bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 205: The Effect of Increased Tibial Tubercle Trochlear Groove Distance on Post-Operative Outcomes Following Anterior Cruciate Ligament Reconstruction
Authors: Johnson Emma , Hall Anya , Clements Ari , Bishop Meghan , Ciccotti Michael , Cohen Steven , Erickson Brandon , Paul Ryan
Published: July 2022

Objectives:

Outcomes following anterior cruciate ligament reconstruction (ACLR) are generally good/excellent. While some risk factors for poor outcomes following ACLR have been determined, there are many that remain unknown. It is unclear if an elevated tibial tubercle trochlear groove (TT-TG) distance is a risk factor for poor outcomes following ACLR. Therefore, the purpose of this study was to determine if an elevated TT-TG increases risk of failure following ACLR. The authors hypothesized that patients with an elevated TT-TG will have an increased risk of failure following ACLR.

Methods:

All patients who underwent primary ACLR at a single institution between July 2018-June 2019 with a minimum of 2-year follow-up were eligible for inclusion. TT-TG distance was measured on preoperative magnetic resonance imaging (MRI) scans by 2 independent investigators. Clinical outcomes, complication rates, ability to RTS, and Lysholm scores were compared between patients with a TT-TG < 12.5mm (normal) and those with a TT-TG ≥ 12.5mm (elevated). Sub-analyses comparing normal and elevated TT-TG distance were also made after isolating athletes and bone-patellar tendon-bone (BTB) graft patients.

Results:

Overall, 159 patients were included, 98 with normal TT-TG distance and 61 with elevated TT-TG distance. There were no differences in demographics, concomitant procedures or injury mechanism between groups. There were also no differences in rates of reinjury, post-operative complications, need for revision ACLR, or RTS rates (all p>0.05). Patients with an elevated TT-TG distance had worse post-operative Lysholm scores than patients with a normal TT-TG distance (83.0 vs. 95.0, p=0.010), and also had differing rates of subjective instability (13.1% vs. 5.1%, p=0.083) and reoperation (13.1% vs. 4.1%, p=0.060) that trended towards significant. In patients who received a bone-patellar tendon-bone (BTB) graft, an elevated TT-TG distance was associated with higher rates of subjective instability (13.0% vs. 3.0%, p=0.041), reoperation (13.0% vs. 1.5%, p=0.012), and post-operative complications (25.0% vs. 8.2%, p=0.026), as well as lower ACL psychological readiness scores (324.1 vs. 446.7, p=0.015).

Conclusions:

Following ACLR, patients with an elevated TT-TG distance have worse Lysholm scores with a minimum 2-year follow-up. Patients with an elevated TT-TG who underwent ACLR with BTB grafts had significantly higher rates of subjective instability, reoperation, and post-operative complications, while no differences in reinjury, complication, revision, or RTS rates were observed. [Table: see text][Table: see text]
Poster 219: Posterior Sagittal Position of the Tibial Tubercle as Measured by the Sagittal Tibial Tubercle – Trochlear Groove Distance Correlates with an Increased Risk for Surgery in Patients with Patellofemoral Chondral Lesions
Authors: Mojica Edward , Ortega Paola , Triana Jairo , Strauss Eric , Jazrawi Laith , Gonzalez-Lomas Guillem , Kaplan Daniel
Published: July 2022

Objectives:

The etiology of isolated patellofemoral (PF) cartilage defects without patellar instability is currently incompletely understood. The purpose of the present study was to evaluate the variation in knee sagittal alignment in patients with and without PF cartilage wear.

Methods:

This was a single-center, retrospective review of patients that underwent a cartilage restoration procedure for isolated PF cartilage wear from 2014-2020. Patients were matched in a 1:2:2 ratio for age, sex, and BMI to anterior knee pain diagnosis and meniscectomy procedure cohorts as controls. Exclusion criteria included knee flexion angle >10°, elevated Caton-Deschamps index (CDI>1.3), increased sulcus angle (>145°), increased patellar tilt (>5°), elevated coronal TT-TG (>15mm), varus/valgus malalignment (>5°), or ICRS patellofemoral cartilage defects of ≥3 in either control group. The sagittal TT-TG (sTT-TG) distance was measured on preoperative axial T2 magnetic resonance imaging (MRI) and was defined as the distance between a point at the nadir of the trochlear cartilage and the most anterior point of the tibial tubercle. Comparisons between the 3 groups were made using ANOVA testing with Bonferroni corrections. Reliability was assessed with the interclass correlation coefficient (ICC). Odds ratios were calculated based on a sTT-TG measurement threshold obtained from a receiver operative characteristic curve graph.

Results:

Two hundred and thirty-five patients (47 cartilage restoration, 94 anterior knee pain, 94 meniscectomy) were included. Mean age, BMI, and height were 33.8 +/- 8.7 and 26.7 +/- 5.7, 170.6 +/- 24.3 respectively, with 130 males (55%) and 105 females (45%). There were no significant differences between groups for age, BMI or sex(p>0.05). Mean sTT-TG was significantly more posterior in the cartilage restoration group compared to the meniscectomy group (-2.5 mm +/-5.9 vs 1.72 mm +/- 5.3, p<0.001). The anterior knee pain group sTT-TG was between the meniscectomy and cartilage restoration groups, but was not significantly different from either (p=0.067, p=0.13). Interrater reliability was excellent (ICC=0.927, p<0.001). Patients with a posterior translation of -2.15 or greater were 2.12 times more likely to undergo a cartilage restoration procedure (OR 2.12, 95% CI 1.1 to 4.1).

