bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Complementary and Alternative Medicine on Cancer-Related Fatigue in Adults: An Overview of Systematic Reviews
Authors: Li Peijin , Wang Qian , Liu Lixing , Zhang Qinglin , Zhou Rui , Wang Yue , Liu Tingting , Feng Li
Published: July 2023

Background:

Cancer-related fatigue (CRF) has an enormous adverse impact on quality of life and subsequent therapy of cancer patients. Complementary and alternative medicine (CAM) is reported to improve CRF in many systematic reviews (SRs), but the effects are controversial because of variations in the quality and outcomes.

Methods:

Thirteen databases were searched from inception to September 2022. Only SRs of randomized controlled trials (RCTs) were included. We assessed the quality of included SRs with the AMSTAR-2 tool, the strength of evidence with the GRADE system, the risk of bias with the ROBIS tool, and the integrity of SRs with the PRISMA checklist.

Results:

We included 30 eligible SRs (27 meta-analyses). Based on the AMSTAR-2 tool, 29 SRs were rated as “critically low” quality, and only one was rated as “low” quality. With the ROBIS tool, 19 SRs demonstrated a low risk of bias. According to the PRISMA checklist, no SRs reported all the items, and 10 SRs sufficiently reported over 70%. Based on the GRADE system, 7 outcomes were assessed as high-quality evidence.

Conclusion:

This overview demonstrates promising evidence for the effectiveness of CAM interventions in the treatment of CRF in adults. The roles of qigong, music, auricular point therapy, and dietary supplements in CRF need further evaluation. Although findings are mixed, it is recommend to select appropriate CAM to manage cancer-related fatigue under the guidance of physicians. More studies with rigorous methodological designs and sufficient sample sizes are needed.
Non–ECG-gated cardiac CT angiography in acute stroke is feasible and detects sources of embolism
Authors: Lee Peter , Dhillon Gurmohan , Pourafkari Marina , DaBreo Dominique , Jaff Zardasht , Appireddy Ramana , Jin Albert , Boissé Lomax Lysa , Durafourt Bryce A , Boyd John Gordon , Nasirzadeh Amir Reza , Tampieri Donatella , Jalini Shirin
Published: July 2023

Background:

A significant portion of cryptogenic stroke is hypothesized to be secondary to cardiac embolism. However, transthoracic echocardiogram is usually delayed after stroke, and more detailed cardiac imaging is not routinely done.

Aims:

This study aimed to determine whether non–ECG-gated cardiac CT angiography (cCTA) during hyperacute stroke would provide diagnostic quality images and act as an adjunct modality of cardiac imaging to detect sources of emboli.

Methods:

In this single-center prospective cohort study, modified Code Stroke imaging was implemented with a 64-slice CT scanner, where the longitudinal axis of CT angiography was extended from the carina to the diaphragm. The primary outcomes of image quality, recruitment feasibility, impact on hyperacute time metrics, and additional radiation dose were assessed. Secondary outcomes consisted of detection of high-risk cardiac sources of embolism, mediastinal or lung pathology, and impact on etiologic classification.

Results:

One hundred and twenty eligible patients were enrolled, of which 105 (87.5%) had good/moderate quality images for motion artifact and 119 (99.2%) for contrast opacification. Total CT time, door-to-needle time, and door-to-groin puncture time were unchanged with the addition of cCTA. Eighty-nine patients received a final diagnosis of ischemic stroke, of which 12/89 (13.5%) had high-risk cardioembolic findings on cCTA. Incidental findings, such as pulmonary embolism (PE) (7/89, 7.9%) and malignancy (6/89, 6.7%), were observed. cCTA led to changes in management for 19/120 (15.8%) of all patients, and reclassification of stroke etiology for 8/89 (9%) of patients.

Conclusions:

Non–ECG-gated cCTA can be feasibly incorporated into Code Stroke and provide diagnostic quality images without delays in hyperacute time metrics. It can detect high-risk cardiac sources, and other findings impacting patient care. This may help reclassify a subset of cryptogenic stroke cases and improve secondary prevention.
Standards for research in NHS Wales critical care units: A modified Delphi study
Authors: Twose Paul , Lynch Ceri , Pugh Richard , Szakmany Tamas
Published: July 2023

Introduction:

The importance of research and development in all aspects of healthcare is well acknowledged. Within critical care, national guidelines provide a limited number of standards and series of recommendations on Research and Development (R&D) activity. The aim of this study was to create a broader set of standards in support of R&D activity in critical care departments.

Methods:

A modified Delphi study was undertaken across NHS Wales critical care units. Proposed standards were developed by a group of experts, which across three rounds, majority agreement was sought. Additional standards were added based on participant’s responses.

Results:

This study identified 49 standards for R&D activity within critical care units in NHS Wales. All these standards reached majority agreement, as determined by >70% of multi-disciplinary participants determine each standard as essential.

Conclusions:

The results of this study will be utilised within Wales to inform wider service specification with regard workforce requirements, responsibilities, reporting and collaboration.
Utilising a non-surgical intervention in the knee osteoarthritis care pathway: a 6-year retrospective audit on NHS patients
Authors: Benn Robyn , Rawson Lewis , Phillips Amanda
Published: July 2023

Background:

Knee osteoarthritis (OA) is a chronic, debilitating, musculoskeletal condition that affects millions. The increase in prevalence and its economic impact on healthcare and society raise the need for additional non-surgical interventions.

