Citations

Purpose To evaluate the clinical, radiographic, and functional outcomes of arthroscopic treatment of scaphoid nonunion in adolescents, using cancellous bone grafting combined with headless compression screw fixation. Methods This retrospective study included adolescent patients treated between 2015 and 2022 with arthroscopically assisted bone grafting and headless compression screw fixation for scaphoid nonunion. Inclusion criteria were nonunion ≥6 months after injury and minimum 12‐month follow‐up; exclusion criteria included degenerative wrist changes. Collected variables included demographic data, injury‐to‐surgery interval, radiographic parameters (including scapholunate angle), time to union, pain scores (visual analog scale), functional outcomes (QuickDASH), and range of motion. Statistical analysis showed significant improvements in visual analog scale and QuickDASH scores ( P < .05). Results Fifteen patients (14 males; mean age 16 years, range 13‐19) met inclusion criteria. The mean follow‐up was 29.2 months. All patients achieved bone union, with an average healing time of 5.7 weeks. Pain (visual analog scale) improved from 2.6 to 0.8, and QuickDASH scores improved from 26.5 to 7.9. The scapholunate angle improved from 60.6° to 46.6°, with stable range of motion postoperatively. No major complications or reoperations occurred. Minimal clinically important difference analysis confirmed meaningful clinical improvement in 93% of patients for pain and 87% for QuickDASH. Conclusions Arthroscopic treatment of scaphoid nonunion in adolescents shows high union rates, improved function, and low morbidity. Level of Evidence Level IV, therapeutic retrospective case series.

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity affecting 30–40% of patients treated with neurotoxic chemotherapy. Sensory symptoms arise from injury to dorsal root ganglion (DRG) neurons and their axons; yet, the underlying mechanisms remain incompletely understood. While human induced pluripotent stem cell (iPSC)-derived sensory neuron (iSN) monolayers have provided mechanistic insight, they lack the three-dimensional architecture and cellular heterogeneity of native DRG tissue. Here, we generated human iPSC-derived DRG organoids (iDRGOs) containing mixed neuronal and peripheral glial populations and established a quantitative neurite outgrowth assay to model chemotherapy-induced neurotoxicity in a 3D context. iDRGOs from three healthy donors were exposed to bortezomib, vincristine, or paclitaxel. All three drugs caused dose-dependent neurite outgrowth impairment without significant short-term changes in organoid size, consistent with early axonal injury. Vincristine reduced MAP2 levels when normalized to total protein, whereas bortezomib and paclitaxel showed divergent microtubule-associated responses compared to monolayer cultures. The developmental stage significantly influenced the baseline neurite outgrowth, highlighting the need for age standardization. These results establish iDRGOs as a physiologically relevant human platform that complements monolayer models for mechanistic studies and therapeutic screening in CIPN.

Extracellular vesicles derived from mesenchymal stem cells (MSC-EVs) exhibit great therapeutic potential in ischemia-associated conditions and diseases such as myocardial infarction, ischemic stroke, and wound healing. Enhancing the therapeutic efficacy of MSC-EVs could advance their clinical application. Diverse cargos (proteins, mRNA, microRNA, etc.) in MSC-EVs contribute to the therapeutic effects in various diseases. Vascular endothelial growth factor (VEGF) is one of the primary driving molecules in promoting angiogenesis and protecting endothelial cells lining blood vessels from apoptosis. In this study, we explored the feasibility of engineering parent MSCs with VEGF mRNA to potentiate therapeutic effects of their derived EVs. We first detected elevated levels of VEGF mRNA and protein in transfected MSCs and demonstrated the bioactivity of secreted VEGF by an angiogenesis assay. Furthermore, EVs derived from VEGF mRNA-engineered MSCs (VEGF-MSC-EVs) contained high levels of VEGF mRNA and protein and showed superior ability to protect human umbilical vein endothelial cells (HUVECs) from apoptosis compared to EVs derived from control MSCs (control MSC-EVs). To our knowledge, this is the first report demonstrating that VEGF-MSC-EVs boost therapeutic efficacy by promoting endothelial cell survival. Our findings offer a novel approach for cell-free therapy in ischemia-associated conditions and diseases.

Abstract Background Metabolic dysfunction–associated steatotic liver disease (MASLD) is increasingly recognized among people with human immunodeficiency virus (PWH), which is likely related to metabolic alterations and fat redistribution. Anthropometric measures such as body mass index (BMI) and waist circumference (WC) are commonly used for assessing metabolic risk. However, their predictive accuracy for MASLD in this population remains uncertain. Method This multicenter cross-sectional study enrolled adults with HIV who underwent transient elastography with controlled attenuation parameter (CAP) measurement. Anthropometric and metabolic indices, including BMI, WC, hip circumference, waist-to-hip ratio (WHR), and visceral adiposity index (VAI), were collected from the study participants. Receiver operating characteristic (ROC) curve analyses were performed to determine the diagnostic performance of these indices for detecting hepatic steatosis, defined as CAP value of ≥248 dB/m. Analyses were stratified by sex assigned at birth. Results Altogether, 256 participants were included. WC demonstrated the numerically highest discrimination for CAP-defined steatosis (area under the ROC curve 0.769), followed by BMI and hip circumference, whereas WHR and VAI showed weaker performance. In sex-stratified analyses, WC remained the numerically highest-performing measure among males, whereas BMI, WC, hip circumference, and VAI showed similar discrimination among females. Conclusions Simple anthropometric measures, particularly WC, show fair ability to discriminate CAP-defined hepatic steatosis in PWH and may facilitate targeted fatty liver screening in routine HIV care.

