bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiographic and Clinical Outcomes After Tibial Tubercle Osteotomy for the Treatment of Patella Alta: A Systematic Review and Meta-analysis
Authors: Knapik Derrick M. , Kunze Kyle N. , Azua Eric , Vadhera Amar , Yanke Adam B. , Chahla Jorge 
Published: May 2021

Background: Patella alta is a known risk factor for patellar instability and, in the setting of recurrent patellar instability with significant patella alta, correction of patellar height with a tibial tubercle osteotomy (TTO) may help decrease the failure of soft tissue–based stabilization. Purpose: To perform a systematic review and meta-analysis of radiographic and clinical outcomes after TTO for patella alta. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: PubMed, OVID/Medline, and Cochrane databases were queried in June 2020 for studies reporting outcomes of TTO for patella alta. Data pertaining to study characteristics and design, radiographic and clinical outcome values, and incidence of complications and reoperations were extracted. DerSimonian-Laird continuous and binary random-effects models were constructed to (1) perform subgroup-based analysis of mean changes in radiographic indices after TTO and (2) quantify the pooled incidence of complications and reoperations. Results: Eight studies including 340 patients (420 knees) with a mean age of 24.7 ± 8.4 years were included. The mean follow-up was 53.1 months (range, 3-120 months), with 1 study reporting a mean follow-up of less than 2 years. The pooled mean anterior transfer was 5.6 mm; the mean medial transfer was 8.7 ± 1.3 mm; and the pooled mean distalization of the tibial tubercle was 12.2 ± 4.5 mm. Continuous random-effects meta-analysis determined that significant reductions in the mean Insall-Salvati ratio (1.40 vs 0.98, P < .001), Caton-Deschamps index (1.26 vs 0.97, P < .001), and tibial tubercle to trochlear groove ratio (18.27 vs 10.69, P < .001) were observed after TTO. The overall incidence of complications was 7.6% (95% CI, 4.8%-10.5%), while the overall incidence of reoperations was 14.3% (95% CI 6.2%-22.4%). Conclusion: TTO for patellar instability in the setting of patella alta results in a significant decrease in patellar height with varying degrees of medialization depending on the utilized technique. A mean postoperative complication rate of 7.6% was reported with a reoperation incidence of 14.3%, related primarily to hardware removal.
Altered Knee Laxity and Stiffness in Response to a Soccer Match Simulation in Players Returning to Sport Within 12 Months After Anterior Cruciate Ligament Reconstruction
Authors: Nuccio Stefano , Labanca Luciana , Rocchi Jacopo Emanuele , Mariani Pier Paolo , Sbriccoli Paola , Macaluso Andrea 
Published: May 2021

Background: The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose/Hypothesis: The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise. Study Design: Controlled laboratory study. Methods: A total of 13 soccer players cleared to return to sport after ACLR and 13 healthy control soccer players matched for age, physical activity level, limb dominance, and anthropometric characteristics were recruited. To assess the effects of a standardized soccer match simulation (Soccer Aerobic Field Test [SAFT45]) on AKL and AKS, an arthrometric evaluation was carried out bilaterally before and immediately after SAFT45. To conduct a comprehensive examination of the force-displacement curve, the absolute and side-to-side difference (SSD) values of both AKL and AKS were extracted at 67, 134, and 200 N. Results: The ACLR and control groups showed similar AKL and AKS at baseline ( P > .05). In response to SAFT45, laxity increased bilaterally at all force levels by 14% to 17% only in the control group ( P < .025). Similarly, AKS at 134 and 200 N decreased in response to SAFT45 only in the control group (10.5% and 20.5%, respectively; P < .025). After SAFT45, the ACLR group had 1.9 and 2.5 times higher SSDs of AKS at 67 and 134 N compared with the control group, respectively ( P < .025), as well as a 1.9 times higher SSD of AKS at 134 N compared with baseline ( P = .014). Conclusion: Soccer players at the time of return to sport after ACLR showed an altered mechanical response to a sport-specific match simulation consisting of bilaterally unchanged AKL and AKS. Clinical Relevance: Soccer players showing altered AKL and AKS in response to exercise after ACLR may not be ready to sustain their preinjury levels of sport, thus potentially increasing the risk of second ACL injuries.
Nasal Chondrocyte–Based Engineered Grafts for the Repair of Articular Cartilage “Kissing” Lesions: A Pilot Large-Animal Study
Authors: Šećerović Amra , Pušić Maja , Kostešić Petar , Vučković Mirta , Vukojević Rudolf , Škokić Siniša , Sasi Biljana , Vukasović Barišić Andreja , Hudetz Damir , Vnuk Dražen , Matičić Dražen , Urlić Inga , Mumme Marcus , Martin Ivan , Ivković Alan 
Published: May 2021

