bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of a mobile app for traumatic stress management using neurofeedback-based meditation and binaural beat music: A pilot randomized controlled trial
Authors: Choi Yun-Jung , Cho Dong-Hee , Lee Na-Rae 
Published: December 2024

Objective Individuals who have experienced traumatic events often encounter a variety of changes in their lives and and may suffer from them. To help and alleviate these traumatic stress, we developed an evidence-based mobile application (app) for easy accessibility. This study aimed to test the effects of the mobile app for traumatic stress management using neurofeedback-based meditation and binaural beat music. Method Fifty-eight participants were enrolled in a pilot randomized controlled trial (Trial Registration Number: KCT007724) consisting of two groups: (a) experimental group (n = 28) and (b) control group (n = 30). Participants used the mobile app 3 days a week at home for 4 weeks, engaging in neurofeedback-based meditation and binaural beat music. Participants completed self-report measures (SCL-47-R, Psychological Well-Being Post-traumatic Changes questionnaire) and EEG test (emotional stability, anti-stress) at a pretreatment and 1-month follow-up. Results Participants in the experimental group demonstrated significant improvements in psychological well-being (F = 16.37, p < 0.001), emotional stability (F = 10.38; p = 0.002), and the anti-stress index (F = 11.37; p = 0.001). Conclusion The results of this pilot trial, involving a neurofeedback-based meditation and binaural beat-centered music intervention, provide preliminary support and a readily accessible option for individuals seeking to recover from the effects of traumatic events. Additionally, we have established the groundwork for subsequent research to study the efficacy of a neurofeedback-based meditation program and a binaural beat-centered music intervention for those who have experienced traumatic events.
Cognitive Behavioral Therapy Reduces Unhelpful Thinking Among People with Musculoskeletal Symptoms: A Meta-Analysis
Authors: Patel Deven Niraj , Pathapati Rajeev , Hand Catherine , Varma Ashwin , Ramtin Sina , Ring David 
Published: December 2024

Background Greater unhelpful thinking is associated with greater musculoskeletal discomfort and incapability. Cognitive-behavioral therapy (CBT) fosters healthy thinking to help alleviate symptoms. Questions In a meta-analysis of randomized control trials (RCT) of CBT for unhelpful thinking among people with musculoskeletal symptoms, we asked: 1) Does CBT reduce unhelpful thinking and feelings of distress, and improve capability, in individuals with musculoskeletal symptoms? 2) Are outcomes affected by CBT delivery methods? Methods Following QUOROM guidelines, we searched databases using keywords of pain catastrophizing, kinesiophobia, cognitive-behavioral therapy, musculoskeletal and variations. Inclusion criteria were RCT's testing CBT among people with musculoskeletal symptoms. Study quality was assessed with Cochrane Review of Bias 2. Meta-analysis of means and standard deviations was performed. Results CBT led to modest reductions in catastrophic thinking (−0.44 CI: −0.76 to −0.12; P = .01, kinesiophobia (−0.60 CI: −1.07 to −0.14; P = .01) and anxiety symptoms (−0.23 CI: −0.36 to −0.09; P < .01) over six months compared to usual care. There were no improvements in levels capability (−0.28 CI: −0.56 to 0.01; P = .05). CBT led by mental health professionals reduced catastrophic thinking more than CBT led by other clinicians (QB Test = 4.73 P = .03). There were no differences between online and in-person sessions, group versus individual therapy, or surgical versus non-surgical interventions. Conclusion The evidence that CBT delivered by various clinicians in various settings fosters healthier thinking in people presenting for care of musculoskeletal symptoms, supports comprehensive care of musculoskeletal illness. More research is needed to develop indications and interventions that also improve levels of capability. Level-I, meta-analysis of RCT's
‘Deep Deltoid Paradox Sign’ - Anterior Talofibular Ligament Laxity Prevents Development of Deep Deltoid Ligament Laxity in the Presence of Unstable Planus - A Cadaveric Study
Authors: Li Zhikai , Li Zhiheng , Jarvis Gavin , Potten Stephanie , Brassett Cecilia , Pasapula Chandra 
Published: December 2024

