bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wide Awake Local Anesthesia No Tourniquet Technique in Hand Surgery: The Patient Experience
Authors: Pina Matthew , Cusano Antonio , LeVasseur Matthew R. , Olivieri-Ortiz Rafael , Ferreira Joel , Parrino Anthony 
Published: December 2021

Background: We attempted to evaluate patient satisfaction and overall experience during wide awake, local anesthesia, with no tourniquet (WALANT) hand surgery and quantify surgery-related outcomes. Methods: We conducted a retrospective analysis of patient demographics, comorbidities, and patient reported outcomes via Single Assessment Numeric Evaluation (SANE) scores collected pre- and postoperatively of patients undergoing WALANT surgery by the 2 participating senior authors. A solution of 1% lidocaine with 1:100,000 epinephrine was used by 1 surgeon, while the other used a 1:1 ratio of 1% lidocaine with 1:100,000 epinephrine and 0.5% bupivacaine for local anesthetic injection. Patients were administered a postoperative survey to assess patient experience, including anxiety and pain levels, and overall satisfaction in the perioperative period. Results: Overall, 97.7% of patients indicated that they would undergo a WALANT-style surgery if indicated in the future, 70.5% ate the day of surgery, and a total of 39.1% of patients reported driving to and from surgery. Postoperative SANE scores increased as compared with preoperative scores across all patients. The use of combination 1% lidocaine with 1:100,000 epinephrine and 0.5% bupivacaine was associated with lower intraoperative and postoperative visual analog scale pain scores. Conclusions: WALANT hand surgery was generally well tolerated with excellent surgical outcomes. Patients reported ease of preparation for surgery, faster recovery, and lack of anesthetic side effects as the main benefits of wide-awake surgery. Combination use of lidocaine and bupivacaine may be better than lidocaine alone with respect to pain control in the initial recovery period.
Metal failure and nonunion at L5-S1 after long instrumented fusion distal to pelvis for adult spinal deformity: Anterior versus transforaminal interbody fusion
Authors: Park Se-Jun , Park Jin-Sung , Lee Chong-Suh , Lee Keun-Ho 
Published: December 2021

Purpose Pseudoarthrosis and metal failure at L5-S1 following long fusion surgery for adult spinal deformity (ASD) remain major issues. Few studies report on which anterior column support technique is better in terms of achieving fusion and avoiding metal failures. Our study aimed to evaluate the fusion status and metal failure rate at L5-S1 after anterior lumbar interbody fusion (ALIF) versus transforaminal lumbar interbody fusion (TLIF). Methods The study population included patients aged >50 years who underwent surgery for ASD. Anterior column supports at L5-S1 using ALIF and TLIF were compared with ≥ 2-year follow-up. Fusion status on 2-year computed tomography (CT) scan, metal failure, visual analog scale (VAS), and Oswestry disability index (ODI) were evaluated. Results 98 patients were included in this study (53 ALIF group and 45 TLIF group). We achieved solid fusion on 2-year CT scans in 88.9% and 69.8% patients in the TLIF and ALIF group, respectively. Metal failure developed in nine (17.0%) and six (13.3%) patients in the ALIF and TLIF group, respectively. The most common failure type was unilateral L5-S1 rod fracture (7 and five patients in the ALIF and TLIF group, respectively). Only one patient with bilateral rod fractures in the ALIF group required revision surgery. There were no differences in the VAS and ODI scores at the last follow-up. Conclusions TLIF showed a better fusion rate than ALIF at L5-S1 after long instrumented fusion for ASD. However, the capacity to restore sagittal parameters was greater in the ALIF group. There were no differences between the groups regarding metal failure rate, revision surgery, or clinical outcomes.
Demographic analysis of knee dislocation: A rare mechanism of injury
Authors: Bozkurt Ibrahim , Ozdemir Guzelali , Bingol Olgun , Kilic Enver , Korucu Alperen , Ocguder Durmus Ali 
Published: December 2021