Objective:

To assess the referral rates to secondary care consultation and clinical outcomes in patients with severe knee OA treated with a home-based, non-surgical intervention.

Design:

This was a retrospective audit on 571 patients with knee OA who met the clinical criteria for total knee replacement (TKR) and received the service between October 2015 and March 2020.

Methods:

Patients were treated with a non-surgical, home-based, biomechanical intervention that aims to reduce pain and improve function, involving a foot-worn device for gait rehabilitation. The device is adjusted to the patient based on their gait patterns and clinical symptoms. Patients are advised to use the device at home or work and continue their routine. Patients are also advised to return to follow-up appointments to readjust the device and treatment plan. The primary outcome measure was the referral rates to secondary care consultation. Secondary outcomes included patient-reported outcome measures to assess pain and function and a computerised gait test. Follow-up time was between 1 and 6 years post-treatment initiation with a mean follow-up time of 1308.1 (SD = 473.4) days (i.e. 3.5 years.).

Results:

There were 65 (11.4%) referrals for secondary consultation with an average follow-up of 3.5 years. The mean days to referral was 480.9 (SD = 399.2) days. Of all referrals, 48% ( n = 31) occurred during the first year of treatment, and 32% ( n = 21) occurred during the second year. The rest were after more than 2 years of treatment. Significant improvements were seen in all clinical outcomes, including a reduction in pain and an improvement in function and gait patterns ( p < 0.05 for all).

Conclusion:

Utilising this intervention as a non-surgical option for patients with knee OA who met the clinical criteria for TKR led to a significant reduction in pain and improvement in function after 3 months that was maintained for up to 3 years. Most patients (89%) did not proceed to secondary care consultation during their time in treatment for up to 6 years.
A prognostic immune nutritional index can predict all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Ahn Sung Soo , Pyo Jung Yoon , Song Jason Jungsik , Park Yong-Beom , Lee Sang-Won
Published: July 2023

Background:

Studies have proposed that nutritional and immune-related markers are relevant with patient outcomes of various medical conditions and could be a useful indicator of patient prognostication.

Objectives:

This study investigated whether a prognostic immune nutritional index (PINI) at diagnosis could predict adverse clinical outcomes in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).

Design:

A retrospective, single-centre observational cohort analysis of patients with AAV.

Methods:

All-cause mortality and end-stage renal disease (ESRD) were investigated outcomes during the observation period. PINI was calculated by serum albumin (g/mL) × 0.9 − monocyte count (/mm3) × 0.0007, and the optimal cut-off of PINI was obtained using a Youden index-based bootstrapping method. Cox hazard analyses were performed to identify independent predictors of patient outcomes.

Results:

Of the 250 eligible patients, the median age of patients was 60.0 years, and 34.0% were men. During the disease course, 33 (13.2%) died and 42 (16.8%) developed ESRD, respectively. The ideal PINI cut-offs for all-cause mortality and ESRD were set as ⩽2.47 and ⩽3.12 (sensitivity and specificity of 75.1% and 60.6% for mortality and 46.2% and 78.6% for ESRD). AAV patients with PINI ⩽2.47 and those with PINI ⩽3.12 exhibited significantly higher rates for all-cause mortality and ESRD compared to those with PINI >2.47 and >3.12. In the multivariable Cox analysis, PINI ⩽2.47 (hazard ratio [HR]: 3.173, 95% confidence interval [CI]: 1.129, 8.916, p = 0.029) was independently associated with all-cause patient mortality; however, PINI ⩽3.12 was not independently associated with ESRD (HR: 1.097, 95% CI: 0.419, 2.870, p = 0.850).

Conclusion:

Findings from this study demonstrated PINI could predict all-cause patient mortality in AAV, and a higher clinical attention is warranted in those with PINI ⩽2.47 at initial diagnosis.
Challenges and Reasons of Using a Passively Known Language in Daily Practice: Cases of Belarusian and Ukrainian
Authors: Liskovets Irina
Published: July 2023

The paper attempts to describe, discuss and analyse the situation of rapid and spontaneous transfer to practical usage of a language which speakers know only passively in the situation of stable closely related bilingualism. Such a transfer – from native Russian to Belarusian – has been taking place in the Republic of Belarus due to various reasons. Partly, this process was connected to the political situation in the country and around it; at the same time, a part of Russian-speaking intelligentsia (mostly residing in the country capital, Minsk) was in the process of reshaping of their national identity. The paper discusses in details both those reasons, as well as the peculiarities of the language situation promoting this process, its linguistic features and their difference from those of an interlanguage which arises in the situation of a foreign language acquisition and from those of trasyanka, the code in-between Russian and Belarusian. The phenomenon in the focus is also compared with the newest tendency of Russian-speaking Ukrainians to transit to using Ukrainian instead of Russian in their everyday communication and in social media. The paper is based on the data obtained in the course of longitude field study conducted in Minsk in 1999–2022 and the data derived from media and internet sources.
Culture of Excellence in Academia in the UAE: A Model of Transformational Leadership and Leadership Development
Authors: Fenech Roberta , Abdulla Ayesha , Zairi Adel , Kinsella Katrina , Misra Anamika
Published: July 2023

