bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Management of Complex Ankle Bony Impingement Combined With Chronic Ankle Instability
Authors: Bai Lu , Liu Sanbiao , Tang Lubo , Guan Siyao , Xie Xiaoxiao , Zhang Xintao
Published: October 2024

Background:

Anterior ankle bony impingement, which can cause pain and dysfunction of the ankle, is commonly seen in sports injuries. Its primary cause is repeated injury due to chronic ankle instability. An excellent clinical result has been reported by surgically removing osteophytes and ankle stabilization. However, reports of complex anterior impingement combined with lateral ankle instability are rare, which remains challenging in clinical practice.

Purpose/Hypothesis:

The purpose of this study was to evaluate the clinical outcomes of anterior ankle bony impingement combined with lateral ankle instability with surgical dissection of osteophytes and stabilization. It was hypothesized that complex ankle osteophytes with instability would achieve optimal clinical outcomes through surgical management.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 57 patients with complex ankle bony impingement combined with lateral instability treated with surgical dissection of complex osteophytes between September 2013 and January 2019 were enrolled in the study. The clinical outcomes were evaluated by visual analog scale (VAS) for pain score, American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson score, and radiographic examination with a mean follow-up time of 39.6 months. Postoperative ankle function and complications were compared using the t test and post hoc Tukey significant difference test.

Results:

The mean AOFAS score significantly increased at the 3-month, 1-year, and 2-year follow-ups compared with the preoperative condition ( t = 10.57, P = .0001). The mean Karlsson score after surgery also significantly improved at each follow-up time compared with the preoperative score ( t = 12.93, P = .0001). The preoperative VAS score significantly decreased at 3 months, 1 year, and 2 years postoperatively ( t = 8.73, P = .001). A significant improvement of mean dorsiflexion difference was observed at 3 months and 1 year compared with the preoperative condition, but it seemed to have regressed at the 2-year follow-up ( t = 2.11, P = .01). Tibial side recurrence was found in 9 cases, including 7 Scranton type 1 and 2 Scranton type 2. Talar side recurrence was also found in 3 of those cases.

Conclusion:

Our retrospective study demonstrated that complex ankle bony impingement combined with lateral instability can yield good clinical results when treated surgically with both ankle stabilization and osteophyte removal.
Management Anterior Cruciate Ligament Tibia Spine Avulsion Fracture
Authors: Wien Aryana IGN
Published: October 2024

Anterior cruciate ligament (ACL) tibial avulsion fractures, also known as tibial eminence fractures, are intra-articular fractures of the bony attachment of the ACL on the tibia. The Meyers and McKeever classification categorizes fractures of the tibial eminence into 3 types. Type I fractures refer to nondisplaced or minimally displaced eminence fractures. Type II fractures indicate that the anterior one-third to one-half of the avulsed bone has been displaced proximally or hinged. Type III fractures refer to complete separation of the avulsed fragments. Rotated and comminuted fractures are identified as type IV. For displaced ACL avulsion fractures, nonoperative treatment commonly results in higher rates of nonunion; therefore, surgical fixation should be considered for these types of fractures.

Fixation for avulsion fracture fragments can be achieved by using a variety of implants such as Kirschner wires, sutures, and screws. Among these techniques, arthroscopic fixations with screws or sutures are the current mainstream interventions. In biomechanical performance, the comparative fixation strength between sutures and screws remains inconclusive. Tsukada et al found screw fixation to be superior in obtaining rigid fixation under cyclic loading. Mahar et al showed no clear biomechanical differences, including in failure tensile force and deformation after cyclic loading, between fixation methods using screws and sutures. Other studies concluded that sutures provide more fixation strength than screw fixations.

In addition to the biomechanical findings, the clinical results showed contrasting findings for screw fixations and suture fixations used for tibial avulsion fractures. Better pivot-shift performance and shorter operating times were observed in screw-fixation surgical procedures, whereas lower subsequent surgery rate and better functional outcome scores were observed for suture-fixation surgical procedures. The latest clinical study conducted by Callanan et al revealed that suture and screw fixations lead to comparable clinical outcomes.

Common complications following treatment are residual laxity, knee stiffness, and nonunion or malunion.
Diagnosis and Treatment of Patellar Instability
Authors: Adachi Nobuo
Published: October 2024

The patellar instability is the complicated knee condition, which has several potential congenital factors, such as balance disorder between medial and lateral soft tissues, dysplasia of femoral condyle, patella height, rotation of femur and tibia, or general joint laxity. The patella dislocation is usually categorized in to “permanent”, “habitual”, and “recurrent” dislocation. It goes without saying that precise diagnosis and proper selection of treatment is indispensable for successful clinical outcomes for any patellar instability. First, we will demonstrate some knacks and pitfalls for diagnosis of patella instability.

There have been many surgical procedures for those disorders, such as proximal realignment or distal realignment. Because some biomechanical studies demonstrated that the medial patellofemoral ligament (MPFL) is main restraint against lateral dislocation or displacement of the patella, recently, MPFL reconstruction has become the most popular procedure for especially recurrent patellar instability. Many MPFL reconstructions have been reported using artificial ligaments, free semitendinosus, gracilis, quadriceps, or other autogenous tendons. We have performed the MPFL reconstruction using semitendinosus tendon for young and adult patients.

