bluuebunny/crossref_metadata_2025 huggingface dataset:
A Policy Analysis of State Plans for Independent Living in the U.S.
Authors: Kayali Yasmine L. , Johnson Alisha H. , Harrison Tracie Culp
Published: November 2022

People aging with disability and people of retirement age depend upon their respective states to follow the philosophical tenets of independent living (IL) to remain self-sufficient in their communities with a high quality of life. Independent living services are specified, programmatic sets of services funded by the Administration for Community Living (ACL) in line with expressly stated goals for implementation by state agencies for their state indepdent living centers (SILCSs) to implement through a State Plan for Independent Living (SPIL). Designated state agencies are required to submit their SPIL every three years to maintain funding through the ACL. This policy analysis of funded state plans for inclusion of people with disability aimed to determine which SPILs promote the IL philosophies of consumer choice and control. To this end, qualitative and quantitative content analyses were done to evaluate SPIL's inclusion of IL philosophies. Specifically, the consumer choice and control philosophy, involvement of people with disability, as well as the coherency of IL services from state to state were reviewed. The results of this paper indicate disparities in consumer choice and control initiatives across states, with approximately half of all states clearly promoting consumer control initiatives in their plans. Only three states made it clear that people with disability were involved in the SPIL development. The results give direction for nursing organizations who wish to work with and support SILCs as they advocate for person-centered approaches for people with disability.
Deteriorating dispersibility of flushable wet wipes during storage: Role of fibre swelling and ionic shielding
Authors: Harter Thomas , Steiner Helena , Bračič Matej , Kargl Rupert , Hirn Ulrich
Published: November 2022

Wet wipes are everyday products with the purpose to be flushed down the toilet after usage and dispersed into single fibres and small fragments thereby. During wet storage, these wipes can deteriorate their dispersibility over time, characterized by the slosh box disintegration test, recently named dispersibility ageing. This effect in flushable wet wipes, usually made of long man-made cellulose fibres and short wood pulp fibres, can be reduced by using unbleached softwood kraft pulp as the short fibre component. The aim of this work is to analyse mechanisms that could contribute to dispersibility ageing. Therefore, we will discuss three mechanisms that are able to explain this effect, that occurs in cellulosic fabrics when stored in water. Swelling (1) is demonstrated to be a long-term effect, but altering swelling with pH and salt addition has no effect on dispersibility ageing, making it unlikely that swelling contributes to it. With ionic shielding (2) a mechanism has been introduced that could impact dispersibility ageing by cations leaching from the wood pulp, which was demonstrated for an unbleached softwood kraft pulp by conductivity measurements over wet storage time. These cations neutralize the negatively charged pulp fibre fibrils and restrict their possibility to entangle with each other, which could contribute to decreasing dispersibility ageing. We will discuss the mechanism of interdiffusion (3) in dispersibility ageing, although we were not able to find a method that quantifies the contribution of cellulosic polymer diffusion to the time-dependent deterioration in dispersibility.
Combining timelining and storyboarding to create a novel method for INtervention DesIGn with stakehOlders: INDIGO
Authors: Birtwell Kelly , Morris Rebecca , Armitage Christopher J.
Published: November 2022

Design is a key part of the healthcare intervention development process, yet it is often viewed as unclear, unstructured, and challenging. INDIGO (“INtervention DesIGn with stakehOlders”) is a new mixed method that brings structure and creativity to the healthcare intervention design process and facilitates a holistic perspective of complex interventions. INDIGO combines and adapts timelining and storyboarding and enables users to create a visual representation of a complex intervention. It comprises card storyboard tokens representing intervention elements that can be moved around on a timeline chart. We discuss the background and development of INDIGO, including existing mixed methods approaches to intervention design. We then provide examples of the use of INDIGO in two empirical studies that informed the development of a brief mindfulness-based intervention, illustrating how INDIGO supported the generation of new insights. We go on to discuss the practicalities, benefits and challenges of INDIGO, including feedback from study participants. This article contributes to the field of mixed methods research by extending the scope and utility of timelining and storyboarding, and by clearly describing INDIGO so the method can be used by other researchers or intervention developers.
Comorbidity and risk factors of subsequent lower extremity amputation in patients diagnosed with diabetes in Saskatchewan, Canada
Authors: Essien Samuel Kwaku , Zucker-Levin Audrey
Published: November 2022

Objective

Subsequent limb amputation (SLA) may be necessary due to disease progression, infection, or to aid prosthesis fit. SLA in Saskatchewan has increased 3.2% from 2006 to 2019 with minor SLA increasing 9.6% during that period. Diabetes affects a large proportion of patients who require SLA; however, the impact of additional comorbidities is not clear.

Methods

First-episode subsequent lower extremity limb amputation (SLEA) cases with the presence/absence of diabetes, other comorbidities, and demographic characteristics from 2006–2019 were retrieved from Saskatchewan's Discharge Abstract Database. Logistic regression was performed to examine the magnitude of the odds of SLEA.