Higher education institutions have a key role in forming the specialists of the future. In fulfilling their role there is need for transformational leadership, culture of excellence, and academic leadership development. The purpose of this study is to investigate the link between transformational leadership, shaping a culture of educational excellence, and leadership development, as perceived by tertiary education leaders in the UAE. The qualitative approach is of focus groups, using semi-structured questions, with leaders in academia. The main finding is that in the initial stages of an organization life cycle, leadership development precedes transformational leadership and a culture of excellence. In later stages, leadership development is a mediator of transformational leadership and a culture of excellence. In the mature stages of organization life cycle, the three elements engage in an ongoing spiral and synergistic process.
Participatory design of an infographic to help support the care of people living with complex regional pain syndrome
Authors: Beales Darren , Ho Yi Ki , Lewin James , Loh Bianca Wen-Qi , Yusof Amirah Binte , Grieve Sharon , Ranelli Sonia , Holthouse David , Mitchell Tim , Slater Helen
Published: July 2023

Background

Complex regional pain syndrome (CRPS) can be a debilitating pain condition with enduring physical, psychological and social impacts. CRPS is often poorly understood by healthcare professionals and management needs to be tailored to each individual’s presentation. People with lived experience express difficulty in accessing reliable and meaningful information about the condition. This study aimed to co-create a trustworthy infographic to share information about the lived experience of CRPS.

Methods

We adopted a seven-phase, iterative, participatory methodology to co-create the infographic. Potential infographic content was obtained from qualitative work investigating the lived experience of CRPS. Online consumer engagement (people with doctor diagnosed CRPS/their family, n=20) was used to prioritise content to be included in the infographic and then potential designs were sourced. The research team narrowed the selections down to two designs which were presented to consumers online for final selection ( n=25) and refinement ( n=34).

Results

An infographic for understanding the lived experience of CRPS was completed using participatory design, providing a resource aligned to the needs of people with this condition. Using the Patient Education Materials Assessment Tool, the final infographic rated highly for understandability (92%) and participants indicated significant willingness to share this infographic with others (93%).

Conclusion

A process of participatory design was an effective and efficient process for translation of evidence gathered from qualitative research into a trustworthy resource for people with CRPS and their support people.
“Intervening Is a Good Thing but . . .”: The Role of Social Norms in Users’ Justifications of (Non-)Intervention Against Incivility
Authors: Gagrčin Emilija , Milzner Miriam
Published: July 2023

User intervention against incivility as social enforcement of democratic norms on social media platforms is considered an act of “good citizenship” by citizens and scholars alike. However, between ideals and behavior, multiple social norms are at play in shaping individuals’ sense of personal responsibility for intervening. This study explores the role of conflicting norms in situations requiring user intervention against online incivility. By combining the perspectives of norms as expectations and norms as cultural vocabularies, we investigate users’ salient norms, and how these norms influence users’ justifications for (non-)intervention. Based on qualitative interview data from Germany ( N = 20), we identified three distinct reasoning patterns employed to justify (non-)intervention: the pragmatic, the dismissive, and the aspirational. By identifying fault lines, our typology points to normative origins of ambivalence related to user intervention. The findings offer insights into strategies to motivate intervention against online incivility.
Using Fume Hood to Reduce Nurses’ Exposure to Particulate Matters Dispersed Into the Air During Pill Crushing
Authors: Amiri Azita , Guess LeAnn , Gilder Richard , Showalter Darlene , Hart Laura , Sattler Barbara
Published: July 2023

Background:

Pill crushing is a common practice in patient care settings. Crushing pills can disperse particulate matter (PM) into indoor air. The PM is a widespread air pollutant composed of microscopic particles and droplets of various sizes and may carry active and/or inactive ingredients nurses can inhale. This study aimed to quantify PM sizes and concentration in indoor air when pills are crushed and examine the role of a fume hood in reducing particulate pollution.

Methods:

Two scenarios (with and without a fume hood) representing nurses’ pill-crushing behaviors were set up in a positive-pressure cleanroom. Two acetaminophen tablets (325 mg/tablet) were crushed into powder and mixed with unsweetened applesauce. The PM sizes and concentrations were measured before and during crushing.

Results:

Different sizes of PM, including inhalable, respirable, and thoracic particles, were emitted during medication crushing. The total count of all particle sizes and mass concentrations of particles were significantly lower during crushing when a fume hood was used ( p = .00).

Conclusion:

Pill crushing increases PM and should be considered a workplace safety health hazard for nurses. Healthcare professionals should work under a fume hood when crushing pills and wear proper protective equipment. The findings of significant particulate pollution related to pill crushing suggest that further research is warranted.
Poster 145: A Biomechanical Comparison of All-Inside versus Trans-tibial Meniscal Root Repair Techniques
Authors: Pasic Nicholas , Dragoo Jason
Published: August 2023

Objectives:

To evaluate the biomechanical characteristics of an all-inside meniscal root repair procedure versus transtibial repair

Methods:

Nine paired cadaveric knees were prepared with pressure mapping sensors and underwent pressure testing to obtain peak pressures, average pressures, and femorotibial contact area in both the medial and lateral compartments. Testing was performed in three states: meniscus intact, meniscal root cut, and following meniscal root repair with all-inside repair technique. Additionally, testing was completed on eight pairs of cadaveric knees to compare stiffness and maximal load to failure between all-inside and transtibial meniscal root repair techniques.