However, for habitual or permanent patella instability, only MPFL reconstruction is not enough to obtain normal kinematics of the patella, requiring complicated bony procedures. Because we have experienced several interesting cases of permanent or habitual patellar instability, we would like to demonstrate those cases in this presentation.
Superior Capsular Reconstruction for Massive Rotator Cuff Tear
Authors: Priambudi Sumpada
Published: October 2024

Massive rotator cuff tears (RCT) defined as defects measuring >5 cm or involving two or more torn tendons. Irreparable RCT are generally large and retracted with poor or attenuated tissue quality, muscular atrophy, and fatty infiltration. Surgical options for irreparable RCT are arthroscopic debridement, partial repair, margin convergence, patch graft, tendon transfer, balloon spacer, and reverse total shoulder arthroplasty (RSA). Recently, superior capsular reconstruction (SCR) developed by a Japanese surgeon, Mihata et al, has gained attention as potential treatment for patients with irreparable RCT. Anatomically, superior capsule acts as a stabilizing structure and its crucial role in improving shoulder function by re-centering the humeral head into the glenoid socket, thus restoring the force couples to efficiently elevate the arm in case of an irreparable superior cuff tear. Indications include younger patients (aged < 65-70 years) with irreparable, massive RCT involving the supraspinatus and infraspinatus with minimal arthritis, an intact or repairable subscapularis, and a functional deltoid without bony deficiency, stiffness, or advanced arthropathy. Fascia lata is harvested as the graft with 6 – 8 mm thickness should be achieved. The graft is fixed to the superior glenoid with 2 suture anchors, and 4 suture anchors are used to secure the graft laterally to the humerus. The graft should be sutured to the remnant posterior cuff tendon such as the infraspinatus or teres minor tendon. Reconstruction of the superior capsule using fascia lata autograft has shown promising early results with improved clinical scores, range of motion, and muscle strength.
Which One is Better Between Conservative and Surgical Procedure on Navicular Stress Fracture in Professional Runner: A Systematic Review
Authors: Faza Agya Ghilman
Published: October 2024

Introduction:

Stress fractures are common overuse injuries in the lower extremities. Stress fractures are most commonly observed in the tibia (24%), tarsal navicular (18%), metatarsal (16%), fibula (16%), femoral neck (5%). Navicular Stress Fracture (NSF) is becoming increasingly recognized in athletes, with an estimated prevalence about 35% of stress fractures in the foot and ankle. The optimal management of NSF has been a matter of debate for the last decades. Earlier literature suggested that conservative management in the form of non-weight bearing cast immobilization had a comparable success rate with surgical management. This paper describes the best therapy of NSF in runner.

Objectives:

time to return to play (RTP), complication of NSF in future (non-union, mal-union, re-fracture).

Materials and Methods:

Our trial was an international, expertise-based. Details of the trial objectives and design have been published previously. Additional information about the eligibility criteria, interventions, follow-up, outcome definitions, and statistical analysis. To identify studies pertaining to the clinical results about our topic of systematic review, we reviewed the Cochrane, Pubmed, ScienceDirect databases for relevant articles published up to July 2023. We also reviewed the references of all identified articles to identify additional studies. Search terms were as follows: NSF, conservative, surgical, runner. Following the PICOS (Participants, Interventions, Comparisons, Outcomes and Study design) principle, the key search terms included (P) patients were professional runner with NSF; (I) patients were running as a professional runner; (C/O) time to RTP, complication of NSF; (S) Meta-analysis, cohort, case control, systematic review.

Results:

Results Literature search the flow diagram of study selection is shown in Figure 1. A total of 13 meta-analysis, cohort, case control, and systematic review, which one is better between conservative and surgical on NSF in Professional Runner. Discussions: Operative procedure of NSF provides a higher success rate, a lower re-fracture rate, and a lower non-union rate as compared to non-operative management options. The choice of therapy management also depends on the type of sport and target recovery time. Conclusions: Operative procedure is better than conservative treatment in management of NSF for runner.
Functional Outcomes of Anterior Cruciate Ligament Suture Repair in Comparison with Anterior Cruciate Ligament Reconstruction in Anterior Cruciate Ligament Rupture: A systematic review and meta-analysis
Authors: Febriana Andini , Wien Aryana I Gusti Ngurah , Astawa Putu
Published: October 2024

Background:

The goal standard of the treatment is the reconstruction of ACL. However, the result is not satisfactory due to the high risk of re-rupture and early post-traumatic osteoarthritis. The emerging technique was ACL suture repair which seems to be a promising technique. However, the functional outcome of this technique compared to ACL reconstruction is still controversial. This study aimed to compare the functional outcome of ACL suture repair and ACL reconstruction to treat ACL rupture through meta-analysis and systematic review.

