if initial C5 sharp‐dull discrimination was present, 61% (52.7%–69.3%) and 82% (71.4%–89.7%) if initial C5 myotome strength was at least antigravity, and 74% (63.7%–82.5%) and 74% (65.5%–81.4%) if initial C6 myotome strength was at least a 1/5 or 2/5. Synthesizing these three rules, an updated branched nomogram for functional wrist extensor recovery prediction was created. Conclusions In isolation, none of the previously established wrist extensor motor recovery predictive rules had as high of a prognostic value when using a larger dataset. As such, singular reliance on these prediction rules to identify who will gain 1‐year antigravity wrist extension should be approached with decreased certainty. The best positive and negative predictors were trace C6 strength and absent C5 strength, respectively. An updated nomogram provides more nuanced prognostic information to guide clinical care following acute SCI.