Conclusions:

Cartilage restoration procedure patients had a significantly more posterior tibial tubercle than partial meniscectomy controls. Anterior knee pain patient sagittal TT-TG was between both groups, but was not significantly different from either. Patients with sTT-TG of <-2.15 mm were 2.12 x more likely to have a cartilage restoration procedure.
Poster 220: The Effect of Bone-Void Filler on Anterior Knee Pain Following BPTB Autograft ACL Reconstruction
Authors: Vasavada Kinjal , Hurley Eoghan , Strauss Eric , Campbell Kirk , Gonzalez-Lomas Guillem , Jazrawi Laith , Alaia Michael , Strauss Eric , Markus Danielle
Published: July 2022

Objectives:

The purpose of the current study is to evaluate and compare the effect of three different bone void fillers; autogenous bone (auto), calcium phosphate cement (cement), and demineralized bone matrix (DBM), on anterior knee pain following anterior cruciate (ACL) reconstruction with bone-patellar tendon-bone (BPTB) autograft.

Methods:

This is a single-center randomized, controlled trial conducted in 150 patients. Patients undergoing ACL reconstruction with BTPB autograft were equally randomized into the three bone void filler cohorts; 1) auto, 2) cement, or 3) DBM. Baseline day of surgery, postoperative 1 week, and postoperative 1.5, 3, and 6 months VAS scores and KOOS and KUJALA scores at 1.5, 3, 6, and 12 months were evaluated. To compare primary and secondary outcomes between the three groups with auto group as control, an analysis of variance (ANOVA) was performed. A p-value of 0.05 was set to determine statistical significance.

Results:

An interim analysis was conducted on 70 patients with 6 month follow-up outcomes. There were no significant differences in VAS scores between groups at baseline (p =0.919), 1 week postoperatively (p = 0.75), 1.5 months postoperatively (p = 0.708), 3 months postoperatively (p = 0.529), and 6 months postoperatively (p = 0.115). In addition, no significant differences in KOOS scores were seen between the groups at 1.5 months (p = 0.365), 3 months (p = 0.964), or 6 months (p = 0.917). Similarly, no significant differences in KOOS scores were seen between the groups at 1.5 months (p =0.514), 3 months (p =0.763), or 6 months (p =0.815).

Conclusions:

There is no difference in the level of anterior knee pain or patient-reported functional outcome scores between the auto, cement and DBM for patellar bone void filling following ACLR with BPTB.
Poster 226: Autograft versus Allograft for Medial Patellofemoral Ligament Reconstruction: A Systematic Review
Authors: Aliberti Gianna , Kraeutler Matthew , Miskimin Cadence , Scillia Anthony , Mulcahey Mary
Published: July 2022

Objectives:

Patients with recurrent lateral patellar dislocations are often treated with reconstruction of the medial patellofemoral ligament (MPFL). The purpose of this study was to perform a systematic review to evaluate clinical outcomes and the risk of recurrent patellar dislocation following medial patellofemoral ligament reconstruction (MPFLR) with autograft versus allograft.

Methods:

A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify studies comparing outcomes of MPFLR with autograft versus allograft. The search phrase used was: medial patellofemoral ligament reconstruction autograft allograft. The inclusion criteria were full-text studies that directly compared clinical outcomes and/or risk of recurrent patellar instability events between patients undergoing MPFLR with autograft versus allograft. A quality assessment was performed using the Modified Coleman Methodology Score (MCMS). Risk of bias was performed using the ROBINS-I and the Cochrane Collaboration’s risk of bias tools.

Results:

Seven studies (one level II, three level III, three level IV) were identified that met inclusion criteria, including a total of 150 patients who underwent MPFLR with autograft and 193 with allograft (Figure 1, Table 1). All studies showed a moderate risk of bias due to confounding, and five studies showed a moderate risk of bias for using non-blinded but identical postoperative protocols. All six studies showed serious risk of bias for using physicians not blinded to the treatment group (Figure 2). One study found a significantly higher failure rate among autograft patients, and another study found a trend toward a significantly higher failure rate among autograft patients (Table 2). One study demonstrated no significant difference between tibial tubercle-trochlear groove distance (measured on magnetic resonance imaging) in failed versus successful grafts. One study found that patellar tilt angle improved significantly from preoperatively to postoperatively (p<0.001), but there was no difference between the groups. Kujala scores significantly improved for both autograft and allograft patients across studies. Two studies found significant differences in postoperative Kujala scores between the two groups, one of which found better scores in allograft patients (p=0.0032) and another in which scores were better in autograft patients (p=0.02).

Conclusions:

This is the first systematic review limited to comparative studies comparing autograft versus allograft for MPFL reconstruction. Patients undergoing MPFLR with either autograft or allograft can expect to experience improvement in clinical outcomes. Graft failure was more frequently observed in autograft patients. Subjective outcomes improved to a similar degree in both groups. Allograft may be a better option for MPFLR due to lower failure rate. [Figure: see text][Figure: see text][Table: see text][Table: see text]
Poster 230: A Modified Lemaire Lateral Extra-Articular Tenodesis in High-Risk Adolescents Undergoing Anterior Cruciate Ligament Reconstruction: Two-Year Clinical Outcomes
Authors: Cordasco Frank , Perea Sofia Hidalgo , Brusalis Christopher , Green Daniel
Published: July 2022

Objectives:

This study aimed to evaluate the safety and efficacy of performing a lateral extra-articular tenodesis (LET) with a modified Lemaire technique (MLT) in conjunction with anterior cruciate ligament reconstruction (ACLR) in children and adolescents at increased risk for failed ACLR.