Background: Bipolar or “kissing” cartilage lesions formed on 2 opposite articular surfaces of the knee joint are commonly listed as exclusion criteria for advanced cartilage therapies. Purpose: To test, in a pilot large-animal study, whether autologous nasal chondrocyte (NC)–based tissue engineering, recently introduced for the treatment of focal cartilage injuries, could provide a solution for challenging kissing lesions. Study Design: Controlled laboratory study. Methods: Osteochondral kissing lesions were freshly introduced into the knee joints of 26 sheep and covered with NC-based grafts with a low or high hyaline-like extracellular matrix; a control group was treated with a cell-free scaffold collagen membrane (SCA). The cartilage repair site was assessed at 6 weeks and 6 months after implantation by histology, immunohistochemistry, and magnetic resonance imaging evaluation. Results: NC-based grafts, independently of their composition, induced partial hyaline cartilage repair with stable integrity in surrounding healthy tissue at 6 months after treatment. The SCA repaired cartilage to a similar degree to that of NC-based grafts. Conclusion: Kissing lesion repair, as evidenced in this sheep study, demonstrated the feasibility of the treatment of complex cartilage injuries with advanced biological methods. However, the potential advantages of an NC-based approach over a cell-free approach warrant further investigations in a more relevant preclinical model. Clinical Relevance: NC-based grafts currently undergoing phase II clinical trials have a high potential to replace existing cartilage therapies that show significant limitations in the quality and reproducibility of the repair method. We have brought this innovative concept to the next level by addressing a new clinical indication.
PedsQL Multiple Sclerosis Module Domain and Item Development: Qualitative Methods
Authors: Gaudioso Cristina , Oo Samuel , Mar Soe , Hendricks-Ferguson Verna L. , Newland Pamela , Varni James W. 
Published: May 2021

Background: The objective of this qualitative methods study was to develop the domains and items to support the content validity for the Pediatric Quality of Life Inventory (PedsQL) Multiple Sclerosis Module for youth with pediatric-onset multiple sclerosis. Methods: A literature review of multiple sclerosis–specific questionnaires and clinical research was conducted to generate domains. An expert panel composed of 12 neurologists who were pediatric-onset multiple sclerosis specialists provided feedback on the conceptual framework. Focus interviews with 9 youth with pediatric-onset multiple sclerosis and 6 parents were conducted to develop the relevant domains and item content from the patient and parent perspective. In the cognitive interviews phase, 9 youth with pediatric-onset multiple sclerosis and 6 parents provided feedback on item content, relevance, importance, and understandability of the pediatric-onset multiple sclerosis–specific domains and items. The final interview phase with 5 youth with pediatric-onset multiple sclerosis and 5 parents comprised a pilot testing of the new PedsQL MS Module. Results: Eighteen domains were derived from the qualitative methods with item content saturation achieved at 100 items based on 40 interviews with 23 youth with pediatric-onset multiple sclerosis aged 10-21 years and 17 parents. The domains derived include general fatigue, sleep/rest fatigue, cognitive functioning, tingling sensations, numbness sensations, physical weakness, pain, speech, balance, fine motor, vision, urination, constipation, bowel incontinence, worry, communication, treatment, and medicines. Conclusions: Qualitative methods involving 23 youth with pediatric-onset multiple sclerosis and 17 parents in the domain and item development process support the content validity for the new PedsQL MS Module. Future plans include a national field test of the PedsQL MS Module scales and items.
Use of the 33-Item Hypomania Checklist (HCL-33) to Distinguish Bipolar Disorder From Major Depressive Disorder in Older Adults
Authors: Zhang Xinqiao , Li Wen , Zhao Na , Cheung Teris , Ungvari Gabor S. , Wang Gang , Xiang Yu-Tao , Angst Jules 
Published: May 2021