Results:

In the medial compartment, there were significant increases in both median peak pressures (p=0.017) and median average pressures (p=0.047) in the root cut state compared to the intact state (+636 kilopascal (kPA) [246-1026 95% confidence interval (95%CI)] and +190 kPA [49-330 95%CI] respectively). All-inside meniscal root repair restored median peak pressures and median average pressures to approach that of the intact meniscus (p=0.293; +311 kPA [-79-701 95%CI] and p=0.171; +137 kPA [-3-277 95%CI] respectively). In the lateral compartment, there were also significant increases in both median peak pressures (p=0.025) and median average pressures (p=0.05) in the root cut state compared to the intact state (+718 kPA [246-1191 95%CI] and +203 kPA [51-355 95%CI]) respectively). All-inside meniscal root repair restored median peak pressures and median average pressures to be not significantly different from the intact state (p=0.399; +322 kPA [-150-795 95%CI] and p=0.97; +18 kPA [- 134-171 95%CI] respectively). There was no difference between repair techniques regarding load to failure (p=0.896).

Conclusions:

All-inside meniscal root repair restores median peak and average pressures that approach that of the native, intact meniscus. Compared to a transtibial meniscal root repair technique, all-inside repair demonstrated equivalent load to failure.
Poster 160: Arthroscopic Anatomic Glenoid Reconstruction Does Not Affect Subscapularis Muscle Compared To Latarjet
Authors: PEÑA JOSE CASTILLO DE LA , Sparavalo Sara , Ma Jie , Remedios Sarah , Hoyt Benjamin , Riccio Cory , Kilcoyne Kelly , Dickens Jonathan , Wong Ivan
Published: August 2023

Objectives:

The Latarjet technique has been the gold standard treatment for glenoid bone loss following anterior shoulder instability due to its low recurrence rate, but other techniques including arthroscopic anatomic glenoid reconstruction (AAGR) have shown similar outcomes with fewer complications. The Latarjet requires a subscapularis split or take-down for placement of the coracoid, which may compromise post-operative subscapularis quality and strength. The AAGR is a subscapularis-sparing technique that obviates the need for a subscapularis split by using a far medial (Halifax) portal for graft placement. The purpose of this study was to compare subscapularis muscle changes before and after surgery between Latarjet and AAGR patients.

Methods:

This study was a retrospective analysis of patients treated surgically with AAGR and Latarjet that had pre- and post-operative CT scans. Patients’ charts were reviewed to obtain demographic information, as well as CT scan cross-sectional area measurements of the subscapularis muscle on pre- and post-surgery scans. We used a pre-existing validated formula (volume=[0.06(A+C)]-13.02) for calculating the volume of the subscapularis pre- and post-operatively based on the cross-sectional area of the muscle.

Results:

Our cohort included 40 patients in each group with pre- and post-operative CT scans. On average, patients had a CT scan one year post-operatively. Pre-operatively, patients were estimated to have similar subscapularis volumes (p>0.05). We found that the change in medial area of the subscapularis muscle was significantly higher in the Latarjet group (-325.8 mm2) compared to the AAGR group (-73.2 mm2) (p<0.05). We found that AAGR patients had a 3% increase in subscapularis volume post-operatively, while the Latarjet patients had 3% decrease in volume (p<0.05)

Conclusions:

The AAGR technique is subscapularis-sparing both in surgical technique and structural outcomes, resulting in comparable subscapularis cross-sectional area and volume pre- and post- operatively. Latarjet using a subscapularis split results in lower subscapularis medial volumetric area.
Poster 174: Arthroscopic rotator cuff repair with bioinductive patch achieves equivalent patient- reported outcomes at 1 year
Authors: Burdick Gabriel , Fathima Bushra , Gaudiani Michael , Wolternik Trevor , Haan Jager , Kasto Johnny , Kolowich Patricia , Muh Stephanie , Castle Joshua
Published: August 2023

Objectives:

To compare patient reported outcomes, range of motion (ROM), and complications of patients undergoing arthroscopic rotator cuff repair (RCR) augmented with a bioinductive patch compared to standard repair.

Methods:

A retrospective review of patients undergoing primary arthroscopic rotator cuff repair with and without bioinductive bovine collagen patch augmentation for supraspinatus/infraspinatus tears from 2016 to 2021 at a single institution was performed. Patients were excluded based on the following criteria: age <18 years, open or mini-open rotator cuff repair, prior surgery of the affected shoulder (except diagnostic arthroscopy), rheumatological disease, active infection, or cancer. Patients who underwent RCR augmented with a collagen patch were matched 1:1 to those undergoing standard rotator cuff repair based on tear thickness and size. The electronic medical record was used to obtain patient demographics, range of motion (ROM), and assess for complications. MRI or ultrasound was used to confirm tear and classify size using the DeOrio and Cofield classification of small (<1cm), medium (1-3cm), large (3-5cm), and massive (>5cm). In addition, Patient Reported Outcome Information System (PROMIS) scores were recorded at preoperative, 6 weeks, 3 months, 6 months, and 1 year postoperative time points.

