bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of psoriatic arthritis on quality of life: a systematic review
Authors: James Lija , Hailey Louise H. , Suribhatla Rhea , McGagh Dylan , Amarnani Raj , Bundy Christine E. , Kirtley Shona , O’Sullivan Denis , Steinkoenig Ingrid , White Jonathan P. E. , Vivekanantham Arani , Coates Laura C. 
Published: December 2024

Background: Psoriatic arthritis (PsA) is a chronic inflammatory condition that can affect individuals of all ages. Patients may experience a range of physical and psychological issues. Objective: To examine the impact of PsA on an individual’s quality of life (QoL) and physical function. Design: A systematic review of the literature. Data sources and methods: A comprehensive search was conducted across seven electronic databases (Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, EMBASE, Global Health, MEDLINE and PsycINFO) to retrieve articles related to QoL and lifestyle in adults with PsA. The inclusion criteria were studies published between 2010 and 2021 that used outcomes validated in patients with PsA. The methodological quality was assessed using Joanna Briggs Institute Critical Appraisal Tools. Our primary outcomes were patient-reported outcomes (PROs) measuring QoL and the impact of disease on physical function. The secondary outcomes were assessments of fatigue, anxiety, depression, sleep, work productivity and employment. Results: The study included 37 comprehensive studies that examined the impact of PsA on QoL and physical function. The findings revealed that the impact of PsA extends to various aspects of life, including activities of daily living, physical, and emotional aspects, such as fatigue, sleep disturbance, anxiety and depression. Notably, people with PsA experience reduced health-related quality of life (HRQoL), particularly in emotional, social and mental health aspects. The severity of pain and/or fatigue is directly linked to decreased HRQoL. Importantly, those who fail to achieve minimal disease activity face challenges in work productivity and employment status. Conclusion: To conclude, our review underscores the significant impact of PsA on patients’ HRQoL beyond joint disease. The emotional, social, and mental aspects of PsA require compassionate and holistic management. Trial registration: The PROSPERO international prospective register of systematic reviews – CRD42021257395.
Enhancing Workplace Wellness: A Comprehensive Approach to Sleep Apnea Screening in Onsite Health
Authors: Kozan Selina , Kreider Kathryn Evans , Derouin Anne 
Published: December 2024

Background: This quality improvement project aimed to increase the screening rate for OSA in individuals aged 18 and above with obesity (body mass index [BMI] ≥30). Methods: This quality improvement study occurred from March 2023 to August 2023 using a two-independent pre-implementation post-implementation design. The STOP-Bang Questionnaire (SBQ) was implemented during annual exams, chronic disease management visits, and Department of Transportation (DOT) physicals. Findings: There were 946 patients involved in the study, including 471 in the pre-implementation group and 475 in the post-implementation group. OSA screening increased from 14.1% to 71.6% after implementing the screening protocol in the general population and 26.7% to 90.4% in the commercial driver’s license (CDL) holder population. Of the CDL holders screened in the pre-intervention group, 15 (65.2%) were at intermediate to high risk for OSA (SBQ ≥3), and in the post-intervention group, 33 (50%) had an SBQ score of ≥3. Conclusions/Application to Practice: Standardized OSA screening is crucial because it is common but underdiagnosed. Screening for OSA during DOT exams promotes community safety. Earlier identification of at-risk patients leads to earlier diagnosis and treatment of OSA to prevent long-term complications, reduce healthcare costs, improve patient outcomes, and improve community safety.
Addressing Pre-exposure Prophylaxis Awareness and Knowledge Gaps Among Lebanese Medical Professionals: A Cross-Sectional Study
Authors: Azzi Akel , Chartouni Carine , Sakr Charlyne , Ibrahim Racha , Bou Chebel Zeina , Haddad Elie , Chehata Nabil , Choucair Jacques , Pozniak Anton , Saliba Gebrael 
Published: December 2024

