bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Patellar Position After Mobile-Bearing and Fixed-Bearing TKA: A Prospective Randomized Study
Authors: FGA Abreu 
Published: November 2024

Objectives: Total knee arthroplasty (TKA) is the treatment of choice for severe knee osteoarthritis. While many studies compare mobile- and fixed-bearing designs, data on patellar position between these systems remains insufficient. This study aimed to measure and compare patellar position in mobile- and fixed-bearing TKA systems. Methods: This prospective randomized study assessed 160 TKA patients, with 79 receiving a mobile-bearing tibial insert and 81 receiving a fixed-bearing system, between 2007 and 2009. The mean ages were 72 and 70 years, with a mean follow-up of 7.4 years (range 5-11 years). Both groups were comparable pre- and post-operatively using the International Knee Society (IKS) score. Patellar tilt and translation were measured using the technique described by Gomes et al. Results: There were no significant differences between the two groups in the Knee Society knee scores (94 vs 92; p=0.45), pain score (45.8 vs 45.8; p=0.97), function scores (83.2 vs 83.9; p=0.78), or maximum knee flexion (116 vs 112; p=0.07) at the 7-year follow-up. Patellar translation and tilt were also not statistically different between the mobile-bearing and fixed-bearing TKAs. However, a significant difference was found in the subgroup with patellar translation greater than 5mm (OR=2.3; p=0.048) in favor of the mobile-bearing design, although this had no impact on clinical outcomes. Conclusion: No advantages were found for mobile-bearing TKA regarding pain, function, maximum knee flexion, or radiographic outcomes, such as patellar tilt or translation. Longer-term follow-up is required to determine any potential benefits of mobile-bearing over fixed-bearing TKA.
Continuous Vertical Inside-Out Versus Traditional Vertical Inside-Out Meniscal Repair: A Biomechanical Comparison
Authors: Faria JLR , Santos APG , Ocampo More AD , LaPrade RF , Roesler CRM , Salim R 
Published: November 2024

Objectives: To evaluate the displacement, stiffness after cyclical loading, and load to failure for a continuous vertical inside-out meniscal suture compared to a traditional vertical inside-out meniscal suture in a porcine medial meniscus. Methods: Twenty-eight porcine knees were divided into 2 groups of 14 medial menisci each. A 2.0-cm longitudinal cut was made in the red-white zone of the medial meniscus in each knee. The continuous suture (CS) group received 4 vertical stitches using a continuous vertical suture technique, while the inside-out suture (IO) group received a traditional vertical suture with 4 stitches. The specimens underwent load-to-failure testing at 5 mm/s, and displacement, system stiffness, and maximum load to failure were compared between the groups. Results: Displacement after the cyclic test was 0.53 ± 0.12 mm for the CS group and 0.48 ± 0.07 mm for the IO group, with no significant difference (P = .2792). Stiffness at ultimate load testing was 36.3 ± 1.9 N/mm for the CS group and 35.3 ± 2.4 N/mm for the IO group (P = .2557). In the load-to-failure test, the ultimate load was 218.2 ± 63.9 N for the CS group and 238.3 ± 71.3 N for the IO group (P = .3062), showing no significant differences between the groups. Conclusion: The continuous vertical meniscal suture provided biomechanical results similar to the traditional vertical suture technique for the treatment of longitudinal meniscal lesions, offering a viable alternative for meniscal repair.
Correlation Between Catastrophizing and Pain in Knee Osteoarthritis Patients Awaiting Total Knee Replacement
Authors: Campos GC , Pietrobon MS , Moratelli L , Piedade SR , Miranda JB , Zorzi AR 
Published: November 2024