Results:

Fifty-four patients underwent RCR with patch augmentation and were matched to 54 controls. No significant differences were found between groups in terms of age (56.7 ± 9.0 patch vs. 59.3 ± 8.5 years control, p=0.12), sex, smoking, diabetes, degenerative vs. traumatic tears (50% vs. 50.9%, p=1.0), partial vs. full thickness (38.9% vs. 25.5%, p=0.2), as well as tear size (p=0.8). ROM in forward flexion (FF) and abduction (ABD) were significantly increased at 1 year compared to controls (FF 162 +/- 22 vs. 148 +/- 26 degrees, p<0.01; ABD 137 +/- 37 vs. 117 +/- 40, p=0.047). No differences were seen for PROMIS- UE, but PROMIS-PI scores were significantly lower in the patch group at 6 months (55.2 +/- 8.0 vs. 61.9 +/- 2.0, p<0.01) and 1 year (56.0 +/- 7.5 vs. 62.1 +/- 3.6, p<.01). The patch group had 7 retears compared to 0 controls (13.0% vs 0%, 2/7 for subscapularis tears not augmented) and 1 biceps tenodesis rupture, with 5 requiring revision surgery.

Conclusions:

Bioinductive patch augmentation for RCR demonstrated increased ROM, but equivalent physical function after 1 year. [Table: see text][Table: see text]
Poster 198: Forward flexion can reliably be measured with a front-facing camera used for at-home physical therapy
Authors: Denard Patrick , Higgins Laurence , Gobezie Reuben , Shishani Yousef
Published: August 2023

Objectives:

Accurate assessment of shoulder range of motion (ROM) is important for both initial evaluation and evaluating rehabilitation progress. Recently, digital platforms have been developed which assess ROM with the use of a front-facing camera available on smartphones. Such tools allow ROM to be objectively assessed and monitored remotely but require validation. The purpose of this study was, therefore, to compare forward flexion (FF) measured with a digital health platform (PT Genie, Orlando, Fl) ( Figure 1) to in-office measurements with a hand-held digital goniometer (Halo Medical Devices, Australia) ( Figure 2)

Methods:

A prospective evaluation was performed on consecutive patients evaluated in a single shoulder specialist practice. Thirty -two consecutive patients, including 16 males and 16 females, aged 58.5 ± 17.4 years (range 24-80) participated in the study. All participants completed 3 consecutive FF efforts measured first with a digital goniometer, followed by 3 consecutive FF efforts measured with the front-facing camera. All digital goniometer measurements were recorded by the same examiner. All measurements using the front-facing camera were obtained with an iPhone 11 running iOS 15.4.1, and the PT Genie platform ( Figure 1). The mean from the 3 measurements was calculated and the mean differences between the two measurement options were then compared using the simple Student t- test. Analysis was completed using SPSS version 17 (SPSS Inc., Chicago).

Results:

For both the digital goniometer and front-facing camera groups there were no significant differences within the 3 measurements (p > 0.05). Mean FF measured with the digital goniometer was 120.1° ± 24.7° (range 71.7° - 164.7°) compared to 123.5° ± 26.0° (range 74.7° – 173.0°) with the front- facing camera, for a difference of 3.4° between groups (p<0.001).

Conclusions:

These findings suggest that the measurement of FF is comparable between a digital goniometer and a front-facing camera. While small differences were seen between the methods, the differences are not likely clinically relevant, and more importantly, the findings were internally consistent. These preliminary findings help in establishing the use of such an application for remote physical therapy. Further study is needed to assess other planes of range of motion and obtain data in a larger cohort.
Poster 204: Changes in Elbow Stress and Ball Velocity During Reduced Effort Pitching: A Marker-Based Motion Capture Analysis
Authors: Fiegen Anthony , Nezlek Stuart , Loushin Stacy , Christoffer Daniel , Verhoeven Martijn , Kaufman Kenton , Camp Christopher
Published: August 2023

Objectives:

Baseball pitchers often participate in throwing programs that involve throwing at reduced effort levels to gradually increase the amount of stress experienced across the elbow. It is currently unknown how reduced effort pitching compares to maximum effort with respect to elbow stress and ball velocity. The purpose of this study is to determine whether elbow stress and ball velocity correlate with reduced effort pitching, whether elbow stress and ball velocity decrease proportionally while throwing at a reduced effort, and to assess intrathrower reliability.

Methods:

Ten healthy male high school baseball pitchers threw 5 pitches from a regulation pitching mound at 3 effort levels: maximum effort, 75% effort, and 50% effort. Elbow stress, specifically elbow varus torque, was calculated for all pitches using a marker-based 3D motion capture system. Ball velocity was measured using a Doppler radar gun. Intrathrower variability was calculated for each effort level.

Results:

Elbow stress and ball velocity decreased with reduced effort throws (p<0.001 and p=0.003, respectively). However, the reductions in elbow stress and ball velocity were not proportional. At 75% effort throws, elbow stress decreased only 19% and ball velocity decreased only 10%. At 50% effort throws, elbow stress decreased only 25% and ball velocity decreased only 15%. Intrathrower reliability was excellent for elbow stress and ball velocity, with intraclass correlation coefficients all greater than or equal to 0.80.