Method:

This was a systematic review and meta-analysis study. The systematic searching was performed using the keywords (anterior cruciate ligament suture repair) AND (anterior cruciate ligament reconstruction) in the MEDLINE, CENTRAL, and EMBASE databases. The outcomes of interest were the mean score of the International Knee Documentation Committee Subjective Knee Form (IKDC) and the objective IKDC score. The objective IKDC score was dichotomized into favorable and unfavorable outcomes. The mean difference and risk ratios (RR) were pooled and analyzed using software Review Manager 5.3.

Result:

ACL suture repair is significantly more favorable than ACL reconstruction in terms of subjective IKDC score (MD 6.43; 95%CI 2.61 – 10.26; p = 0.001). There is no significant difference in favorable outcome (objective IKDC score) between ACL suture repair and ACL reconstruction (RR 0.94; 95%CI 0.81 – 1.10; p =0.44).

Conclusion:

ACL suture repair is superior to ACL reconstruction in regard to subjective satisfaction based on subjective IKDC score. However, we found no significant difference in objective functional outcomes.
Remnant Preserving Posterior Transseptal Technique Provide Safe Passage for Posterior Cruciate Ligament Reconstruction
Authors: Albar Husnul Fuad , Yudha Dibrata R Permana , Widjaja Arya Cipta
Published: October 2024

Introduction:

General reconstruction procedure of the PCL usually sacrificed its remnant and footprints to allow for better tunnel placement. Better visualization, uncomplicated graft passing, dan elimination of the “killer turn” were mentioned as the possible benefits of utilizing the posterior transseptal portal, while preservation of the PCL remnant was widely encouraged for restoring knee kinematics and healing of the graft.

Objectives:

This study is aimed to evaluate the functional and clinical outcomes of PCL reconstruction using posterior transseptal remnant preservation technique.

Materials & Methods:

Five cases were included in this study. Follow-up was performed at four weeks and consisted of International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee scoring scale, and post-operative complications. All patients underwent similar post-operative rehabilitation program.

Results:

Improvement in IKDC, KOOS, and Lysholm score was recorded in all cases. There were no post-operative complications found at the time of reporting.

Conclusions:

Posterior transseptal portal, which was created through the posterior septum from the posteromedial to the posterolateral compartment, or conversely, is a safe arthroscopic procedure. It offers great visualization of the posterior compartment, without damaging the capsule and neurovascular bundle, while also provides satisfactory early outcomes when used in conjunction with the remnant preservation technique.
The Potency of Induced Pluripotent Stem Cell as a New Promising Treatment Regeneration: A Systematic Review
Authors: Setyawardani Astuti , Bastian Johan
Published: October 2024

Introduction and Objective:

Articular cartilage has a restricted capacity for self-regeneration when injured through trauma or disease. The inability to treat focal chondral lesions results in changes that inevitably progress to osteoarthritis. Lately, there have been many developments in the use of cell-based regenerative therapies for cartilage defects. The improvement of regenerative treatments for cartilage injury has been enormously supported by recent advances in stem cell biology. Some potential cell-based regenerative therapies include chondrocytes, multipotent stem cells (e.g. multipotent stem cells [MSCs]), and pluripotent stem cells (e.g. embryonic stem cells [ESCs]). All of these developments are mostly successful but have some limitations such as ethical issues and the potential for immunogenic or teratoma formation. Induced pluripotent stem cell (iPSC) has the potential to provide a prosperous cell source for tissue engineering, as well as produce patient-matched in vitro model study genetics and environmental factor in cartilage regeneration and prevent osteoarthritis. This systematic review aimed to investigate the potency of iPSC for cartilage regeneration through in vivo models.

Material and Methods:

Up until July 2023, multiple electronic databases (PubMed, Google Scholar, and Science Direct) were searched. Original research articles or research reports were included. Review, case report, case series, and conference abstract were excluded. Articles with full-text unavailability, non-English, and irrelevant topics were also excluded. The included studies were assessed for risk of bias using the systematic review center for laboratory animal experimentation (SYRCLE)

Results:

A total of 1072 studies were recorded from all databases. Amongst them, five studies, all original research articles, were eligible for qualitative synthesis. All of these articles show that iPSCs have the potential to produce high-quality cartilage regeneration which can successfully repair cartilage defects in vivo studies. Furthermore, no abnormal proliferation or teratoma was detected.

Conclusion:

The use of iPSC could be a new promising treatment in the use of cell-based regenerative therapies with unlimited pluripotent tissue regeneration with minimally ethical issues. In addition, further research related to clinical trials, dosage, method of administration, and long-term side effects are still needed further
The Influence of Anterior Translation of the Tibia with Patellar Height Measurements in Anterior Cruciate Ligament Insufficient Knee
Authors: Pontoh Ega , Zufar Muhammad , Fathurrahman Irfan , Pontoh Ludwig Andre , Tua Lubis Andri Maruli , Dilogo Ismail Hadisoebroto , Fiolin Jessica
Published: October 2024

Introduction and Objectives:

Anterior cruciate ligament (ACL) injury is one of the most common knee injuries in sport activities. Diagnosis of ACL injury relies on examining primary and secondary signs through magnetic resonance imaging (MRI) and definitively through arthroscopy. Anterior translation of the tibia (ATT) of ≧7 mm has been an established secondary sign of ACL injury visualised in MRI. Furthermore, patellar malalignment was associated with ACL injury which can be detected through several patellar height measurements. The present study aimed to examine the differences in patellar height measurements between ACL insufficient knees with ATT ≧7 mm and <7 mm, and the association between ATT and patellar height measurements.

