bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Demand for State Support in the Post-Communist Welfare State: The Case of Russia
Authors: Anikin Vasiliy A , Lezhnina Yulia P , Mareeva Svetlana V , Slobodenyuk Ekaterina D
Published: July 2022

This study explores the roots and details of the Russian population’s demand for broad state interventions in three areas: labour market, social investment, and material support. Demands in labour market policy are the most frequent among the Russian population and stem from the need to eliminate inequalities in access to ‘good’ jobs and ensure fair remuneration of skilled labour. In Russia, unlike in Europe, needs in social investment policy do not stem from individualistic interests and the imperative to compensate for market failure. Instead, they result from state failure, leading in particular to growing inequality of life chances in healthcare and worsening health of the broader society. These impacts are perceived as a fundamental adverse effect of unsuccessful social policy changes, and this type of demand for state support is growing alongside household income. At the same time, wealthy Russians also hardly believe in state efficiency in the labour market, show less demand for employment policy interventions, and generally prefer ‘state escapism’. The study argues that an individualistic mindset per se is a cornerstone of the absence of request for state support in any form. These findings support the concept of bottom-up sociocultural modernisation while helping explain state escapism in post-communist welfare regimes. In general, the study provides empirical contributions to the literature on diversity of statist expectations in post-communist welfare regimes.
Autism presentation in female and Black populations: Examining the roles of identity, theory, and systemic inequalities
Authors: Diemer Maire Claire , Gerstein Emily D , Regester April
Published: July 2022

The prevalence of autism is rising, a dynamic attributed to numerous explanations (e.g. better diagnostic practices, decreased stigma). As this neurodevelopmental disability increases in visibility, disparities in its diagnostic rate grow. Female and Black populations in the United States have historically lower prevalence, are diagnosed later, are more likely to have co-occurring intellectual disability, and experience exclusion from research. Autistic Black girls are effectively invisible in the literature. To combat this exclusion, this narrative review discusses intersectionality theory and how it may be used to provide integrated models that are inclusive toward diverse gender, ability, and racial/ethnic backgrounds. Systemic inequalities, including prenatal care and misdiagnosis, disproportionately negatively impact the quality of care available to female and Black autistic populations. The authors recommend that research include autistic populations with co-occurring intellectual disability, include a diagnostic evaluation as part of protocols, and clinically, universal screening and improved provider competence and confidence in working with diverse autistic populations.

Lay abstract

Although the prevalence of autism has been rising in recent years, disparities in diagnosis still remain. Female and Black populations in the United States are diagnosed later, are more likely to have an intellectual disability, and are excluded from research as well as services designed for autistic individuals. Autistic Black girls are effectively invisible in the current scientific literature. Intersectional theory, which looks at a person as a whole, examines models that are inclusive toward diverse gender, ability, and racial/ethnic backgrounds. This theory may be a useful approach to clinical and research work with autism so that practitioners may be most effective for the whole population of autistic people. The authors recommend research focusing on inclusion of autistic populations with intellectual disability and research studies that include evaluations as part of the procedure. Clinically, the authors recommend a focus on screening all young children for autism and improving provider knowledge in working with diverse autistic populations.
Ghosts in the machinery: Living with and beyond radiotherapy treatment for gynaecological cancer
Authors: Stewart Hilary , Ashmore Lisa , Kragh-Furbo Mette , Singleton Vicky , Hutton Daniel
Published: July 2022

This paper explores post-treatment experiences of women who have had radiotherapy for gynaecological cancer. Drawing on data from a project which explored post-treatment wellbeing, conceptual metaphors of ghosts/haunting are used to engage with enduring legacies of cancer and ‘neglected matters’ in post-treatment trajectories. Current arrangements of care contribute to the idea that participants are ‘out of the other side of cancer’ once active treatment completes. Despite broader ambitions for holistic cancer rehabilitation, fragilities of body and mind persist, even when the outward representation is one of health, of looking well, of moving on. We show how neglected matters of cancer (visceral late effects, psychological suffering and lives not lived) are part of living with and beyond cancer. These ‘ghosts’ manifest in chronic states of unsettledness that are temporarily relieved by individualised ‘fixes’, such as mobilisation of ‘mind over matter’ discourse and mindfulness. This discourse and its associated tools are a powerful yet impoverished framing of approaches to living with and beyond cancer. We argue for the need to attend to ‘neglected matters’ of post-treatment trajectories differently.
A Vascular Surgery–Specific Ultrasound Model for Vascular Access
Authors: Man Jeanette H. , Nicholson Rachael , Aboul Hosn Maen
Published: July 2022

The objective of this project was to develop a realistic, inexpensive, and accessible model for vascular surgery residents to use for improving their vascular access skills. We have developed a simple gelatin model to simulate a nondiseased, diseased, and branched vessel. Our model visually mimics real-life tissue under ultrasound, physically mimics real-life tissue during access, and realistically mimics both nondiseased and diseased branched vessels. Needle and wire access to the vessel can be clearly visualized using this model. This vascular surgery–specific ultrasound model will provide a realistic simulation for training in ultrasound-guided vascular access.
Association of Radial Head Fracture Treatment With Long-Term Function
Authors: Burke Cynthia E. , McKegg Phillip C. , Wong Alison L. , DeLeon Genaro A. , Gupta Jayesh , Healey Kathleen , Enobun Blessing , O’Hara Nathan N. , O’Toole Robert V. , Pensy Raymond A. , Langhammer Christopher G. , Eglseder W. Andrew
Published: July 2022

Background:

Radial head fractures are often associated with poor outcomes. Both open reduction and internal fixation (ORIF) and radial head arthroplasty (RHA) might be considered in operative cases. This study aimed to compare long-term patient-reported functional outcomes among patients with operatively treated radial head fractures.

