bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Functional Outcomes of Nonoperatively Treated Extra-articular Distal End Radius Fractures in Older Individuals: A Prospective Clinical Study
Authors: Aggarwal Neel , Sinha Siddhartha , Kumar Arvind , Kumar Sandeep , Qureshi Owais A. , Jameel Javed 
Published: December 2024

Background: Distal radius fractures (DRFs) are some of the most common injuries suffered by the elderly; however, there are varied opinions on management. As there is limited research on patient factors affecting functional outcomes in conservatively managed patients with DRFs, this study aimed to find predictive factors for functional outcomes in such patients. Methods: Patients with DRFs satisfying the inclusion criteria were managed with closed reduction and slab followed by cast application. Radiological parameters (radioulnar angulation, dorsal tilt, radial height, and ulnar variance) and functional scores (patient-rated wrist evaluation [PRWE] score, Short Form 8 questionnaire [SF-8], and QuickDASH [Disabilities of the Arm, Shoulder, and Hand]-9) were recorded prereduction, postreduction, at the time of cast removal, and in follow-up visits. Patient factors such as underlying diseases were also recorded, and correlations were analyzed using appropriate software. Results: Patients with diabetes (43.33% of patients) and those with loss in radial height through the course of treatment were found to have poorer functional outcomes ( P-values less than .05 for all functional scores—PRWE, QuickDASH-9, SF-8—except SF-8 at 12 weeks). Patients younger than 60 years were also found to have better functional outcomes at 24 weeks (for PRWE: P-value = .048, for QuickDASH-9: P-value = .032, and for SF-8: P-value = .026). Conclusion: Conservative management plays a major role in the treatment of DRFs, despite the increasing trend of operative management. Diabetes was found to be a predictor of poorer functional outcomes; however, further research is needed to determine the role of these and other factors in detail.
Anatomical Characterization and Topographic Mapping of the Distal Ulnar Nerve and Its Peripheral Branches: A Cadaveric Analysis
Authors: Pautler Benjamin , Marchese Charles , Swancutt Makayla , Beutel Bryan G. 
Published: December 2024

Background: Understanding peripheral ulnar nerve anatomy is necessary to refine surgical treatment of ulnar nerve injuries. This study topographically mapped the ulnar nerve and its distal branch points from a well-defined surgical landmark and assessed for variations in interfascicular motor arrangement and branch size. Methods: Fifty-four cadaveric upper extremities were dissected to expose the distal ulnar nerve and its branches (dorsal cutaneous (DCB), volar sensory (VSB), and motor branches). The motor branch underwent internal neurolysis to record the topographic orientation of abductor digiti minimi (ADM) and flexor pollicis brevis (FPB) fascicles and the combined intrinsic fascicle identified by its terminal branch (first dorsal interosseus (FDI)). Using a standardized grid system, the branch point location of each terminal branch was measured relative to the hook of the hamate. Diameters of VSB, DCB, and motor fascicles were also measured. Results: Mean branch point coordinates relative to the hook of the hamate for the FDI were 22.8 mm radial/32.1 mm distal, 13.6 mm radial/25.1 mm distal for FPB, 7.7 mm ulnar/5.2 mm proximal for ADM, and 15.7 mm ulnar/95.3 mm proximal for DCB. The diameters of the VSB, motor branch, and DCB had a mean of 2.3, 1.9, and 1.6 mm, respectively. Proximal to the hook of the hamate, the fascicular arrangement from radial-to-ulnar was VSB, FPB, FDI/intrinsics, ADM, and DCB. Conclusions: This study provides a complete characterization and mapping of the distal ulnar nerve and its branches to assist surgeons with treatment of ulnar nerve injuries, including nerve transfer.
Reevaluating the Need for Antibiotic Prophylaxis in Adult Upper Extremity Surgery With Hardware
Authors: Yan Yufan , Khabyeh-Hasbani Nathan , Abuqubo Rami Z. , Cohen Joshua M. , Robbins Victoria P. , Pothula Aravind , Koehler Steven M. 
Published: December 2024

