bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative analysis of clinico-metabolic profiles between St Thomas and del Nido cardioplegia solutions: A pilot study
Authors: Rastogi Amit , Tewari Prabhat , Pande Shantanu , Trivedi Rimjhim , Agarwal Surendra Kumar , Dubey Durgesh , Kumar Dinesh 
Published: December 2024

Introduction Cardioplegia (CP) is integral to myocardial protection during cardiac surgery. Two standard cardioplegic solutions viz. Del Nido solution (DNS) and St Thomas solution (STS) are widely used in cardiac surgeries. The DNS is a single-dose CP that offers superior myocardial protection in adults, and studies have claimed myocardial injury in STS patients. The elevated circulatory level of citric acid cycle intermediate, succinate is a metabolic hallmark of ischemia. Its rapid oxidation after reperfusion causes ischemia-reperfusion (IR) injury through mitochondrial reactive oxygen species production. Succinate has been identified as an early marker of IR injury through blood plasma/serum-based clinical metabolomics studies. The primary objective of the study was metabolomic profiling of succinate from the coronary sinus and venous blood. Methods Two blood samples each were obtained from coronary sinus (CS) & venous reservoir from patients before the application of aortic cross-clamp and after the release of aortic cross-clamp from 22 patients divided into two groups. The blood-serum metabolic profiles were measured by 800 MHz NMR spectrometer and compared using univariate statistical analysis methods. The study also compared the two groups’ cardiopulmonary bypass variables and left ventricle functions. Result DNS leads to increased serum levels of succinate in the coronary sinus blood after the reperfusion compared to STS. The results of our study are consistent with a previous study that found DNS administration (90 minutes) increases the inflammatory response in the myocardium. Conclusion NMR-based serum metabolomics revealed significantly increased circulatory succinate in coronary sinus blood of patients administered with DNS cardioplegia in comparison to STS cardioplegia. URL- https://ctri.nic.in/Clinicaltrials/login.php .
From Classroom to Computer: Evaluating the Impact of E-Learning on Lifestyle and Learning Experience in Indian Adolescents
Authors: Chandak Alaka Omprakash , Muraleedharan Manesh , Holkar Mrudula , Washikar Ketaki 
Published: December 2024

Introduction: Amid the COVID-19 pandemic, education systems worldwide were forced to convert to e-learning, with India’s educational system facing unprecedented hurdles. This study investigates the consequences of the shift, including lifestyle changes, and difficulties associated with e-learning and its advantages. Objective: To study the factors associated with e-learning during the COVID-19 pandemic and their correlation with the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Method: The study collected data from 415 students in Pune using a cross-sectional survey method, examining the effects of e-learning on mental health, academic performance, and daily routines using statistical and thematic analytic tools. The UTAUT model’s constructs were used to frame the questionnaire and analyze the data. Results: E-learning was viewed as advantageous in understanding course material, lowering travel costs, and making lifestyle adjustments, particularly in eating habits and sleep patterns. However, disadvantages such as space constraints, connectivity issues, and the cost of gadgets were also reported. Conclusion: E-learning has many advantages, such as better learning perspectives, reduced travel costs, and saving time. However, it is essential to ensure resource availability and technological support while switching to e-learning, especially in India, where the population is high and there is a vast disparity in socioeconomic status and resource and technological allocation. The involvement of multiple stakeholders is essential, including education experts, public health experts, and digital technologists.
Deep learning-based automated tool for diagnosing diabetic peripheral neuropathy
Authors: Qiao Qincheng , Cao Juan , Xue Wen , Qian Jin , Wang Chuan , Pan Qi , Lu Bin , Xiong Qian , Chen Li , Hou Xinguo 
Published: December 2024

Background Diabetic peripheral neuropathy (DPN) is a common complication of diabetes, and its early identification is crucial for improving patient outcomes. Corneal confocal microscopy (CCM) can non-invasively detect changes in corneal nerve fibers (CNFs), making it a potential tool for the early diagnosis of DPN. However, the existing CNF analysis methods have certain limitations, highlighting the need to develop a reliable automated analysis tool. Methods This study is based on data from two independent clinical centers. Various popular deep learning (DL) models have been trained and evaluated for their performance in CCM image segmentation using DL-based image segmentation techniques. Subsequently, an image processing algorithm was designed to automatically extract and quantify various morphological parameters of CNFs. To validate the effectiveness of this tool, it was compared with manually annotated datasets and ACCMetrics, and the consistency of the results was assessed using Bland­–Altman analysis and intraclass correlation coefficient (ICC). Results The U2Net model performed the best in the CCM image segmentation task, achieving a mean Intersection over Union (mIoU) of 0.8115. The automated analysis tool based on U2Net demonstrated a significantly higher consistency with the manually annotated results in the quantitative analysis of various CNF morphological parameters than the previously popular automated tool ACCMetrics. The area under the curve for classifying DPN using the CNF morphology parameters calculated by this tool reached 0.75. Conclusions The DL-based automated tool developed in this study can effectively segment and quantify the CNF parameters in CCM images. This tool has the potential to be used for the early diagnosis of DPN, and further research will help validate its practical application value in clinical settings.
Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability
Authors: Cho Byung-Ki , Choi Seung-myung , Kim Sunghoo , Kim Yoon-ho 
Published: December 2024