Results

Among the 956 first-episode SLEA patients investigated, 78.8% were diagnosed with diabetes. Of these, 76.1% were male and 83.0% were aged 50 + years. Three comorbidities: renal failure (AOR = 1.9, 95% Cl 1.1 − 3.0), hypertension (AOR = 3.0, 95% Cl 2.0 − 4.5), and congestive heart failure (AOR = 2.0, 95% CI 1.2 − 3.2), conferred the highest odds of SLEA. The odds of SLEA is greatest for those aged 50–69 years, males, Registered Indians, and associated with a prolonged hospital stay.

Discussion

These data are important as they may help medical providers identify patients at the highest risk of SLEA and target interventions to optimize outcomes.
‘Our (Civil) Way of Life’: The Folkloric Civil Sphere
Authors: Shoham Hizky
Published: November 2022

Does the civil sphere consist merely of conscious and reflective subjects? Do folkloric habits, customs, and traditions contribute anything to its universalism? This article proposes the term ‘folkloric civil sphere’ to describe a non-intentional dimension of social life and of the civil sphere, composed of conventional rituals – such as those of holidays – that are followed without reflection or debate and that together form a collective ‘way of life,’ but which are nevertheless civil, in that they transcend primordial loyalties and encourage universalistic discourse. As opposed to the neo-Durkheimian focus on the meanings of delineated and emotionally moving performances, the article relies on ethnological history to develop a bottom-up model for grasping the civil meanings of conventional rituals. It suggests recreating the gradual chronological process in which conventions appear, are disseminated, turn into rituals and into group icons, and only then may acquire ambiguous meanings. Hence the meanings of folkloric customs often lie in the perceived universalism of social conventions – what ‘everyone’ does – rather than in their symbolic significance or semiotic thickness. The article proposes a shift in focus in the discussions of civil solidarity: instead of institutional, legal, and discursive processes, it centers on the slow and quiet integration of minority groups – religious and ethnic groups or undocumented immigrants – into the symbolic civil sphere, by means of cultural codes that become embedded in everyday conventions and create, bottom up, a sense of belonging to the universalist civil sphere and its distinct ‘way of life.’
Perceptions of Concussion and Associated Anxiety in Irish Collegiate Athletes
Authors: O’Connor Siobhán , Geaney Deirdre , Whyte Enda F. , Kontos Anthony P. , O’Halloran Philip J. , Beidler Erica
Published: November 2022

Background:

Concussion nondisclosure and poor management after a concussion are a concern in Irish collegiate sports. How athletes perceive concussions and appraise their own concussion may affect their decisions and behaviors after a suspected concussion. However, this has yet to be examined in an Irish context. This study aimed to (1) establish concussion perceptions and associated anxiety in Irish collegiate athletes; (2) examine how sex, concussion, and mood disorder history influenced their perceptions; and (3) investigate factors associated with higher anxiety perceptions.

Hypothesis:

Irish collegiate athletes will display negative concussion perceptions and anxiety related to concussion, especially in female athletes and those without a concussion history.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

Irish collegiate athletes [n = 268 (141 women,127 men), mean age = 21.5 ± 2.2 years] from high-risk sports completed a survey including the Perceptions of Concussion Inventory for Athletes (PCI-A), demographics, diagnosed concussion history, self-reported mood disorder history, and a concussion knowledge assessment. Differences in concussion perceptions by sex, concussion history, mood disorder history were examined using Mann-Whitney U tests, and factors associated with anxiety-related concussion perceptions were identified using multivariate logistic regression.

Results:

Over half (53.0%, n = 142) of participants reported concerns regarding concussion. The thoughts of sustaining a concussion made participants feel upset (63.4%, n = 170), fearful (47.7%, n = 128), and anxious (35.1%, n = 94). Women reported significantly higher anxiety ( P < 0.01, r = 0.23), effects ( P = 0.04, r = 0.12), and clarity ( P = 0.01, r = 0.16) perception scores. Participants with a diagnosed concussion history displayed greater symptom variability perception scores ( P = 0.04, r = 0.12), but lower anxiety ( P = 0.03, r = 0.13) and treatment ( P < 0.01, r = 0.19) beliefs on the PCI-A. No differences were observed for those with a history of a mood disorder ( P > 0.05). A significant multivariate model was established (χ2 = 55.44, P < 0.01), with female sex [odds ratio (OR) = 1.53], concussion history (OR = 0.63), effects (OR = 1.31), and treatment (OR = 1.15) subscales associated with greater anxiety.

Conclusion:

Concerns about sustaining a concussion are prevalent in Irish collegiate athletes. Women displayed more negative perceptions and those with a concussion history displayed fewer perceived benefits of treatment.

Clinical Relevance:

The findings support the need for concussion awareness campaigns to provide accurate concussion information to mitigate anxiety-related concussion perceptions and injury belief misconceptions.
Integrated bioinformatics analysis reveals novel key biomarkers in diabetic nephropathy
Authors: Joshi Harish , Vastrad Basavaraj , Joshi Nidhi , Vastrad Chanabasayya
Published: November 2022

Objectives:

The underlying molecular mechanisms of diabetic nephropathy have yet not been investigated clearly. In this investigation, we aimed to identify key genes involved in the pathogenesis and prognosis of diabetic nephropathy.