Background: Bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD) in older patients. This study examined the psychometric properties of the 33-item Hypomania Checklist (HCL-33) and its accuracy to differentiate BD from MDD among older adults. Method: A total of 215 depressed older patients were recruited; 107 were diagnosed with BD (71 with BD-type I and 36 with BD-type II) and 108 with MDD. Principal components analysis (PCA) was used to explore the factor structure of the HCL-33. Cronbach’s alpha was calculated to test the internal consistency. Intra-class correlation coefficient (ICC) was used to measure test-retest reliability. The receiver operating characteristic (ROC) analysis was used to generate the optimal cut-off value to differentiate between BD and MDD. Results: Two factors were identified in the PCA analysis accounting for 33.9% of the total variance. The Cronbach’s alpha value for the HCL-33 was 0.912, with 0.922 for factor I and 0.664 for factor II. The test-retest reliability was excellent (ICC: 0.891). The optimal cut-off of the HCL-33 total score for discriminating between MDD and BD was 14, with a sensitivity of 88.8% and specificity of 82.4%. Conclusion: The HCL-33 had satisfactory reliability and validity and could be used to distinguish BD from MDD in older adults.
Prevalence of Obesity in India and Its Neurological Implications: A Multifactor Analysis of a Nationwide Cross-Sectional Study
Authors: Venkatrao Murali , Nagarathna Raghuram , Majumdar Vijaya , Patil Suchitra S. , Rathi Sunanda , Nagendra Hongasandra 
Published: May 2021

Background: India is undergoing a rapid epidemiological transition, from underweight to overweight/obese population. Obesity is a major risk factor in type 2 diabetes and cardiovascular diseases, and is also implicated as a factor in neurological diseases such as Alzheimer’s disease. A robust, pan-Indian estimate of obesity is not yet available. Purpose: This study estimates the pan-Indian prevalence of obesity, stratified across nonmodifiable (age and gender) and modifiable (education and physical activity levels) factors, and across zones and urban/rural. Methodology: Data for 1,00,531 adults from a nationwide randomized cluster sample survey ( Niyantrita Madhumeha Bharata 2017, phase 1) were analyzed. Obesity was determined using body mass index, and cross-tabulations were calculated across zones, age, gender, education, physical activity, and area. To determine statistical significance, t-tests were used. The odds of obesity within each category of the various factors were calculated using binary logistic regression. Results: Prevalence of obesity in India is 40.3%. Zonal variations were seen as follows: south highest at 46.51% and east lowest at 32.96%. Obesity was higher among women than men (41.88% vs. 38.67%), urban than rural (44.17% vs. 36.08%), and over 40 than under 40 (45.81% vs. 34.58%). More education implied a higher obesity (44.6% college vs. 38% uneducated), as did lowered physical activity (43.71% inactive vs. 32.56% vigorously active). The odds ratio for physical activity was 3.83, stronger than age (1.58), education (1.4), urban (1.3), and gender (1.2). Conclusion: Obesity levels in India are very high, across all zones. The odds of being obese increases with age, and is higher among women and among urban dwellers. Obesity is the highest among aging urban men and women who are college educated and are sedentary. Physical activity and aging are the strongest determinants of obesity. Given the high cost of obesity in terms of type 2 diabetes, cardiovascular diseases, and Alzheimer’s disease, urgent public health measures are necessary to reduce its impact.
Industrial policy-making after COVID-19: Manufacturing, innovation and sustainability
Authors: Dean Mark , Rainnie Al , Stanford Jim , Nahum Dan 
Published: May 2021

This article critically analyses the opportunities for Australia to revitalise its strategically important manufacturing sector in the wake of the COVID-19 pandemic. It considers Australia’s industry policy options on the basis of both advances in the theory of industrial policy and recent policy proposals in the Australian context. It draws on recent work from The Australia Institute’s Centre for Future Work examining the prospects for Australian manufacturing renewal in a post-COVID-19 economy, together with other recent work in political economy, economic geography and labour process theory critically evaluating the Fourth Industrial Revolution (i4.0) and its implications for the Australian economy. The aim of the article is to contribute to and further develop the debate about the future of government intervention in manufacturing and industry policy in Australia. Crucially, the argument links the future development of Australian manufacturing with a focus on renewable energy. JEL Codes: L50; L52; L78; O10; O13: O25; O44; P18; Q42
Are multi-cat homes more stressful? A critical review of the evidence associated with cat group size and wellbeing
Authors: Finka Lauren R , Foreman-Worsley Rachel 
Published: May 2021