Category: Sports; Ankle Introduction/Purpose: Even after a considerable period following the modified Broström procedure, it is not uncommon for individuals to fail to fully regain their pre-injury sports activity capabilities. Return to sports activity can be influenced by various factors beyond the patient's determination (hope for sports activity), including residual pain or swelling, inadequate mechanical stability, deficits in postural control abilities or proprioception, among others. This study aimed to investigate the factors influencing the return to sports activity after anatomical ligament repair for chronic ankle instability. Methods: We conducted a study involving 62 patients under the age of 35 who underwent the modified Broström procedure for chronic ankle instability and were followed up for over 3 years. Among them, 51 patients (82.3%) were able to return to their pre-injury level of sports activity (return group), while 11 patients (17.7%) experienced some or significant limitations (non-return group). Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM). Mechanical stability was assessed through physical examination and stress radiography. peroneal strength was evaluated using Biodex isokinetic dynamometer to measure peak torque and total work during eversion movement. Postural control abilities were analyzed using the static and dynamic stability assessment modes of Biodex posturography. Results: There was a significant difference between the two groups in FAOS pain (94.7 points in return group vs 85.1 points in non-return group, p=0.004) and sports (91.2 points vs 78.8 points, p<.001) subscales. In FAAM assessment, there was a significant difference in the sports activity (90.5 points vs 77.4 points, p<.001). Recurrence of mechanical instability was confirmed in 2 patients (3.9%) in the return group and 4 patients (36.4%) in the non-return group. There were no significant differences between the groups in evertor peak torque and total work. Regarding posturography assessment, static postural control ability(overall stability index) did not show significant differences between the groups, but significant differences were observed in dynamic postural control ability (1.4 vs 2.3, p=0.002). Conclusion: It has been analyzed that residual pain, recurrence of mechanical instability, and inadequate recovery of dynamic postural control ability affect the return to pre-injury level of sports activity after the modified Broström procedure for chronic ankle instability. It is deemed necessary to develop effective treatment strategies considering these factors during the rehabilitation process aimed at returning to sports activity after surgery.
Non-Chilled Saline Irrigation Does Not Affect Postoperative Complication Rate in Percutaneous Foot and Ankle Surgery When Compared to Chilled Saline Irrigation
Authors: Idris Maksat , Gonzalez Tyler , Chien Bonnie Y. , Kaplan Jonathan , Aiyer Amiethab A. , Vulcano Ettore 
Published: December 2024

Category: Other; Midfoot/Forefoot Introduction/Purpose: The advent of minimally invasive percutaneous foot and ankle surgery techniques has helped lower certain complication rates, including wound infection and nonunion. The percutaneous burr is the working horse to perform these procedures. One concern with using the burr is that heat generated from prolonged use may induce bone thermal necrosis, affecting healing and outcomes. It is in contention whether further chilling the irrigation fluid may affect postoperative complication rates. Thus, the objective of this study is to assess the impact of chilled vs non-chilled saline during burr use on percutaneous foot surgery. Methods: Data was prospectively collected for 384 consecutive patients undergoing percutaneous foot and ankle surgeries at two separate facilities, treated with either non-chilled saline or chilled saline. Age, sex, complication rates, union rates and time to union data were collected. Categorical and numerical statistical analysis was performed. Results: 384 patients (chilled = 191, non-chilled = 193) were included. The mean age (SD) for all patients was 50.82 (14.28). Time to union took an average (SD) of 9.87 (3.59) weeks for the chilled saline group and 9.27 (2.91) weeks for the non-chilled saline group (P = .07). Union rates were 100% in the chilled saline group and 99.5% in the non-chilled saline group (P = .50). Complication rates were 1.6% in both the chilled and non-chilled saline groups (P = .65). The complications seen in the chilled saline group included one superficial wound dehiscence, and two delayed unions. The non-chilled saline group saw one non-union, one case of sural neuritis and one case of painful hardware removal. Conclusion: Based on the available data, no significant difference could be detected between chilled saline and non-chilled saline groups during burr use for percutaneous foot surgery when comparing union times, union rates and complication rates.
Osteochondral Lesions of the 1st Metatarsal Head: A Systematic Review
Authors: Butler James J. , Calton Megan , Mener Amanda , Rosenbaum Andrew , Mulligan Michael , Kennedy John G. 
Published: December 2024