Methods:

We downloaded next-generation sequencing data set GSE142025 from Gene Expression Omnibus database having 28 diabetic nephropathy samples and nine normal control samples. The differentially expressed genes between diabetic nephropathy and normal control samples were analyzed. Biological function analysis of the differentially expressed genes was enriched by Gene Ontology and REACTOME pathways. Then, we established the protein–protein interaction network, modules, miRNA-differentially expressed gene regulatory network and transcription factor-differentially expressed gene regulatory network. Hub genes were validated by using receiver operating characteristic curve analysis.

Results:

A total of 549 differentially expressed genes were detected including 275 upregulated and 274 downregulated genes. The biological process analysis of functional enrichment showed that these differentially expressed genes were mainly enriched in cell activation, integral component of plasma membrane, lipid binding, and biological oxidations. Analyzing the protein–protein interaction network, miRNA-differentially expressed gene regulatory network and transcription factor-differentially expressed gene regulatory network, we screened hub genes MDFI, LCK, BTK, IRF4, PRKCB, EGR1, JUN, FOS, ALB, and NR4A1 by the Cytoscape software. The receiver operating characteristic curve analysis confirmed that hub genes were of diagnostic value.

Conclusions:

Taken above, using integrated bioinformatics analysis, we have identified key genes and pathways in diabetic nephropathy, which could improve our understanding of the cause and underlying molecular events, and these key genes and pathways might be therapeutic targets for diabetic nephropathy.
Studying in vivo and in vitro effects of a novel polyvinyl benzyl chloride-D-glucaro-1, 4-lactonate polymer-coated bile duct stent for anti-biliary mud deposition
Authors: Zhang Weixing , Kanwal Fariha , Batool Aima Iram , Mustaqeem Muhammad , Rehman Muhammad Fayyaz ur , Wan Xinjian
Published: November 2022

Background:

We aim to coat a novel polyvinyl benzyl chloride-D-glucaro-1, 4-lactonate polymer-coated bile duct stent for anti-biliary mud deposition and investigate its in vivo and in vitro impacts. Biliary mud deposition is a leading cause of plastic biliary stent obstruction after its placement. Orally administrated D-glucaro-1, 4-lactonate is a specific competitive inhibitor of β-glucuronidase that causes biliary mud deposition.

Methods:

In this study, the stents coated with polyvinyl benzyl chloride-D-glucaro-1,4-lactonate polymer (PVBC-DGL) were placed in an ex vivo bile duct model perfused with porcine bile and observed every week until completely blocked. Post establishing the model of bile duct stenosis in piglets, stents are observed through endoscopy, hematology, patency time, and pathological changes within 6 months.

Results:

The 70% PVBC-DGL stents achieved the highest percentage of the inhibitory effect when the drugs were completely released in vitro. Results were obtained from 14 pigs (5: no coating (original), 4: 0% coating, and 5: 70% coating). The overall patency time of the stents was prolonged in all groups; however, the group with 70% coated stents showed a significantly prolonged patency time as compared to no coating (original) and the 0% coating groups in pigs (23.4 ± 1.8 vs 11.2 ± 2.1 w ( p = 0.05); 23.4 ± 1.8 vs 10.5 ± 2.5 w ( p = 0.05), respectively).

Conclusion:

The stents with 70% PVBC-DGL better prevent and control the deposition of bile mud and prolong the patency time of stent placement in the subject animals and may be proposed for further clinical trials in patients.
Linking Safety Climate and Safety Citizenship Behaviour in the Bangladeshi Garment Industry: Role of Employees’ Prosocial Motivation
Authors: Rahaman Munmun , Arefin Md. Shamsul
Published: November 2022

Drawing on the self-determination theory, this study aimed to examine whether perceived safety climate influenced prosocial motivation, consequently affecting two types of safety citizenship behaviours: prosocial and proactive. Two-wave time-lagged data were collected from 334 readymade garment employees in Bangladesh. Hypothesised relationships were examined using analysis of moment structures (AMOS) and statistical package for the social sciences (SPSS). This study revealed that the perceived safety climate positively influenced prosocial motivation among garment employees. In addition, perceived safety climate is related to both types of safety citizenship behaviours. Moreover, this study found that the relationship between perceived safety climate and safety citizenship behaviours was mediated by prosocial motivation. This study is a pioneer in investigating the motivating mechanism of perceived safety climate to stimulate garment employees’ citizenship behaviours. These findings provide significant evidence and guidance for garment manufacturers and managers to bolster garment employees’ prosocial and proactive safety behaviours.
Role of Lateral Soft Tissue Release in Percutaneous Hallux Valgus Surgery: A Systematic Review of the Literature
Authors: Bernasconi Alessio , Izzo Antonio , Vallefuoco Salvatore , Basso Morena A. , Marasco Domenico , Mariconda Massimo , Lintz Francois , Smeraglia Francesco
Published: November 2022

Category:

Bunion; Midfoot/Forefoot

Introduction/Purpose:

The utility of Lateral soft tissue release (LSTR) in the setting of percutaneous Hallux Valgus (PHV) surgery is still debated. Our aim was to conduct a systematic review of the literature comparing the results of PHV surgery with and without LSTR in order to define the benefits and risks related to this procedure. Our hypotheses were that LSTR would 1) reduce the risk or recurrence of the deformity without increasing the risk of complication and 2) lead to an improved clinical outcome with greater radiological correction.