Materials and Methods:

A total of 133 study participants with ACL injury were included in this study. Study participants were examined clinically and radiologically. Furthermore, all study participants underwent arthroscopic ACL reconstruction surgery. Age, gender, and BMI were recorded during admission. All study participants underwent MRI scan to assess ATT and patellar height measurements which include Insall-Salvati ratio, Modified Insall-Salvati ratio, Caton-Deschamps index, and Blackburne-Peel ratio. Independent sample T-test was carried out to compare parameters between ATT values. Linear regression was done to examine the association between ATT and patellar height measurements.

Results:

There were significant differences between those with ≧7 mm and <7 mm of ATT in patellar tendon length [42.14 (4.95) vs 43.98 (5.33), p=0.045] and Insall-Salvati ratio [1.04 (0.16) vs 1.11 (0.16), p=0.017]. Every increase in ATT was negatively associated with Insall-Salvati ratio (regression coefficient -5.71, 95%CI -8.67, -2.75, p<0.001) and Caton-Deschamps index (regression coefficient -2.90, 95%CI -5.75, -0.04, p=0.047) after adjusting to age, sex, and BMI.

Conclusion:

Greater anterior translation of the tibia was associated with a reduction in Insall-Salvati ratio and Caton-Deschamps index. Lower value of patellar tendon length and Insall-Salvati ratio was observed in subjects with ATT ≧7 mm. The findings in this study signify the role of ACL injury in demonstrating patellar malalignment secondary to increased ATT.
Characteristics of Ruptured Anterior Cruciate Ligament (ACL) Patients at Siti Fatimah Regional Hospital South Sumatera
Authors: Simanungkalit Ian Ervan , Putra Ramadhan Ananditia
Published: October 2024

Introduction:

The anterior cruciate ligament is one of the two cruciate ligaments that aids in stabilizing the knee joint. ACL injuries are injuries common in the young adult population. The incidence of ACL injuries is more than 200,000 worldwide. Many factors can cause ACL injuries. The purpose of this study was to assess the characteristics of patients with ACL injuries at Siti Fatimah Regional General Hospital South Sumatera period 2021-2023.

Materials and Method:

This study is a descriptive retrospective study, data taken from medical records of ACL Injuries patients treated in Siti Fatimah Regional General Hospital for the 2021-2023 period. Sampling used total sampling.

Results:

Patients receiving ACL treatment at Siti Fatimah Regional General Hospital for the 2021-2023 period total 8 people with ages ranging from 19-43 years and an average age of 28 years. Most patients occur in men with 62.5%, 75% occur in the right knee, 37.5% didn’t finish school and 75% unemployed.

Conclusions:

From the results of this study, the characteristics of patients with ACL rupture were found to be on average at the age of 28 years, male gender, most location of injuries at right knee, didn’t finish school and unemployed.
Medial Meniscus Root Reconstruction using Gracillis Tendon Autograft in Managing Medial Meniscus Posterior Root Tear: A Preliminary Case Series
Authors: Fidiasrianto Kevin , Riantho Albert , Ivander Gian , Parsaoran Butarbutar John Christian
Published: October 2024

Introduction:

Medial Meniscus Posterior root tears (MMPRT) are defined as complete radial tear within 10 mm from the meniscus attachment or bony root avulsion. Currently, repair of meniscal root injuries is the treatment of choice with the aim of restoring joint kinematics, contact pressures, and delaying the development of OA. Although encouraging results have been reported, the repair techniques do not provide any biological substance to stimulate biological healing, remembering that the attachment of medial meniscus root to the tibial plateu contain a ligament-like structures, the usage of graft may recreate that ligamentous structure. Therefore the purpose of this case series is to describe the clinical outcome of medial meniscus root reconstruction in 3 cases of degenerative MMPRT.

Method:

Three patients was diagnosed with MMPRT by a history taking, physical examination and the use of non-contrast knee MRI. All of the patients underwent arthroscopic surgical reconstruction with 2 tunnel transtibial pullout repair (TPR) technique and the use of gracillis tendon autograft (3 mm in diameter, 6 cm in length) that is passed through the meniscus. The surgery was performed by one orthopaedic surgeon. Follow up was done at 3 month after the surgery. KOOS and VAS are used to assess both patient subjective outcome and pain score.

Result and Discussion:

Patients underwent reconstruction shows an improvement in KOOS and VAS score. The average improvement in total KOOS is 43% and VAS score is 6,3 points. From the study by Wendel et al. meniscus root reconstruction can provide reattachment to the anatomic footprint and cartilaginous graft to facilitate healing. Also in agreement with the study by Li et al arthroscopically assisted meniscus root reconstruction with gracillis autograft showed superior clinical outcome and meniscus root healing rate.