Methods:

A consecutive series of patients ≤19 years who underwent simultaneous ACLR and LET with minimum two-year follow-up data were reviewed. Patients were indicated for LET when one or more of the following risk factors were present: participant in high-risk competitive sport such as football, lacrosse, soccer or basketball, grade 3 pivot shift, hyperlaxity (Beighton score > 6), recurvatum, revision ACLR, contralateral ACLR, or chronic ACL insufficiency. ACLR was performed using either full-thickness quadriceps tendon (QUAD) for skeletally immature patients or bone-patellar tendon-bone (BTB) autograft for skeletally mature patients. All-epiphyseal (AE) or complete transphyseal (CT) techniques were used depending on patients’ skeletal maturity. At a minimum two-year follow-up, patient-reported outcome measures included Single Assessment Numeric Evaluation (SANE), Pediatric International Knee Documentation Committee (Pedi-IKDC), and the HSS Functional Activity Brief Scale (HSS Pedi-FABS) scores. Return-to-sport (RTS) data and second surgeries were also obtained.

Results:

Sixty-one consecutive patients (mean age 15.17 ±1.73 years, range 11-19 years, 62% female) were analyzed (Table 1). 59 patients (97%) participated in organized sports including soccer, basketball, football and lacrosse, with soccer being the most popular one. The average grade at the time of surgery was 9th grade. Ten patients (16%) were revision ACLR procedures. Seven (11%) patients underwent AE and 54 (89%) underwent CT ACLR. Forty-two (69%) cases employed a QUAD autograft, while 19 (31%) utilized a BTB autograft. All patients underwent a LET with a MLT and 2 patients underwent simultaneous implant mediated guided growth with a plate for structural genu valgum. At two-year follow-up, mean SANE score was 95, median Pedi-IKDC score was 91, and median HSS-Pedi Fabs score was 27. RTS rate was 91.8%. Ten patients had subsequent surgical procedures, including two hardware removal procedures for hemiepiphysiodesis, three contralateral ACLR, three meniscus surgeries, one lysis of adhesions, and one revision ACLR for BTB graft re-rupture. Two patients were lost to follow-up and excluded from the study.

Conclusions:

The findings suggest that concomitant LET and ACLR in adolescent patients with risk factors for failed ACLR is associated with favorable patient-reported outcomes, high return to sports participation, and low ACL re-rupture rate at two years follow-up. [Table: see text]
Poster 237: Distance Between the Tibial Physis and Meniscotibial Ligament: Implications for Meniscus Repair
Authors: Tompkins Marc , Yen Yi-Meng , Karius Alex , Cinque Mark , Vuong Brian , Ganley Theodore , Wilson Philip , Ellis Henry , Green Daniel , Fabricant Peter , Boucher Laura , Shea Kevin , Dingel Aleksei
Published: July 2022

Objectives:

Anatomic meniscus repair is frequently performed in young patients to maximize joint preservation and long-term joint health. Increasingly, surgeons are considering the role and function of the meniscotibial ligament structures during meniscus repair and transplant. The purpose of this study was to determine the distance between the tibial insertion of the meniscotibial ligament capsular attachment and the proximal tibial physis in skeletally immature subjects.

Methods:

14 pediatric knee cadaver knee specimens (ages 3 months to 11 years) were dissected to clarify the relationship physis and meniscus/meniscotibial ligament complex. Metallic markers were placed marking the meniscotibial ligament capsular attachment in specific domains (Figure 1). The specimens underwent CT scanning to evaluate pin placement and relationship to the physis. OsiriX was used to measure the distances between the proximal tibial physis and the pins (placed at 5 points on both the lateral and medial meniscus- anterior root, 12 o’clock, 3/9 o’clock, 6 o’clock and posterior root). Specimens were divided into two groups for analysis- Group 1: ages 3 months- 2 years (10 pediatric knee specimens: 8 male, 2 female), and Group 2: ages 10-11 years (4 pediatric knee specimens: 2 male, 2 female).

Results:

There was an increase in the distance between the proximal tibial physis and the insertion points of the meniscotibial ligament with increasing specimen age. For both the medial and lateral menisci, Group 1’s meniscotibial ligament insertion points were less than 10mm away from the physis. Group 2’s meniscotibial ligament insertion points tended to be further away from the physis, but less than 20mm away, and sometimes even as close as <5mm (lateral posterior root). (Figure 2).

Conclusions:

This anatomic study defines the relationship between the physis and meniscotibial ligament capsular attachments that increases with age. These anatomic parameters can be considered as future meniscus repair and reconstruction techniques seek to restore the meniscus anatomy, stability, and mobility provided by the meniscotibial ligament structures. This anatomic information and may be used by surgeons to develop techniques to perform meniscal repair/reconstruction in patients that utilize the meniscotibial ligament structures. Avoiding direct physeal injury during menisco-tibial ligament repair is possible. [Figure: see text][Figure: see text]
Poster 243: Synovial Fluid MMP-1 and VEGF Concentration Correlates with Chondral Defects Severity and Symptoms in the Knee
Authors: DeFroda Steven , Trasolini Nicholas , Zavras Athan , Darwish Reem , Cole Brian , Yanke Adam , Dandu Navya
Published: July 2022

Objectives:

The clinical significance of the concentration of inflammatory biomarkers in the synovial fluid of the knee has been studied in the context of several pathologies. However, there is a paucity of literature examining concentrations of synovial fluid inflammatory biomarkers in patients with focal chondral defects and their correlation with imaging findings. This study sought to explore the correlations between preoperative synovial fluid biomarkers, cartilage structural characteristics on MRI, and pre- and postoperative PROs in patients undergoing chondroplasty for focal chondral defects. We hypothesized that certain biomarkers within the synovial fluid would correlate with more severe grading of cartilage defects on MRI and have a negative relationship with patient reported outcomes.