Abstract Purpose The aim of this systematic review and meta‐analysis was to quantify and compare the evidence on the results obtained with the surgical treatments for meniscal lesions in athletes. Methods A literature search was conducted on PubMed, Cochrane and Web of Science in August 2025 according to the PRISMA guidelines. Inclusion criteria were clinical studies (randomised controlled trials [RCTs], non‐randomised comparative studies and case series), ≥6 patients, in the English language, on the surgical treatment of meniscal lesions in athletes. A meta‐analysis was conducted on the rate of patients returning to sport, the time to return to sport, and the rate of patients returning to the pre‐injury level of sport. Patient‐reported outcome measures, adverse events, failures and reoperation rates, as well as risk of bias and quality of evidence, were also documented. The risk of bias was assessed using the Cochrane RoB 2.0 tool, the Cochrane ROBINS‐I tool, and the JBI Critical appraisal checklist. The quality of evidence was assessed using a modified Coleman score and the GRADE tool. Result The mean time to return to sport was 2.1 months for meniscectomy, 5.8 months for meniscal repair, and 8.9 months for meniscal allograft transplantation (MAT). Statistically significant differences were observed between meniscectomy and repair and between meniscectomy and MAT (both p < 0.001). Meniscectomy showed a return to sport rate of 98.2%, meniscal repair of 96.9%, and MAT of 94.2%, while return to the same pre‐injury level of sport was reported as 84.4% for meniscectomy, 81.3% for meniscal repair, and 77.4% for MAT, with no statistically significant differences between groups. The mean modified Coleman Methodology Score for the included studies was 66.6 ± 7.0. Conclusion Meniscectomy, meniscal repair, and MAT are all able to provide high rates of return to sport in athletes. In the investigated treatment cohorts, meniscectomy presented the shortest pooled time to return to sport, followed by meniscal repair and MAT. Importantly, all treatments offered good rates of return to the same level of athletic performance. The treatment choice should be guided by an individualised, multidisciplinary approach aimed at providing a patient‐tailored treatment strategy to optimise both athletic recovery and joint preservation. Level of Evidence Level I.

Background: Nonpharmacologic interventions have known benefits for managing chronic pain, particularly for conditions such as fibromyalgia, and are included in clinical guidelines. However, eye movement desensitization and reprocessing (EMDR) has not been established as a routine clinical practice for pain management. Objective: To systematically review the efficacy of EMDR for managing chronic pain. Methods: A search was conducted to identify randomized clinical trials (RCTs) and observational studies by using the keywords “EMDR” and “chronic pain.” Information was collected on the study population, EMDR protocol, methods for pain assessment, and outcomes. Risk of bias was evaluated, and intervention effect sizes were determined by calculating Hedges g values for long-term follow-up data in RCTs. Results: A total of nine studies, including seven RCTs, were reviewed. The studies used various diverse pain measurement tools and EMDR protocols. All reported significant improvements in pain symptoms with EMDR. Most of the studies reported statistically significant improvements in associated mental health issues, notably in psychological distress (four out of four studies), anxiety (three out of three studies), and depression (three out of four studies). Effect sizes varied among the studies, with three RCTs reporting large effects, two RCTs reporting moderate effects, and one RCT reporting small or nonsignificant effects. Conclusion: EMDR shows promise for managing chronic pain and addressing associated mental health symptoms. Despite study differences and limitations, the findings of this systematic review support the potential use of EMDR for chronic pain management.

Background: In the last decade, a surge of advancements in and approvals of immunotherapies has revolutionized the treatment of non-small-cell lung cancer (NSCLC). Even as an increasing number of immune checkpoint inhibitors and antibody–drug conjugates gained FDA approval for the remarkable response and durable remission they imparted to some patients, persistent challenges of primary and acquired resistance, imperfect predictive biomarkers, and toxicity remain. Methods: This review identifies and summarizes the most significant emerging clinical data being reported for immunotherapies in NSCLC. Results: We found that the most recent clinical trials are centered on antibody–drug conjugates, bispecific and multispecific antibodies, cellular therapies, and immunocytokines, while other ongoing trials continue to explore new monoclonal antibodies as well as a variety of immunotherapy modalities. Conclusions: Immunotherapy in NSCLC remains an area of rapid advancement, with the potential for further improvements in safety and efficacy as monotherapy and in multimodal approaches.