Conclusion:

Meniscus root reconstruction showed a promising result in managing patients with MMPRT. No serious complications are reported.
Outcome of Meniscus Repair vs Meniscectomy in 40 Years and Older Patient: Systematic Review and Meta Analysis of Direct Comparative Studies
Authors: Barustan Muhammad Fakhri , Shiddieqy Pohan Muhammad Alvin
Published: October 2024

Introduction and Objectives:

An older age of the patient is a common reason for choosing meniscectomy instead of meniscus repair. Lately, there have been more meniscus repairs done for all ages. But not many studies have looked at how well meniscus repair works compare to meniscectomy in people who are 40-years-old and older. And there is not a lot of review of the studies about how well meniscus repair works. The goal of this research was to look at the results of a recent study on patients who were 40-years-old and older and had either meniscus repair or meniscectomy. The hypothesis was that repair the meniscus would give better results than meniscectomy procedure in patients who are 40-years-old and older.

Materials and Methods:

The study design was following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, including 5 comprehensive literature databases. Inclusion criteria: (1) Patient with meniscus tear who got arthroscopic meniscal repair or meniscectomy; (2) Studies were written in English, (3) Studies are direct outcome comparison between Meniscus repair to meniscectomy. Exclusion criteria: (1) Studies other than direct comparison of Meniscus repair to meniscectomy; (2) Expert opinions, case reports, case series, review articles, and meta-analyses were excluded.; (3) Studies did not analyzed outcomes evaluations. Search terms used are included the following: (menisci OR meniscus) AND (meniscus injuries OR menisci tear) AND (meniscectomy OR meniscus repair) AND (40 Years old or Elderly).

Result:

A total of 3 studies with sample of 220 knees were direct outcome comparison of meniscus repair and meniscectomy in 40 years old and older. The Lysholm score and IKDC score of Meniscus repair are superior and statistically significant compare to meniscectomy. The satisfactory score of meniscus repair is superior but not statistically significant compare to meniscectomy.

Conclusion:

This study found that meniscus repair in patients with meniscus tear in 40 years old and older has better clinical outcomes than meniscectomy. But, the study has a limitation because the lack of RCT studies. We need future RCT studies for a better result of the study.
Outcomes Comparison in Anterior Cruciate Ligament Reconstruction Between Hamstring Tendon and Quadriceps Tendon Autograft: A Systematic Review and Meta-Analysis
Authors: Randy  , Yosua Khandar , Guntara Aswin , Dasril Demy Faheem
Published: October 2024

Introduction and Objectives:

Anterior cruciate ligaments (ACL) accounted for the most frequent ligamentous injury. ACL reconstruction (ACLR) when indicated, has been the standard of care to treat instability and to restore functional stability.While hamstring tendon autografts (HT) are commonly used in ACLR, quadriceps tendon autografts (QT) have gained popularity in recent years Thus, this study performed a systematic review and meta-analysis comparing the outcomes of QT to HT for ACLR.

Materials and Methods:

Comprehensive database searches were performed in two databases, 452 studies were found and 14 studies were included in the study. This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline. Included studies will be extracted for characteristics such as author, study year, design, and outcomes.

Results:

Fourteen studies were included in the study after a comprehensive literature search was done. 2219 patients, 847 were treated with QT and 1372 were treated with HT, functional outcomes such as International Knee Documentation Committee score (IKDC), Cincinnati score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, Tegner score, VAS score, active knee flexion, return to previous activity, and Patient and Observer Scar Assessment Scale(POSAS) were measured, there were differences in KOOS pain score and Symptom score with mean difference of 2.40 (95%CI 0.75 to 4.06, I2=26%, p=0.004), and 4.40 (95%CI 0.81 to 7.89, I2= 60%, p=0.02) respectively. However, there were no significant differences in other functional outcomes and secondary outcomes.

Conclusion:

This study demonstrates comparable results between ACLR using QT and HT. QT appeared to have better functional outcomes in KOOS pain and KOOS symptoms than in HT
Principals’ Instructional Leadership and Support Needs in Prekindergarten and Kindergarten: A Case Study in Texas
Authors: Brown Christopher P. , Reyes Pedro , McKenzie Lauren C. , DeMatthews David E. , Woulfin Sarah L.
Published: October 2024

In states that fund public prekindergarten and kindergarten in elementary schools, principals are central to ensuring these programs support children’s learning and development. Yet few studies explore how principals position these programs within their instructional leadership and what they perceive should be done by district leaders to support their efforts to lead these programs. This case study investigated these issues with a sample of elementary school principals (N = 14) working in Texas. Using a modified conceptual lens that categorizes four essential dimensions of instructional leadership for prekindergarten and kindergarten, we found that principals possessed insight into many of these leadership practices but often did not enact these visions due to the academic performance pressures of the upper grades. Furthermore, principals wanted additional support from their district and state administrators to lead their prekindergarten and kindergarten programs better. Such findings illuminate several opportunities to strengthen principals’ instructional leadership of prekindergarten and kindergarten.
Faithfully Gendered? How Religious Attendance Shapes Views of Women’s Leadership in Politics and Business Cross-Nationally
Authors: Chan Esther , Di Di
Published: October 2024