Category: Midfoot/Forefoot; Other Introduction/Purpose: The purpose of this systematic review was to evaluate outcomes following surgical intervention for osteochondral lesions of the 1st metatarsal head. Methods: During February 2024, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following surgical intervention for the management of osteochondral lesions of the 1st metatarsal head. Data regarding study characteristics, patient demographics, subjective clinical outcomes, radiological outcomes, complications, and failure rates were extracted and analyzed. In addition, the level of evidence and quality of evidence for each individual study was also assessed. Fifteen studies were included. Results: In total, 324 patients (367 metatarsal) underwent surgical intervention for a 1st metatarsal OCL at a weighted mean follow-up time of 32.1±9.2 months. The mean lesion size was 52.3 ± 8.4 mm2. The most common procedure was osteochondral autograft in 123 cases (19.4%). Other procedures performed included subchondral drilling, particulated juvenile cartilage allograft, osteochondral mosaicplasty, microfracture and anterograde drilling. There were statistically significant improvements in subjective clinical outcomes across all surgical techniques. The overall complication rate was 2.2%, the most common of which was persistent pain (1.5%). There were 29 failures (8.9%) all of which warranted a further surgical procedure. Conclusion: This systematic review demonstrated that osteochondral lesions of the 1st metatarsal head are an uncommon pathology with no consensus regarding the optimal treatment strategy. The most common surgical procedure (osteochondral autograft) restores the osteochondral unit, leading to excellent clinical outcomes at final follow-up. Microfracture destroys the subchondral plate and produces inferior quality fibrocartilage, thus should not be recommended.
Outcomes Following Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus at A Minimum of 10-Year Follow-Up: A Retrospective Review
Authors: Butler James J. , Robert Guillaume , Dahmen Jari , Lin Charles , Samsonov Alan P. , M.M.J. Kerkhoffs Gino M , Kennedy John G. 
Published: December 2024

Category: Ankle; Sports Introduction/Purpose: The purpose of this study was to evaluate outcomes following autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesions of the talus (OLT) at a minimum of 10-year follow-up. Methods: Retrospective chart review identified patients who underwent AOT for the treatment of OLT. Pre-operative magnetic resonance imaging (MRI) scans were obtained in all patients. Clinical outcomes assessed included: pre- and post-operative foot and ankle outcome score (FAOS), visual analog scale (VAS), patient satisfaction, complications, failures and secondary surgical procedures. Results: Thirty-nine patients with a mean lesion size was 122.3±64.1 mm2 and mean follow-up time of 138.9±16.9months were included. The mean FAOS scores improved from a preoperative score of 51.9±16.0 to 75.3±21.9 (p < 0.001). Increasing lesion size was variable associated with inferior FAOS scores (R2=0.2228). There was statistically significant higher mean T2 relaxation values at the superficial layer at the site of the AOT graft (42.9±5.2ms) compared to the superficial layer of the adjacent native cartilage (35.8±3.8ms) (p < 0.001). Seventeen complications (43.6%) were observed, the most common of which was anterior ankle impingement (25.6%). There were 2 failures (5.1%), both of which had a history of prior bone marrow stimulation via microfracture and post-operative cysts identified on MRI. Conclusion: This retrospective review found that AOT for the treatment of large OLTs produced a 94.9% survival rate at a minimum of 10-year follow-up. Increasing lesion size was associated with inferior clinical outcomes. The findings of this study indicates that AOT is a viable long-term surgical strategy for the treatment of large OLTs.
Outcomes Following In-Office Peroneal Needle Tendoscopy: A Retrospective Review
Authors: Butler James J. , Randall Grace W. , Wingo Taylor , Gianakos Arianna , Kennedy John G. 
Published: December 2024

