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Lateral extra-articular tenodesis and other anterolateral procedures improve patient outcomes when combined with anterior cruciate ligament reconstruction. Failure rates are >50% lower in young patients at high risk of reinjury. check details We defined patients at high risk as those aged 14 to 25 years with 2 or more factors of the following criteria 1) returning to contact pivoting sport, 2) high-grade anterolateral rotatory laxity, as measured by pivot shift test (grade 2 or higher), and 3) generalized ligamentous laxity (Beighton score greater than 4) or knee hyperextension recurvatum of greater than 10°. Other indications may include Segond fracture, chronic anterior cruciate ligament lesion, radiographic lateral femoral notch sign, and lateral coronal plane laxity. A clearer understanding of indications determined by a comprehensive clinical assessment and risk stratification is needed. As indications continue to be "stretched," we need to better understand the role of lateral extra-articular tenodesis and when to employ it in our practice.The majority of surgeons caring for elite American football teams choose bone-patellar tendon-bone (BTB) autograft for anterior cruciate ligament reconstruction. As we strive to continue to improve currently favorable outcomes, we need to consider all options regarding graft choice, surgical technique, and postoperative rehabilitation. Advantages of BTB include an excellent track record, potential for faster incorporation with bone-to-bone healing. Disadvantages include risk of patellar fracture/tendon rupture and anterior knee pain. The pros of quadrupled hamstring (QH) graft include stronger graft (higher ultimate load to failure) and less anterior knee pain and stiffness, and the cons include loss of flexion/hamstring strength and slower healing in the tunnels. Several studies have shown that smaller grafts have higher failure rates, and recent research shows that QH grafts >9 mm had decreased risk of revision compared to BTB. We can now quadruple the semitendinosus tendon to provide elite athletes with even more robust grafts. Large-diameter QH autografts are an acceptable option for National Collegiate Athletic Association Division I college football players.With sincere appreciation to the AANA Education Foundation for their generous support, we announce our Annual Awards for the best Clinical Research, Basic Science Research, Resident/Fellow Research, and Systematic Reviews published in 2021, as well as the Most Downloaded and Most Cited papers published 5 years ago. Also, as is customary and as we require of authors, our editors update their annual disclosures of potential conflicts of interest. Finally, we annually update our masthead, thus introducing a new Associate Editor and many new members of the Editorial Board and Social Media Board.

Excess weight can cause structural and functional cardiac disorders. The presence of left ventricular hypertrophy in the obese patient is an independent predictor of cardiovascular morbidity and mortality. The major aim of the present study is to know the prevalence of cardiac morphofunctional disorders in obese patients, before and after weight loss due to bariatric surgery (BS).

Prospective cohort study of 75 patients with obesity without known heart disease referred to gastric bypass. Anthropometric, analytical and echocardiographic parameters were measured before and after 6 and 12 months after BS.

The study included 75 patients (66.6% women, mean age 39.3 [9.7] years and BMI 47.8 [7.1] kg/m

). At 6 and 12 months after BS there was a significant reduction in body weight and an improvement in metabolic, inflammatory and prothrombotic parameters and in cardiovascular risk factors associated with obesity (hypertension, type 2 diabetes, dyslipidemia and obstructive sleep apnea-hypopnea syndrome). Before surgery, cardiac remodeling was present in 62.7%, most frequently in the form of concentric remodeling (38.7%). Diastolic dysfunction occurred in 50.7% of the patients. One year after surgery, the ventricular pattern was normal in 92% of cases and the diastolic function improved significantly.

Our results support the negative effect of obesity on cardiac geometry and function and the potential reversibility of these cardiac alterations after marked weight loss due to BS.