Methods:

This systematic review followed the PRISMA checklist and was prospectively registered in the Prospero database (CRD4202230). Pubmed, Embase, Cochrane Library and Scopus were used to identify clinical papers reporting results after PHV surgery. Studies were pooled in two categories: PHV with LSTR (Group 1 or G1) and PHV without LSTR (Group 2 or G2). Data regarding the study design, demographics, the surgical procedure and the clinical and radiological outcome were extracted and compared. The modified Coleman Methodology score (mCMS) was used to assess the quality of studies included.

Results:

Sixteen studies were selected (G1:594 feet;G2:553 feet). The sample size (p=0.11), sex distribution (p=0.57), length of follow-up (p=0.79), size of the incision (p=0.13) were comparable. Studies in G2 included a younger population (54+-6.3 vs 44.4+- 6.8 years;p=0.006), however age did not correlate with the clinical and radiological outcome (all p>0.05). The pooled proportion of complication in the two groups (27%, 95%CI 17-38 and 25%, 95%CI 12-37, respectively) and the pooled proportion of recurrence at a minimum 18-month follow-up (2%, 95%CI 0-3 and 2%, 95%CI 0-5, respectively) didn't differ (p=0.79 and p=0.70). The pre- (51.7+-10.6 and 45.8+-1.7 points;p=0.23) and post-operative AOFAS scores (89.4+-4.3 and 86.9+-3.2 points;p=0.16) and the pre-(HVA:29.7+-2.9 and 44.1+-26.8 degrees,p=0.23)(IMA:12.5+-4.2 and 14.1+-2.6 degrees;p=0.94) and post-operative radiological angles (HVA:12.1+-4.3 and 12.3+-2.3;p=0.47)(IMA:9.2+-2.2 and 7.9+-1.3;p=0.2) didn't differ in the two groups. The methodological quality of studies (mCMS: 68.7+-11 points in G1, 63.4+-14.3 points in G2;p=0.2) was similar in G1 and G2

Conclusion:

Lateral soft tissue release during percutaneous HV surgery does not seem to improve the clinical and radiological outcome nor reduces the risk of recurrence of the deformity at a mean 4-year follow-up.
Anatomic Landmarks for Minimally Invasive Exposure for Flexor Digitorum Longus (FDL) Tendon Transfers and Spring Ligament Reconstruction
Authors: Black Sarah E. , Jastifer James R. , Brunejes Joseph
Published: November 2022

Category:

Other; Basic Sciences/Biologics; Hindfoot; Midfoot/Forefoot

Introduction/Purpose:

The approach for identification of the FDL tendon is classically described through an incision proximal to the medial malleolus extending past the navicular following the inferior border of the first metatarsal.1This incision is lengthy, and we believe that the navicular tuberosity, medial malleolus, and/or sustentaculum tali can be used as reliable landmarks for identification of the FDL more precisely and reliably. The purpose of this study is to detail spatial anatomy of the medial arch to allow for a more reliable and less invasive exposure of the FDL.

Methods:

Ten cadaver specimens were used for a total of 20 extremities. Anatomic locations were identified and pinned with the foot positioned in neutral dorsiflexion. Anatomic locations pinned included tip of the anterior colliculus, navicular tuberosity, proximal portion of the sustentaculum tali, and the distal portion of the sustentaculum tali. Photographs were taken of each cadaveric specimen with pins in place. Image J calibrated software was then used to calculate the distance between anatomic points. Averages were calculated for all measurements.

Results:

On average the superior margin of the sustentaculum tali was located 8 mm from the FDL with a range of 5-15 mm. Average distance from inferior sustentaculum tali to the FDL was 9 mm with a range of 5-12 mm. Average distance from medial malleolus to superior FDL was 18 mm with a range of 11-27 mm. Average distance from medial malleolus to inferior FDL was 27 mm with a range of 20-36mm. Average distance from navicular tuberosity to anterior FDL was 22 mm with a range of 11-27 mm. Average distance from navicular tuberosity to posterior FDL was 30 mm with a range of 19-42 mm.

Conclusion:

The 'lighthouse' for the harvest of the FDL tendon is the sustentaculum tali. Intraoperatively, the FDL tendon is found 22-31 mm directly posterior to the navicular and 18-27 mm inferior to the medial malleolus. This provides a reliable anatomic region where a 40 mm oblique approach can be made to access the FDL and spring ligament complex for a more minimally invasive approach in all of the studied specimen.
The Use of Amniotic Membrane for Peripheral Nerve Injury in Lower Extremity Surgical Procedures
Authors: Cacace Alexis , Haywood Jillian , Ashkani-Esfahani Soheil , Vrolyk Michael A. , Gianakos Arianna L. , DiGiovanni Christopher W. , Guss Daniel , Waryasz Gregory R.
Published: November 2022

Category:

Basic Sciences/Biologics; Other

Introduction/Purpose:

Patients undergoing nerve decompression surgery often report persistent symptoms. Some have suggested that wrapping the affected nerve with amniotic membrane may improve outcomes if the nerve is wrapped with amniotic membrane at the time of surgery, possibly related to anti-inflammatory, antifibrotic, or pro-regenerative effects. There is little in the foot and ankle literature to support such approaches. The aim of this preliminary study was to assess the initial safety of amniotic membrane use outcomes in foot and ankle surgery during nerve decompression procedures as an initial study in anticipation of a randomized, prospective trial.