Background: Although it is well established that antibiotic prophylaxis is not needed in soft tissue upper extremity cases, there is still no definitive consensus when hardware implantation is involved. We hypothesize that antibiotic prophylaxis is not necessary and there is no difference in postoperative surgical site infection rates regardless of preoperative antibiotic administration. Methods: A retrospective cohort analysis was performed on upper extremity surgical cases with hardware implantation performed at a single institution amongst 5 hand surgeons between November 2021 and November 2023. Implants included plates, screws, Kirschner wires, and suture anchors. Primary outcome measures were diagnosis of surgical site infection by 14 and 30 days postoperatively. Secondary outcomes included the type of management used to treat infection. Categorical variables were compared using Fisher exact test, and continuous variables were compared using Wilcoxon rank-sum test. Results: A total of 232 patients were included for analysis—152 received antibiotic prophylaxis and 80 did not. There were no differences between the 2 groups in terms of demographic factors, comorbidities, or smoking status. There was no difference in infection rates between the group who received antibiotic prophylaxis and the group who did not. Infection rate in the antibiotic prophylaxis group was 4.6% and in the sans antibiotics group was 2.5%. All infections were treated with antibiotics, and there were no differences in the rates of operative washout and hardware removal between the 2 groups. Conclusions: Antibiotic prophylaxis is not necessary in upper extremity surgical cases even when implantation of hardware is involved.
Safety and efficacy of staged primary coiling followed by delayed flow diversion of ruptured intracranial aneurysms: A systematic review and meta-analysis
Authors: Alayli A. , Monsour M. , Schimmel S. , Pressman E. , Klocksieben F. , Mokin M. , Guerrero W.R. , Vakharia K. 
Published: December 2024

Background Ruptured intracranial aneurysms lead to significant mortality and morbidity. Recent advancements have suggested staged coiling with subsequent flow diverter stent placement may reduce the risk of hemorrhage with dual antiplatelet therapy (DAPT) or stent thrombosis in the acute inflammatory phase after aneurysm rupture while still appropriately mitigating risk of aneurysmal rehemorrhage. Materials and Methods A systematic review and single-arm meta-analysis was conducted. Studies reporting patients receiving coiling followed by delayed flow diverter placement on a separate day were included. Results Five studies, comprising 94 patients, were included for meta-analysis. Average time between procedures ranged from 9.8 to 169 days; 24% (95% CI: 10–41%) of patients had a poor functional neurologic outcome (modified Rankin Scale > 2) at discharge compared to 4% (0–11%) at last follow-up. There was one incidence of rehemorrhage between treatments, 0% (0–4%). Vasospasm after coiling was the most common adverse event, 16% (1–41%). There was low risk of ischemic complications [1% (0–8%) with coil placement and 5% (1–11%) with stent placement]. Intraprocedural intracranial hemorrhage was also rare (two patients during coil placement; no cases during stent placement). There were no significant differences if flow diversion was performed less than or greater than 100 days from coiling. Conclusions Our study highlights the benefit of primary coiling with staged flow diversion for the management of ruptured intracranial aneurysms with a low risk for complications. Namely, the rate of rebleeding between treatments was exceptionally low. We advocate for the greater consideration of this treatment combination in the treatment of ruptured intracranial aneurysms.
The effect of rotator cuff repair on sleep quality: Influencing factors and the impact of narcotic medication on postoperative sleep patterns: A systematic review and meta-analysis
Authors: Mozes Adam Daniel , Danilkowicz Richard M , Haichin Loren Stephany , Gonzalez Felipe , Yona Tzadok , Lindner Dror , Beer Yiftah , Garrigues Grant E , Gilat Ron 
Published: December 2024