Introduction Sleep is routinely assessed in the management of mental health conditions. Wearable technologies like smartwatches offer a non-intrusive method to quantitatively measure sleep. However, there are limited empirical benchmarks for sleep duration and sleep quality measured by wearables against user reports. This study aims to evaluate the concordance between user-reported and smartwatch-measured hours of sleep and sleep quality. Methods Participants were recruited from two decentralized digital health well-being studies and completed a 7-day sleep diary while simultaneously wearing their smartwatch to sleep (November 7, 2023 - June 30, 2024). Participants self-reported sleep timestamps and perceived sleep quality using the Sleep Quality Scale. Sleep timestamps and quality were also derived from their smartwatches (Garmin Vívoactive 4 2019, Garmin Venu 2 Plus 2022, and Garmin Venu 3/3S 2023). Statistical analyses included paired t-tests, equipercentile linking, and chi-square tests to assess agreement between smartwatch and self-reported sleep parameters. Exploratory analyses established the difference between reported and recorded sleep duration in healthcare shift workers. Results From 841 sleep instances reported by 130 participants wearing three different generation smartwatches, the mean difference in sleep duration between smartwatch-recorded and participant-reported was 21.22 (Garmin Vívoactive), 11.67 (Garmin Venu 2 Plus), and 6.58 (Garmin Venu 3/3S) minutes, respectively. There were statistically significant between-group differences in mean sleep durations assessed by participant self-report vs. Vívoactive 4 smartwatches, but not self-report vs. Venu 2 Plus or Venu 3/3S smartwatches. Equipercentile linking revealed concordance between smartwatch sleep scores and self-reported sleep quality using the Sleep Quality Scale (SQS) between 4 and 7, with disagreements observed at the SQS ranges from 0–4 and 7-10. Conclusions These results suggest that wearables can reliably measure sleep duration, and future research warrants improvements in algorithms that estimate sleep quality with validations across different wearable vendors.

Objective: To compare 1-year changes in estimated 10-year and lifetime atherosclerotic cardiovascular disease (ASCVD) risk following metabolic and bariatric surgery (MBS) versus glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy among adults with obesity. Summary Background Data: Obesity is a major driver of ASCVD through adverse metabolic and inflammatory pathways. Metabolic and bariatric surgery and GLP-1 receptor agonists represent the most effective contemporary treatments for obesity and are increasingly used to mitigate cardiovascular risk. However, their comparative effects on integrated short-term and lifetime ASCVD risk in real-world clinical practice remain incompletely characterized. Methods: We conducted a retrospective cohort study of adults with obesity (body mass index ≥30 kg/m²) who underwent MBS or initiated GLP-1RA therapy between 2020 and 2023 within a large tertiary health care system in the United States. Participants were identified from electronic health records and followed for 12 months. Primary outcomes were 1-year changes in estimated 10-year and lifetime ASCVD risk. Secondary outcomes included percent total body weight loss, blood pressure, and lipid parameters. Multivariable linear regression models were used to adjust for baseline body mass index and baseline ASCVD risk. Results: The final cohort included 812 patients, of whom 579 underwent MBS and 233 initiated GLP-1RA therapy. At baseline, patients receiving GLP-1RAs were older and had higher estimated ASCVD risk. At 1 year, reductions in 10-year ASCVD risk were similar between groups (−0.8% vs. −1.1%; P =.36). In contrast, lifetime ASCVD risk decreased significantly more following MBS than GLP-1RA therapy (−8.6% vs. −1.7%; P <.001). MBS was associated with greater percent total body weight loss (−27.8% vs. −11.1%; P <.001) and more favorable lipid changes, including larger reductions in low-density lipoprotein cholesterol and greater increases in high-density lipoprotein cholesterol. After adjustment, MBS remained independently associated with a greater reduction in lifetime ASCVD risk compared with GLP-1RA therapy (β −6.92; 95% CI −9.22 to −4.62). Conclusions: In this real-world cohort, both MBS and GLP-1RA therapy were associated with improvements in estimated cardiovascular risk, but MBS conferred substantially greater reductions in lifetime ASCVD risk, accompanied by superior weight loss and lipid improvements. These findings highlight the complementary roles of surgical and pharmacologic therapies in obesity management and may inform strategies to optimize long-term cardiovascular risk reduction.

Abstract INTRODUCTION Repetitive head impacts (RHI) from contact sports may cause a unique pattern of white matter hyperintensities (WMH) on T2‐weighted fluid‐attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI), termed RHI‐associated WMH (RHI‐WMH). These lesions are punctate, circular, and located at the gray–white matter boundary, an area vulnerable to trauma‐related damage. METHODS We investigated the association of RHI with these lesions in two aging cohorts: (1) former American football players versus asymptomatic unexposed men and (2) individuals with RHI from various contact sports versus non‐RHI participants. RHI‐WMH were assessed using visual ratings and a novel automated quantification pipeline. RESULTS Individuals with RHI had greater RHI‐WMH by both detection methods in both cohorts. RHI‐WMH were associated with plasma neurofilament light and p‐tau231, and flortaucipir positron emission tomography (PET) uptake. DISCUSSION RHI‐WMH may represent a new supportive biomarker for the detection of RHI‐related neuropathologies later in life.