Conclusions:

Pitching at a reduced effort level resulted in decreased elbow stress and ball velocity. However, for every 25% reduction in perceived effort, elbow stress decreased by a mean of 13% and ball velocity decreased 8%. When baseball pitchers attempt to throw at a reduced effort of maximum, throwing metrics do not decrease proportionately. While pitching at a reduced effort of maximum decreases elbow stress and ball velocity, the decrease is not proportional, subjecting the elbow to more stress than intended. This has significant clinical importance to pitchers, coaches, and medical professionals in the setting of injury prevention and return to sport. [Table: see text]
Poster 211: Prolonged Opioid Use Following Distal Radius Fracture Fixation: Who is at Risk?
Authors: Runge William , Gabig Andrew , Karzon Anthony , Cooke Hayden , Gottschalk Michael , Suh Nina , Wagner Eric
Published: August 2023

Objectives:

Opioid pain medication is most commonly prescribed after distal radius fracture fixation, and there is high variability in the quantity and duration prescribed. Comorbidities including substance use and depression have been associated with higher consumption habits and increased sizes of postoperative opioid prescriptions has been previously linked to increasing risk of chronic opioid use and opioid use disorder. The purpose of this study was to investigate opioid prescription patterns after distal radius fracture fixation and identify patient specific risk factors for increased postoperative opioid consumption.

Methods:

A retrospective review of 34,629 opioid-naïve patients was conducted. Demographic, comorbidity, complication data and prescription pharmacy claims were analyzed. Patients were sorted according to the number of postoperative prescription refills of opioid pain medication.

Results:

Seventy-three percent of patients required no additional refills outside the perioperative window. Twenty percent required additional refill prescriptions and 6.4% of patients continued to fill opioid medication beyond 6-months postoperatively. Multiple factors increased the risk for increased opioid use including medical and surgical complications, substance use, diabetes,cardiovascular disease, and obesity. Patients with longer duration of opioid use postoperatively had higher rates of medical and surgical complications. Perioperative prescription quantities were 62.9, 78.6, 83.3 tablets for No Refill, Refill, and Prolonged Use groups, respectively.

Conclusions:

Many patient-specific factors for prolonged opioid consumption after distal radius fracture fixation can be identified prior to prescribing postoperative pain management. Patients most at risk for prolonged opioid use can be targeted for alternative pain management options. Surgeons should take a more patient specific approach in prescribing opioid medication after distal radius fracture fixation. [Table: see text][Table: see text][Table: see text][Table: see text]
Poster 266: Outcomes of Surgical Stabilization for Recurrent Patellar Instability in Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 6 years Mean Follow Up
Authors: Marigi Erick , Wasserburger Jory , Smith John-Rudolph , Stuart Michael , Camp Christopher , Krych Aaron
Published: August 2023

Objectives:

The purpose of this study was to assess return to play (RTP), patient-reported outcomes (PRO), and reoperation rates following patellofemoral stabilization surgeries (PSS) for recurrent patellar instability (RPI) in a cohort of competitive wrestlers.

Methods:

All competitive wrestlers with a history of an RPI and subsequent PSS at a single institution between 2000 and 2020 were identified. Primary PSS ranged from MPFL reconstruction (n = 31; 50%) or MPFL repair (n = 22; 33.5%), and other PSS (n = 9; 14.5%) in the form of tibial tubercle osteotomy (TTO), lateral retinaculum release (LRR), and medial retinaculum reefing (MRR). Exclusion criteria included revision PSS, or concomitant anterior cruciate ligament reconstruction or multi ligament knee injury. All patients were contacted for determination of reinjury rates, current sport status, and PROs. Surgical failure defined as subsequent patellar dislocation despite operative management or need for secondary PSS.

Results:

Ultimately, 62 knees in 56 wrestlers were included at a mean follow-up time of 6.6 years (range, 2.0 – 18.8 years). RTP occurred in 55.3% of wrestlers at a mean of 8.8 ± 6.7 months. Among the PSS no differences were observed between rates of RTP (P = .676), postoperative pain (P = .176), Tegner activity level (P = .801), International Knee Documentation Committee (P = .378), Lysholm (P = .402), or Kujala scores (P = .370). Recurrent patellar instability was the most common complication in 21% of knees. Among PSS types, MPFL reconstruction had the lowest rate of RPI (6.5% vs. 27.3% vs. 55.6%; P = .005), and surgical failure (9.7% vs. 31.8% vs. 55.6%; P = .008). Kaplan-Meier survivorship free from surgical failure of the entire cohort was 91.9% at 1 year, 77.7% at 5 years, and 65.7% at 15 years. MPFL reconstruction had the highest survivorship when compared to MPFL repair and other PSS up to 10 years after the index surgery (90.3% vs. 64.1% vs. 27.8%; P = .048).