Methods:

We retrospectively reviewed outcomes among 22 patients, >=18 years old, who had undergone amniotic membrane neurorrhaphy for lower extremity nerves including sural, saphenous, superficial peroneal, common peroneal, deep peroneal, digital (Morton's neuroma), Baxter's and posterior tibial nerve. Patients may have had multiple nerves wrapped and have had other procedures done. All patients had failed conservative treatments including cortisone injections, orthotics, nonsteroidal anti- inflammatory drugs, and physical therapy. Patients' demographics, postoperative complications, patient reported outcome measures (PROMs), and preoperative/postoperative Visual Analog Scores (VAS) for pain was collected. Data were reported in a descriptive manner.

Results:

Twenty-two patients, 16 females and 6 males averaging 51 years of age were assessed. Only one patient of the twenty- two reported a higher postoperative VAS compared to the preoperative VAS. There were no post-operative infections or reactions to the amniotic membrane. No patient required repeat surgery. The average pre- and post-operative VAS were 6.36 and 2.77, respectively. The average PROMs Pain Interference and Pain Intensity (Short Form 4a and 3a, respectively) were 42.02 and 35.94, respectively, that were within the normal range.

Conclusion:

The use of amniotic membrane wrap in lower extremity nerve decompression procedures was shown to be safe regarding post-operative short-term complications in this series of patients. However, in order to prove the usefulness of this technique for pain and function improvement, further studies with larger populations, particularly randomized clinical trials with long term follow up are necessary.
Radiographic Outcomes of Proximal vs Distal Syndesmotic Low Tibial Osteotomy
Authors: Choi Jun Young , Suh Jin Soo
Published: November 2022

Category:

Ankle Arthritis; Ankle

Introduction/Purpose:

We aimed to determine whether the location of tibial osteotomy affects the outcome during low tibial osteotomy (LTO) with fibular osteotomy for varus ankle arthritis by comparing proximal syndesmotic (PS) and distal syndesmotic (DS) tibial osteotomy.

Methods:

We retrospectively reviewed the radiographic findings of 50 cases (among 47 patients) who underwent LTO with fibular osteotomy for varus ankle arthritis. The enrolled patients were divided into two groups according to the location of the tibial osteotomy: the PS group (25 cases, 24 patients) and the DS group (25 cases, 23 patients). Radiographic parameters were compared between the two groups.

Results:

There were no significant differences in tibial anterior and lateral surface angles, tibiomedial malleolar angle, talar center migration, and intermalleolar distance correction between the two groups (all, P>.05). However, the decreases in talar tilt (TT) and talocrural angle (TCA) were more pronounced in the DS group than in the PS group (both P<.05). Among patients with TT >=8 degrees, a greater decrease in TT (+1.0 degrees vs. -2.8 degrees) and TCA was observed in the DS group, while the PS group demonstrated greater increases in TCA and intermalleolar distance (all, P<.01).

Conclusion:

In this series, DS tibial osteotomy combined with fibular osteotomy was a more effective operative option than PS tibial osteotomy to correct both extra- and intra-articular deformity for varus ankle arthritis.
Clinical Outcomes of Synthetic Cartilage Implant for Second Metatarsophalangeal Joint Arthritis
Authors: Chopra Aman , Fletcher Amanda N. , Madi Naji S. , Parekh Selene G.
Published: November 2022

Category:

Midfoot/Forefoot

Introduction/Purpose:

Second metatarsophalangeal joint (MTPJ) arthritis can be caused by both traumatic and non-traumatic conditions such as inflammation, osteoarthritis, and Freiberg's disease. Although many treatment options for second MTPJ arthritis are available, resurfacing with a synthetic cartilage implant (SCI) has recently gained popularity since it demonstrates similar biomechanical properties as native cartilage, eliminates pain, and preserves second MTPJ motion. With limited data available on the efficacy of SCI resurfacing for the lesser toes, the purpose of this study was to report on the clinical outcomes of SCI resurfacing in patients with second MTPJ arthritis.

Methods:

Electronic health records were queried from July 2017 to December 2020 for patients who were experiencing symptomatic second MTPJ pain and were treated with SCI (Cartiva Synthetic Cartilage Implant; Cartiva Inc., Alpharetta, GA) by a single surgeon. Patient demographics such as body mass index (BMI), age, sex, medical comorbidities, American Society for Anesthesiologists (ASA) physical status, past surgical history, and followup periods were recorded. Preoperative and postoperative range of motion, visual analog scale (VAS) pain scores, and x-ray imaging were compared. Descriptive and univariate statistics were used to analyze data.

Results:

A total of six patients received SCI resurfacing for second MTPJ pathologies including Freiberg's disease (50%), osteoarthritis (67%), and subluxation (50%). All six patients were female and the mean BMI and age were 28.3+-6 Kg/m2 and 56.3+-14 years, respectively. Three patients (50%) received index SCI resurfacing, while three patients (50%) received SCI resurfacing as a revision procedure. No significant differences were observed between preoperative and postoperative pain VAS, dorsiflexion, and plantarflexion measurements. The mean followup period was 16.4+-14 (range, 5-38) months and no postoperative complications were reported. When reviewing imaging, all patients demonstrated second MTPJ alignment within 10 degrees of valgus and maintenance of articular space (Table 1).