Objectives The primary objective of this review was to conduct a systematic critical appraisal of published literature, in order to assess the evidence regarding the impact of cat group size on cat wellbeing in the domestic home. The secondary objectives were to: (i) identify additional social and environmental mediators of cat wellbeing in these contexts; and (ii) identify general limitations within the current evidence and provide recommendations for future studies. Methods A systematic search of electronic databases (Scopus, Web of Science and Google Scholar) was conducted using targeted Boolean phrasing. Papers were retained for appraisal of full text where they included a comparison of both single (n = 1) and multi-cat (n ⩾2) domestic housing conditions and/or comparison of different multi-cat group sizes, within a single study, and where they compared outcome measures that were either behavioural and/or physiological and deemed as relevant indicators of cat wellbeing. Results A total of 1334 unique papers were returned, 15 of which were retained. Of these papers, only four stated their primary aim to be an investigation of links between cat group size and cat wellbeing. Overall, the reviewed papers did not indicate consistent directions of effects regarding cat group size and outcome measures relevant to wellbeing. This was similar for the other social and environmental mediators identified. Conclusions and relevance Inconsistency in results is likely due to the substantial methodological variation, limitations in measures used as indicators of wellbeing and limitations in general study designs and reporting. Results also highlight the complex, multifactorial relationships between cat wellbeing and various social and environmental factors. These may be as, if not more, important than absolute numbers of cats residing within a household. Due to the various limitations and general paucity of research, further studies are recommended to provide a suitable evidence base regarding impacts of multi-cat living on cat wellbeing in domestic environments.
Vitamin D Deficiency in Children and Adolescents: Role of Puberty and Obesity on Vitamin D Status
Authors: Saneifard Hedyeh , Shakiba Marjan , Sheikhy Ali , Baniadam Leila , Abdollah Gorji Fatemeh , Fallahzadeh Aida 
Published: May 2021

Background: Vitamin D deficiency is common among children and adolescents and can be affected by several factors such as puberty and obesity. Objective: The aim of this study was to evaluate vitamin D status in children and adolescents and to analyse the influence of puberty and obesity on its level. Method: A cross-sectional study was carried-out, in which clinical and biochemical data were gathered from 384 healthy children and adolescents between May 2019 to May 2020. Results: 220 females and 164 males were enrolled (aged 7-16 years; mean ± SD: 11 ± 2.5). Vitamin D deficiency was found in 49% of the total cases and was significantly more prevalent in females than males (33.1% in female; 15.9% in male, P < .001). Mean vitamin D level was lower in obese children compared with non-obese ( P < .001). Non-obese group had significantly higher levels of vitamin D in Tanner stage IV of puberty than obese individuals (20.1 ± 17.0 vs 5.4 ± 2.0) ( P = .03). Vitamin D levels were significantly lower in females than males only in Tanner stage II (12.3 ± 9.0 vs 19.6 ± 16.6) ( P = .005). The lowest level of Vitamin D was in Tanner stage Ⅳ-Ⅴ in boys and in Tanner stage Ⅱ-Ⅲ in girls ( P < .001). Conclusion: Puberty is an additional risk factor for vitamin D deficiency especially in girls and obese children. This increased risk, together with the fact that most important time for building a proper skeleton is during childhood and adolescent, makes it essential to monitor vitamin D in these age groups.
Best Practices in Specialized Amyloidosis Centers in the United States: A Survey of Cardiologists, Nurses, Patients, and Patient Advocates
Authors: Nativi-Nicolau Jose , Sarswat Nitasha , Fajardo Johana , Finkel Muriel , Abdulsattar Younos , Castaño Adam , Klein Lori , Haddad-Angulo Alexandra 
Published: May 2021

