Background: Few studies have investigated the relationship between the Patient-Reported Outcomes Measurement Information System (PROMIS) and legacy patient-reported outcome (PRO) measurements. Purpose: To compare patient-reported outcomes from the PROMIS physical function (PF) and upper extremity (UE) platforms against one another and against legacy PRO measurements to assess the potential strengths and weaknesses of the National Institutes of Health PROMIS initiative and expand on the use of PRO measurements in clinical orthopaedic practice. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of the PubMed, Embase, and Cochrane Library databases was conducted following PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines. All English-language studies published between 2017 and 2019 using PROMIS to evaluate patients for shoulder surgery were analyzed. PROs were compared based on survey administered and the shoulder condition being investigated. Study quality was evaluated using the Modified Coleman Methodology Score and the Methodological Index for Non-Randomized Studies score. Results: We included 9 studies (5 studies were level 2; 3 studies were level 3; 1 study was level 4) encompassing a total of 1130 patients (60.2% male; mean age, 52.6 ± 16.5 years; mean BMI, 29.8 ± 2.8 kg/m2). Of these, 6 studies administered the PROMIS PF, and 6 studies administered the PROMIS UE. The strongest correlation was between PROMIS PF computer adaptive test and the 36-Item Short Form Health Survey Global Health (SF-36 GH) ( r = 0.75). The highest overall correlation with the PROMIS UE was found with the American Shoulder and Elbow Surgeons (ASES) Shoulder Score ( r = 0.70). The lowest correlations were found between PROMIS PF and the Marx Shoulder Activity Scale ( r = 0.08) and the PROMIS UE and the Marx Shoulder Activity Scale ( r = 0.18). Conclusion: From available data, the PROMIS PF and PROMIS UE were most closely correlated with outcomes measured by the SF-36 GH. The PROMIS UE alone was most correlated with ASES Shoulder Score. Thus, either PROMIS PF or UE may provide a possible alternative to legacy PRO measurements but with a lower overall number of questions and higher generalizability. Future research should compare the time and question burden of the various PROMIS platforms with a more consistent evaluation of standard PRO measurements.
Purpose: To evaluate the quality and content of internet-based information available for some of the most common orthopaedic sports medicine terms. Methods: A search of the PubMed, Embase, and Cochrane databases following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines was performed. All Englishlanguage literature published from 2010 to 2020 discussing information quality pertaining to orthopaedic sports medicine terms was included. Outcomes included the search engines used, number and type of websites evaluated, platform, and quality scoring metrics. Descriptive statistics are presented. Results: This review includes 21 studies. Of these, 3 evaluated both the upper and lower extremity. Twelve focused on either the upper or lower extremity, most commonly rotator cuff tears (3 of 12) and/or anterior cruciate ligament pathologies (7 of 12). The most common engines were Google (18 of 21), Bing (16 of 21), Yahoo (16 of 21), YouTube (3 of 21), Ask (3 of 21), and AOL (2 of 21). The average number of media files assessed per study was 87 AE 55. Website quality was assessed with DISCERN (7 of 21), Flesch-Kincaid (9 of 21), Health on the Net (7 of 21), and/or Journal of the American Medical Association Benchmark (7 of 21) scores. YouTube was evaluated with Journal of the American Medical Association Benchmark scores (1.74 AE 1.00). Image quality was reported in 2 studies and varied with search terminology. Conclusions: The results of this systematic review suggest that physicians should improve the quality of online information and encourage patients to access credible sources when conducting their own research. Clinical Relevance: Doctors can and should play an active role in closing the gap between the level of health literacy of their patients and that of most common online resources.
P.N.) § The authors contributed equally to the study. Abstract MhsT of Bacillus halodurans is a transporter of hydrophobic amino acids and a homologue of the eukaryotic SLC6 family of Na + -dependent symporters for amino acids, neurotransmitters, osmolytes, or creatine. The broad range of transported amino acids by MhsT prompted the investigation of the substrate recognition mechanism. Here, we report six new substrate-bound structures of MhsT, which, in conjunction with functional studies, reveal how the flexibility of a Gly-Met-Gly (GMG) motif in the unwound region of transmembrane segment 6 (TM6) is central for the recognition of substrates of different size by tailoring the binding site shape and volume. MhsT mutants, harboring substitutions within the unwound GMG loop and substrate binding pocket that mimick the binding sites of eukaryotic SLC6A18/B 0 AT3 and SLC6A19/B 0 AT1 transporters of neutral amino acids, exhibited impaired transport of aromatic amino acids that require a large binding site volume. Conservation of a general (G/A/C)ΦG motif among eukaryotic members of SLC6 family suggests a role for this loop in a common mechanism for substrate recognition and translocation by SLC6 transporters of broad substrate specificity. amino acids uptake / MhsT / Neurotransmitter:sodium symporters / substrate recognition / X-ray crystallography
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