Our results support the negative effect of obesity on cardiac geometry and function and the potential reversibility of these cardiac alterations after marked weight loss due to BS.Social and health care equity and justice should be prioritized by the mantra of medicine, first do no harm. Despite highly motivated national and global health strategies, there remains significant health care inequity. Intrinsic and extrinsic factors, including a number of biases, are key drivers of ongoing health inequity including equity of access and opportunity for nuclear medicine and radiology services. There is a substantial gap in the global practice of nuclear medicine in particular, but also radiology, between developed health economies and those considered developing or undeveloped. At a local level, even in developed health economies, there can be a significant disparity between health services, including medical imaging, between communities based on socioeconomic, cultural or geographic differences. Artificial intelligence (AI) has the potential to either widen the health inequity divide or substantially reduce it. Distributed generally, AI technology could be used to overcome geographic boundaries to health care, thus bringing general and specialist care into underserved communities. However, should AI technology be limited to localities already enjoying ample healthcare access and direct access to health infrastructure, like radiology and nuclear medicine, it could then accentuate the gap. There are a number of challenges across the AI pipeline that need careful attention to ensure beneficence over maleficence. Fully realized, AI augmented health care could be crafted as an integral part of the broader strategy convergence on local, national and global health equity. The applications of AI in nuclear medicine and radiology could emerge as a powerful tool in social and health equity.Carcinoid syndrome, a paraneoplastic condition linked with the release of multiple humoral factors, affects around 30-40% of patients with well-differentiated neuroendocrine tumours. Carcinoid syndrome has a major and unfavourable impact on patients' quality of life; it raises costs when compared to non-functioning neuroendocrine tumours; and it causes patients' lifestyles to alter, such as food, job, physical activity, and social life. Somatostatin analogues have been the first-line therapy for individuals with neuroendocrine tumours and carcinoid disease for decades. While these drugs give considerable relief from carcinoid syndrome symptoms, clinical progression is unavoidable, necessitating further research into newer treatment measures. Carcinoid tumours are sometimes difficult to diagnose because of their vague or nonspecific symptoms. There have been several advancements in all aspects of carcinoid syndrome, as well as novel therapeutics, in the previous few years. New epidemiological studies show thatndicators of aggressiveness improved serum tumour markers, and the molecular aetiology of carcinoid heart disease are all possible because of advances in molecular biology. We conducted a comprehensive review to update knowledge regarding the pathophysiology, diagnostic protocols, and current and newer treatments for carcinoid syndrome, which presently requires a multidisciplinary approach, due to the complexity of the illness's aetiology, diagnosis, and therapy.In this paper, the sensor fault detection problem considering the drilling disturbances is studied for the dynamic point-the-bit rotary steerable system. Firstly, the DPRSS is modeled as a linear system with the drilling disturbances, including unknown inputs, measurement noises, and model perturbations. Then, a finite-frequency zonotopic fault detection observer is proposed. The finite-frequency range H- performance and the P-radius criterion are considered to design the observer gains such that the residuals are sensitive to sensor faults and robust against the drilling disturbances simultaneously. Subsequently, the calculation method of minimum detectable faults is presented for the proposed sensor fault detection mechanism. Finally, simulations and experiments are presented to illustrate the effectiveness of the proposed methods.Real-time tracking of the dynamic intrusion targets consists of two crucial factors the path forecast of the target and real-time path optimization of multi-UAV target tracking. For the first one, the uncertainty of the target trajectory is an obstacle to realizing real-time tracking. Thus a trajectory prediction method is proposed in this paper to ensure the sampling period of the target. Owing to the poor prediction accuracy of the single-step trajectory, a multi-step Unscented Kalman Filter (MUKF) is proposed to forecast its multi-step trajectory further in different regions. For the second one, there are two problems poor optimization accuracy of the tracking trajectory and larger local optimization deviation, which will cause failure of the regional tracking. Under this circumstance, a hybrid algorithm called SAQPSO is proposed, combining the specific mechanism of two intelligence algorithms. The annealing mechanism in the Simulated Annealing (SA) algorithm is used to modify the Quantum Particle Swarm Optimization (QPSO) algorithm. Then the characteristic of quantum particles is used to update the population and enhance global searchability. Furthermore, to testify the effectiveness of the trajectory optimization algorithm and related target prediction method, a specific simulation environment is given as an example, in which the tracking trajectories of eight different algorithms are compared. Simulation results show the effectiveness of the proposed algorithm.Bond graph is a unified graphical approach for describing the dynamics of complex engineering and physical systems and is widely adopted in a variety of domains, such as, electrical, mechanical, medical, thermal and fluid mechanics. Traditionally, these dynamics are analyzed using paper-and-pencil proof methods and computer-based techniques. However, both of these techniques suffer from their inherent limitations, such as human-error proneness, approximations of results and enormous computational requirements. Thus, these techniques cannot be trusted for performing the bond graph based dynamical analysis of systems from the safety-critical domains like robotics and medicine. Formal methods, in particular, higher-order-logic theorem proving, can overcome the shortcomings of these traditional methods and provide an accurate analysis of these systems. It has been widely used for analyzing the dynamics of engineering and physical systems. In this paper, we propose to use higher-order-logic theorem proving for performing the bond graph based analysis of the physical systems. In particular, we provide formalization of bond graph, which mainly includes functions that allow conversion of a bond graph to its corresponding mathematical model (state-space model) and the verification of its various properties, such as, stability. To illustrate the practical effectiveness of our proposed approach, we present the formal stability analysis of a prosthetic mechatronic hand using HOL Light theorem prover. Moreover, to help non-experts in HOL, we encode our formally verified stability theorems in MATLAB to perform the stability analysis of an anthropomorphic prosthetic mechatronic hand.