Background Impaired sleep quality often drives patients with rotator cuff tears (RCT) to seek surgical intervention. This meta-analysis reviews the impact of arthroscopic rotator cuff repair (ARCR) on sleep quality beyond six months and identifies influencing factors, primarily narcotics, on sleep quality. Methods The search spanned PubMed, Google Scholar, Embase, and the Cochrane Central Register, targeting articles evaluating rotator cuff injury and sleep quality. Information gathered included study features, bias risk assessment, evaluation of sleep quality using sleep-specific patient-reported outcomes, and the effects of opiates on sleep outcomes. Results Ten studies, including 445 patients who underwent ARCR were included. The preoperative mean Pittsburgh Sleep Quality Index (PSQI) varied from 6.6 to 15. Eight studies presented a mean PSQI score of 3.6–7.1 at 6 months postoperatively; two studies reported mean score of 4.2 and 5.4 at 12 months. Both were found to be statistically significant by this meta-analysis compared to preoperative scores. Three studies found narcotic use, RCT size, alcohol consumption, diabetes, and hypertension to negatively affect PSQI scores. Discussion Arthroscopic rotator cuff repair significantly improves sleep quality at 6 and 12 months following surgery. Perioperative narcotic use, RCT size, alcohol consumption, diabetes, and hypertension may negatively impact sleep quality.
Cognitive impairment in Huntington's disease and its impact on functioning: Concept elicitation and cognitive debriefing for the Huntington's Disease Everyday Functioning (Hi-DEF) scale
Authors: Petrillo Jennifer , Levine A Alex , Johannesen Jason , Lovell Teya , Rams Alissa , Cano Stefan , Anderson Karen , Klapper Jennifer , Koenig Aaron 
Published: December 2024

Background Cognitive impairment in Huntington's disease (HD) is a key driver of disability that can have deleterious impacts on everyday functioning. Currently available patient-reported outcome measures may not adequately capture the impact of HD-related cognitive impairment on daily life, particularly higher-order executive functioning (i.e., processing information, decision making, multi-tasking, planning, etc.). Objective To address the unmet need to better quantify the functional sequelae of HD-related cognitive impairment by developing the Huntington's Disease Everyday Functioning (Hi-DEF) scale. Methods Qualitative interviews were conducted in two adult cohorts (25–65 years) with early stages of HD (i.e., huntingtin [ mHTT] gene carriers with self-reported cognitive complaints but could still function independently). Cohort 1 included 10 dyads of participants with HD and their care partners, who completed concept elicitation interviews to identify cognitive challenges impacting everyday tasks, which was used to design a draft item-set. Cohort 2, which included 15 additional participants with HD, cognitively debriefed this item-set. Results In Cohort 1, issues with executive functioning were reported 32 times by participants with HD and 22 times by care partners, and challenges with functioning were reported 46 times by participants with HD and 20 times by care partners. Based on these reports, the Hi-DEF scale was developed and cognitive debriefing interviews evaluated its content validity, relevance, clarity, interpretation, and acceptability. Psychometric validation of the Hi-DEF scale is reported elsewhere. Conclusions These interviews revealed the impact of HD-related cognitive impairment on everyday functioning and supported the content validity, relevance, clarity, interpretation, and acceptability of the Hi-DEF scale.
Enhancing the Efficacy of Radiotherapy in Gastric Adenocarcinoma Cells by Gut Microbiota Metabolites: Implications for Urolithin Combination Therapy
Authors: Ahmadi Abdolreza , Hosseini Fatemehsadat , Ostadi Hassan , Gholamhosseinian Hamid , Iranshahy Milad , Rassouli Fatemeh B. 
Published: December 2024

Background Gastric adenocarcinoma (GA) ranks as the fourth leading cause of cancer-related mortality. The clinical effectiveness of radiotherapy in GA patients is often limited by the development of radiation resistance. Urolithins, which are metabolites produced by gut microbiota from ellagitannins, possess good bioavailability and exhibit beneficial pharmaceutical properties. The aim of present study was to determine whether urolithins can enhance the effects of ionizing radiation (IR) on GA cells for the first time. Methods Urolithins were synthesized and MKN-45 cells were pretreated with UroA, UroB, and mUroA for 24, 48 and 72 h, followed by 400, 600 and 800 cGy IR exposure. After recovery, the viability of the cells was evaluated by resazurin assay, and the mode of interaction between urolithins and IR was determined. Then, interactome mapping and gene set enrichment analyses were performed. Upon validating CHEK1 expression in GA tissues and MKN-45 cells, molecular docking was conducted to predict the interaction of urolithins with CHK1. Results Pretreatment with urolithins significantly decreased viability upon radiotherapy. The most considerable decrease in the cell viability was observed after 400 cGy IR exposure. In comparison to the control treatments, 24 h pretreatment with UroA and mUroA significantly ( p < .0001) reduced cell viability to 57.4% and 62.8%, respectively. In addition, 48 h pretreatment with UroA and mUroA significantly ( p < .001) reduced viability to 69.7% and 72.7% after exposure to 400 cGy IR, respectively. Upon 72 h pretreatment with urolithins, only mUroA induced synergistic effects with 400 cGy IR. In silico analyses highlighted CHK1 as one of the main proteins involved in the response to IR-induced DNA damage, showing overexpression in GA samples and MKN-45 cells. Additionally, molecular docking revealed favorable interactions between urolithins and CHK1. Conclusion Present study highlights the notable synergistic effects of urolithins in combination with IR, indicating their potential to improve therapeutic outcomes.
Risk of Chondral Fracture During Implantation of Distal Femur Osteochondral Autograft Plugs: A Human Cadaveric Comparison of Four Different Donor Regions
Authors: Massey Patrick A. , Hayward Daniel , Bonner Christian , Scalisi Wayne , Taylor Ryan , Vincent Elise , W. Rutz Robert , F. Solitro Giovanni 
Published: December 2024