Category: Arthroscopy; Sports Introduction/Purpose: The purpose of this retrospective review is to evaluate the clinical and radiological outcomes following In-Office peroneal Needle Tendoscopy for peroneal tendon dysfunction. Methods: Chart review was conducted to identify patients who underwent In-Office Peroneal Needle Tendoscopy with a minimum of 1-year follow-up. Data collected and assessed included: patient demographics, pathological characteristics, treatment characteristics, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, visual analog scale (VAS) scores, return to sport (RTS), and failures. Results: Ten cases were included. The mean follow-up was 30±6.3 months and the mean age was 45.27±22.15 years. There were 6 men and 4 women. IONT identified 5 tears that were not identified on pre-operative MRI. The mean AOFAS improvement was not statistically significant from 49.3 ± 8.3 preoperatively to 53.2±19.7 at final follow-up (p=0.45). There was no change in mean VAS at 5.4±2.2 preoperatively to 4.6±2.7 at final follow-up (p=.27). All patients returned to work at an average time of 3 days, however only 2 patients reported returning to their sport at the same level following in-office needle tendoscopy. The complication rate was 50% and the failure rate at final follow-up was 80%. The mean time to failure was 8 months. Conclusion: This retrospective study found that IONT is an effective modality in the management of peroneal tendon dysfunction. In particular, IONT identified peroneal tears that were not captured on pre-operative MRI and thus required treatment in an operating suite. The exact role of IONT for the management of peroneal tendon disorders remains unclear, thus further research is warranted.
Outcomes Following Minimally Invasive Dorsal Cheilectomy for Hallux Rigidus: A Systematic Review
Authors: Esser Katherine , Butler James J. , Roof Mackenzie , Mercer Nathaniel , Harrington Michael , Samsonov Alan P. , Rosenbaum Andrew , Kennedy John G. 
Published: December 2024

Category: Midfoot/Forefoot; Other Introduction/Purpose: Cheilectomy of the 1st metatarsophalangeal joint is one of the most common procedures for the management of hallux rigidus. However, there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy (MIDC) for the management of hallux rigidus. The purpose of this systematic review was to evaluate outcomes following MIDC for the management of hallux rigidus. Methods: : During November 2023, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux rigidus. In total, 6 studies were included. Results: In total, 348 patients (370 feet) underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9 ± 16.5 months. The distribution of patients by Coughlin and Shurna's classification was as follows: I (58 patients,27.1%), II (112 patients,52.3%), III (44 patients,20.6%). Three studies performed an additional 1st MTPJ arthroscopy and debridement following MIDC. Retained intra-articular bone debris was observed in 100% of patients in 1 study. The weighted mean AOFAS score improved from a preoperative score of 68.9±3.2 to a postoperative score of 87.1. The complication rate was 8.4%, the most common of which was persistent 1st MTPJ pain and stiffness. Thirty-two failures(8.7%) were observed. Thirty-three secondary procedures(8.9%) were performed at a weighted mean time of 8.6±3.2 months following the index procedure. Conclusion: This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up. A moderate re-operation rate at short-term follow-up was recorded. The marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.
Outcomes Following the Plantar Condylectomy for the Management of Plantar Plate Injuries: A Retrospective Review
Authors: Samsonov Alan P. , Butler James J. , Kennedy John G. 
Published: December 2024

Category: Sports; Midfoot/Forefoot Introduction/Purpose: The purpose of this study was to evaluate outcomes following outcomes following plantar condylectomy for the management of plantar plate injuries. Methods: Retrospective chart review identified 20 patients who underwent a PRP injection for the treatment of plantar plate injuries. Pre-operative magnetic resonance imaging (MRI) scans were obtained and the grade of the plantar plate injury was recorded. Clinical outcomes assessed included: pre- and post-operative foot and ankle outcome score (FAOS), visual analog scale (VAS), complications, failures, secondary surgical procedures, and return to sport data. Results: Twenty patients with a mean follow-up time of 32.1±7.8 months were included. There were 0 patients that were grade 1, 5 patients were grade 2 (25.0%) and 15 patients were grade 3 (75.0%). There was a statistically significant improvement in both FAOS (58.1 -> 91.4) and VAS scores (6.5 -> 1.8) following plantar condylectomy for the management of plantar plate injuries. No complications were observed. There was 1 failure, which underwent a scorpion procedure at 15.6 months following plantar condylectomy. 15 patients played sport pre-operatively, all of which (100%) returned to sport at a mean time of 7.5 weeks following plantar condylectomy. Conclusion: This retrospective review demonstrated improvement clinical and functional outcomes following plantar condylectomy for plantar plate injuries. There was a 100% return to sport rate at a mean time of 7.5 weeks. The failure rate was 5.0%. Further comparative studies with longer follow-up are warranted to determine the precise role of plantar condylectomy for the management of plantar plate injuries.