Category: Hindfoot; Sports Introduction/Purpose: Adult Acquired Flatfoot Deformity (AAFD)/Progressive collapsing foot deformity (PCFD) starts with failure of the medial longitudinal arch. Determining which feet progress to anteromedial instability of the tibiotalar joint, prior to complete deltoid ligament rupture, is not fully understood. We have observed clinically that, in the presence of anterior talofibular ligament (ATFL) laxity, deep deltoid ligament (DD) laxity and anteromedial ankle instability does not develop (indicated by a negative neutral heel external rotation test/anteromedial drawer test). To date, the protective effect that ATFL rupture/laxity (the most common foot ligament injury) has on preventing DD laxity and anteromedial ankle instability developing in AAFD/PCFD has not been investigated. This understanding is crucial for accurate staging, treatment, and prognosis of both AAFD/PCFD and ATFL repairs. Methods: Unstable planus was induced in 12 cadaveric feet from 6 donors by complete sectioning of the plantar fascia, spring ligament and the plantar 1st tarsometatarsal joint. Paired feet were randomly assigned to having ATFL sectioned or ATFL intact. Feet underwent cyclic loading (2000 cycles) on a custom mounted jig and photos were taken with positional markers on the medial malleolus, fibula, and the talus before and after antero-posterior force application. ImageJ quantified anteromedial and anterolateral ankle joint displacement to reflect DD and ATFL laxity respectively. Results: In ATFL-intact feet, anteromedial displacement increased by 3.46 ± 0.41 µm/cycle (mean ± SD; P = 0.000005; two-tailed, one-sample t-test). In ATFL-sectioned feet, displacement increased 0.61 ± 0.66 µm/cycle (p = 0.072), an 82% reduction in DDL laxity development (P = 0.00006; two-tailed, paired t-test). There was minimal cycle-induced change in anterolateral displacement (ATFL-intact: 0.50 ± 0.50 µm/cycle (p = 0.06); ATFL-sectioned: -0.04 ± 0.90 µm/cycle (p = 0.17). However, absolute anterolateral displacement increased in ATFL-sectioned feet by 7.40 ± 0.12 mm (p = 0.00002). Conclusion: These findings corroborate our clinical findings; in AAFD/PCFD, feet with ATFL laxity paradoxically do not develop DD instability (negative heel external test and anteromedial draw test), which we ascribe the ‘deep deltoid paradox sign’. This phenomenon has significant implications in determining which feet progress to DD laxity in AAFD/PCFD and ultimately DD rupture. Furthermore, surgical management of ATFL ruptures may require patient counselling regarding the development of DD laxity after ATFL repair if AAFD/PCFD is also present. Finally, we propose putative mechanisms based on differential axes of talar rotation and navicular abduction during stance, straining DD when ATFL is intact.
2D or Not 2D, That Is the Question? Weight-Bearing Radiography vs Weight-Bearing Computed Tomography in the Preoperative Evaluation of Charcot-Marie-Tooth Deformity
Authors: Blough Christian , Song Jaehwang , Michalski Max P. , Pfeffer Glenn 
Published: December 2024