Methods:

This study prospectively enrolled patients undergoing chondroplasty for symptomatic focal chondral defects of the knee. Prior to the initiation of arthroscopy, synovial fluid was aspirated from the operative knee. Multiplex ELISA was then performed on the supernatant for several analytes. The relationships between biomarker concentrations, demographic factors, MRI findings as measured by AMADEUS score, and pre- and postoperative PROs were explored via independent t-test or Pearson correlation analysis. Variables significant on univariate analysis were included for multivariate linear regression.

Results:

Cartilage defects of greater severity on MRI were significantly associated with increased concentration of MMP-1 and VEGF in synovial fluid (p<.05). Decreased preoperative KOOS Symptoms scores were correlated with increased concentrations of MMP-1 (r = -0.786, p<.001) and VEGF (r= -0.810, p<.001). These variables were non-significant on multivariate regression for KOOS Symptoms, although dominance analysis demonstrated that MMP-1 and VEGF were the greatest contributors to overall model fit, contributing 27.5% and 29.7%, respectively. Increased preoperative VEGF (r= -0.835, p=.019) and MMP-1 (r= -0.788, p=.036) were correlated with decreased improvement, or worsening of WOMAC stiffness score at 6 weeks after chondroplasty, while increased FGF2 (r=0.758, p=.049) and CCL2 (r= 0.777, p=.040) were positively correlated with improvement.

Conclusions:

This study demonstrated that the concentration of MMP-1 and VEGF in synovial fluid correlate with cartilage lesion severity and may correlate with patient function and symptoms. These inflammatory biomarkers may be an important target in clinical practice towards improving outcomes when managing chondral defects of the knee.
Poster 255: Lateral Extra-Articular Tenodesis Staple Risks Penetration of ACL Reconstruction Tunnel
Authors: Anderson Gregory , Barras Laurel , Graf Ryan , Moran Thomas , Gwathmey F. Winston , Diduch David , Miller Mark , MacLean Ian
Published: July 2022

Objectives:

The purpose of this study was to identify the risk of ACL femoral tunnel penetration by a small Richards staple used for Lateral Extra-Articular Tenodesis (LET) fixation and to determine whether or not the risk varies between two techniques for ACL femoral tunnel creation.

Methods:

20 paired fresh frozen cadaver knees underwent ACL reconstruction with a LET using the modified Lemaire technique (Getgood et al. AJSM, Jan 2020). Left and right knees were randomized to ACL reconstruction with femoral tunnel creation by either the accessory anteromedial portal (AMP) technique or the flexible guide pin and reamer method. The femoral tunnels in the accessory AMP technique arm were created using a 7mm offset guide. Both arms used a 10mm reamer and were reamed to a depth of 25mm. After tunnel creation and prior to passing the ACL graft, the LET was performed. This was completed by harvesting an 8cm long and 10mm wide central portion of the IT band which was left attached to its distal insertion on Gerdy’s tubercle. This was routed underneath the LCL and fixed with a small Richards staple on the lateral metaphyseal flare proximal and posterior to the LCL insertion. The staple was angled anteriorly and distally. Fluoroscopy was used to obtain a lateral view of the knee to ensure appropriate position of the staple (Figure 1). Finally, tunneloscopy was performed from the anteromedial portal to investigate penetration of the staple into the femoral tunnel (Figure 2). A Fisher’s exact test was conducted to determine if there was any difference in tunnel penetration between tunnel creation techniques.

Results:

The staple was noted to penetrate the ACL femoral tunnel in 8/20 (40%) extremities. When stratified by tunnel creation technique, the Richards staple violated 5/10 (50%) of the tunnels made via the accessory AMP technique compared to 3/10 (30%) of those created with a flexible guide pin and reamer (p = 0.65).

Conclusions:

Staple fixation of a LET carries significant risk of penetrating the ACL tunnel that does not vary by the technique of femoral tunnel creation. This raises concerns over the potential effect of the staple on ACL graft fixation and the ACL graft itself.
Can Patients Read, Understand, and Act on Online Resources for Anterior Cruciate Ligament Surgery?
Authors: Gao Burke , Shamrock Alan G. , Gulbrandsen Trevor R. , O’Reilly Olivia C. , Duchman Kyle R. , Westermann Robert W. , Wolf Brian R.
Published: July 2022

Background:

Patients undergoing elective procedures often utilize online educational materials to familiarize themselves with the surgical procedure and expected postoperative recovery. While the Internet is easily accessible and ubiquitous today, the ability of patients to read, understand, and act on these materials is unknown.

Purpose:

To evaluate online resources about anterior cruciate ligament (ACL) surgery utilizing measures of readability, understandability, and actionability.

Study Design:

Cross-sectional study; Level of evidence, 4.