Conclusions:

Recurrent patellar instability remains a concern for competitive wrestlers after PSS. MPFL reconstruction may serve as a more durable surgical treatment option with lower rates of RPI and failure when compared to other PSS up to 10 years after surgery. [Table: see text]
Supply Chain Networks and the Prospects of Sustainable Industrialization in Asia
Authors: Biswas Sayan
Published: August 2023

India and China are home to the world’s 2.8 billion people. Ancient nations but young republics, India and China have been through their good and bad times. There are numerous studies suggesting that the urban population, rate of growth, and population percentage residing in agglomerations all have a statistically notable and constructive effect on Human Development Index (HDI). Industrialization has historically encouraged urbanization by fostering economic expansion and job opportunities that entice people to relocate to cities. This article exclusively focuses on strategic planning regarding how to build and improve supply chain networks. It also looks at how factories built in a location increase demand for manufacturing and managerial workers personnel, resulting in a population inflow. Following the factories, other businesses such as construction makers, retailers, and service providers follow to meet the workers’ product demands. As a result, more jobs and housing demand are created, forming a city.
Leveraging Social Media to Build Online Social Capital and Employer Brand
Authors: Mukul Kumar , Itam Urmila Jagadeeswari
Published: July 2023

Organisations increasingly use virtual means to connect with stakeholders to project an employer image among job seekers. Social media-based networking and employer branding strategies to attract and retain talent are effective strategies in the post-COVID scenario. A proper context exists to explore networking activities’ role in building solid social media capital and how this contributes to employer branding efforts. The present study explains how social media activities affect social media capital generation and employer branding. Second, the research examines how social media activities by organisations may help them leverage online social capital resources to create a strong employer brand. Extant literature illustrates how social media has increased the reach and scope for meaningful networking and greater possibilities of reaching out to potential employees through employer branding initiatives. Innovative social media tools for messaging and communicating, such as hashtags, tweeting, pinning, posting, likes and sharing, have made the outcomes more tangible, measurable and reliable. This facilitates effective social capital management to generate an employer’s reputation and a superior employer brand.
‘Life @ Work’ Storytelling: Exploring a New Meaning of Employee Experience
Authors: Chaudhari Shrirang Ramdas , Singh Ankita , Saini Gordhan K.
Published: July 2023

The global reset after the pandemic has changed the work aspirations of employees across industries and brought an unprecedented focus on employees’ experiences at work. Numerous studies have reported that increasing employee disengagement at work has ripple effects on business outcomes. Thus, providing valuable work experience to improve engagement at work has been a central theme of recruiters’ employee value proposition. In this article, we discussed online social media storytelling as a third-party employer branding practice and analysed the work experiences shared by employees via LinkedIn and Facebook posts. Through the content analysis of LinkedIn and Facebook posts, we discern Associated Pride, Nourishing Culture and Inclusive Explorations as the three key aspects of employee experience as perceived by the employees. This article contributes to the literature related to the emerging aspects of employee experiences and the potential dimensions of a compelling employee value proposition.
Assessing Employer Branding Business Case and Proposing an Employer Brand Attractiveness Model
Authors: Krishnan Sandeep K. , Kumar Abhishek , Jaganathan Suraj , Srivastava Praveen Kumar
Published: July 2023

Employer branding as a field is evolving very rapidly. Organisations are also investing in employer branding for various business needs. The article explores the business case through literature and real business examples. The business cases show that while the generic business cases around attracting and retaining talent still hold, contextual relevance and embedding the new realities and expectations in employee–employer relationship is critical in articulating a relevant business case for the employer brand. One of the missing links in research and practice is a method for evaluating employer brand attractiveness. The article proposes an evolving model for evaluating employer brand attractiveness that could also be relevant to build a business case.
Evaluation of reduced computational approaches to assessment of tsunami hazard and loss using stochastic source models: Case study for Tofino, British Columbia, Canada, subjected to Cascadia megathrust earthquakes
Authors: Goda Katsuichiro , Orchiston Keith , Borozan Jovana , Novakovic Mark , Yenier Emrah
Published: July 2023

Probabilistic tsunami hazard and risk analyses are important decision support tools in developing tsunami risk reduction strategies and actions for coastal communities. A stochastic source modeling method facilitates the consideration of uncertainties associated with earthquake rupture processes. However, the computational costs are high when inland tsunami inundation and building damage need to be evaluated accurately. To develop a practical solution by keeping the computational requirements at a manageable level, probabilistic tsunami hazard analysis based on low-resolution tsunami simulations but considering a wide range of possible earthquake ruptures can be used to identify smaller sets of stochastic rupture models for target probability levels. These identified stochastic rupture models can be used to obtain the estimates of tsunami building loss by running high-resolution tsunami inundation simulations. A case study is set up for Tofino, British Columbia, Canada, under the potential tsunami threat from the Cascadia megathrust earthquakes to investigate the correlation between the maximum modeled tsunami wave amplitudes at offshore locations and the tsunami building loss. A practical solution is proposed to obtain the tsunami risk estimates based on a limited number of high-resolution tsunami inundation simulations, thus reducing the computational costs for the probabilistic tsunami risk analysis. The effectiveness of the approach is demonstrated by comparing the median value of the tsunami risk estimates from 20 stochastic rupture model simulations that are selected based on probabilistic tsunami hazard analysis for a representative offshore location using the low-resolution tsunami simulations (i.e. 270 m grids) with the full probabilistic tsunami risk analysis of the target building portfolio based on the 1200 high-resolution tsunami simulations (i.e. 5 m grids).
Ten open questions in migraine prophylaxis with monoclonal antibodies blocking the calcitonin-gene related peptide pathway: a narrative review
Authors: Schoenen Jean , Van Dycke Annelies , Versijpt Jan , Paemeleire Koen
Published: August 2023