Methods:

A cross sectional study conducted at a Level I trauma center was used to identify patients with a radial head fracture who underwent ORIF or RHA between 2006 and 2018, and agreed to complete a survey in 2020. The primary outcome measure was the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score.

Results:

Seventy-six patients participated in the study. No significant differences in outcomes were observed between groups. QuickDASH scores were similar for both groups (ORIF: mean = 15.7, SD = 18.4; RHA: mean = 22.8, SD = 18.6; mean difference = 0.2 [-9.0 to 9.3], P = .97). Nineteen (37%) ORIF patients and 12 (48%) RHA patients reported a need for pain medication (adjusted odds ratio [OR] = 0.8 [0.3-2.4], P = .70). Thirteen (25%) ORIF patients and 6 (24%) RHA patients required additional surgery (adjusted OR = 1.7 [0.5-6.2], P = .39). A subgroup analysis of multi-fragmentary fractures revealed similar findings.

Conclusion:

Patient-reported outcomes, which included a subgroup analysis of multi-fragmentary fractures, were similar between ORIF and RHA groups at an average of 7.5 years from surgery. Reconstructing the radial head might not result in worse outcomes than RHA when both options are employed according to the best judgment of the operating surgeon.
Why Fans of the Evil Genius Remain Fans: The Case of Richard Wagner and the Bayreuth Festival
Authors: Smith Philip , Stoll Florian
Published: July 2022

An enduring feature of public life has been the social death of prominent artists, impresarios and entertainers after moral transgressions. But not everyone is shunned. Often fans and general audiences continue to consume, advocate and revere the artistic product of tainted but gifted individuals. How is this love of the ‘evil genius’ possible? The article provides answers with reference to the paradigm case of Richard Wagner and the Bayreuth Festival that he founded. The composer and event remain contaminated by deep association with antisemitism, Hitler and the Third Reich. We draw from an interview study with Wagner fans and opera connoisseurs to report on the interpretative techniques, justifications and folk-logics through which Wagner’s operas can still be listened to and found pleasurable in light of a troubled history. These involve articulations between and over four domains: (i) self (ii) artwork (iii) artist and (iv) history. These are variously connected and disconnected. We speculate that this four-factor model will be applicable in other domains where art, politics and morality make for uneasy bedfellows and the ‘evil genius’ remains culturally salient.
Inflammatory bowel disease and immune-mediated inflammatory diseases: looking at the less frequent associations
Authors: Bezzio Cristina , Della Corte Cristina , Vernero Marta , Di Luna Imma , Manes Gianpiero , Saibeni Simone
Published: July 2022

Patients with inflammatory bowel disease (IBD) often have other immune-mediated inflammatory diseases (IMIDs), and the prevalence of any IMID is higher in IBD patients than in the general population. IBD and other IMIDs involve alterations in innate and adaptive immune responses. Their co-occurrence depends on shared immune and inflammatory processes, pathogenic mechanisms, and genetic and environmental risk factors, including drugs, especially tumor necrosis factor inhibitors. The more common IMIDs associated with IBD have been widely described, so this review focuses on the less frequent associations. The IMIDs discussed here are skin disorders (psoriasis, atopic dermatitis, vitiligo, epidermolysis bullosa acquisita, cutaneous polyarteritis nodosa, and hidradenitis suppurativa), hepato-pancreatic diseases (autoimmune hepatitis, granulomatous hepatitis, and autoimmune pancreatitis), endocrine diseases (autoimmune thyroid diseases, and type 1 diabetes mellitus), multiple sclerosis, and respiratory diseases (asthma, bronchiectasis, and interstitial pneumonia). The early detection of IMIDs in IBD patients is important to prevent their deleterious clinical course and limit their psychological impact. Care for IBD patients with IMIDs should be multispecialist, with a single therapeutic strategy instead of treating each disease separately.
Rapid and efficient generation of cartilage pellets from mouse induced pluripotent stem cells by transcriptional activation of BMP-4 with shaking culture
Authors: Zhang Maolin , Niibe Kunimichi , Kondo Takeru , Limraksasin Phoonsuk , Okawa Hiroko , Miao Xinchao , Kamano Yuya , Yamada Masahiro , Jiang Xinquan , Egusa Hiroshi
Published: July 2022