Conclusion:

SCI resurfacing can be utilized as a treatment option for second MTPJ arthritis. Future prospective studies should be performed to expand upon the limited clinical outcomes data presently available.
A 10 Year Review of Designated Leadership Positions of the American Orthopaedic Foot & Ankle Society (AOFAS)
Authors: Chrea Bopha , Johnson A. Holly , Baumhauer Judith F. , Meeker James E. , Atwater Lara C. , Poon Selina
Published: November 2022

Category:

Other

Introduction/Purpose:

In 2019 the majority of U.S medical students were women (50.5%). Despite this, in 2019 Orthopaedic surgery had the lowest representation of female surgeons (5.8%). Previously, the American Society for Surgery of the hand (ASSH) and Pediatric Orthopaedic Society of North America (POSNA) published their gender diversity data. However, no such study has been conducted in the largest membership organization for foot and ankle trained orthopaedic surgeons. This study sought to investigate whether increased female representation in the American Orthoapedic Foot & Ankle Society (AOFAS) membership roster is reflected in different levels within the organization.

Methods:

The 2012-2022 membership rosters were obtained from the American Orthopaedic Foot & Ankle Society (AOFAS) and compared by gender. Volunteer, elected and appointed leadership positions and rates of engagement were compared for each of the activities. Leadership positions were defined as appointment as committee chair, vice chair of board of directors. When available, time for advancement through leadership positions was analyzed by gender. Comparative data was available for comparison to two other respective subspecialty groups (ASSH and POSNA) from previously published studies.

Results:

Between 2012-2022, the percentage of female membership in the AOFAS has continued to increase from 7.5 (n=76) to 13% (n=163) (Table 1). Engagement in committee membership positions in this time has more than doubled from 11/26 (14.4%) to 57/163 (34.9%) (Table 1-3). When participation trends were evaluated by gender, women showed higher rates of committee involvement than their male counterparts (Table 4). In 2021 the percentage of female committee involvement more than doubled their male counterparts (female 57% vs male 23.2 %) (Figure 1). This committee gender composition trend has been seen in the ASSHA and POSNA however is more pronounced in the AOFAS. Representation of women in committee chair positions and elected positions has not seen this same parallel increase (Figure 2).

Conclusion:

The AOFAS is on trend with the respective Orthopaedic subspecialities. Female membership within the society has increased over the past ten years. The rates of female involvement within committee membership positions have seen a parallel increase. It will take time to mature into leadership roles as we continue to increase diversity within our respective subspecialty organizations. Inception of the Diversity Equity and Inclusion and Women's Subcommittee demonstrate a continued emphasis on this core value within the society.
Assessing the Stability of Talar Defect Repairs: Does Shape Matter?
Authors: Farndon Mark A. , Canden Ahranee , Brockett Claire
Published: November 2022

Category:

Basic Sciences/Biologics; Ankle; Sports

Introduction/Purpose:

The management of osteochondral lesions of the talus (OLTs) provides a challenging predicament for clinicians; with an increased array of treatment options available. In many cases, the management strategy used is dependent on both the size and location of the lesion. One of the current treatments used for mid-sized (10-20 mm) lesions is Chondro-Gide membrane. To apply this therapy, the defect site is debrided into a shape of the clinicians' preference with a template being used to prepare the Chondro-Gide matrix to the correct size and shape. However, there is some debate within the clinical community as to which shape allows for improved treatment. In this study we aim to assess whether a square or circular scaffold repair provided improved treatment when tested tribologically.

Methods:

16-mm circular chondral defects were introduced to the talar dome of cadaveric donor tissue (n = 3). The tibiotalar joints were cemented with the centre of rotation preserved. The ankle joint was loaded into a ProSim Pendulum Friction simulator and tested using the following loading and motor conditions. Simulations were run at a 1-Hertz for 3600 cycles with a constant tibial load of 640 N and 20° sweep arc through flexion and extension. Data was normalised using a mean frictional offset value calculated using 2 minute pre- and post- test to account for additional frictional torque. Nanofracture was performed on the defect site and a circular Chondro-Gide patch was fixed using a synthetic fibrin glue before testing using the same conditions. The circular defect site was modified to create a 16-mm square defect which was repaired with a square patch in the same manner and tested as described.

Results:

The overall mean frictional factors over the 1-hour test for the defect, circular and square repairs were 0.039, 0.042 and 0.026, respectively. These values are within the expected range for in vitro testing of two cartilage surfaces previously reported in the literature of 0.003 and 0.08, suggesting that frictional values did not differ between the samples. However, visual changes to the stability of the repair and the reciprocal tibial cartilage could be seen post testing. In all cases the circular repair remained in the defect site. In comparison, for 2 out of 3 of the defects repaired with a square Chondro-Gide patch did not remain stable within the defect site. In both cases further delamination was seen on the reciprocal tibial cartilage tissue.