Researchers have explored the relationship between religiosity and people’s gendered perspectives within the private sphere. However, there is limited research on how religiosity relates to people’s gendered perspectives in the public sphere. The authors examine the association between religiosity and the view that men make better leaders than women in two public spheres, politics and business, and explore variations by national context. Drawing on data collected in 44 national contexts, the analysis reveals that individuals with higher religious attendance are more inclined to support men’s leadership over women’s leadership in both political and business domains. Notably, this relationship is nuanced by a country’s level of economic development. Greater religiosity is associated with greater support for men’s leadership in more economically developed countries, whereas the reverse occurs in countries with lower economic development. The findings urge a more critical examination of religion’s role in shaping global perspectives on gender equity.
The Transformation of an Existing Integrated Behavioral Health Primary Care Program for Adolescents and Young Adults
Authors: Young Melissa A. , Nyquist Alex , Herbst Rachel B. , Chandler Emmanuel , Britto Maria T. , McClure Jessica
Published: October 2024

Behavioral and mental health (BMH) concerns are commonly identified within the pediatric primary care setting. In recent years the increasing acuity of BMH needs identified within the pediatric primary care setting has led to numerous efforts to develop effective and sustainable prevention-focused integrated behavioral health (IBH) programs; however, these programs typically emphasize prevention and early intervention for young children. Although integrated models of care targeting specific BMH concerns exist, these models typically do not account for the unique needs of adolescents and young adults (AYAs) and do not include BMH prevention. This article describes the core components that were identified and subsequently utilized to guide the adaptation of an existing prevention-focused IBH primary care program for AYAs. Adaptation of the existing IBH program resulted in an expansion of prevention-focused services across the BMH continuum of care. Specifically, primary, secondary, and tertiary-level prevention services were identified as clinically necessary to meet the vast array of BMH needs among AYAs within the primary care setting.
Hello, Neihou: Anchoring and adjustment in personality assessment
Authors: Yik Michelle
Published: October 2024

Despite the common belief that Chinese individuals are industrious and determined high achievers, in cross-cultural studies they consistently rate themselves lower on conscientiousness than their Western counterparts. In bilingual studies, Chinese–English individuals rate their conscientiousness lower than that of U.S. individuals, regardless of whether they respond to a questionnaire in Chinese or in English, but their self-rating is higher when they respond in Chinese than when they respond in English. I posit that the anchoring-and-adjustment heuristic might offer a mechanism to explain personality assessment in this context: individuals initially estimate their conscientiousness level based on a cultural ideal, then adjust this estimate according to the context suggested by the test language. Contrary to the cultural ideal of high-conscientiousness (high-C anchor), Chinese subjects rate themselves low on conscientiousness in both Chinese and English, a contrasting effect (rating adjusted away from an anchor). However, the version of the questionnaire in Chinese, which is associated with a high-C anchor in Chinese communities, might lead individuals to rate themselves higher on conscientiousness, an assimilation effect (rating adjusted toward an anchor), than the version in English, which is associated with a lower level of conscientiousness (low-C anchor). Future research is needed to test this innovative idea and enable new insights into cross-cultural comparisons of personality.
The effects of the changes in the depression on suicidal ideation among older adults aged 75 and above before and after the COVID-19
Authors: Jeong Kyu-Hyoung , Cho Sunghwan , Hwang Yeon Jae , Park Dayoon , Lee Seoyoon
Published: October 2024

Background

The unprecedented pandemic situation of COVID-19 has had a negative impact on the mental health of many people, especially among the "old-old" older adults who are aged 75 or older. Therefore, the aim of this study is to investigate the changes in depression among "old-old" older adults before and after the onset of COVID-19, and the extent to which depression affects suicidal ideations.

Method

The 12th to 16th Korea Welfare Panel Study(KoWePS) conducted from 2017 to 2021 was used for analysis. For this study, 771 older individuals with complete data to estimate the degree of change of depression were selected as the final analysis subjects.

Result

A Growth Mixture Modeling(GMM) analysis was conducted, resulting in the classification of two groups: an increasing group and a decreasing group. The study findings showed that "old-old" older individuals with high levels of depression, specifically those in the decreasing group, may be more susceptible to suicidal ideation. Despite this steep change slope, the decreasing group still exhibited a higher level of depression in 2021 compared to the increasing group. As per characteristics, the decreasing group, which showed a higher prevalence of suicidal ideation, had a higher proportion of women and individuals with lower levels of education, those living alone, and a lower household income compared to the increasing group.

Conclusion

It is important to note that although the study emphasized the need to prioritize intervention for the decreasing group with consistently high levels of depression, the majority of individuals belong to the increasing group, which exhibited a gradual increase in depression levels over time. Therefore, intervention plans should be developed concurrently for both groups. Also, it is crucial to implement proactive efforts targeting groups with understandings of these characteristics when establishing preventative measures for depression and suicidal ideation among "old-old" older adults.
Spartalizumab in combination with platinum-doublet chemotherapy with or without canakinumab in patients with PD-L1-unselected, metastatic NSCLC
Authors: Santoro Armando , Pilar Garrido , Tan Daniel S.W. , Zugazagoitia Jon , Shepherd Frances A. , Bearz Alessandra , Barlesi Fabrice , Kim Tae Min , Overbeck Tobias R. , Felip Enriqueta , Cai Can , Eddy Simantini , McCulloch Tracey , Schaefer Eric S.
Published: October 2024

Background

Despite promising outcomes of treatment with anti-programmed cell death (PD)-1/PD-ligand (L)1 agents in combination with platinum-doublet chemotherapy (PDC) in the first-line setting, a significant unmet medical need remains in patients with PD-L1-unselected non-small cell lung cancer (NSCLC).