OBJECTIVE In Lebanon, HIV prevalence among key populations such as men who have sex with men is high at 12%, warranting a need for targeted healthcare efforts. Pre-exposure prophylaxis (PrEP) is an effective prevention measure, yet global challenges persist, including limited awareness of PrEP among healthcare professionals. This study investigates PrEP awareness within the Lebanese medical community. METHODS A survey targeted 201 participants from the Saint Joseph University of Beirut, Faculty of Medicine, comprising students, residents, and physicians. Analyses, including chi-square tests, mid- P exact test, and point-biserial correlation, assessed PrEP knowledge and perceptions. RESULTS Significant disparities in PrEP awareness were noted among medical students, residents, and physicians, revealing misconceptions about its purpose, administration, and effectiveness. Positive correlations between age and awareness among medical students suggest evolving awareness during medical education. Residents exhibited higher awareness compared to physicians, emphasizing the impact of recent training. No significant correlation based on specialty was found among physicians, indicating the need for uniform PrEP education across all medical fields. CONCLUSION Addressing PrEP awareness gaps among medical professionals is crucial for effective HIV prevention in Lebanon, necessitating tailored educational strategies integrated into medical curricula and ongoing professional development.
Automated Syndesmotic Distance, Area, and Volume Measurements Using 3D Segmentations of Weightbearing Computed Tomography Scans
Authors: Ghandour Samir , Gholipour Alireza , Guss Daniel , Waryasz Gregory R. , Bejarano-Pineda Lorena , Kwon John Y. , DiGiovanni Christopher W. , Ashkani-Esfahani Soheil 
Published: December 2024

Category: Ankle; Sports Introduction/Purpose: Syndesmotic injuries may be associated with subsequent instability, even following operative fixation of etiologic fractures. The development of advanced imaging techniques like weightbearing computed tomography (WBCT) has enabled clinicians to identify subtle syndesmotic instability under physiologic conditions that would otherwise go undetected using conventional CT scans. Moreover, the normal reference ranges for the syndesmotic interval distance, area at 1 cm above the plafond, and volume 5 cm above the plafond have been established. These measurements, however, may be cumbersome and time-consuming to perform. This validation study aims to develop and evaluate the reliability of an automated algorithm that automatically segments WBCTs of the ankle and performs dimensional measurements. Methods: Five bilateral WBCT scans of individuals with operatively confirmed syndesmotic instability were included (10 ankles). An independent observer manually performed the anterior tibiofibular distance (ATFD) at 1 cm above the plafond, posterior talofibular distance (PTFD) at 1 cm above the plafond, the syndesmotic area (SA) at 1 cm above the plafond using 2D ROI, and the syndesmotic volume (SV) at 5 cm above the plafond using 3D ROI. Visage software was used to perform the measurements manually. The same WBCT scans were fed into the automated algorithm to perform the same measurements. The time required to perform the manual and automated measurements was recorded for comparison. The intraclass correlation coefficient (ICC) was measured for repeated automated measurements to evaluate the automation's consistency Results: The manual measurements required 19 (+/-4) minutes on average to perform for each case compared to 9 (+/-1) minutes for the automated measurements (P< 0.05). The ICC between the repeated automated measurements for each case was 0.99. Conclusion: Our automated syndesmosis dimension measurement tool can efficiently perform the ATFD, PTFD, SA, and SV measurements as reliably as an expert clinician would with significantly less time. Incorporating such a tool into existing healthcare software infrastructure, particularly in foot and ankle clinics, may expand the accessibility of this tool and provide immediate data for clinicians to support their decision-making in real time.
Can ChatGPT Answer Patient Questions Regarding Ankle Fractures & Fixation?
Authors: Kelley Raegan , Mika Aleksander , Luther Lauren , Schultz Jacob , Mitchell Phillip , Strasser Nicholas L. 
Published: December 2024

Category: Trauma; Ankle Introduction/Purpose: The contemporary patient has access to numerous resources on common orthopaedic procedures. Recently, artificial intelligence (AI) driven chatbots have become mainstream, allowing patients to interact with interfaces which supply convincing, human-like answers to posed questions. ChatGPT, a recently developed AI-based chat application, is one such application that has garnered rapid growth and popularity and exhibited high functionality in answering common patient questions regarding a gambit of orthopaedic procedures. While ChatGPT has previously demonstrated reliability in answering questions regarding elective orthopaedic procedures, there is little evidence of its effectiveness in the acute, traumatic setting. Given the likelihood that patients may call on this technology for preoperative education, we sought to determine whether ChatGPT could appropriately answer frequently asked questions (FAQs) regarding traumatic ankle fractures. Methods: Ten FAQs regarding ankle fractures were posed to the chatbot during a conversation thread with no follow up questions or repetition. Each FAQ was analyzed for accuracy using an evidence-based approach. Answers were rated as “Excellent requiring no clarification”, “Satisfactory requiring minimal clarification”, Satisfactory requiring moderate clarification” or “Unsatisfactory response requiring significant clarification.” Results: Of the answers given by the chatbot none received an “unsatisfactory” rating with four not requiring any correction and the majority either requiring minimal (4/10) or moderate (2/10) clarification. Although several answers require nuanced clarification, the chatbot's responses were generally unbiased and evidence based, even for controversial topics. Conclusion: The chatbot effectively provides evidence-based responses to common patient FAQs regarding ankle fractures and fixation, presenting the information in a way that most patients can understand. This resource may serve as a valuable clinical tool in the future especially in the acute, traumatic setting.
Comparison of Achilles Tendon Ruptures Treated with Open, Percutaneous, or Mini-Open Repair Techniques: A Meta-Analysis
Authors: Cho Thomas , Liu Jiayong , Shendge Shradha , Sohn Elisabeth , Mustapha Rayanne 
Published: December 2024