Conclusion:

This method will allow for potential preclinical evaluation of treatments for OLTs in an appropriately simulated environment to assess tribological changes. The values obtained for the frictional factor all sit within the expected range for friction between two cartilage surfaces that has been reported in the literature 0.003 and 0.08. Thus, providing a reliable platform for comparing different methods of osteochondral defect repair in the tibiotalar joint.
Portable Dynamic Ultrasonography is a Useful Tool for the Evaluation of Suspected Syndesmotic Instability
Authors: Hagemeijer Noortje , Lubberts Bart , Saengsin Jirawat , Bhimani Rohan , Sato Go , Waryasz Gregory R. , Kerkhoffs Gino , DiGiovanni Christopher W. , Guss Daniel
Published: November 2022

Category:

Ankle

Introduction/Purpose:

Portable ultrasonography (P-US) is increasingly used to diagnose syndesmotic instability. The aim of this study was to evaluate syndesmotic instability by measuring the distal tibiofibular clear space (TFCS) in a cadaveric model using P- US with progressive stages of syndesmotic ligamentous transection.

Methods:

Ten fresh lower leg cadaveric specimens amputated above the proximal tibiofibular joint were used. Using P-US, the TFCS was evaluated in the intact stage and after progressive sectioning of the 1) anterior-inferior tibiofibular ligament (AITFL), 2) interosseous ligament (IOL), and 3) posterior-inferior tibiofibular ligament (PITFL). The TFCS was measured in both the unstressed (0 Nm) state and with 4.5 Nm, 6.0 Nm, 7.5 Nm, and 9.0 Nm of external rotation stress at each stage of ligamentous transection stage using both P-US and fluoroscopy.

Results:

When assessed with P-US, partial syndesmotic injury encompassing the AITFL and IOL resulted in significant TFCS widening at 4.5 Nm of external rotation torque when compared to intact state with a TFCS-opening of 2.6 +- 2 mm, p = 0.01. In contrast, no significant differences in TFCS were detected using fluoroscopy. Only a moderate correlation was found between P- US and fluoroscopy.

Conclusion:

P-US is much more sensitive than fluoroscopy in diagnosing syndesmotic instability during external rotation stress examination. Extrapolated to the clinical setting, 4.5 Nm of force can be used when comparing to the stressed, uninjured side, and may be better tolerated by patients than higher torque values. When using P-US, a TFCS-opening of 2.6 mm is likely to correlate with syndesmotic instability. While absolute threshold values may vary between individuals, the ready availability of the contralateral, uninjured side overcomes this constraint.
TreeQNet: a webserver for Treatment evaluation with Quantified Network
Authors: Li Zhenlei , Huang Ya , Li Qingrun , Sun Yidi , Li Chen , Wu Jiarui , Zheng Haoran , Zeng Rong
Published: November 2022

Background

Personalized therapy has been at the forefront of cancer care, making cancer treatment more effective. Since cancer patients respond individually to drug therapy, predicting the sensitivity of each patient to specific drugs is very helpful to apply therapeutic agents. Traditional methods focus on node (molecular) information but ignore relevant interactions among different nodes, which has very limited application in complex situations, such as cancer drug responses in real clinical practice.

Results

Treatment evaluation with Quantified Network (TreeQNet) is a webserver which could predict sensitivity to drugs for patients through the innovative use of proteomic and phosphoproteomic network from tumor tissues.

Conclusion

TreeQNet service: http://bioinfo.ustc.edu.cn/. TreeQNet source code: https://github.com/Really00/treeqnet-web-front/.
DIAMIN: a software library for the distributed analysis of large-scale molecular interaction networks
Authors: Di Rocco Lorenzo , Ferraro Petrillo Umberto , Rombo Simona E.
Published: November 2022

Background

Huge amounts of molecular interaction data are continuously produced and stored in public databases. Although many bioinformatics tools have been proposed in the literature for their analysis, based on their modeling through different types of biological networks, several problems still remain unsolved when the problem turns on a large scale.

Results

We propose , that is, a high-level software library to facilitate the development of applications for the efficient analysis of large-scale molecular interaction networks. relies on distributed computing, and it is implemented in Java upon the framework Apache Spark. It delivers a set of functionalities implementing different tasks on an abstract representation of very large graphs, providing a built-in support for methods and algorithms commonly used to analyze these networks. has been tested on data retrieved from two of the most used molecular interactions databases, resulting to be highly efficient and scalable. As shown by different provided examples, can be exploited by users without any distributed programming experience, in order to perform various types of data analysis, and to implement new algorithms based on its primitives.

Conclusions

The proposed has been proved to be successful in allowing users to solve specific biological problems that can be modeled relying on biological networks, by using its functionalities. The software is freely available and this will hopefully allow its rapid diffusion through the scientific community, to solve both specific data analysis and more complex tasks.
Genome-wide association study uncovers major genetic loci associated with flowering time in response to active accumulated temperature in wild soybean population
Authors: Yang Guang , Li Wei , Fan Chao , Liu Miao , Liu Jianxin , Liang Wenwei , Wang Ling , Di Shufeng , Fang Chao , Li Haiyang , Ding Guohua , Bi Yingdong , Lai Yongcai
Published: November 2022