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: This is the first study to compare weight-bearing radiographs to weight-bearing computed tomography (WBCT) in the preoperative evaluation of Charcot-Marie-Tooth patients. This comparison is important as WBCT is not widely available, and its current role in preoperative planning remains unclear. Methods: We performed a retrospective review of CMT patients with cavovarus deformity with weight-bearing radiographs (WBR) and WBCT. Lateral talus-first metatarsal angle, calcaneal pitch, anteroposterior (AP) talus-first metatarsal angle, and talonavicular coverage angle were measured on WBR on WBCT. Intraclass correlation coefficients (ICC) between raters and imaging modalities were calculated. ICC values were interpreted as follows: ICC < 0.50 = poor agreement; 0.50 < ICC < 0.75 = moderate agreement; 0.75 < ICC < 0.90 = good agreement; and ICC > 0.90 = excellent agreement. Results: 38 feet from 34 patients, 21 female, 13 male, with an average age of 42 years old (range 19-72) were included. Interrater reliability was good or excellent for all measures except talonavicular coverage angle, which was moderate for both WBR and WBCT (Table 1A). Inter-method reliability was good for all measures except talonavicular coverage angle which was moderate (Table 1B). Conclusion: In the 38 CMT feet assessed in this study, we found good agreement between WBR and WBCT measurements, except for talonavicular coverage angle. For surgeons without access to WBCT, these results may ease concern regarding surgical planning using weight-bearing radiographs alone.
9 Out of 10 Patients Participate in Sports after Talar Osteoperiostic Grafting from the Iliac Crest for Large Osteochondral Lesions of the Talus
Authors: Dahmen Jari , Rikken Quinten , Stufkens Sjoerd , M.M.J. Kerkhoffs Gino M 
Published: December 2024

Category: Ankle Introduction/Purpose: Osteochondral lesions of the talus (OLT) are often caused by sports. The Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) is an autologous press-fit bone grafting technique for large (cystic) primary- and non-primary OLT. The purpose of this study was to prospectively evaluate sport outcomes after the TOPIC surgery. The purpose of this study was to prospectively evaluate sports outcomes for patients with OLT who were treated with the TOPIC procedure. Methods: 61 patients who underwent the TOPIC procedure for a symptomatic OLT were prospectively included up-to 24 months follow-up. Using digital questionnaires, an in-depth telephone interview, and electronic patient files, the return to any level of sport (primary outcome), the return to preoperative level of sport, the return to preinjury level of sport, the return to performance, the participation in improved preoperative level of sport and participation in desired level of sport rates were determined 1- and 2-years after TOPIC. On top of that the Ankle Activity Scale (AAS), Numeric Rating Scale (NRS) for pain while running preoperatively, 1- and 2-years after TOPIC were assessed. Lastly complication and reoperation types and rates were presente Results: 2 years after TOPIC surgery, 98% of patients returned to any level of sport. Of the 61 participants, 90% participated in an improved level of sports compared to pre-operatively, 59% returned to their preinjury level of sports and 3% returned to perform on a higher level of sports than preinjury. The AAS increased significantly from 2 to 5 out of 10 (p < 0.01) both 5 points both 1- and 2-years post-TOPIC. The NRS for pain during running improved from 9 to 5 out of 10 (p < 0.01) 5 points both 1- and 2-years post-TOPIC. Any complication occurred in 3% of cases and in 31% of cases a reoperation was conducted, primarily due to hardware removal. Conclusion: The TOPIC procedure for large OLT results in high return to sport and participation in sport rates 1- and 2-years postoperatively making it a suitable treatment option for the athletic population suffering from OLT.
A Step in the Right Direction. An Analysis of the Most Popular Online Ankle Fracture-Related Patient Education Materials
Authors: Arif Haad A. , Lebrun Gavin , Moore Simon , Friscia David A. 
Published: December 2024

Category: Ankle; Trauma Introduction/Purpose: Due to the increasing accessibility of Internet access, it is becoming more and more important to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. Methods: After conducting a Google search using six terms related to ankle fractures, we collected the first 20 non-sponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using an author-created Ankle Fracture Index (AFI). Results: A total of 46 out of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an “acceptable” quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. Conclusion: Ankle fractures are a common injury among young and old patients alike. With a varied range of treatments available, patients are likely to perform their own Internet searches before arriving at the doctor’s office. Current, online patient education materials on ankle fractures diverge from the overall trend in orthopaedics by demonstrating an eight grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery.
Are there Differences between Osteosynthesis of the Posterior Malleolus with Plates or with Posteroanterior Screws?
Authors: Gonzalez Alonso Marcos , Lajara Heredia Alfonso , Jose Madera Gonzalez Francisco , Rosa Trapote Cubillas Ana , Antonio Sanchez Lazaro Jaime , Fernandez Hernandez Oscar 
Published: December 2024