Methods

This multicenter, open-label, phase 1b study comprising dose-confirmation and dose-expansion parts investigated the combination of spartalizumab and various PDC regimens, with or without canakinumab, in treatment-naïve patients with PD-L1-unselected, metastatic NSCLC. The primary objectives were to determine maximum tolerated dose (MTD) and/or recommended dose for expansion (RDE) of spartalizumab, with or without canakinumab, in combination with PDC in the dose-confirmation part and antitumor activity of spartalizumab in the dose-expansion part.

Results

The MTD/RDE of spartalizumab was 300 mg every 3 weeks (Q3W) when administered with either gemcitabine (1250 mg/m2)/cisplatin (75 mg/m2) (group A; no dose-limiting toxicities [DLTs]), pemetrexed (500 mg/m2)/cisplatin (group B; 2 DLTs: grade 2 posterior reversible encephalopathy syndrome and grade 4 hyponatremia), or paclitaxel (200 mg/m2)/carboplatin area under the curve 6 min*mg/mL (group C; 1 DLT: grade 4 neutropenic colitis). The RDE of canakinumab combined with spartalizumab and pemetrexed/cisplatin (group E; no DLTs) was 200 mg Q3W (no dose-expansion part was initiated). No new safety signals were identified. In groups A, B, C, and E, the overall response rates were 57.6%, 55.3%, 51.5%, and 57.1%, respectively. Group B compared with other groups had the longest median progression-free survival (10.4 months vs. 6.2–7.5 months), overall survival (29.7 months vs. 16.1–21.0 months), and duration of response (30.1 months vs. 6.0-8.2 months).

Conclusions

The combination of spartalizumab and PDC, with or without canakinumab, was well tolerated across treatment groups. The antitumor activity across treatment groups was comparable with that of pembrolizumab and pemetrexed combination. Canakinumab did not appear to improve the antitumor activity when combined with spartalizumab, pemetrexed and cisplatin.

Trial registration

The trial was registered in Clinicaltrials.gov with identifier no. NCT03064854. Date of Registration: 06 February 2017.
Natural frequency tree- versus conditional probability formula-based training for medical students’ estimation of screening test predictive values: a randomized controlled trial
Authors: Kim Soela , Kim Soyun , Choi Yong-jun , Do Young Kyung
Published: October 2024

Background

Medical students and professionals often struggle to understand medical test results, which can lead to poor medical decisions. Natural frequency tree-based training (NF-TT) has been suggested to help people correctly estimate the predictive value of medical tests. We aimed to compare the effectiveness of NF-TT with conventional conditional probability formula-based training (CP-FT) and investigate student variables that may influence NF-TT’s effectiveness.

Methods

We conducted a parallel group randomized controlled trial of NF-TT vs. CP-FT in two medical schools in South Korea (a 1:1 allocation ratio). Participants were randomly assigned to watch either NF-TT or CP-FT video at individual computer stations. NF-TT video showed how to translate relevant probabilistic information into natural frequencies using a tree structure to estimate the predictive values of screening tests. CP-FT video showed how to plug the same information into a mathematical formula to calculate predictive values. Both videos were 15 min long. The primary outcome was the accuracy in estimating the predictive value of screening tests assessed using multiple-choice questions at baseline, post-intervention (i.e., immediately after training), and one-month follow-up. The secondary outcome was the accuracy of conditional probabilistic reasoning in non-medical contexts, also assessed using multiple-choice questions, but only at follow-up as a measure of transfer of learning. 231 medical students completed their participation.

Results

Overall, NF-TT was not more effective than CP-FT in improving the predictive value estimation accuracy at post-intervention (NF-TT: 87.13%, CP-FT: 86.03%, p = .86) and follow-up (NF-TT: 72.39%, CP-FT: 68.10%, p = .40) and facilitating transfer of training (NF-TT: 75.54%, CP-FT: 71.43%, p = .41). However, for participants without relevant prior training, NF-TT was more effective than CP-FT in improving estimation accuracy at follow-up (NF-TT: 74.86%, CP-FT: 58.71%, p = .02) and facilitating transfer of learning (NF-TT: 82.86%, CP-FT: 66.13%, p = .04).

Conclusions

Introducing NF-TT early in the medical school curriculum, before students are exposed to a pervasive conditional probability formula-based approach, would offer the greatest benefit.

Trial registration

Korea Disease Control and Prevention Agency Clinical Research Information Service KCT0004246 (the date of first trial registration: 27/08/2019). The full trial protocol can be accessed at https://cris.nih.go.kr/cris/search/detailSearch.do?seq=15616&search_page=L.
Synthetic double inversion recovery imaging for rectal cancer T staging evaluation: imaging quality and added value to T2-weighted imaging
Authors: Wang Zi , Dai Zhuozhi , Zhou Xinyi , Dai Jiankun , Ge Yuxi , Hu Shudong
Published: October 2024

Objective

To assess the image quality of synthetic double inversion recovery (SyDIR) imaging and enhance the value of T2-weighted imaging (T2WI) in evaluating T stage for rectal cancer patients.