Objectives: Osteoarthritis is a leading cause of pain and disability, particularly in the elderly population. Total knee replacement is the primary treatment for advanced knee osteoarthritis, but not all individuals who undergo total knee arthroplasty are satisfied with the outcome. Psychological factors, such as pain catastrophizing, have been identified as significant contributors to the development of chronic pain after knee replacement. This study aims to correlate catastrophizing thoughts with knee pain, function, and quality of life in patients with knee osteoarthritis awaiting total knee replacement. Methods: Patients awaiting total knee replacement completed questionnaires assessing pain, function, and quality of life, along with the Pain-Related Self-Statements Scale (pain catastrophizing scale). Results: Fifty-three patients were included in the final analysis (64.2% female). The mean PRSS score was 2.6 on a 0-5 scale. The mean VAS and WOMAC scores were 68.0 and 57.34, respectively. A strong positive correlation was found between PRSS and VAS (ρ=0.615; p=0.000) and between PRSS and WOMAC (ρ=0.682; p=0.000). There was also a negative correlation between PRSS and almost all SF-36 domains (-0.6 < ρ < 0.4; p < 0.01). Conclusion: This study found a high incidence of pain catastrophizing among patients awaiting knee replacement and a direct correlation between pain catastrophizing scores and worse pain, function, and quality of life outcomes.
Reinforced static spacer for periprosthetic knee joint infection: Surgical technique and review of literature
Authors: TEMPONI EDUARDO FROIS , DE CARVALHO JUNIOR LUCIO HONORIO , SOARES LUIZ FERNANDO MACHADO , GONCALVES MATHEUS BRAGA JACQUES , PIMENTA FREDERICO SILVA , TEIXEIRA LUAN BERTOLACINI 
Published: November 2024

Objectives This paper reports a simple technique to make a static spacer that can be used in two-stage procedures for periprosthetic knee joint infection with massive bone loss Methods This work, in addition to describing step by step the technique for creating the metallic reinforced static spacer used in revision TKA for periprosthetic joint infection with massive bone loss, makes an important review of the literature on the subject. Results Cement spacers to treat periprosthetic knee joint infection are classified as static or mobile and are used in two-stage procedures. A static knee spacer has been used to deliver high doses of antibiotics locally, to minimize contractures of collateral ligaments and to preserve joint space for subsequent prosthesis re implantation. Conclusion Reinforced static spacer is an option for massive bone loss during periprosthetic joint infection treatment in two-stage procedure. Patients with massive bone loss, lack of soft tissue or ligamentous integrity may be the ideal candidate for its use. Reinforced static spacer provides stable fixation across the knee, local antibiotic delivery, maintenance of the joint space, preservation of soft-tissue tension around the joint and length maintenance
Hormonal Fluctuation and Ankle Instability in Women—Is There a Correlation?
Authors: Hartman Hayden , Fehr Shannon , Gianakos Arianna L. 
Published: November 2024

Background: With higher incidences of ankle sprains and chronic ankle instability in women, it has been postulated that hormonal modulation and ligamentous laxity influences injury propensity. The purpose of this study is to investigate the impact of hormonal fluctuation on ankle stability and ligamentous laxity and their potential contribution to injury propensity in the female athlete. Methods: In November 2023, a systematic review of the MEDLINE, Embase, and Cochrane Library databases was performed following PRISMA guidelines. Articles were included if they were published after the year 2000, evaluated outcomes related to the impact of hormones on ankle stability in healthy patients, and included menstrual tracking. The following search terms were used: “(sex or gender) AND (ankle stability)” and “(hormone) AND (ankle).” Results: Thirteen articles were included, with 253 (76.4%) women at a weighted mean age of 21.9 ± 2.0 years (range, 20.0-25.9). Five studies evaluated postural sway and balance noting greater sway rates during ovulation compared with the follicular phase. Greater muscle tone ( P < .001) was observed in the follicular phase than ovulation for the tibialis anterior, peroneus longus, and lateral gastrocnemius. Significantly higher ankle joint laxity was observed in ovulation ( P = .016). Conclusion: This review found that during ovulation, when estrogen peaks, subjects showed impaired balance with higher postural sway rates, greater ankle joint laxity, and decreased muscle and ligamentous tone and stiffness—an indicator of laxity. An underlying hormonally mediated etiology for the increased propensity to ankle instability in the female athlete is suggested. Syncing an athlete’s workout type and intensity around menstrual cycle phase may be an advantageous strategy for injury prevention.
Sarcopenia and Sarcopenic Obesity in Asian-Indian Patients with Type 2 Diabetes Mellitus and Established Cardiovascular Disease: A Pilot Study of Prevalence
Authors: Wasir Amanpreet Singh , Wasir Jasjeet Singh , Bansal Manish , Joshi Anuradha Rajiv 
Published: November 2024

