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BACKGROUND Treatment methods for popliteal cysts have varied over the past several decades and have posed challenges to providers as recurrences were frequent. With greater understanding of relevant anatomy, both operative and nonoperative treatment methods have evolved to appropriately target relevant pathology and improve outcomes. The purposes of this review were to outline the evolution of treatment methods and to qualitatively summarize clinical outcomes. METHODS We performed a systematic review on treatments for popliteal cysts to include publications from 1970 to 2019. Other inclusion criteria consisted of studies with ≥10 patients enrolled, studies with a patient age of ≥16 years, studies with an adequate description of the treatment technique, and studies with a Level of Evidence of IV or higher. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and literature quality was assessed using a modified Coleman methodology scortion of levels of evidence.BACKGROUND Numerous studies have reported the use of laboratory multistation joint simulators to successfully predict wear performance and functionality of hip and knee replacements. RP3500 In contrast, few studies in the peer-reviewed literature have used joint simulation to quantify the wear performance and functionality of ankle replacements. We performed a systematic review of the literature on joint simulator studies that quantified polyethylene wear in total ankle arthroplasty. In addition to the quantified wear results, the load and motion parameters were identified and compared among the studies. METHODS A search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify articles reporting total ankle replacement polyethylene wear using joint simulators. RESULTS Nine studies that used joint simulators and 1 study that used a computer simulation were found. Although all studies used physiological multidirectional motions (i.e., internal/exals, or to draw clinically relevant conclusions from these simulations. More work is required to enhance the predictive capability of in vitro simulations of total ankle replacements. CLINICAL RELEVANCE The results of joint wear simulator studies may not accurately represent in vivo wear of total ankle replacements. Joint simulator studies should establish that they are accurately replicating in vivo wear, thus enabling use of their predictive capabilities for new materials and designs.OBJECTIVES Polymorphisms in microRNA genes are related to the risk of ischemic stroke, but the association between miR-34b/c polymorphisms and the risk of ischemic stroke has not been reported. METHODS MiR-34b/c rs2187473 and rs4938723 polymorphisms were genotyped by Snapshot assay among 495 controls and 492 ischemic stroke patients. Expression levels of miR-34b and miR-34c were quantified by real-time PCR. Transcriptional activity of miR-34b/c promoter was measured by luciferase reporter assay. RESULTS Rs4938723 was associated with an increased risk of ischemic stroke in our study (CC versus TT OR = 2.34, 95% CI = 1.47-3.72, P = 0.001; C versus T OR = 1.37, 95% CI = 1.12-1.68, P = 0.002; CC versus TT + TC OR = 2.12, 95% CI = 1.37-3.29, P = 0.001). The expression levels of miR-34b and miR-34c were significantly downregulated in cases by contrast with controls (P  less then  0.05). Further analysis demonstrated that the expression levels of miR-34b and miR-34c were also downregulated in the individuals carrying rs4938723 CC genotype by contrast with that carrying TT + TC genotypes (P  less then  0.05). The result of luciferase reporter assay showed that rs4938723C allele decreased the transcriptional activity of miR-34b/c promoter compared with rs4938723 T allele. CONCLUSION Our study showed a positive relation between the miR-34b/c rs4938723 polymorphism and the risk of ischemic stroke, which indicated that rs4938723 may be used for ischemic stroke prediction or therapy in the future.BACKGROUND The aim of the present prospective randomized study was to evaluate the long-term outcomes of minimally invasive chevron osteotomy as compared with open distal chevron osteotomy for the correction of hallux valgus deformity. METHODS A randomized controlled design was applied. The following parameters were assessed at 6 and 12 weeks, 9 months, and 5 years postoperatively the American Orthopaedic Foot & Ankle Society (AOFAS) Forefoot Score, a visual analog scale (VAS) score for pain, and a patient-satisfaction score. In addition, several radiographic parameters for hallux valgus correction and joint degeneration were collected. Range of motion was also assessed. Thirty-nine of 47 feet were available for analysis at the time of the latest follow-up. RESULTS During the 5-year study period, the outcomes of the minimally invasive technique were comparable with those of the open technique. No significant differences were seen between the 2 groups within 5 years postoperatively in terms of clinical outcomes (VAS, AOFAS, satisfaction), radiographic outcomes, joint degeneration, or range of motion. CONCLUSIONS Five years after treatment, the outcome following minimally invasive distal chevron osteotomy is comparable with that for the open technique for hallux valgus surgery. LEVELS OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.OBJECTIVE The aim of this study was to evaluate the dental status and temporomandibular diseases (TMDs)-related symptoms in children with generalized joint hypermobility (GJH) and compare them with healthy controls (HCs). METHODS This is a cross-sectional, observational study carried out between September 2016 and April 2017. A total of 124 children with GJH (n = 62) and HC (n = 62) were enrolled. link2 The GJH was assessed with the Beighton hypermobility score. The subjects were screened for dental status and TMD-related symptoms. The assessment included the index for "decayed," "missing," and "filled teeth" (DMFT, dmft); plaque; gingival bleeding; tooth