Purpose The aim of this study was to present to the literature a rare injury mechanism that causes knee dislocation (KD) and describe its characteristics. Methods A retrospective review of patients with KD who were treated between January 2014 and December 2019 at our hospital was performed. Patients with KD due to rotavator machine injury were included in Group 1 and all patients with KD due to other etiological reasons were included in Group 2. Patients’ age, gender, side, injury mechanism, time to surgery, length of stay (LOS), operation time, follow-up time, neurological injury status, vascular injury status, open injury status, and surgical interventions were evaluated. Results A total of 34 patients were evaluated in the study. There was no statistically significant difference between the groups in terms of age, gender, side, or follow-up time ( p = .915, p = 1.000, p = .682, p = .374, respectively). However, LOS and time to surgery were statistically significantly longer in Group 1 ( p = .037, p = .010, respectively). Moreover, neurovascular damage was statistically significantly more common in Group 1. Conclusion As a rare injury mechanism for KD, rotavator machine injuries cause more neurovascular injuries in patients compared to other injury mechanisms and increase the time to surgery and LOS due to preoperative soft tissue damage.
Does posterior cruciate ligament sacrifice influence dynamic balance after total knee arthroplasty? Comparison of cruciate-retaining and cruciate-substituting designs in bilaterally operated patients
Authors: Guven Mehmet Fatih , Karaismailoglu Bedri , Kara Eyyup , Ahmet Serpil Hulya , Guler Cevaydin , Tok Okan , Ozsahin Mahmut Kursat , Aydıngöz Önder 
Published: December 2021

Purpose This study aimed to evaluate whether the posterior cruciate ligament sacrifice during total knee arthroplasty (TKA) has any effect on postoperative standing balance or not. Methods The patients who underwent bilateral TKA with either CR or PS design were analyzed. 30 patients (10 PS, 20 CR) were included for the final analysis. TKA designs were compared in terms of Lysholm score, range of motion, and balance characteristics including somatosensorial, vestibular, and visual balance scales, adaptation, limits of stability, and weight-bearing/squat tests by computerized dynamic posturography. Results The mean follow-up time was 59 months for CR, 49 months for PS group. The average Lysholm score values were 94 for CR and 95 for PS group, indicating functionally similar patient groups. The average knee flexion was found significantly higher in PS group (114°) compared to CR group (102°) ( p = 0.009). In the CR group, motor adaptation tests (toes up/toes down) were found to be better ( p = 0.034). In the on-axis velocity parameter (linear goal orientation) of limits of stability test, PS group patients were found to be more successful ( p = 0.035). Conclusions The use of CR implants can be recommended in patients with a high risk of falling since they provide better motor adaptation providing rapid reactions to rapid surface changes. Better linear goal orientation in PS group, providing a faster movement in an intended direction, should be considered when planning the ideal implant for the patients with relevant activities.
Systematic Review of Platelet-Rich Plasma for Rotator Cuff Repair: Are We Adhering to the Minimum Information for Studies Evaluating Biologics in Orthopaedics?
Authors: DeClercq Madeleine G. , Fiorentino Alyson M. , Lengel Haylie A. , Ruzbarsky Joseph J. , Robinson Sara K. , Oberlohr Verena T. , Whitney Kaitlyn E. , Millett Peter J. , Huard Johnny 
Published: December 2021

Background: The therapeutic efficacy of orthobiologic therapies for rotator cuff repair is difficult to evaluate owing to reporting inconsistences. In response, the Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines were developed to ensure standard reporting on orthobiologic therapies. Purpose: To systematically review clinical studies evaluating platelet-rich plasma (PRP) for full-thickness rotator cuff repair and adherence to MIBO guidelines. Study Design: Scoping review; Level of evidence, 4. Methods: A search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, EMBASE, and the Cochrane Library databases. Inclusion criteria were clinical studies reporting on rotator cuff tears (≥1 cm) surgically repaired with PRP. Patient demographics, biologic intervention, and adherence to the MIBO guidelines were systematically reviewed. Results: A total of 19 studies (1005 patients) were included in this review. Across all studies, 58.5% of the MIBO checklist items for PRP were reported. Out of 47 checklist items, 19 were reported in over 85% of studies, whereas 22 were reported in less than half of studies. Details of whole-blood processing and characteristics, as well as PRP processing and characteristics, were reported inconsistently, and no study provided adequate information to enable the precise replication of preparation protocols for PRP. Conclusion: This systematic review highlights the current reporting deficiencies within the scientific literature of important variables for evaluating PRP for full-thickness rotator cuff repair. There was widespread variability among published studies that evaluate PRP for this application and, more specifically, studies were limited by inconsistent universal reporting of whole-blood and PRP processing and postprocessing characteristics. To improve our understanding of biologic efficacy and to promote repeatability, stricter adherence to the MIBO guidelines is necessary. We propose that the checklist limitations be addressed and that modification of the MIBO guidelines be considered to improve the reporting of individual components within certain categories.
Not Using a Tourniquet May Reduce the Incidence of Asymptomatic Deep Venous Thrombosis After ACL Reconstruction: An Observational Study
Authors: Nagashima Masaki , Takeshima Kenichiro , Origuchi Nobuto , Sasaki Ryo , Okada Yoshifumi , Otani Toshiro , Ishii Ken 
Published: December 2021