Flowering time and active accumulated temperature (AAT) are two key factors that limit the expanded production especially for soybean across different regions. Wild soybean provides an important germplasm for functional genomics study in cultivar soybean. However, the studies on genetic basis underlying flowering time in response to AAT especially in wild soybean were rarely reported. In this study, we used 294 wild soybean accessions derived from major soybean production region characterized by different AAT in Northeast of China. Based on genome-wide association study (GWAS), we identified 96 SNPs corresponded to 342 candidate genes that significantly associated with flowering time recorded in two-year experiments. Gene Ontology enrichment analysis suggests that the pathways of photosynthesis light reaction and actin filament binding were significantly enriched. We found three lead SNPs with -log10(p-value) > 32 across the two-year experiments, i.e., Chr02:9490318, Chr04:8545910 and Chr09:49553555. Linkage disequilibrium block analysis shows 28 candidate genes within the genomic region centered on the lead SNPs. Among them, expression levels of three genes (aspartic peptidase 1, serine/threonine-protein kinase and protein SCAR2-like) were significantly differed between two subgroups possessing contrasting flowering time distributed at chromosome 2, 4 and 9, respectively. There are 6, 7 and 3 haplotypes classified on the coding regions of the three genes, respectively. Collectively, accessions with late flowering time phenotype are typically derived from AAT zone 1, which is associated with the haplotypic distribution and expression levels of the three genes. This study provides an insight into a potential mechanism responsible for flowering time in response to AAT in wild soybean, which could promote the understanding of genetic basis for other major crops.
Wochenende — modular and flexible alignment-based shotgun metagenome analysis
Authors: Rosenboom Ilona , Scheithauer Tobias , Friedrich Fabian C. , Pörtner Sophia , Hollstein Lisa , Pust Marie-Madlen , Sifakis Konstantinos , Wehrbein Tom , Rosenhahn Bodo , Wiehlmann Lutz , Chhatwal Patrick , Tümmler Burkhard , Davenport Colin F.
Published: November 2022

Background

Shotgun metagenome analysis provides a robust and verifiable method for comprehensive microbiome analysis of fungal, viral, archaeal and bacterial taxonomy, particularly with regard to visualization of read mapping location, normalization options, growth dynamics and functional gene repertoires. Current read classification tools use non-standard output formats, or do not fully show information on mapping location. As reference datasets are not perfect, portrayal of mapping information is critical for judging results effectively.

Results

Our alignment-based pipeline, Wochenende, incorporates flexible quality control, trimming, mapping, various filters and normalization. Results are completely transparent and filters can be adjusted by the user. We observe stringent filtering of mismatches and use of mapping quality sharply reduces the number of false positives. Further modules allow genomic visualization and the calculation of growth rates, as well as integration and subsequent plotting of pipeline results as heatmaps or heat trees. Our novel normalization approach additionally allows calculation of absolute abundance profiles by comparison with reads assigned to the human host genome.

Conclusion

Wochenende has the ability to find and filter alignments to all kingdoms of life using both short and long reads, and requires only good quality reference genomes. Wochenende automatically combines multiple available modules ranging from quality control and normalization to taxonomic visualization. Wochenende is available at https://github.com/MHH-RCUG/nf_wochenende.
Evaluating methodological approaches to assess the severity of infection with SARS-CoV-2 variants: scoping review and applications on Belgian COVID-19 data
Authors: Meurisse Marjan , Van Oyen Herman , Blot Koen , Catteau Lucy , Serrien Ben , Klamer Sofieke , Cauët Emilie , Robert Annie , Van Goethem Nina
Published: November 2022

Background

Differences in the genetic material of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may result in altered virulence characteristics. Assessing the disease severity caused by newly emerging variants is essential to estimate their impact on public health. However, causally inferring the intrinsic severity of infection with variants using observational data is a challenging process on which guidance is still limited. We describe potential limitations and biases that researchers are confronted with and evaluate different methodological approaches to study the severity of infection with SARS-CoV-2 variants.

Methods

We reviewed the literature to identify limitations and potential biases in methods used to study the severity of infection with a particular variant. The impact of different methodological choices is illustrated by using real-world data of Belgian hospitalized COVID-19 patients.

Results

We observed different ways of defining coronavirus disease 2019 (COVID-19) disease severity (e.g., admission to the hospital or intensive care unit versus the occurrence of severe complications or death) and exposure to a variant (e.g., linkage of the sequencing or genotyping result with the patient data through a unique identifier versus categorization of patients based on time periods). Different potential selection biases (e.g., overcontrol bias, endogenous selection bias, sample truncation bias) and factors fluctuating over time (e.g., medical expertise and therapeutic strategies, vaccination coverage and natural immunity, pressure on the healthcare system, affected population groups) according to the successive waves of COVID-19, dominated by different variants, were identified. Using data of Belgian hospitalized COVID-19 patients, we were able to document (i) the robustness of the analyses when using different variant exposure ascertainment methods, (ii) indications of the presence of selection bias and (iii) how important confounding variables are fluctuating over time.

Conclusions

When estimating the unbiased marginal effect of SARS-CoV-2 variants on the severity of infection, different strategies can be used and different assumptions can be made, potentially leading to different conclusions. We propose four best practices to identify and reduce potential bias introduced by the study design, the data analysis approach, and the features of the underlying surveillance strategies and data infrastructure.