Methods:

Using the term “ACL surgery,” 2 independent searches were performed utilizing a public search engine ( Google.com ). Patient education materials were identified from the top 50 results. Audiovisual materials, news articles, materials intended for advertising or medical professionals, and materials unrelated to ACL surgery were excluded. Readability was quantified using the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index, and Gunning Fog Index. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) was utilized to assess the actionability and understandability of materials. For each online source, the relationship between its Google search rank (from first to last) and its readability, understandability, and actionability was calculated utilizing the Spearman rank correlation coefficient (ρS).

Results:

Overall, we identified 68 unique websites, of which 39 met inclusion criteria. The mean Flesch-Kincaid Grade Level was 10.08 ± 2.34, with no website scoring at or below the 6th-grade level. Mean understandability and actionability scores were 59.18 ± 10.86 (range, 33.64-79.17) and 34.41 ± 22.31 (range, 0.00-81.67), respectively. Only 5 (12.82%) and 1 (2.56%) resource scored above the 70% adequate PEMAT-P threshold mark for understandability and actionability, respectively. Readability (lowest P value = .103), understandability (ρS = –0.13; P = .441), and actionability (ρS = 0.28; P = .096) scores were not associated with Google rank.

Conclusion:

Patient education materials on ACL surgery scored poorly with respect to readability, understandability, and actionability. No online resource scored at the recommended reading level of the American Medical Association or National Institutes of Health. Only 5 resources scored above the proven threshold for understandability, and only 1 resource scored above it for actionability.
Biomechanical Characteristics of the Support Leg During Side-Foot Kicking in Soccer Players With Chronic Ankle Instability
Authors: Tamura Akihiro , Shimura Keita , Inoue Yuri
Published: July 2022

Background:

Chronic ankle instability (CAI) in soccer players can increase the risk of recurrent ankle varus sprains and damage the articular surface of the ankle joint, thus increasing the risk of osteoarthritis. It is important to understand the biomechanical characteristics of the support leg during kicking in soccer players with CAI.

Purpose/Hypothesis:

The purpose of this study was to clarify the kinematics of the kicking motion of soccer players with CAI. It was hypothesized that at the point before ball contact when the support leg makes flat-foot contact with the ground, soccer players with CAI will land with ankle inversion in the support leg during a side-foot kick compared with players without CAI.

Study Design:

Controlled laboratory study.

Methods:

The study cohort included 19 male college soccer players (mean age, 20.5 ± 0.9 years) with greater than 8 years of soccer experience who were recruited from August 2019 to March 2020. Of these athletes, 10 had CAI and 9 had no CAI in the support leg, as diagnosed according to the Cumberland Ankle Instability Tool. Kinematic data for the trunk, hip, knee, and foot of the support leg during a side-foot kick were obtained using a 3-dimensional, motion-analysis system. The Mann-Whitney U test or Student t test was selected to identify differences in variables between the CAI and non-CAI groups.

Results:

There were no significant differences in physical characteristics between the CAI and non-CAI groups. At the point when the support leg made flat-foot contact with the ground, the players with CAI had more eversion of the hindfoot with respect to the tibia (-28.3° ± 12.1° vs -13.9° ± 14.2°; P = .03), a more varus alignment of the knee (26.0° ± 10.7° vs 13.7° ± 10.5°; P = .03), and a lower arch height index (0.210 ± 0.161 vs 0.233 ± 0.214; P = .046) compared with non-CAI players.

Conclusion:

Significant differences between players with and without CAI were seen in the support leg kinematics at flat-foot contact with the ground during the kicking cycle.

Clinical Relevance:

The biomechanical alignment of the support leg during a side-foot kick in players with CAI may reflect a subconscious attempt to avoid inversion of the foot and further ankle sprains.
Exploring the landscape, hot topics, and trends of bariatric metabolic surgery with machine learning and bibliometric analysis
Authors: Song Yancheng , Ni Zhenni , Li Yi , Li Zhaopeng , Zhang Jian , Guo Dong , Yuan Chentong , Zhang Zhuoli , Li Yu
Published: July 2022

Background:

This study aimed to analyze the landscape of publications on bariatric metabolic surgery through machine learning and help experts and scholars from various disciplines better understand bariatric metabolic surgery’s hot topics and trends.

Methods:

In January 2021, publications indexed in PubMed under the Medical Subject Headings (MeSH) term ‘Bariatric Surgery’ from 1946 to 2020 were downloaded. Python was used to extract publication dates, abstracts, and research topics from the metadata of publications for bibliometric evaluation. Descriptive statistical analysis, social network analysis (SNA), and topic modeling with latent Dirichlet allocation (LDA) were used to reveal bariatric metabolic surgery publication growth trends, landscape, and research topics.

Results:

A total of 21,798 records of bariatric metabolic surgery–related literature data were collected from PubMed. The number of publications indexed to bariatric metabolic surgery had expanded rapidly. Obesity Surgery and Surgery for Obesity and Related Diseases are currently the most published journals in bariatric metabolic surgery. The bariatric metabolic surgery research mainly included five topics: bariatric surgery intervention, clinical case management, basic research, body contour, and surgical risk study.