Background: Deep venous thrombosis (DVT) and pulmonary embolism are serious potential complications after anterior cruciate ligament reconstruction (ACLR). Little is known about the influence of tourniquet use on the incidence of DVT after ACLR. Purpose: To compare the incidence of DVT after ACLR with and without the use of a tourniquet. Study Design: Cohort study; Level of evidence, 3. Methods: Between November 2018 and May 2020, a total of 60 consecutive ACLRs in 60 patients, including 7 revision surgeries, were performed without tourniquet use at our hospital and were enrolled in this study (T– group). In addition, 55 consecutive ACLRs in 55 patients, including 10 revision surgeries, were performed with tourniquet use between April 2017 and September 2018 and were enrolled as the control group (T+ group). DVT was diagnosed using ultrasonography of both legs performed preoperatively and at postoperative week 1. The incidence of postoperative DVT was compared between the T– and T+ groups. Logistic regression analysis was performed to evaluate the effect of older age (≥40 vs <40 years) and tourniquet use on the occurrence of DVT. Results: No DVTs were detected preoperatively. The incidence of postoperative DVT was significantly lower in the T– group compared with the T+ group (1 patient [1.7%] vs 9 patients [16.4%]; P = .005). All patients with DVT were asymptomatic. Although the mean operative time was not significantly different (80.8 minutes in the T+ group vs 78.5 minutes in the T– group; P = .461), the mean blood loss from the drain was significantly lower in the T– group than in the T+ group (149.9 vs 201.9 mL; P < .001). Age ≥40 years and tourniquet use were significantly related to the occurrence of DVT (odds ratio, 8.3 [95% CI, 1.9-36.8]; P = .005; and odds ratio, 8.8 [95% CI, 1.0-75.3]; P = .047, respectively). Conclusion: ACLRs performed without tourniquet resulted in a significantly lower incidence of DVT after ACLR and significantly less bleeding from drains. If adequate visibility of the surgical field is obtained, ACLR without tourniquet use may reduce the incidence of DVT.
Treatment of Full-Thickness Acetabular Chondral Flaps During Hip Arthroscopy: Bone Marrow Aspirate Concentrate Versus Microfracture
Authors: Kucharik Michael P. , Abraham Paul F. , Nazal Mark R. , Varady Nathan H. , Eberlin Christopher T. , Meek Wendy M. , Naessig Sara A. , Martin Scott D. 
Published: December 2021

Background: The optimal treatment strategy for patients with full-thickness chondral flaps undergoing hip arthroscopy is controversial. Purpose: To compare functional outcomes of patients who underwent bone marrow aspirate concentrate (BMAC) application with those of patients who underwent microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective case series of prospectively collected data on patients who underwent arthroscopic acetabular labral repair by 1 surgeon between June 2014 and April 2020. The inclusion criteria for this study were age ≥18 years, preoperative radiographs of the pelvis, arthroscopic acetabular labral repair, exposed subchondral bone with overlying chondral flap seen at the time of hip arthroscopy, microfracture or BMAC to address this lesion, and completed patient-reported outcome measures (PROMs) (International Hip Outcome Tool–33 [iHOT-33], Hip Outcome Score–Activities of Daily Living [HOS-ADL], Hip Outcome Score–Sports Subscale [HOS-Sport], modified Harris Hip Score [mHHS], and visual analog scale [VAS] for pain) at enrollment and 12-month follow-up. Clinical outcomes were assessed using PROM scores. Results: A total of 81 hips with full-thickness chondral flaps were included in this study: 50 treated with BMAC and 31 treated with microfracture. There were no significant differences between groups in age, sex, body mass index, tear size, radiographic osteoarthritis, or radiographic femoroacetabular impingement. In the BMAC cohort, all PROM scores improved significantly from preoperatively to follow-up: 41.7 to 75.6 for iHOT-33, 67.6 to 91.0 for HOS-ADL, 41.5 to 72.3 for HOS-Sport, 59.4 to 87.2 for mHHS, and 6.2 to 2.2 for VAS pain ( P < .001 for all). In the microfracture cohort, the score improvements were 48.0 to 65.1 for iHOT-33 ( P = .001), 80.5 to 83.3 for HOS-ADL ( P = .275), 59.2 to 62.4 for HOS-Sport ( P = .568), 70.4 to 78.3 for mHHS ( P = .028), and 4.9 to 3.6 for VAS pain ( P = .036). Regarding clinically meaningful outcomes, 77.6% of the BMAC group and 50.0% of the microfracture group met the minimal clinically important difference for iHOT-33 at the 12-month follow-up ( P = .013). Conclusion: Patients with full-thickness chondral flaps at the time of hip arthroscopy experienced greater improvements in functional outcome scores at the 12-month follow-up when treated with BMAC as opposed to microfracture.
Meniscal Root Repair
Authors: Matthews John R. , Paul Ryan W. , Hammoud Sommer 
Published: December 2021