Methods

A total of 112 pathologically confirmed rectal cancer patients were retrospectively selected after undergoing MRI, including synthetic MRI. The image quality of T2WI and SyDIR imaging was compared based on signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), overall picture quality, presence of motion artifacts, lesion edge sharpness, and conspicuity. The concordance between MRI and pathological staging results, using T2WI alone and the combination of T2WI and SyDIR for junior and senior radiologists, was assessed using the Kappa test. The area under the receiver operating characteristic curve (AUC) was used to assess the diagnostic efficacy of extramural infiltration in rectal cancer patients.

Results

No significant differences in imaging quality were observed between conventional T2WI and SyDIR (p = 0.07–0.53). The combination of T2WI and SyDIR notably improved the staging concordance between MRI and pathology for both junior (kappa value from 0.547 to 0.780) and senior radiologists (kappa value from 0.738 to 0.834). In addition, the integration of T2WI and SyDIR increased the AUC for diagnosing extramural infiltration for both junior (from 0.842 to 0.918) and senior radiologists (from 0.917 to 0.938).

Conclusion

The combination of T2WI and SyDIR increased the consistency of T staging between MRI and pathology, as well as the diagnostic performance of extramural infiltration, which would benefit treatment selection.

Critical relevance statement

SyDIR sequence provides additional diagnostic value for T2WI in the T staging of rectal cancer, improving the agreement of T staging between MRI and pathology, as well as the diagnostic performance of extramural infiltration.

Key Points

Synthetic double inversion recovery (SyDIR) and T2WI have comparable image quality.

SyDIR provides rectal cancer anatomical features for extramural infiltration detections.

The combination of T2WI and SyDIR improves the accuracy of T staging in rectal cancer.

Graphical Abstract
Methodologies and clinical applications of lower limb muscle ultrasound in critically ill patients: a systematic review and meta-analysis
Authors: Venco Roberto , Artale Alessandro , Formenti Paolo , Deana Cristian , Mistraletti Giovanni , Umbrello Michele
Published: October 2024

Background

Reduced muscle mass upon admission and development of muscle wasting are frequent in critically ill patients, and linked to unfavorable outcomes. Muscle ultrasound is a promising instrument for evaluating muscle mass. We summarized the findings of lower limb muscle ultrasound values and investigated how the muscle ultrasound parameters of the examination or the patient characteristics influence the results.

Methods

Systematic review and meta-analysis of studies of lower limb ultrasound critically ill adults. PubMed, CINAHL, Embase, PEDro and Web of Science were searched. PRISMA guidelines were followed, and studies evaluated with the appropriate NIH quality assessment tool. A meta-analysis was conducted to compare the values at admission, short and long follow-up during ICU stay, and the association between baseline values and patient characteristics or ultrasound parameters was investigated with a meta-regression.

Results

Sixty-six studies (3839 patients) were included. The main muscles investigated were rectus femoris cross-sectional area (RF-CSA, n = 33/66), quadriceps muscle layer thickness (n = 32/66), and rectus femoris thickness (n = 19/66). Significant differences were found in the anatomical landmark and ultrasound settings. At ICU admission, RF-CSA ranged from 1.1 [0.73–1.47] to 6.36 [5.45–7.27] cm2 (pooled average 2.83 [2.29–3.37] cm2) with high heterogeneity among studies (I2 = 98.43%). Higher age, higher BMI, more distal landmark and the use of probe compression were associated with lower baseline muscle mass.

Conclusions

Measurements of muscle mass using ultrasound varied with reference to patient characteristics, patient position, anatomical landmarks used for measurement, and the level of compression applied by the probe; this constrains the external validity of the results and highlights the need for standardization.

Study registration:

PROSPERO CRD42023420376.
A successful surgical repair for supravalvular aortic stenosis with a bicuspid valve and malpositioned coronary orifices by partial Brom’s technique: a case report
Authors: Hara Midori , Honda Yoshihiro , Kaga Shigeaki , Sakamoto Kisaburo , Nakajima Hiroyuki
Published: October 2024

Background

Supravalvular aortic stenosis (SVAS) is a relatively rare form of left ventricular outflow tract obstruction, often accompanied by other cardiac conditions. However, a standard surgical reparative technique has not been established and repairing SVAS remains challenging.

Case presentation

We repaired SVAS of a 3-year-old boy accompanied by a bicuspid aortic valve and malpositioned coronary orifices by partial Brom’s technique with two glutaraldehyde-treated autologous pericardial patches, using recent advanced preoperative information, including geometric and effective heights. Echocardiography after the surgery revealed release of SVAS without aortic regurgitation.

Conclusions

In repair for SVAS, it is important not only to release stenosis but also to make a functional aortic valve, using recent advanced preoperative information. In the case of children, repairing the aortic valve by only using autologous tissue having growth potential, is also important.