Induced pluripotent stem cells (iPSCs) offer an unlimited source for cartilage regeneration as they can generate a wide spectrum of cell types. Here, we established a tetracycline (tet) controlled bone morphogenetic protein-4 ( BMP-4) expressing iPSC (iPSC- Tet/BMP-4) line in which transcriptional activation of BMP-4 was associated with enhanced chondrogenesis. Moreover, we developed an efficient and simple approach for directly guiding iPSC- Tet/BMP-4 differentiation into chondrocytes in scaffold-free cartilaginous pellets using a combination of transcriptional activation of BMP-4 and a 3D shaking suspension culture system. In chondrogenic induction medium, shaking culture alone significantly upregulated the chondrogenic markers Sox9, Col2a1, and Aggrecan in iPSCs- Tet/BMP-4 by day 21. Of note, transcriptional activation of BMP-4 by addition of tet (doxycycline) greatly enhanced the expression of these genes. The cartilaginous pellets derived from iPSCs- Tet/BMP-4 showed an oval morphology and white smooth appearance by day 21. After day 21, the cells presented a typical round morphology and the extracellular matrix was stained intensively with Safranin O, alcian blue, and type II collagen. In addition, the homogenous cartilaginous pellets derived from iPSCs- Tet/BMP-4 with 28 days of induction repaired joint osteochondral defects in immunosuppressed rats and integrated well with the adjacent host cartilage. The regenerated cartilage expressed the neomycin resistance gene, indicating that the newly formed cartilage was generated by the transplanted iPSCs- Tet/BMP-4. Thus, our culture system could be a useful tool for further investigation of the mechanism of BMP-4 in regulating iPSC differentiation toward the chondrogenic lineage, and should facilitate research in cartilage development, repair, and osteoarthritis.
The Neural Basis of Tonal Processing in Music: An ALE Meta-Analysis
Authors: Asano Rie , Lo Vivian , Brown Steven
Published: July 2022

Music is used as an important medium for communication in human societies, often times to enhance the emotional meaning of narrative scenarios and ritual events. Music has a number of domain-specific tonal devices for doing this, spanning from scale structure to harmonic progressions and beyond. In order to explore the neural basis of tonal processing in music, we carried out an activation likelihood estimation (ALE) meta-analysis of 20 published functional magnetic resonance imaging studies of tonal cognition, with an emphasis on harmony processing. The most concordant areas of activation across these studies occurred at the junction of the inferior frontal gyrus, anterior insula, and orbitofrontal cortex in Brodmann areas 47 and 13 in the right hemisphere. This region is associated not only with emotion in general, but with the conveyance of affective meanings during communication processes, including speech prosody and music.
Paper 09: Differences in Glenohumeral Range of Motion and Humeral Torsion Between Right-Handed and Left-Handed Major League Baseball Pitchers.
Authors: Harris Jeremy , Freeston Jonathan , Soloff Lonnie , Himmerick Daniel , Pipkin Andrew , Genin Jason , Schickendantz Mark , Frangiamore Salvatore , Maier Jacob
Published: July 2022

Objectives:

Substantial differences in throwing metrics, like velocity, spin rate and pitcher break, have been observed between left and right-handed pitchers. Elite pitchers have demonstrated significant changes in glenohumeral range of motion and humeral torsion compared to the normal population. Differences in these anatomical parameters between left and right-handed pitchers may explain these performance trends. Furthermore, changes in shoulder range of motion measurements have been associated with different injury risks and challenges in assessing rehabilitation progress. This study seeks to determine if differences in glenohumeral range of motion and humeral torsion exist between left-handed and right-handed pitchers.

Methods:

217 MLB pitchers from a single organization were evaluated over a 7-year period from 2013-2020. Range of motion was evaluated by three trained examiners using a Standard Goniometer. Ultrasound scanning was used to determine neutral position of the shoulder and the degree of humeral torsion was measured with a goniometer. The mean and standard deviation were assessed for normality using Shapiro Wilk. Differences between right and left-handed pitchers were assessed using one-way ANOVA. Arm effects were assessed using paired samples t-tests.

Results:

Right-handed pitchers showed, on average, 13.9 degrees more shoulder external rotation range in their dominant arm compared with their non-dominant arm, whereas left-handers averaged only 2.2 degrees. RHPs showed greater asymmetries in shoulder internal rotation range (13.9 vs 4.8 degrees) and humeral torsion (-23.1 vs -2.2 degrees). Left-handed pitchers showing significantly greater range of non-dominant shoulder flexion (165.8 vs 160.7 degrees) leading to greater flexion deficits in the dominant arm compared to their right-handed counterparts, (7.5 vs 0.0 degrees).

Conclusions:

Right-handed pitchers demonstrate significantly greater measures of external rotation, humeral retrotorsion, and shoulder flexion compared to left-handed counterparts. The correlation between humeral retrotorsion and increased external rotation indicate that osseus adaptations are a major contributor to range of motion differences associated with handedness. Additionally, these findings may explain observed differences in several throwing metrics between right and left-handed pitchers. Furthermore, knowledge of these differences can inform rehabilitations programs and shoulder maintenance regimens. [Table: see text][Table: see text][Figure: see text][Figure: see text]
Paper 12: Revision Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers: Effect on Fastball Velocity and Usage
Authors: Cinque Mark , Chona Deepak , Abrams Geoffrey , Sherman Seth , Safran Marc , Freehill Michael , LaPrade Christopher
Published: July 2022

Objectives:

Ulnar collateral ligament (UCL) tears are prevalent in Major League Baseball (MLB) pitchers and cause significant loss of time with varying reports of impact on performance. Revision UCL reconstruction (UCLR) is increasingly common, with little known about the effects on both fastball (FB) velocity and usage (%) in this setting. The purpose of this study was to evaluate the effect of revision UCLR on MLB pitchers with respect to post-operative FB % and velocity at one and two years after return-to-play. The hypothesis was that post-operative FB usage (FB%) and velocity would significantly decrease versus pre-injury levels in the revision UCLR group, and that revision UCLRs would result in significantly decreased FB % and velocity in comparison to a matched group of MLB pitchers after primary UCLRs.