Conclusion:

Despite a rapid increase in bariatric metabolic surgery–related publications, few studies were still on quality of life, psychological status, and long-term follow-up. In addition, basic research has gradually increased, but the mechanism of bariatric metabolic surgery remains to be further studied. It is predicted that the above research fields may become potential hot topics in the future.
Yoga as a Mindfulness Practice on Music Educators’ Stress During the COVID-19 Pandemic
Authors: Koner Karen , Potter-Gee Jennifer , Borden Brianne
Published: July 2022

The purpose of the study was to examine the impact of yoga as a mindfulness practice on music educators’ stress and stress management. We designed this multiple-case study through the conceptual framework of practicing yoga to reduce teachers’ stress because yoga reduces stress in some populations. Participants attended a weekly virtual yoga class for 45 min and answered weekly reflection questions from the Five Facet Mindfulness Questionnaire and the Mindfulness Attention Awareness Scale. Findings indicated that yoga positively impacted participants in terms of improving mood, reducing stress, feeling more relaxed, remembering to breathe, and maintaining more focus while teaching. Participants also indicated that they were bringing yoga and mindfulness practices into their teaching and focusing on their breath to help with stress management.
The interplay between GPIb/IX antibodies, platelet hepatic sequestration, and TPO levels in patients with chronic ITP
Authors: Amini Sufia N. , Nelson Vivianne S. , Porcelijn Leendert , Netelenbos Tanja , Zwaginga Jaap Jan , de Haas Masja , Schipperus Martin R. , Kapur Rick
Published: July 2022

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder with an incompletely understood pathophysiology but includes platelet-clearance in the spleen and liver via T cells and/or platelet autoantibodies. Strikingly, thrombopoietin (TPO) levels remain low in ITP. Platelet-glycoprotein (GP)Ibα has been described to be required for hepatic TPO generation; however, the role of GPIb antibodies in relation to platelet hepatic sequestration and TPO levels, with consideration of platelet counts, remains to be elucidated. Therefore, we examined 53 patients with chronic and nonsplenectomized ITP for whom we conducted indium-labeled autologous platelet scintigraphy and measured platelet antibodies and TPO levels. Upon stratification toward the severity of thrombocytopenia, no negative association was observed between GPIb/IX antibodies and TPO levels, suggesting that GPIb/IX antibodies do not inhibit or block TPO levels. Surprisingly, we observed a positive association between GPIb/IX antibody levels and TPO levels and GPIb/IX antibodies and platelet hepatic sequestration in patients with severe, but not mild or moderate, thrombocytopenia. In addition, platelet hepatic sequestration and TPO levels were positively associated. This collectively indicates that GPIb/IX antibodies may be associated with increased platelet hepatic sequestration and elevated TPO levels in patients with severe thrombocytopenic ITP; however, further research is warranted to elucidate the pathophysiologic mechanisms.
Biologic drugs in treating allergic bronchopulmonary aspergillosis in patients with cystic fibrosis: a systematic review
Authors: Manti Sara , Giallongo Alessandro , Parisi Giuseppe Fabio , Papale Maria , Mulè Enza , Aloisio Donatella , Rotolo Novella , Leonardi Salvatore
Published: July 2022

Background

Aspergillus fumigatusis a common saprophytic fungus causing allergic bronchopulmonary aspergillosis (ABPA) in patients with cystic fibrosis (CF). The recommended first-line treatment for ABPA is oral steroids, followed by antifungal therapy. However, both treatments are not free from adverse effects; thus, efforts are being made to identify new drugs showing the same effectiveness but with fewer or no side-effects. Therein, biologic drugs have been significantly implemented in clinical practice in treating ABPA in patients with CF.

Objective

To systematically review the available literature, providing evidence for the administration of biologic drugs as a new potential treatment of ABPA in both the paediatric and adult populations with CF.

Methods

A systematic review of the literature published between January 2007 and July 2021 was performed, using a protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42021270932).

Results

A total of 21 studies focusing on the use of biologics in treating ABPA in CF patients was included. We highlighted a paucity of data providing evidence for biologic drug use in ABPA.

Conclusion

Scientific evidence is insufficient to support firm conclusions and randomised clinical trials are urgently required to investigate the efficacy and safety of biologics for ABPA in CF patients.
Immune processes in the pathogenesis of chronic lung allograft dysfunction: identifying the missing pieces of the puzzle
Authors: Bos Saskia , Milross Luke , Filby Andrew J. , Vos Robin , Fisher Andrew J.
Published: July 2022

Lung transplantation is the optimal treatment for selected patients with end-stage chronic lung diseases. However, chronic lung allograft dysfunction remains the leading obstacle to improved long-term outcomes. Traditionally, lung allograft rejection has been considered primarily as a manifestation of cellular immune responses. However, in reality, an array of complex, interacting and multifactorial mechanisms contribute to its emergence. Alloimmune-dependent mechanisms, including T-cell-mediated rejection and antibody-mediated rejection, as well as non-alloimmune injuries, have been implicated. Moreover, a role has emerged for autoimmune responses to lung self-antigens in the development of chronic graft injury. The aim of this review is to summarise the immune processes involved in the pathogenesis of chronic lung allograft dysfunction, with advanced insights into the role of innate immune pathways and crosstalk between innate and adaptive immunity, and to identify gaps in current knowledge.
Past asthma exacerbation in children predicting future exacerbation: a systematic review
Authors: Lowden Rachel , Turner Steve
Published: July 2022

Acute exacerbations are common in children and potentially preventable. Currently, a past exacerbation is the best predictor of a future exacerbation. We undertook a systematic review of the literature describing the relationship between past and future exacerbations. Our analysis considered whether the odds ratios for one exacerbation to predict a recurrence were different across different categories of exacerbation.