Background: Meniscal root tears typically result from a hyperflexion/squatting injury or are in conjunction with ligamentous knee injury. Once a complete tear occurs, the meniscus is unable to convert axial loads to transverse hoop stresses which result in increased tibiofemoral contact pressure and osteoarthritis. The goal of a meniscal root repair is to anatomically reattach the meniscal root to the tibia plateau. Complete and partial healing occurs in over 93% of cases with retear rates ranging from 0% to 7%. Indications: We present a case of a highly active 21-year-old male collegiate soccer play that sustained a medial meniscal root tear after slipping on ice. Technique: An anatomic medial meniscal root repair was performed using a transtibial guide and 2 loop sutures tied over a button. Results: Full anatomic footprint coverage was able to be achieved intraoperatively and gentle range of motion from 0 to 90° of flexion did not result in gap formation. Discussion/Conclusion: Successful outcomes with full anatomic footprint coverage of the medial meniscal root can be achieved with 2-loop suture button configuration.
The effect and mechanism of Jiao-tai-wan in the treatment of diabetes mellitus with depression based on network pharmacology and experimental analysis
Authors: Tang Yueheng , Su Hao , Wang Hongzhan , Lu Fuer , Nie Kexin , Wang Zhi , Huang Wenya , Dong Hui 
Published: December 2021

Abstract
Background
The incidence of diabetes mellitus (DM) and depression is increasing year by year around the world, bringing a serious burden to patients and their families. Jiao-tai-wan (JTW), a well-known traditional Chinese medicine (TCM), has been approved to have hypoglycemic and antidepressant effects, respectively, but whether JTW has such dual effects and its potential mechanisms is still unknown. This study is to evaluate the dual therapeutic effects of JTW on chronic restraint stress (CRS)-induced DM combined with depression mice, and to explore the underlying mechanisms through network pharmacology.

Methods
CRS was used on db/db mice for 21 days to induce depression-like behaviors, so as to obtain the DM combined with depression mouse model. Mice were treated with 0.9% saline (0.1 ml/10 g), JTW (3.2 mg/kg) and Fluoxetine (2.0 mg/kg), respectively. The effect of JTW was accessed by measuring fasting blood glucose (FBG) levels, conducting behavioral tests and observing histopathological change. The ELISA assay was used to evaluate the levels of inflammatory cytokines and the UHPLC-MS/MS method was used to determine the depression-related neurotransmitters levels in serum. The mechanism exploration of JTW against DM and depression were performed via a network pharmacological method.

Results
The results of blood glucose measurement showed that JTW has a therapeutic effect on db/db mice. Behavioral tests and the levels of depression-related neurotransmitters proved that JTW can effectively ameliorate depression-like symptoms in mice induced by CRS. In addition, JTW can also improve the inflammatory state and reduce the number of apoptotic cells in the hippocampus. According to network pharmacology, 28 active compounds and 484 corresponding targets of JTW, 1407 DM targets and 1842 depression targets were collected by screening the databases, and a total of 117 targets were obtained after taking the intersection. JTW plays a role in reducing blood glucose level and antidepressant mainly through active compounds such as quercetin, styrene, cinnamic acid, ethyl cinnamate, (R)-Canadine, palmatine and berberine, etc., the key targets of its therapeutic effect include INS, AKT1, IL-6, VEGF-A, TNF and so on, mainly involved in HIF-1 signal pathway, pathways in cancer, Hepatitis B, TNF signal pathway, PI3K-Akt signal pathway and MAPK signaling pathway, etc.