Background: Because transthyretin amyloid cardiomyopathy (ATTR-CM) poses unique diagnostic and therapeutic challenges, referral of patients with known or suspected disease to specialized amyloidosis centers is recommended. These centers have developed strategic practices to provide multidisciplinary comprehensive care, but their best practices have not yet been well studied as a group. Methods: A qualitative survey was conducted by telephone/email from October 2019 to February 2020 among eligible healthcare providers with experience in the management of ATTR-CM at US amyloidosis centers, patients with ATTR-CM treated at amyloidosis centers, and patient advocates from amyloidosis patient support groups. Results: Fifteen cardiologists and 9 nurse practitioners/nurses from 15 selected amyloidosis centers participated in the survey, with 16 patients and 4 patient advocates. Among participating healthcare providers, the most frequently cited center best practices were diagnostic capability, multidisciplinary care, and time spent on patient care; the greatest challenges involved coordination of patient care. Patients described the “ideal” amyloidosis program as one that provides physicians with expertise in ATTR-CM, sufficient time with patients, comprehensive patient care, and opportunities to participate in research/clinical trials. The majority of centers host patient support group meetings, and patient advocacy groups provide support for centers with physician/patient education and research. Conclusions: Amyloidosis centers offer comprehensive care based on staff expertise in ATTR-CM, a multidisciplinary approach, advanced diagnostics, and time dedicated to patient care and education. Raising awareness of amyloidosis centers’ best practices among healthcare providers can reinforce the benefits of early referral and comprehensive care for patients with ATTR-CM.
Contrasting the brain imaging features of MOG-antibody disease, with AQP4-antibody NMOSD and multiple sclerosis
Authors: Messina Silvia , Mariano Romina , Roca-Fernandez Adriana , Cavey Ana , Jurynczyk Maciej , Leite Maria Isabel , Calabrese Massimiliano , Jenkinson Mark , Palace Jacqueline 
Published: May 2021

Background: Identifying magnetic resonance imaging (MRI) markers in myelin-oligodendrocytes-glycoprotein antibody-associated disease (MOGAD), neuromyelitis optica spectrum disorder-aquaporin-4 positive (NMOSD-AQP4) and multiple sclerosis (MS) is essential for establishing objective outcome measures. Objectives: To quantify imaging patterns of central nervous system (CNS) damage in MOGAD during the remission stage, and to compare it with NMOSD-AQP4 and MS. Methods: 20 MOGAD, 19 NMOSD-AQP4, 18 MS in remission with brain or spinal cord involvement and 18 healthy controls (HC) were recruited. Volumetrics, lesions and cortical lesions, diffusion-imaging measures, were analysed. Results: Deep grey matter volumes were lower in MOGAD ( p = 0.02) and MS ( p = 0.0001), compared to HC and were strongly correlated with current lesion volume (MOGAD R = −0.93, p < 0.001, MS R = −0.65, p = 0.0034). Cortical/juxtacortical lesions were seen in a minority of MOGAD, in a majority of MS and in none of NMOSD-AQP4. Non-lesional tissue fractional anisotropy (FA) was only reduced in MS ( p = 0.01), although focal reductions were noted in NMOSD-AQP4, reflecting mainly optic nerve and corticospinal tract pathways. Conclusion: MOGAD patients are left with grey matter damage, and this may be related to persistent white matter lesions. NMOSD-AQP4 patients showed a relative sparing of deep grey matter volumes, but reduced non-lesional tissue FA. Observations from our study can be used to identify new markers of damage for future multicentre studies.
Competition and collaboration: Title IX Coordinators and the barriers to achieving educational equity
Authors: Pappas Brian 
Published: May 2021

How do compliance occupations successfully navigate complex institutional environments characterized by changing policy initiatives, managerial logics, unclear expectations, and competition from other occupational groups? This article examines the work of Title IX Coordinators at U.S. Colleges and Universities, who often hold dual roles, operate at lower levels within the institution, and lack the necessary resources to do their work. Using interviews, surveys, professional association materials, and Title IX job ads, this paper describes how Title IX Coordinators adapt to a complex institutional environment and overcome these obstacles in their efforts to enforce Title IX. Title IX Coordinators develop and create collaborative networks of expertise that develop and build shared institutional influence. Using pre-existing relationships and sharing information and expertise, Title IX Coordinators partner with legal counsel, campus police, human resources, ombuds, student affairs, and other occupations to co-produce Title IX compliance.