Four databases were searched systematically (MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health and PsycInfo). Exacerbations were categorised by severity as: presentation to emergency department (ED); hospital admission; paediatric intensive care unit (PICU) admission; and “unspecified severity” (i.e.no distinction between severity categories was made). Meta-analysis was performed for studies where sufficient data were provided for inclusion.

There were 26 eligible articles from 9185 identified. There was significant heterogeneity in duration of follow-up, healthcare system and exacerbation definition between studies. For the unspecified severity definition, the odds ratio for an exacerbation after a previous exacerbation was 9.87 (95% CI 5.02–19.39; six studies, 162 583 individuals). PICU admission was also associated with increased risk of future admission (OR 5.87, 95% CI 2.96–11.64; two studies, 730 individuals). Meta-analysis was not possible for ED visits or hospitalisation. The median odds ratio (range) for past ED visit predicting future ED visit was 6.27 (3.3–8.26) and for past hospitalisation predicting future hospitalisation was 3.37 (1.89–5.36).

The odds for a second asthma exacerbation do not necessarily increase with increasing severity of an initial exacerbation.
Grinding/Cutting Technology and Equipment of Multi-scale Casting Parts
Authors: Wang Meng , Song Yimin , Wang Panfeng , Chen Yuecheng , Sun Tao
Published: July 2022

Multi-scale casting parts are important components of high-end equipment used in the aerospace, automobile manufacturing, shipbuilding, and other industries. Residual features such as parting lines and pouring risers that inevitably appear during the casting process are random in size, morphology, and distribution. The traditional manual processing method has disadvantages such as low efficiency, high labor intensity, and harsh working environment. Existing machine tool and serial robot grinding/cutting equipment do not easily achieve high-quality and high-efficiency removal of residual features due to poor dexterity and low stiffness, respectively. To address these problems, a five-degree-of-freedom (5-DoF) hybrid grinding/cutting robot with high dexterity and high stiffness is proposed. Based on it, three types of grinding/cutting equipment combined with offline programming, master-slave control, and other technologies are developed to remove the residual features of small, medium, and large casting parts. Finally, the advantages of teleoperation processing and other solutions are elaborated, and the difficulties and challenges are discussed. This paper reviews the grinding/cutting technology and equipment of casting parts and provides a reference for the research on the processing of multi-scale casting parts.
Galcanezumab in episodic migraine: the phase 3, randomized, double-blind, placebo-controlled PERSIST study
Authors: Hu Bo , Li Gang , Li Xiaohong , Wu Shan , Yu Tingmin , Li Xiang , Zhao Hongru , Jia Zhihua , Zhuang Junpeng , Yu Shengyuan
Published: July 2022

Background

Galcanezumab, a humanized monoclonal antibody that binds calcitonin gene-related peptide, has demonstrated efficacy and good tolerability in patients with episodic migraine in previous phase 3 trials. We report results from the PERSIST study, which was designed to assess the efficacy and safety of galcanezumab in patients with episodic migraine from China, India, and Russia.

Methods

This phase 3 study was conducted at 40 centers in China (n = 26), India (n = 10), and Russia (n = 4). Eligible adult patients with episodic migraine were randomized in a 1:1 ratio to receive monthly galcanezumab 120 mg (with 240 mg loading dose) or placebo during a double-blind, 3-month treatment period. The primary endpoint was the overall mean change from baseline in monthly migraine headache days (MHDs). Key secondary endpoints were the mean proportion of patients with ≥ 50%, ≥ 75%, and 100% reductions from baseline in MHDs and mean change in the Migraine-Specific Quality of Life Questionnaire (MSQ) Role Function-Restrictive domain score.

Results

In total, 520 patients were randomized and received at least one dose of galcanezumab (N = 261) or placebo (N = 259). The least squares (LS) mean reduction from baseline in monthly MHDs over 3 months was significantly greater with galcanezumab compared with placebo (-3.81 days vs. -1.99 days;p < 0.0001). Significantly greater mean proportions of patients with galcanezumab versus placebo had ≥ 50%, ≥ 75%, and 100% reductions from baseline in MHDs (allp < 0.0001). The overall mean improvement from baseline in MSQ Role Function-Restrictive score over 3 months was significantly greater with galcanezumab versus placebo (p < 0.0001). There were no clinically meaningful differences between the galcanezumab and placebo group on any safety parameters except for a higher incidence of injection site pruritus (5.0% vs. 0.0%), injection site reaction (3.8% vs. 0.4%), and injection site discomfort (2.3% vs. 0.0%). TEAEs related to injection sites were mild in severity, except in 1 patient who had a moderate injection site reaction. Six serious adverse events were reported by 6 patients (2 galcanezumab, 4 placebo).

Conclusions

Galcanezumab 120 mg once monthly was effective and well tolerated in patients with episodic migraine from China, India, and Russia.