Introduction Distal femoral cartilage lesions can be treated using osteochondral autograft transfer (OAT). When impacting plugs into a recipient site, the cartilage may fracture. This study aimed to analyze OAT donor regions and impaction energies to identify characteristics that lead to fracture. Methods Fifteen cadaver femurs were used with OAT plugs harvested from the following regions: lateral and medial trochlea (LT and MT), lateral and medial intercondylar notch (LIN and MIN). Plugs were impacted into a bone surrogate block using a custom anvil-type system with pre-determined impact heights; 30, 50, 70, and 90 mm. Each plug’s cartilage was examined and determined to be intact or fractured. Chi-square was used to compare the rate of chondral fracture for each region. Results In all, 221 plugs were included. The overall rate of chondral fracture was 45.7%. There was a significant difference in the rate of fracture between regions, with LIN, MIN, LT, and MT, having a fracture rate of 46.6%, 62.7%, 25.0%, and 51.9%, respectively ( P = 0.001). An impact height of 30 mm resulted in a fracture rate of 17.7%. Increasing the impact height from 30 to 50 mm resulted in significantly increased chondral fracture risk ( P = 0.001). Conclusion Different donor regions have varying rates of chondral fracture during OAT plug impaction, with the lateral and medial trochlea being the most resistant to chondral fracture at lower forces. Increased impact energy increases risk of chondral fracture. Surgeons should maintain caution and utilize lower impact energy when inserting OAT plugs.
Smartphone use and personality: Their effects on sleep quality across groups using mediation analysis
Authors: Rahman Tauseef Ur , Jan Zahoor , Alam Aftab , Ali Raian 
Published: December 2024

Purpose The rapid rise in smartphone use has led to declining sleep quality. Excessive internet use has been linked to negative impacts on physical and mental health, and individual personality traits (PT) may contribute to internet addiction and mitigate its harmful effects. This study aims to: (1) examine whether PT mediate the relationship between smartphone use and sleep quality, and (2) investigate whether the relationship between smartphone use and sleep quality varies across different gender and age groups. Methods There were 269 participants in the dataset. The daily averages for sleep duration, sleep distraction, and smartphone use were extracted from the usage data acquired through a dedicated smartphone application. Structural equation modeling was employed to investigate the mediating role of personality in the relationship of smartphone use and sleep quality. Results Results indicated that PT partially mediated the relationship, with a significant negative indirect impact of smartphone use on sleep quality. Age differences were observed, showing distinct patterns between younger and older participants, while no significant gender differences emerged. Conclusions This study found that excessive smartphone use, coupled with low personality indicators, leads to poor sleep quality. Positive personality traits improve sleep outcomes, with age influencing the impact of smartphone use on sleep. Our findings support and contribute to existing concerns about technology overuse and highlight the need for targeted interventions to promote more beneficial technology design and usage patterns.
The effectiveness of digital tools to maintain physical activity among people with a long-term condition(s): A systematic review and meta-analysis
Authors: Howes Sarah , Stephenson Aoife , Grimmett Chloe , Argent Rob , Clarkson Paul , Khan Ameera , Lait Emily , McDonough Leah Rose , Tanner Giorgia , McDonough Suzanne M 
Published: December 2024