Category: Trauma; Sports Introduction/Purpose: Achilles tendon ruptures is the most common tendon rupture in the lower extremity, causing pain and disability. This injury most commonly occurs in those who engage in physical activities, such as soccer and basketball. Historically the most common surgical technique that was used was the open repair technique, then followed the percutaneous repair technique, and even more recently the mini-open repair technique. Although there have been previous studies that looked at the differences between two of these techniques, there is no meta-analysis to compare all three surgical techniques. The primary purpose of this study was to compare the outcomes between the three surgical techniques for Achilles tendon rupture, which are open repair, percutaneous repair, and mini-open repair. Methods: We searched multiple databases, including PubMed, Google Scholar, and EMBASE, from the inception to November 2023. The eligibility for articles selected included being a comparative study between two of the surgical techniques and having included at least one outcome that was of interest in this study. Meta-analysis was processed by RevMan Web for the open versus percutaneous and open versus mini-open repair groups, and the continuous variables (AOFAS score, ATRS score, average operating time) in the percutaneous versus mini-open group. The Fisher test was used for the dichotomous variables in the percutaneous versus mini-open group due to the small sample sizes. A p-value of ≤ .05 was considered statistically significant. Results: 26 studies including a total of 1898 patients met the inclusion criteria. The percutaneous group had a significantly higher sural nerve injury rate (p < 0.001), lower infection rate (p = 0.006), higher AOFAS score (p = 0.03), higher ATRS score (p = 0.03), and shorter average operating time (p < 0.001) than the open group. In relation to the mini-open group, the percutaneous group had a significantly lower AOFAS score (p = 0.02), lower ATRS score (p = 0.001), shorter average operating time (p < 0.001), higher re-rupture rate (p = 0.03), and higher sural nerve injury rate (p = 0.05). The open group had significantly a higher infection rate (p = 0.04) than the mini-open group. Conclusion: Percutaneous repair had advantages in infection rate, AOFAS score, ATRS score, and average operating time compared to the open repair group. However, the mini-open repair seems to be the superior technique, having advantages in AOFAS score, ATRS score, re-rupture and sural nerve injury rates compared to the percutaneous repair and having a lower infection rate than open repair. In the future, more studies with larger sample sizes should be done to further determine which operative technique is most beneficial.
Comparison of Dorsal and Plantar Approaches for Hoffmann Resection Arthroplasty in Rheumatoid Forefoot
Authors: Bastias Gonzalo F. , Pino Felipe , Parada Cristian , Jofre Magdalena , Henriquez Hugo , Chaparro Felipe 
Published: December 2024

Category: Midfoot/Forefoot; Lesser Toes Introduction/Purpose: Forefoot involvement in patients with Rheumatoid Arthritis (RA) is the most frequent reason for consultation in patients with Rheumatoid Arthritis. Although the use of biologics has substantially improved forefoot deformity at the time of consultation, there are still patients with severe deformities who are not candidates for joint-sparing procedures. Resection arthroplasty is a commonly used procedure for severe deformities of the lesser toes, To our knowledge, no studies have compared the use of plantar and dorsal approaches from the point of view of functional and radiological results and associated complications. Methods: Retrospective study including RA patients with symptomatic foot deformities who underwent 1stMTP arthrodesis and Hoffman resection arthroplasty using a double dorsal longitudinal or transverse plantar approach. AOFAS and VAS scores were applied to all patients pre-and postoperatively at one-year follow-up. In addition, radiological results were evaluated by reestablishing the post-resection metatarsal formula in weight-bearing radiographs. General complications and those associated with the type of approach were recorded. Results: Twenty-four patients were included and divided into two groups: dorsal approach (DA) with 11 patients and plantar approach (PA) with 13 patients. All hallux arthrodesis showed complete healing. Patients in both groups achieved a statistically significant improvement in function and pain compared to their preoperative status. A comparison between both approaches showed no significant differences in the AOFAS scores (p=0.17) and VAS scores (p=0.88). There were no significant differences in the rates of complications associated with the approach or restoration of the metatarsal formula. Conclusion: Dorsal and plantar approaches presented similar results in terms of function and postoperative pain. In this group of patients, there were no significant differences in complications associated with the approach. The metatarsal formula was successfully re-established in both groups.
Comparison of Intermediate-Term Prognosis Between Surgical and Non-Surgical Treatments for Early-Stage Osteoarthritis Conjunction with Chronic Ankle Instability
Authors: Cho Byung-Ki , Choi Seung-myung , Kim Sunghoo , Kim Yoon-ho 
Published: December 2024