Category: Trauma; Ankle Introduction/Purpose: Cadaver studies suggest that the use of a plate allows a biomechanically more stable osteosynthesis than screws alone in posterior malleolus fractures. The objectives of this study are to test the subjective functional outcomes and the development of radiographic signs of early osteoarthritis in a cohort of patients with the two treatment groups. Methods: This is a retrospective study of patients operated on between 2020 and 2022 for ankle fractures with osteosynthesis of the posterior malleolus. Patients without preoperative CT scan, follow-up of less than one year and fractures without posterior malleolus synthesis were excluded. A total of 42 patients with a mean age of 53.39 years (± 17.25) and the median follow-up was 12 months (range: 12-45) were included. The Olerud-Molander Ankle Score (OMAS) subjective scale was used and the last follow-up radiograph was analyzed to assess the presence of early osteoarthritis using the Takakura classification. There were no differences in the immobilization time (p=0.843) or in the moment of loading (p=0.275) between both groups. Results: 65% of the patients were women. 52.4% of fractures corresponded to Bartonicek type 3 fractures, followed by type 2 (35.7%) and type 4 (11.9%). The predominant method of osteosynthesis for the posterior malleolus was posteroanterior screws in 24 patients, compared to 18 patients treated with plate and screws. No differences were found between the two groups when analyzing mean age, Bartonicek classification or the proportion of fragment size measured in the axial plane. The OMAS scale obtained a mean of 64.0 points (± 21.58) in the group treated with screws and 58.75 points (± 21.86) in the group treated with screws and plates, finding no significant differences (p=0.06). Ddifferences were found in the radiological results (p=0.511). No secondary displacements were observed in either group. Conclusion: We found no significant differences in the variables studied between the two methods of osteosynthesis in our cohort. These data suggest that posteroanterior screw synthesis may be a valid treatment alternative, although studies with a higher level of evidence are needed to confirm this theory.
Articular Contact Mechanics in Osteochondral Lesions of the Talus: A Weightbearing-CT study
Authors: Peiffer Matthias , Hollander Julian , Arne Burssens Bsc , Stufkens Sjoerd , Ashkani-Esfahani Soheil , Audenaert Emmanuel , M.M.J. Kerkhoffs Gino M , Kwon John Y. , DiGiovanni Christopher W. 
Published: December 2024

Category: Sports; Ankle Introduction/Purpose: Osteochondral Lesions of the Talus (OLT) may progress into a cascade of cartilage degeneration. While edge-loading on the surrounding tibiotalar articular surfaces has been proposed as principal determinant of cartilage degeneration, the pathophysiological pathways have not yet been clarified. The present study aims to evaluate the patient-specific influence of OLTs on the mechanical behaviour of the surrounding cartilage of the talus and tibia. More specifically, this study aims to investigate whether the location of the OLTs influences their loading characteristics during the range of motion of the ankle joint. Methods: Patient-specific 3D models from 36 patients with an OLT, derived from weightbearing CT, were used to analyse the contact stress on the tibiotalar articulation using Discrete Element Analysis (DEA). A matched, virtual healthy control group was developed for each talus. Mean- , peak contact-stress and contact area were calculated during simulated ankle flexion. Results: The mean talar contact-stress was elevated in the OLT cases, with a notable correlation between ankle flexion and OLT location. Edge loading occurred predominantly in anteromedial lesions during dorsiflexion (2.9 MPa (IQR: 1.3) for OLT versus 2.4 MPa (IQR: 0.9) for the controls), while posteromedial lesions were mostly loaded during plantarflexion (3.5 MPa (IQR: 1.7) for the OLT versus 2.9 MPa (IQR: 1.1) for the controls). Conclusion: OLTs influence the whole-joint articular contact mechanics of the ankle, leading to increased stress on both the talus and the opposing tibia. More specifically, a clear pattern of edge-loading on the surrounding OLT cartilage was found. Anterior lesions had the highest stresses in neutral and dorsiflexion, while Posterior lesions experienced higher stress during plantarflexion. OLT versus Healthy Twin Contact Stress Contact stress plot, depicting the difference between OLT (upper) and the matched, healthy twin (lower) for increasing plantarflexion
The ligamentum teres and its role in hip arthroscopy for femoroacetabular impingement: a systematic review
Authors: Migliorini Filippo , Cocconi Federico , Bardazzi Tommaso , Masoni Virginia , Gardino Virginia , Pipino Gennaro , Maffulli Nicola 
Published: December 2024