Methods:

Public records were used to identify MLB pitchers from 2008 to 2020 who underwent a revision UCLR. The PITCHf/x system, which was installed in 2007 and is a standardized recording of all pitches thrown in MLB stadiums, collected FB velocity for four-seam (4FB) and two-seam (2FB) fastballs and total FB % for pitchers in the pre-injury year as well as the first two years after return. A matched control group of pitchers who underwent primary UCLR was used for comparison.

Results:

Nineteen pitchers fit the study criteria. There were no significant differences in the revision UCLR group in FB velocity between pre-injury levels (4FB 92.87 mph, 2FB 91.43 mph) and years one (4FB 92.55 mph, p=.375) (2FB 91.2 mph, p=0.448) and two (4FB 93.38 mph, p=.695) (2FB 91.59 mph, p=0.806) after return (Table 1). There were also no significant differences in FB % usage between the pre-injury season (60.4) and first (56.5, p=.095) or second years (52.5, p=.053) after return (Table 1). In terms of walks and hits per innings pitched (WHIP), strikeouts per 9 innings (K/9), and walks per 9 innings (BB/9), the only significant difference between pre-injury and post-injury outcomes was a significant higher K/9 in the first season after return (p=0.031) (Table 1). There were no significant differences between FB velocity or % usage between the revision and primary UCLR groups at any time point (Tables 2-4). There were also no significant differences in the revision and primary UCLR groups between WHIP, K/9, or BB/9 with the exception of lower WHIP (p=0.015) and K/9 (p=0.001) in the pre-injury season (Tables 2-4).

Conclusions:

In pitchers that return to the MLB level, there were no significant differences in FB velocity versus their pre-injury levels or in comparison to pitchers after primary UCLR. While not statistically significant, a trend was demonstrated that there was a clinically relevant decrease in FB % usage, potentially suggesting less confidence in their FB. [Table: see text][Table: see text][Table: see text][Table: see text]
Paper 76: Utilization of Validated Outcome Scores in Evaluating Treatment of Osteochondral Lesions: A Comparison of Ankle Versus Knee Literature
Authors: Bhargava Kathrine , Docter Shgufta , Park Sam Si-Hyeong , Lee Jong Min
Published: July 2022

Objectives:

Osteochondral lesions (OCLs) are commonly seen in the ankle and knee joints, and present difficult challenges for treatment. Evaluating the effectiveness of a treatment is dependent on how well constructed, content specific, reliable, and responsive the outcome measures used are. Currently, a considerable variety of outcome scores are used to assess the treatment effect of OCLs. The purpose of this study was to compare the frequency of validated outcome scores utilized in the ankle versus knee literature.

Methods:

A computerized search of multiple electronic databases was performed for all clinical studies from 2011 to 2020 assessing treatment outcome of ankle and knee OCLs. Eligible studies were independently screened by two reviewers. Outcome scores used in each eligible study were recorded and the overall frequency calculated. Correlation coefficients were used to determine if there was an association between use of validated outcome score with journal impact factor, publication year, or study level of evidence.

Results:

A total of 75 eligible ankle OCL studies were identified, with 27 different outcome scores utilized. The most frequently used scores were the American Orthopaedic Foot and Ankle Society (AOFAS) Clinical Rating Systems (47.7%), Visual Analog Scale (VAS) (34.4%), and Foot and Ankle Outcome Score (FAOS) (6.3%). Validated outcome scores were used in only 14.7% of all ankle OCL studies. There was no correlation between the use of validated outcome scores and journal impact factor (p=0.72), publication year (p=0.45), or level of evidence (p=0.66). A total of 239 eligible knee OCL studies were identified, with 34 different outcome scores utilized. The most frequently used scores were the International Knee Documentation Committee subjective knee forms (IKDC) (33.2%), Knee injury and Osteoarthritis Outcome Score (KOOS) (19.8%), and Tegner Activity Scale (TAS) (17.1%). Validated outcome scores were utilized in 87.4% of all knee OCL studies, compared to 14.7% in ankle OCL studies (p<0.001). There was no correlation between the use of validated outcome scores and journal impact factor (p=0.19), publication year (p=0.58), or level of evidence (p=0.62).

Conclusions:

Validated outcome scores were more frequently utilized in knee OCL studies compared to ankle OCL studies. Nearly half the ankle OCL studies utilized the AOFAS score despite the score not being shown to be valid or reliable. The extremely low frequency of validated scores used within the ankle literature may limit how well treatment effectiveness in ankle OCLs is appropriately evaluated.
Poster 123: Concussion Rates in Youth Lacrosse
Authors: Macknofsky Brandon , Brown Shimron , Lavin Alessia , Sabesan Vani
Published: July 2022

Objectives:

Sport related concussions are estimated to occur up to 3.8 million times per year in the United States. Despite the popularity of youth sports in the US, there has been little focus on concussions in youth lacrosse. The purpose of this study was to provide a descriptive analysis of the epidemiology and incidence of concussions in youth lacrosse and compare our results to well-documented analyses of concussions in American football.

Methods:

The National Electronic Injury Surveillance System (NEISS) was used to collect data on concussion injuries occurring during lacrosse in pediatric patients from 2006-2019. Nationwide estimation of injury incidence was determined using weighted calculations and combined participation data obtained from the U.S. Lacrosse membership records. A comparison dataset was collected for football using the NEISS data on football related concussions. Type of lacrosse contact was categorized into player-to-player, player-to-stick, player-to-ball, and player-to-ground. Incidence was compared over each year, by age and gender.