Conclusion
Our experimental study showed that JTW has hypoglycemic and antidepressant effects. The possible mechanism was explored by network pharmacology, reflecting the characteristics of multi-component, multi-target and multi-pathway, which provides a theoretical basis for the experimental research and clinical application of JTW in the future.
SpinSPJ: a novel NMR scripting system to implement artificial intelligence and advanced applications
Authors: Liu Zao , Chen Zhiwei , Song Kan 
Published: December 2021

Abstract
Background
Software for nuclear magnetic resonance (NMR) spectrometers offer general functionality of instrument control and data processing; these applications are often developed with non-scripting languages. NMR users need to flexibly integrate rapidly developing NMR applications with emerging technologies. Scripting systems offer open environments for NMR users to write custom programs. However, existing scripting systems have limited capabilities for both extending the functionality of NMR software’s non-script main program and using advanced native script libraries to support specialized application domains (e.g., biomacromolecules and metabolomics). Therefore, it is essential to design a novel scripting system to address both of these needs.

Result
Here, a novel NMR scripting system named SpinSPJ is proposed. It works as a plug-in in the Java based NMR spectrometer software SpinStudioJ. In the scripting system, both Java based NMR methods and original CPython based libraries are supported. A module has been developed as a bridge to integrate the runtime environments of Java and CPython. The module works as an extension in the CPython environment and interacts with Java via the Java Native Interface. Leveraging this bridge, Java based instrument control and data processing methods of SpinStudioJ can be called with the CPython style. Compared with traditional scripting systems, SpinSPJ better supports both extending the non-script main program and implementing advanced NMR applications with a rich variety of script libraries. NMR researchers can easily call functions of instrument control and data processing as well as developing complex functionality (such as multivariate statistical analysis, deep learning, etc.) with CPython native libraries.

Conclusion
SpinSPJ offers a user-friendly environment to implement custom functionality leveraging its powerful basic NMR and rich CPython libraries. NMR applications with emerging technologies can be easily integrated. The scripting system is free of charge and can be downloaded by visiting http://www.spinstudioj.net/spinspj.
Five crucial prognostic-related autophagy genes stratified female breast cancer patients aged 40–60 years
Authors: Li Xiaolong , Zhang Hengchao , Liu Jingjing , Li Ping , Sun Yi 
Published: December 2021

Abstract
Background
Autophagy is closely related to the progression of breast cancer. The aim at this study is to establish a prognostic-related model comprised of hub autophagy genes (AGs) to assess patient prognosis. Simultaneously, the model can guide clinicians to make up individualized strategies and stratify patients aged 40–60 years based on risk level.

Methods
The hub AGs were identified with univariate COX regression and LASSO regression. The functions and alterations of these selected AGs were analyzed as well. Moreover, the multivariate COX regression and correlation analysis between hub AGs and clinicopathological parameters were done.

Results
Totally, 33 prognostic-related AGs were obtained from the univariate COX regression (P < 0.05). SERPINA1, HSPA8, HSPB8, MAP1LC3A, and DIRAS3 were identified to constitute the prognostic model by the LASSO regression. The survival curve of patients in the high-risk and low-risk groups was statistically significant (P < 0.05). The 3-year and 5-year ROC displayed that their AUC value reached 0.762 and 0.825, respectively. Stage and risk scores were independent risk factors relevant to prognosis. RB1CC1, RPS6KB1, and BIRC6 were identified as the most predominant mutant genes. It was found that AGs were mainly involved in regulating the endopeptidases synthesis and played important roles in the ErbB signal pathway. SERPIN1, risk score was closely related to the stage (P < 0.05); HSPA8, risk score were closely related to T stag (P < 0.05); HSPB8 was closely related to N stag (P < 0.05).

Conclusions
Our prognostic model had the relatively robust predictive ability on prognosis for patients aged 40–60 years. If the stage was added into the prognostic model, the predictive ability would be more powerful.