Objective Given the well-accepted health benefits, it is important to identify scalable ways to support people with long-term conditions (LTCs) to remain physically active. This systematic review aimed to evaluate the effect of digital tools on the maintenance of physical activity (PA) amongst this population. Methods Electronic databases were searched for randomised controlled trials investigating the effect of digital tools on PA maintenance at least three months post-intervention compared with a non-digital control in participants with long-term conditions. Meta-analyses were conducted at post-intervention and longest maintenance timepoint; subgroup analyses explored the effect of the type of control. Prospero registration: CRD42022299967. Results Twenty-three studies ( n = 5350 participants) were included, with the majority at unclear/high risk of bias. Web-based tools were commonly used (18 studies), 10 monitored PA with a sensor, and digital interventions were often combined with supervised exercise/walks. The overall meta-analysis showed no significant difference in PA between digital interventions compared with any type of control (device-based outcomes: SMD = −0.07, 95% CI [−0.35, 0.21]; self-reported outcomes: SMD = 0.11, 95% CI [−0.01, 0.24]). However, this was moderated by type of control group with subgroup analyses suggesting that the effect of digital interventions on PA surpassed that of an inactive/minimal control at post-intervention (SMD = 0.29) and maintenance timepoints (SMD = 0.24). Conclusions This review provides preliminary evidence that interventions incorporating digital tools may be more effective than minimal controls at supporting people with LTCs to maintain PA. Given the quality of the evidence, confidence in these findings is very low and may change with future research.
Comparing Postoperative Outcomes of Isolated Anterior Cruciate Ligament Reconstruction and the “Terrible Triad” Anterior Cruciate Ligament Reconstruction With Medial Meniscus Ramp and Lateral Meniscus Root Repairs
Authors: Shoemaker Evan P. , Tollefson Luke V. , Kennedy Nicholas I. , McGaver Rebecca Stone , Homan Morgan , Sieffert Kayla J. , Shah Ayush D. , Wulf Corey A. , Larson Christopher M. , Bjerke Brian P. , LaPrade Robert F. 
Published: December 2024

Background: A new “terrible triad” has been reported to be an anterior cruciate ligament (ACL) tear with a concomitant medial meniscus ramp tear and lateral meniscus root tear. Patient-reported outcomes (PROs) for isolated ACL reconstruction (ACLR) versus an ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs are not well known. Purpose: To compare postoperative outcomes between isolated ACLR and ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs. Study Design: Cohort study; Level of evidence, 3. Methods: An initial cohort of 1228 patients with ACLRs were retrospectively identified between April 2016 and November 2021. A total of 41 patients with isolated ACLR (isolated cohort) were age and sex matched to 41 patients who had an ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs (triad cohort). Patients in the triad cohort were identified consecutively by date of surgery. Preoperative and ≥2-year postoperative PROs were evaluated to compare the isolated cohort with the triad cohort. Statistical analysis was performed with unpaired t tests and chi-square tests. Results: Both the isolated cohort and triad cohort demonstrated significant differences between preoperative and postoperative PROs in all questionnaire categories assessed. Postoperative scores for the International Knee Documentation Committee (isolated, 88.8; triad, 86.2; P = .392), Cincinnati (isolated, 91.1; triad, 88.1; P = .295), and Lysholm (isolated, 92.1; triad, 90.1; P = .472) PROs demonstrated no significant differences between the cohorts. No significant difference was found between the isolated and triad cohorts for all preoperative questionnaire categories. Additionally, no significant difference was found in revision or reoperation rates between isolated and triad patients ( P = .733). Conclusion: No significant differences in PROs were found at minimum follow-up of 2 years postoperatively between the patients who underwent isolated ACLR (isolated cohort) and those who underwent ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs (triad cohort). Inferior outcomes were not observed in the triad cohort when revision rates, reoperation rates, and postoperative PROs were compared. Given the optimistic short-term outcomes for isolated versus triad ACLR patients and the known biomechanical consequences of these untreated meniscal injuries, medial meniscus ramp and lateral meniscus root repairs should be performed when encountered concurrently with an ACL tear when possible.