Results:

The database yielded 1,302 concussions related to lacrosse over the study period, of which 67.6% occurred in males. National participation in lacrosse steadily increased from 2006 to 2012 by an average of 10.27% annually and then experienced a lower annual growth rate of 2.53% from 2012 to 2019. There was a statistically significant increase in incidence of concussions for girls and boys from 2006 to 2012 which then declined for the duration of the study period. An increase in incidence of concussions was also seen in football players through 2012, but then marginally declined from 2012 to 2019. The average concussion incident rate for youth lacrosse was 23.29% per 100,000 participants which was significantly higher than the incident rate for football (7.19% per 100,000 participants).

Conclusions:

Lacrosse has experienced a lower annual rate of growth in participation over recent years. As participation rates increased from 2006 to 2012, the relative rates of concussions in both genders rose as well. However, since 2012, the rate of concussions has declined which may be attributed to the declining rate of growth in the sport and rule changes in lacrosse which varied by gender. While the incidence of concussion in lacrosse is declining, it remains at a much higher rate per participant than what is observed in football. Future studies should focus on education and increased prevention efforts for concussions in lacrosse given the higher incidence than youth football.
Poster 129: Reliability and Accuracy of Telemedicine-Based Shoulder Examinations
Authors: Fiedler Anna , Warth Ryan , Bailey Lane , Shupe Paul , Gregory James , Wang Grace
Published: July 2022

Objectives:

Telemedicine has become a critical component in the evaluation and management of patients with shoulder pathology. However, the reliability and accuracy of findings on a virtual physical exam relative to in-person evaluation is unclear. The purpose of this study is to determine the reliability and accuracy of a recorded telemedicine physical exam for diagnosis of shoulder pathology compared to the traditional in-person physical exam performed in an outpatient shoulder clinic.

Methods:

This study is a randomized controlled trial. New patients presenting with unilateral shoulder pain to a singlesurgeon shoulder clinic were recruited between July and November 2020. In a single visit, patients were evaluated with standardized in-person and telemedicine physical exams, and the order was randomized. The telemedicine exam was recorded and consisted of a pre-recorded video guide displaying self-directed shoulder exam maneuvers that patients performed under remote coaching by an independent observer. The in-person physical exam was performed by the treating physician and results were used as the gold standard. The telemedicine videos were evaluated by two independent observers for inter-observer reliability. The treating physician subsequently evaluated the telemedicine videos after a minimum 2-month washout period for intra-observer reliability. Inter- and intra-observer reliability analyses were conducted using the Kuder-Richardson 20 (KR-20) formula.

Results:

Thirty-two patients (17 male, 15 female; average age 50.2 ±16.2 years) were enrolled and included in the analysis. Overall KR-20 reliability across all 40 physical exam maneuvers was 0.391±0.332 (76.4% ± 15.4% agreement) between the in-person and telemedicine exams. Maneuvers conducted via telemedicine that examined range of motion (ROM) limitations had the highest degree of reliability, sensitivity, specificity, and likelihood of also producing a positive finding on the in-person exam (0.700±0.114, 66.5%, 81.0%, and 6.06, respectively). Exam maneuvers conducted via telemedicine that relied on identifying apprehension associated with glenohumeral instability were found to have the lowest reliability, sensitivity, and likelihood of producing a positive finding on the in-person exam (0.176±0.440, 23.5% and 0.518, respectively). All included patients were satisfied with their telemedicine experience.

Conclusions:

Overall reliability of telemedicine physical examination maneuvers was poor. ROM limitations identified on the telemedicine exams were found to be the most reliable and accurate, while techniques used to evaluate instability were found to be the least reliable and accurate. While the telemedicine exam can be reliable as a screening tool in certain pathologic conditions, providers should use the in-person exam and imaging results to confirm any suspected diagnoses. [Table: see text][Table: see text][Table: see text]
Poster 135: Minimum 2 year Clinical Outcomes after Latarjet for anterior shoulder instability: clinical and imaging factors that correlate with success or failure
Authors: Millett Peter , Provencher Matthew , Casp Aaron , Lee Simon , Rakowski Dylan , Peebles Annalise , Ernat Justin
Published: July 2022

Objectives:

The open Latarjet procedure has been demonstrated to be reliable in achieving acceptable patient reported outcomes (PROs). However, clinical predictors of outcome, return to sport and complications/failures have been more variable. The purpose of this study is to report patient reported outcomes (PROs), clinical correlations, and predictors of failure in patients who have received an open Latarjet surgery.

Methods:

Patients who received an open Latarjet with by two fellowship–trained surgeons between August 2006 - November 2018 were included. Prospectively collected data was reviewed, and PROs included ASES, SF–12 PCS, SANE, QuickDASH, and satisfaction. Age, sex, sports participation, pain, primary vs. revision (prior failed arthroscopic/open Bankart) surgery, dislocation number, glenoid bone loss (GBL), glenoid track concept, and projected glenoid track were evaluated. Projected track was calculated using the axial diameter of the corcoid as part of the glenoid track concept. Postoperative ASES <70, recurrent dislocation, or revision instability surgery were considered failures.