Abstract
Background
The ligamentum teres (LT) has received attention in patients undergoing hip arthroscopy (HA) for femoroacetabular impingement (FAI). Indeed, a better understanding of the function of the LT and its implications for clinical outcomes in the presence of a torn LT is required. This systematic review analyses the patient-reported outcome measures (PROMs) and the complication rate when an intact or torn LT is encountered during HA for FAI.

Methods
Studies that compared patients with an intact to those with a torn LT managed with debridement during hip arthroscopy for FAI were identified from the Web of Science, PubMed, and Embase. The minimum follow-up for inclusion was 24 months. The Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tool was used to assess the risk of bias. Patient characteristics and PROMs were assessed at the baseline and last follow-up.

Results
The systematic review identified two studies comprising 611 patients. No statistically significant difference was found in pain, Harris Hip Score, and the activities of daily living and sports subscales of the Hip Outcome Score between patients with an intact LT and those with a torn LT treated with debridement, both of whom underwent HA for FAI.

Conclusions
In patients undergoing arthroscopic management for FAI, an intact or torn ligamentum teres managed with debridement does not influence postoperative PROMs. Given the importance of the LT as a structure of the hip joint and the increasing interest in HA for FAI, further standardised studies will be a valuable source for surgeons encountering this pathology.
Heart failure patients’ experiences of self-care neglect: a content analysis
Authors: Bahrodi Parisa Sadat , Safa Azade , Ajorpaz Neda Mirbagher , Avanji Fatemeh Sadat Izadi 
Published: December 2024

Abstract
Background
Heart failure is a chronic and common disorder worldwide. Patients with heart failure need self-care behaviors to manage their condition. Despite the importance of self-care in positive health outcomes, many patients with heart failure neglect their self-care behaviors. Therefore, the present study was conducted to explain heart failure patients’ experiences of self-care neglect.

Methods
This qualitative study was conducted using conventional content analysis method. Participants included 15 patients with heart failure. Data were collected through semi-structured interviews and using purposive sampling method. Sampling continued until data saturation was reached. Data analysis was performed concurrently with data collection. Lincoln and Guba’s four criteria were used to ensure the trustworthiness of the data. Data management was performed using MAXQDA version 24 software.

Results
The results were presented in the form of four main categories and 10 subcategories. In analyzing the data of the study, four main categories emerged in the participants’ experiences: “false cultural beliefs in self-care”, “weakening of mental-psychological power”, “synergy of physical problems”, and “inappropriate support”.

Conclusion
The patients in their experiences of neglect in self-care pointed to false cultural beliefs in self-care, weakening of mental-psychological power, synergy of physical problems, and inappropriate support. Knowing the factors that influence self-care neglect and preventing their occurrence can improve self-care skills and prevent neglect-related side effects in patients with heart failure. Healthcare providers can help improve the health of these patients by developing interventions to mitigate these factors. It is suggested that future research be designed in the form of an intervention to reduce the effect of each of these factors.

Trial registration
This is a qualitative study and has not been registered in Iranian Registry of Clinical Trials.