mobility; and temporomandibular joint (TMJ) evaluation. RESULTS The mean Beighton hypermobility score was 6.3 ± 1.2 in the GJH group. Visible plaque index and gingival bleeding index scores were found to be significantly higher in children with GJH then in the HC (p = 0.031, p = 0.023). No differences were found regarding the DMFT scores between the groups (p = 0.16). Temporomandibular disorder-related symptom frequencies were significantly higher in children with GJH (p less then 0.001). The most common clinically determined sign of TMD was clicking with a maximum active mouth-opening. Combined TMJ symptoms and TMD were observed in approximately one third of the children with GJH. CONCLUSIONS The presence of GJH in a child may be indicative of future dental or TMJ problems, and it may cause dental problems due to increased gingival bleeding index and visible plaque index scores. Therefore, children with GJH require preventive dental and TMJ care.OBJECTIVES Vestibular reflexes have traditionally formed the cornerstone of vestibular evaluation, but perceptual tests have recently gained attention for use in research studies and potential clinical applications. However, the unknown reliability of perceptual thresholds limits their current importance. This is addressed here by establishing the test-retest reliability of vestibular perceptual testing. DESIGN Perceptual detection thresholds to earth-vertical, yaw-axis rotations were collected in 15 young healthy people. Participants were tested at two time intervals (baseline, 5 to 14 days later) using an adaptive psychophysical procedure. RESULTS Thresholds to 1 Hz rotations ranged from 0.69 to 2.99°/s (mean 1.49°/s; SD 0.63). They demonstrated an excellent intraclass correlation (0.92; 95% confidence interval 0.77 to 0.97) with a minimum detectable difference of 0.45°/s. CONCLUSIONS The excellent test-retest reliability of perceptual vestibular testing supports its use as a research tool and motivates further exploration for its use as a novel clinical technique.OBJECTIVES The motivation for this research is to determine whether a listening-while-balancing task would be sensitive to quantifying listening effort in middle age. The premise behind this exploratory work is that a decrease in postural control would be demonstrated in challenging acoustic conditions, more so in middle-aged than in younger adults. DESIGN A dual-task paradigm was employed with speech understanding as one task and postural control as the other. For the speech perception task, participants listened to and repeated back sentences in the presence of other sentences or steady-state noise. Targets and maskers were presented in both spatially-coincident and spatially-separated conditions. The postural control task required participants to stand on a force platform either in normal stance (with feet approximately shoulder-width apart) or in tandem stance (with one foot behind the other). Participants also rated their subjective listening effort at the end of each block of trials. link3 RESULTS Postural cossfully listen in adverse environments leaves fewer resources for maintaining balance, particularly as people age. These results provide preliminary support for using this type of ecologically-valid dual-task paradigm to quantify the costs associated with understanding speech in adverse acoustic environments.OBJECTIVES Cochlear implants (CIs) are remarkable in allowing individuals with severe to profound hearing loss to perceive speech. Despite these gains in speech understanding, however, CI users often struggle to perceive elements such as vocal emotion and prosody, as CIs are unable to transmit the spectro-temporal detail needed to decode affective cues. This issue becomes particularly important for children with CIs, but little is known about their emotional development. In a previous study, pediatric CI users showed deficits in voice emotion recognition with child-directed stimuli featuring exaggerated prosody. However, the large intersubject variability and differential developmental trajectory known in this population incited us to question the extent to which exaggerated prosody would facilitate performance in this task. Thus, the authors revisited the question with both adult-directed and child-directed stimuli. DESIGN Vocal emotion recognition was measured using both child-directed (CDS) and adult-direc emotion recognition to the CDS condition which also had more variability in pitch and intensity and thus more exaggerated prosody, in comparison to the ADS condition. Results suggest that pediatric CI users struggle with vocal emotion perception in general, particularly to adult-directed speech. The authors believe these results have broad implications for understanding how CI users perceive emotions both from an auditory communication standpoint and a socio-developmental perspective.BACKGROUND Following birth, women may access preventive care in adult settings or, with their infants, in pediatric settings. Preventive care can improve future birth outcomes and long-term health, particularly for women with health risks. METHODS This cohort study linked mother-infant Medicaid claims from 12 states for 2007-2011 births. Pregnancy claims identified health risk categories maternal cardiovascular (diabetes, hypertension, pre-eclampsia, obesity), maternal mental health (depression, anxiety), and premature birth. Claims for 1 year following birth identified adult and pediatric preventive visits. Logistic regression assessed the relationship between visits and risks, adjusting for maternal demographics, perinatal health care utilization, year, and state. RESULTS Of 594,888 mother-infant dyads with Medicaid eligibility for 1 year following birth, 36% had health risks. In total, 38% of all dyads, and 33% with health risks, had no adult preventive visits. Dyads had a median of 1 (IQR, 0-2) adult and 3 (IQR, 2-5) pediatric preventive visits.

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