Results:

126 shoulders (125 patients) met inclusion criteria with mean age of 28.1 years (range 15–57). 7/126 (5.5%) had revision surgery prior to final follow-up and were excluded from outcomes analyses. Mean follow-up 3.7 years (range 2–9.3 years) was attained in 86.6% (103/119) of patients. All PROs significantly improved from preoperative baseline (ASES: 69.7→90.2; SANE: 55.8→85.9; QuickDASH: 28.4→10.5). PROs did not differ with sex, sport participation type, dislocation with/without sports, primary/revision, and preoperative dislocation number. No correlations existed between PROs and age, GBL, or number of previous surgeries. On-track (50/105, 47.6%) and projected on-track (90/105, 85.7%) lesions correlated with better patient satisfaction, but not PROs. A total of 97% (86/89) returned to sport, with 74% (66/89) at the same/slightly below pre-injury level. Failures included 13/126 (10.3%) postoperative dislocations and 6/126 (4.7%) with ASES scores <70.

Conclusions:

The open Latarjet procedure lead to significant improvements in all PROs, and overall 97% of patients returned to sport. On-track and projected on-track measurements correlated with better patient satisfaction, but not improved PROs. No other factors were predictive of outcomes, nor clinically correlated with failure.
Poster 143: Variation in Postoperative Tendon Migration Does Not Result in Significant Differences in Patient Reported Outcomes in Patients Undergoing Arthroscopic or Open Biceps Tenodesis Using All-Suture Suture Anchor and Interference Screw
Authors: Berlinberg Elyse , Forlenza Enrico , Patel Harsh , Williams Brady , Chahla Jorge , Yanke Adam , Cole Brian , Verma Nikhil , Forsythe Brian
Published: July 2022

Objectives:

It is unknown whether the degree of biceps tendon migration influences patient outcomes following biceps tenodesis (BT). We aimed to assess the relationship between in vivo tendon migration and patient reported outcomes (PROs) following arthroscopic and open BT using suture anchor (SA) and interference screw (IS) constructs.

Methods:

One hundred twenty patients undergoing arthroscopic and open BT with SA or IS fixation at a single academic center were prospectively enrolled. Postoperative biceps tendon migration was measured via RSA, using a tantalum bead as a radio-opaque marker for tendon migration, with radiographs at 3- and 12-weeks postoperatively. PROs (Constant, SANE and PROMIS) were collected preoperatively, and at 6 months, 1 year, and 2 years. A Bonferroni correction was made for multiple comparisons.

Results:

Preoperative PRO completion was as follows: 20 (16.7%) ASES, 64 (53.3%) Constant, 96 (80.0%) SANE, and 108 (90.0%) PROMIS-UE. Patients with an open SA had a younger median age (48.4, IQR 38-55.4, P=0.014) and fewer dominant-sided surgeries (8/33 patients or 24.2%, P=0.003). PRO scores did not differ by groups for any questionnaire at all timepoints. There were no significant differences in likelihood of achieving MCID for ASES (P>0.99), Constant (P=0.87), SANE (P=0.68), or PROMIS-UE (P>0.99) between groups. In univariable analysis, no patient- or surgery-related factors served as significant predictors of achieving MCID at 6 months. Notably, neither RSA bead migration>3cm (Constant: OR= -0.54, 95%CI -2.53-1.45, P=0.60; SANE: collinear; PROMIS-UE: collinear) nor Popeye deformities (Collinear for all PROs) were negatively associated with likelihood of achieving MCID.

Conclusions:

Patient-reported outcomes are similar for patients undergoing arthroscopic BT via IS and SA, and open BT via IS and SA. No significant predictors of achieving MCID at 6 months were identified, including migration of the RSA bead. Biceps tendon migration was not significantly correlated with patient reported outcomes. [Table: see text][Figure: see text][Figure: see text][Figure: see text]
Poster 145: Posterior Glenoid Osteotomy with Capsulolabral Repair Restores Force in a Critical Bone Loss Biomechanical Model
Authors: Marcaccio Stephen , O’Donnell Ryan , Owens Brett , Bokshan Steven
Published: July 2022

Objectives:

Bone loss in posterior shoulder instability is an increasingly recognized clinical phenomenon. There is no widespread consensus on the surgical treatment of posterior shoulder instability with critical posterior glenoid bone loss. Here, we study the effect of opening posterior wedge osteotomy on resistance force of soft tissue repair alone in the setting of 20% critical bone loss.

Methods:

Native glenoid retroversion was measured on 9 cadavers. The humerus was potted in 90 degrees of forward flexion and 30 degrees of internal rotation relative to the scapula and a posterior dislocation was performed in order to create a posterior capsulolabral injury model. The specimens were each taken through a fixed sequence of testing: (1) posteroinferior capsulolabral tear, (2) no glenoid bone loss with posteroinferior capsulolabral repair, (3) 20% posterior glenoid bone loss with posteroinferior capsulolabral repair, (4) and 20% glenoid bone loss with posterior glenoid opening wedge osteotomy and posteroinferior capsulolabral repair. The resultant peak forces with 1 centimeter of posterior translation were measured. A one-way repeated-measures analysis of variance (RM-ANOVA) was used to compare mean force values.

Results:

Following the initial dislocation event, all shoulder had a resultant posterior capsulolabral injury. Repairing the capsulolabral complex in the 20% posterior glenoid bone loss group did not result in a statistically significant increase in resistance force compared to the labral deficient group, p = 0.068. When 20% posterior bone loss was created, the posterior glenoid osteotomy with capsulolabral repair was significantly stronger than the posterior repair alone both with and without bone loss, p = 0.008 and p = 0.045, respectively.