Trial registration

ClinicalTrials.gov IdentifierNCT03963232(PERSIST), registered May 24, 2019.
Association of phenylthiocarbamide perception with anthropometric variables and intake and liking for bitter vegetables
Authors: Trius-Soler Marta , Bersano-Reyes Paz A. , Góngora Clara , Lamuela-Raventós Rosa M. , Nieto Gema , Moreno Juan J.
Published: July 2022

Phenylthiocarbamide (PTC) sensitivity, a sensory trait mediated by the bitter taste receptor 38 (TAS2R38), has been described as a promising biomarker of health status or disease risk. The aim of this cross-sectional study was to evaluate the influence of PTC phenotypes on (1) individual anthropometric and clinical history variables; (2) other basic taste recognition thresholds (RTs), and (3) the hedonic perception and habitual intake of Brassicaceae vegetables in a young adult population (18.9 ± 1.7 years old). The PTC phenotype was determined by the quantitative measure of the PTC recognition threshold (non-tasters, 24.1%; tasters, 52.3%; and super tasters, 23.6%). No significant differences in smoking habits, oral and nasal disorders, family antecedents of diseases related to metabolic syndrome, and Brassicaceae vegetable hedonic perception and consumption were found between the PTC phenotype groups. The average BMI of super-taster females and males was significantly lower compared to non-tasters. In addition, the PTC taster status was a predictor of lower scores for other basic taste RTs. Overall, the defined PTC super-taster cohort could be differentiated from the non-tasters by variables related to weight control such as BMI and sucrose RT.
Different types of industrial agglomeration and green total factor productivity in China: do institutional and policy characteristics of cities make a difference?
Authors: He Ziwen , Chen Ziyang , Feng Xiao
Published: July 2022

This paper applies panel data of 281 prefecture-level cities in China from 2004 to 2017 to calculate the green total factor productivity (GTFP) at the city level. Then, it examines the influences of various forms of industrial agglomeration on GTFP and its two decomposition factors. The results demonstrate that the agglomeration of the manufacturing industry rather than producer services can effectively improve the GTFP of cities mainly through stimulating internal technological progress. However, the collaborative agglomeration of manufacturing and producer services has a significant positive correlation with GTFP. In addition, the heterogeneity analysis shows that for cities with institutional and policy advantages, collaborative agglomeration can play a more substantial effect. But, for ordinary cities, manufacturing agglomeration is more beneficial to furthering the growth of GTFP.
The prognostic value of autophagy related genes with potential protective function in Ewing sarcoma
Authors: Wen Jian , Wan Lijia , Dong Xieping
Published: July 2022

Background

Ewing sarcoma (ES) is the second most common primary malignant bone tumor mainly occurring in children, adolescents and young adults with high metastasis and mortality. Autophagy has been reported to be involved in the survival of ES, but the role remains unclear. Therefore, it’s necessary to investigate the prognostic value of autophagy related genes using bioinformatics methods.

Results

ATG2B, ATG10 and DAPK1 were final screened genes for a prognostic model. KM and risk score plots showed patients in high score group had better prognoses both in training and validation sets. C-indexes of the model for training and validation sets were 0.68 and 0.71, respectively. Calibration analyses indicated the model had high prediction accuracy in training and validation sets. The AUC values of ROC for 1-, 3-, 5-year prediction were 0.65, 0.73 and 0.84 in training set, 0.88, 0.73 and 0.79 in validation set, which suggested high prediction accuracy of the model. Decision curve analyses showed that patients could benefit much from the model. Differential and functional analyses suggested that autophagy and apoptosis were upregulated in high risk score group.

Conclusions

ATG2B, ATG10 and DAPK1 were autophagy related genes with potential protective function in ES. The prognostic model established by them exhibited excellent prediction accuracy and discriminatory capacities. They might be used as potential prognostic biomarkers and therapeutic targets in ES.
Trichomes on female reproductive tract: rapid diversification and underlying gene regulatory network in Drosophila suzukii and its related species
Authors: Tanaka Kentaro M. , Takahashi Kanoko , Rice Gavin , Rebeiz Mark , Kamimura Yoshitaka , Takahashi Aya
Published: July 2022

Background

The ovipositors of some insects are external female genitalia, which have their primary function to deliver eggs. Drosophila suzukii and its sibling species D. subpulchrella are known to have acquired highly sclerotized and enlarged ovipositors upon their shifts in oviposition sites from rotting to ripening fruits. Inside the ovipositor plates, there are scale-like polarized protrusions termed “oviprovector scales” that are likely to aid the mechanical movement of the eggs. The size and spatial distribution of the scales need to be rearranged following the divergence of the ovipositors. In this study, we examined the features of the oviprovector scales in D. suzukii and its closely related species. We also investigated whether the scales are single-cell protrusions comprised of F-actin under the same conserved gene regulatory network as the well-characterized trichomes on the larval cuticular surface.

Results

The oviprovector scales of D. suzukii and D. subpulchrella were distinct in size and spatial arrangement compared to those of D. biarmipes and other closely related species. The scale numbers also varied greatly among these species. The comparisons of the size of the scales suggested a possibility that the apical cell area of the oviprovector has expanded upon the elongation of the ovipositor plates in these species. Our transcriptome analysis revealed that 43 out of the 46 genes known to be involved in the trichome gene regulatory network are expressed in the developing female genitalia of D. suzukii and D. subpulchrella. The presence of Shavenbaby (Svb) or svb was detected in the inner cavity of the developing ovipositors of D. melanogaster, D. suzukii, and D. subpulchrella. Also, shavenoid (sha) was expressed in the corresponding patterns in the developing ovipositors and showed differential expression levels between D. suzukii and D. subpulchrella at 48 h APF.

Conclusions

The oviprovector scales have divergent size and spatial arrangements among species. Therefore, these scales may represent a rapidly diversifying morphological trait of the female reproductive tract reflecting ecological contexts. Furthermore, our results showed that the gene regulatory network underlying trichome formation is also utilized to develop the rapidly evolving trichomes on the oviprovectors of these flies.