The monoclonal antibodies (mAbs) blocking the calcitonin-gene related peptide (CGRP) pathway, collectively called here “anti-CGRP/rec mAbs”, have dramatically improved preventive migraine treatment. Although their efficacy and tolerability were proven in a number of randomized controlled trials (RCTs) and, maybe even more convincingly, in real world settings, a number of open questions remain. In this narrative review, we will analyze published data allowing insight in some of the uncertainties related to the use of anti-CGRP/rec mAbs in clinical practice: their differential efficacy in migraine subtypes, outcome predictors, switching between molecules, use in children and adolescents, long-term treatment adherence and persistence, effect persistence after discontinuation, combined treatment with botulinum toxin or gepants, added-value and cost effectiveness, effectiveness in other headache types, and potential contraindications based on known physiological effects of CGRP. While recent studies have already provided hints for some of these questions, many of them will not find reliable and definitive answers before larger studies, registries or dedicated RCTs are available.
Developmental delays in cortical auditory temporal processing in a mouse model of Fragile X syndrome
Authors: Croom Katilynne , Rumschlag Jeffrey A. , Erickson Michael A. , Binder Devin K. , Razak Khaleel A.
Published: July 2023

Background

Autism spectrum disorders (ASD) encompass a wide array of debilitating symptoms, including sensory dysfunction and delayed language development. Auditory temporal processing is crucial for speech perception and language development. Abnormal development of temporal processing may account for the language impairments associated with ASD. Very little is known about the development of temporal processing in any animal model of ASD.

Methods

In the current study, we quantify auditory temporal processing throughout development in the Fmr1 knock-out (KO) mouse model of Fragile X Syndrome (FXS), a leading genetic cause of intellectual disability and ASD-associated behaviors. Using epidural electrodes in awake and freely moving wildtype (WT) and KO mice, we recorded auditory event related potentials (ERP) and auditory temporal processing with a gap-in-noise auditory steady state response (gap-ASSR) paradigm. Mice were recorded at three different ages in a cross sectional design: postnatal (p)21, p30 and p60. Recordings were obtained from both auditory and frontal cortices. The gap-ASSR requires underlying neural generators to synchronize responses to gaps of different widths embedded in noise, providing an objective measure of temporal processing across genotypes and age groups.

Results

We present evidence that the frontal, but not auditory, cortex shows significant temporal processing deficits at p21 and p30, with poor ability to phase lock to rapid gaps in noise. Temporal processing was similar in both genotypes in adult mice. ERP amplitudes were larger in Fmr1 KO mice in both auditory and frontal cortex, consistent with ERP data in humans with FXS.

Conclusions

These data indicate cortical region-specific delays in temporal processing development in Fmr1 KO mice. Developmental delays in the ability of frontal cortex to follow rapid changes in sounds may shape language delays in FXS, and more broadly in ASD.
Metabolomics analysis reveals the differences between Abrus cantoniensis Hance and Abrus mollis Hance
Authors: Cao Kexin , Chen Jianhua , Huang Rongshao , Lu Rumei , Zhou Xiao , Bu Yuanyuan , Li Liangbo , Yao Chun
Published: August 2023

Background

Abrus cantoniensis Hance. (Ac) and Abrus mollis (Am), two edible and medicinal plants with economic value in southern China, belong to the Abrus genus. Due to its growth characteristics, Am often replaces Ac in folk medicine. However, the latest National Pharmacopeia of China only recommends Ac. The differences in the metabolite composition of the plants are directly related to the differences in their clinical efficacy.

Results

The difference in metabolites were analyzed using an untargeted metabolomic approach based on ultrahigh-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC‒ESI‒MS/MS). The roots (R), stems (S) and leaves (L) of the two varieties were examined, and 635 metabolites belonging to 8 classes were detected. A comparative study revealed clear variations in the metabolic profiles of the two plants, and the AmR group had more active ingredients (flavonoids and terpenoids) than the AcR group. The metabolites classified as flavonoids and triterpene saponins showed considerable variations among the various samples. Both Ac and Am had unique metabolites. Two metabolites (isovitexin-2''-xyloside and soyasaponin V) specifically belong to Ac, and nine metabolites (vitexin-2"-O-galactoside, ethyl salicylate, 6-acetamidohexanoic acid, rhein-8-O-glucoside, hederagenin-3-O-glucuronide-28-O-glucosyl(1,2)-glucoside, methyl dioxindole-3-acetate, veratric acid, isorhamnetin-3-O-sophoroside-7-O-rhamnoside, and isorhamnetin-3-O-sophoroside) specifically belong to Am.

Conclusions

The metabolite differences between Ac and Am cause the differences in their clinical efficacy. Our findings serve as a foundation for further investigation of biosynthesis pathways and associated bioactivities and provide guidance for the clinical application of traditional Chinese medicine.