Conclusions:

In the setting of critical posterior glenoid bone loss, an opening wedge posterior glenoid osteotomy with capsulolabral repair significantly improved resistance to posterior humeral translation compared to capsulolabral repair alone.
Poster 169: Prior Rotator Cuff Repair Is Not Associated with Worse Outcomes After Subsequent Superior Capsular Reconstruction: A Comparative Analysis
Authors: Chao Richard , Solomon David , Vyas Dharmesh , Curley Andrew
Published: July 2022

Objectives:

To compare the outcomes of two patient cohorts: (1) primary SCR and (2) SCR after failed rotator cuff repair.

Methods:

A retrospective review was performed of all patients who had a SCR at our institution from 2015 to 2020. Data was collected for patient demographics, prior rotator cuff surgery, comorbidities, and preoperative and postoperative range of motion, strength testing, visual analog scale (VAS) pain scores, Patient-Reported Outcomes Measurement Information System (PROMIS) 10 scores, American Shoulder and Elbow Surgeons (ASES) score, Brophy-Marx shoulder activity scale, and revision surgeries. Missing data points were excluded from analysis at that time point. Comparative analysis was used to assess for differences between patients that underwent an SCR only versus SCR after rotator cuff repair.

Results:

Fifty-four patients met inclusion criteria, consisting of 33 SCR only patients (61 ± 10 years, BMI 30 ± 6, 79% male) and 21 SCR after rotator cuff repair patients (59 ± 8 years, BMI 32 ± 5, 95% male). In the SCR only and SCR after rotator cuff repair groups, no significant difference was observed in age, BMI, gender, comorbidities, preoperative and postoperative range of motion, strength testing, VAS pain scores, PROMIS 10 scores, ASES score, Brophy-Marx shoulder activity scale, and revision surgeries (p>0.05).

Conclusions:

Similar outcomes were observed in patients who underwent primary SCR versus SCR after a failed rotator cuff repair, suggesting that surgeons should attempt to repair the rotator cuff at the index surgery if possible.
Poster 229: Improved Epiphyseal Socket Placement with Intraoperative 3D Fluoroscopy: Consecutive Series of Pediatric All-epiphyseal Anterior Cruciate Ligament Reconstruction.
Authors: Aitchison Alexandra , Cordasco Frank , Green Daniel
Published: July 2022

Objectives:

All-epiphyseal anterior cruciate ligament reconstruction (ACLR) is a safe procedure for skeletally immature patients with ACL tears because the sockets are contained within the epiphysis and do not cross the growth plate. However, due to the undulation of the distal femoral physis, accidental disturbance of the growth plate during tunnel placement is possible. It is imperative to obtain intraoperative imaging to view the trajectory of the guide wire prior to reaming the socket. The purpose of this study was to investigate the effect of the use of 3D intraoperative fluoroscopy on socket placement in patients undergoing all-epiphyseal ACLR. We hypothesized that 3D imaging would allow for better intraoperative visualization of the growth plate and a smaller incidence of growth plate violation.

Methods:

Patients under the age of 18 who underwent a primary ACLR between 2011 and 2018 by the senior authors were retrospectively reviewed. Patients that underwent an all-epiphyseal ACLR with an available postoperative MRI were included. Demographic data, surgical details and type of intraoperative fluoroscopy were collected. The minimal distances between the femoral socket and distal femoral physis (DFP) and tibial socket and proximal tibial physis (PTP) were recorded. Sockets that touched the physis or extended into the metaphysis were recorded as zero. Patients were split into two groups; a 2D imaging group that received intraoperative anterior to posterior and lateral fluoroscopic radiographs and a 3D fluoroscopy imaging group. Interrater reliability of radiographic measurements was evaluated using intraclass correlation coefficient (ICC). Statistical analysis was performed using a student’s t-test to determine differences between groups.

Results:

72 patients fit the inclusion criteria and were retrospectively reviewed. 54 patients had 2D imaging and 18 patients had 3D imaging. The mean age of the cohort at time of surgery was 12.3 ± 1.5 years, 79% of patients were male, and 54% tore their left ACL. The mean time from surgery to postoperative MRI was 2.0 ± 1.1 years. The ICC was 0.92 (95% CI 0.35-0.98), indicating almost perfect interrater reliability. The mean difference in distance between the tibial socket and the PTP was significantly less in the 2D imaging group than the 3D imaging group (1.2 ± 1.7mm vs 2.5 ± 2.2mm, p=0.03). (Table 1). The femoral socket touched or extended beyond the DFP significantly less in the 2D group than in the 3D group (13% vs 43%, p<0.000).

Conclusions:

There was a significantly decreased incidence of DFP violation with use of 3D intraoperative imaging for all-epiphyseal ACLR socket placement. Surgeons should consider utilizing 3D imaging to potentially decrease the rate of growth disturbance due to physis violation in these patients. [Table: see text]
Poster 235: Surgical Management of Patellar Instability in Adolescents with High Grade Trochlear Dysplasia
Authors: Nunally Kianna , Cook Danielle , Hussain Zaamin , Zheng Evan , Yen Yi-Meng , Kramer Dennis , Micheli Lyle , Kocher Mininder , Heyworth Benton , Wilson Benjamin
Published: July 2022

Objectives:

High-grade trochlear dysplasia (HGTD) has previously been identified as a risk factor for failure of surgical management of patellofemoral instability (PFI). However, limited data exists on the influence of the type of surgical procedure performed on postoperative outcomes in these patients. The purpose of this study was to identify the rates of failure of primary PFI surgery in patients with HGTD compared to those without HGTD and to assess the effect of the type of surgery on recurrent instability and return to OR.