Category: Ankle Arthritis; Sports Introduction/Purpose: Repetitive ankle sprains can cause various intra-articular pathologies, and there is a relatively clear consensus on the relationship between chronic ankle instability and osteoarthritis. However, information on the natural course in patients with chronic ankle instability and treatment options for preventing degenerative changes remain limited. This study aimed to compare the intermediate-term prognoses between patients with surgical and non-surgical treatment. Methods: This study included 44 patients who underwent lateral stabilization procedure (anatomical ligament repair or reconstruction) and 62 patients with conservative treatment for chronic ankle instability conjunction with early-stage arthritis of Takakura grade 2. Daily living and sport activities were evaluated using the Foot and Ankle Ability Measure (FAAM). Progression of osteoarthritis was evaluated through periodic weight-bearing radiographs. Additionally, the correlation between clinical evaluation score and the presence of progressive osteoarthritis was analyzed. Results: The FAAM score significantly improved from a mean of 48.8 points preoperatively to 83.6 points at final follow-up (p < .001) in the surgical group, while it also improved in the non-surgical group from a mean of 65.9 points to 74.1 points (p = 0.188). There was no significant difference in daily living ability of the FAAM score between the two groups at final follow-up (88.6 vs 81.4 points, p = 0.385), but the surgical group showed better results than the non-surgical group in sports ability (79.4 vs. 67.3 points, p < .001). The incidence of progression of osteoarthritis grade was not significantly different between surgery group (15.9%) and non-surgical group (17.7%) (p = 0.861). Conclusion: Patients with early medial osteoarthritis accompanied by chronic lateral ankle instability who underwent surgical and non-surgical treatment showed similar intermediate-term clinical outcomes. However, in terms of sports activity ability, the surgical group showed superior results compared to the non-surgical group. The radiological prognosis based on the Takakura grade of degenerative arthritis also showed similar results in both groups. There was a significant difference in clinical evaluation scores between patients with and without progressive osteoarthritis.
Correlation Second-Look Arthroscopy and Magnetic Resonance Image after Arthroscopic Microfracture for Osteochondral Lesions of the Talus
Authors: Lee Kwang-Bok , Kim Jong-Kil 
Published: December 2024

Category: Ankle; Arthroscopy Introduction/Purpose: Arthroscopic microfracture is a commonly used surgical technique for treating osteochondral lesions of the talus. Long-term clinical outcomes have generally been found satisfactory. However, there are few studies that accurately evaluate the quality of cartilage repair after microfracture and its relationship with clinical outcomes. The purpose of this study is to analyze the status of cartilage repair after microfracture using second-look arthroscopy and magnetic resonance imaging (MRI), and compare it with clinical outcomes. Methods: Fifty patients underwent second-look arthroscopy and magnetic resonance imaging (MRI) 12.4 months after microfracture (range, 6-19 months). The MRI performed prior to the second-look arthroscopy was evaluated using the magnetic resonance observation of cartilage repair tissue (MOCART) score. Clinical outcomes were assessed using the Foot and Ankle Outcome Score (FAOS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale, and the Short Form-36 (SF-36) score. Results: In second-look arthroscopy, 13 ankles (39%) exhibited abnormal findings according to ICRS overall repair grades. The postoperative MOCART score was 74.2 (range, 25 to 95). 16 patients (32%) had a mismatch between the MRI and second-look arthroscopic findings. All functional score including FAOS, AOFAS and SF-36 were improved between the preoperative and last follow-up evaluation (p < 0.001). The mean postoperative FAOS scores were 88.8 for grade-I and II ankles (n=37) and 82.9 for grade-III and IV ankles (n=13). There was good correlation between FAOS scores and ICRS grades (p = 0.018). The analysis of the correlation between postoperative FAOS and factors for MOCART evaluation showed that the degree of defect infill (p < 0.001) and subchondral bone (p=0.014) had statistical significance. Conclusion: The second-look arthroscopic evaluation conducted 12.4 months after arthroscopic microfracture indicated incomplete healing in 39% of the lesions. A 32% mismatch between second-look arthroscopy and MRI highlights the challenge for MRI in precisely depicting cartilage repair. Nonetheless, even in the presence of this mismatch, clinical outcomes are predicted to be unfavorable when inadequate cartilage defect infill or the existence of subchondral bone edema is observed on MRI.