Methods:

We retrospectively reviewed patients aged ≤19 years who underwent primary surgery for PFI at our institution between 2008 and 2017. Patients underwent procedures including medial retinacular plication (MRP), medial patellofemoral ligament reconstruction (MPFLR), tibial tubercle osteotomy (TTO), or combined procedures. We excluded patients with incomplete imaging data, BMI >30kg/m2, those that underwent surgery for fixation of a chondral fracture >1cm, and patients with a diagnosis of syndromic disorder. Trochlear dysplasia was evaluated based on pre-operative MRI. Patients were divided between those that had HGTD and those without HGTD. Comparisons were made between the two groups and logistic regression analysis was utilized to determine if surgery category was associated with rate of recurrence in the HGTD patients.

Results:

Three-hundred three patients, average age 15.1 years, underwent primary surgical stabilization for PFI with median follow up time of 3.0 years. Forty-nine percent (149/303) of the cohort had HGTD. Demographics were comparable between HGTD groups (Table 1). When compared to the patients without HGTD, patients with HGTD showed similar rates of recurrent instability, return to the OR for instability, and return to the OR for other reasons. Looking at patients with just HGTD, there was a significant association between surgery type and outcomes (Table 2). HGTD patients who underwent MPFLR had a 63% decrease in the odds of experiencing recurrent instability compared to those undergoing MRP (OR=0.37; p=0.03). Similarly, the TTO surgery group had an 80% decrease in the odds of experiencing recurrent instability compared to patients undergoing MRP (OR=0.20; p=0.002).

Conclusions:

While adolescents with PFI and HGTD overall have similar results after surgical stabilization, there is a significant effect of the type of surgery performed. Patients with HGTD that underwent MRP had significantly more instability and return to the OR for instability surgeries than patients that underwent other procedures. Based on this data, adolescents with PFI and HGTD should be considered for more powerful surgeries to limit the risk of recurrence or return to the OR. [Table: see text][Table: see text]
CD30+ anaplastic large cell lymphoma: a review of its histopathologic, genetic, and clinical features
Authors: Stein Harald , Foss Hans-Dieter , Dürkop Horst , Marafioti Theresa , Delsol Georges , Pulford Karen , Pileri Stefano , Falini Brunangelo
Published: July 2022

Anaplastic large cell lymphoma (ALCL) represents a generally recognized group of large cell lymphomas. Defining features consist of a proliferation of predominantly large lymphoid cells with strong expression of the cytokine receptor CD30 and a characteristic growth pattern. With the use of molecular and clinical criteria, 3 entities of ALCL have been identified: primary systemic anaplastic lymphoma kinase (ALK)+ ALCL, primary systemic ALK− ALCL, and primary cutaneous ALCL. ALK expression is caused by chromosomal translocations, most commonly t(2;5). ALK+ ALCL predominantly affects young male patients and, if treated with chemotherapy, has a favorable prognosis. It shows a broad morphologic spectrum, with the “common type,” the small cell variant, and the lymphohistiocytic variant being most commonly observed. The knowledge of the existence of these variants is essential in establishing a correct diagnosis. ALK− ALCL occurs in older patients, affecting both genders equally and having an unfavorable prognosis. The morphology and the immunophenotype of primary cutaneous ALCL show an overlap with that of lymphomatoid papulosis. Both diseases have an excellent prognosis, and secondary systemic dissemination is only rarely observed. The described ALCL entities usually derive from cytotoxic T cells. In contrast, large B-cell lymphomas with anaplastic morphology are believed to represent not a separate entity but a morphologic variant of diffuse large B-cell lymphoma. Malignant lymphomas with morphologic features of both Hodgkin disease and ALCL have formerly been classified as Hodgkin-like ALCL . Recent immunohistologic studies, however, suggest that ALCLs Hodgkin-like represent either cases of tumor cell–rich classic Hodgkin disease or (less commonly) ALK+ ALCL or ALK− ALCL.
Early differentiation of neurodegenerative diseases using the novel QSM technique: what is the biomarker of each disorder?
Authors: Nikparast Farzaneh , Ganji Zohreh , Zare Hoda
Published: July 2022

During neurodegenerative diseases, the brain undergoes morphological and pathological changes; Iron deposits are one of the causes of pathological changes in the brain. The Quantitative susceptibility mapping (QSM) technique, a type of magnetic resonance (MR) image reconstruction, is one of the newest diagnostic methods for iron deposits to detect changes in magnetic susceptibility. Numerous research projects have been conducted in this field. The purpose of writing this review article is to identify the first deep brain nuclei that undergo magnetic susceptibility changes during neurodegenerative diseases such as Alzheimer's or Parkinson's disease. The purpose of this article is to identify the brain nuclei that are prone to iron deposition in any specific disorder. In addition to the mentioned purpose, this paper proposes the optimal scan parameters and appropriate algorithms of each QSM reconstruction step by reviewing the results of different articles. As a result, The QSM technique can identify nuclei exposed to iron deposition in various neurodegenerative diseases. Also, the selection of scan parameters is different based on the sequence and purpose; an example of the parameters is placed in the tables. The BET toolbox in FSL, Laplacian-based phase-unwrapping process, the V_SHARP algorithm, and morphology-enabled dipole inversion (MEDI) method are the most widely used algorithms in various stages of QSM reconstruction.