Purpose To determine the prevalence of sarcopenia and sarcopenic obesity (SO) in patients with type-2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD). Methods This cross-sectional study included 60 T2DM patients (30 with CVD and 30 without, aged 40-70 years, 80% males). Data collection included body composition analysis using bio-impedance, hand grip strength measurement and gait-speed assessment. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS-19) guidelines, while SO was defined using a body-mass index, waist circumference and percentage of body fat. SPSS software version 23.0 was used. P < .05 was significant. Results Overall sarcopenia (including possible sarcopenia or sarcopenia) was found to be significantly higher in patients with CVD as compared to those without CVD (70% vs. 40%; P = .020). Although numerically greater (in patients with CVD), no statistically significant difference was found in the prevalence of SO (30% vs. 16.7%; P = .222). Conclusion Our study found that the prevalence of overall sarcopenia was significantly higher in patients with T2DM and CVD compared to those without CVD. Sarcopenia appears to be a potential independent risk factor in predicting risk of CVD in patients with T2DM.
Empowering Trusted Messengers With Motivational Interviewing Skills: Improving Dissemination of Accurate Information to Communities
Authors: Ivantechenko Marie , Akhter Shubarna , Gutnick Damara 
Published: November 2024

Background Historical injustices, structural racism, and negative healthcare experiences contribute to Black and Brown communities’ distrust of science. Bridging Research, Accurate Information, and Dialogue (BRAID) is a community engagement model that leverages trusted messengers to share accurate, co-created health and science messages to their community through their social networks. In our prior research, trusted messengers reported encountering resistance or “discord” when conveying information about controversial topics such as COVID-19 vaccines and the importance of diversity in clinical trials. Motivational Interviewing (MI) is an evidence-based communication style widely practiced by healthcare providers to guide ambivalent patients toward behavior change. However, MI’s application by community members, particularly trusted messengers, as a strategy for enhancing health message dissemination remains unexplored. Purpose This study used mixed methods to explore the feasibility of training trusted messengers in MI to support the dissemination of public health messages through social networks. Specifically, we sought to understand perspectives on learning MI and use of MI in conversations about clinical trial diversity and research subject protection. Research Design 13 trusted messengers completed a MI introductory training. Results Eighty-five percent found the training highly valuable, 54% reported high self-efficacy, and 69% expressed a desire for additional training. Qualitative analysis revealed trusted messenger endorsement of MI, recognition of MI’s applicability to various contexts, and a sense of empowerment to share accurate information to their communities. Conclusions Our findings suggest that empowering trusted messengers with communication skills can be a practical, feasible, and cost-effective public health strategy for effective dissemination of accurate public health messages.
Optimising the treatment of chronic ischemic heart disease by training general practitioners to deliver very brief advice on physical activity (OptiCor): protocol of the systematic development and evaluation of a complex intervention
Authors: Hoppe Sabrina , Prinz Alicia , Crutzen Rik , Donner-Banzhoff Norbert , Icks Andrea , Kotz Daniel , Kuß Oliver , Mons Ute , Vomhof Markus , Wilm Stefan , Kastaun Sabrina 
Published: November 2024

Abstract
Background
Chronic ischemic heart disease (IHD) is one of the leading causes of morbidity and mortality. Physical activity (PA) is an effective secondary preventive strategy in IHD management. The German treatment guideline recommends that general practitioners (GPs) deliver PA advice to patients. This recommendation seems inadequately implemented, often due to GP’s insufficient specific training. International guidelines recommend training GPs in how to deliver such advice effectively and efficiently. Evidence is lacking on whether such training can enhance the frequency and quality of PA advice in routine care. The OptiCor project aims to develop and evaluate a GP training in the delivery of very brief PA advice to optimise the treatment of patients with IHD in general practice.

Methods
OptiCor comprises three study phases according to the Medical Research Council recommendations for developing and evaluating complex interventions.
Phase 1 (needs analysis): A nationwide representative household survey will be conducted to collect data on the receipt of GP-delivered PA advice in people with IHD. Qualitative interviews and group discussions with GPs and people with IHD will help to explore, e.g., attitudes, experiences with, and barriers and facilitators of PA advice implementation or reception, respectively. Findings will inform the training development.
Phase 2 (pilot): A pragmatic cluster randomised controlled trial (cRCT) on the effectiveness of the developed training on proportions of GP-delivered PA advice during routine care of IHD patients will be piloted.
Phase 3 (evaluation): A full pragmatic cRCT will be conducted with patient-reported proportions of GP-delivered PA advice as primary endpoint. Collection of health economic and process-related data will facilitate a potential future broad implementation and health economic evaluation of the training.

Discussion
If the developed training successfully improves proportions and quality of GP delivered PA advice to patients with IHD, it could serve as a low-threshold and sustainable strategy for implementing PA recommendations in the secondary prevention of IHD in routine GP practice.

Trial registration
Work package (WP) 1, WP5, and WP6 have been prospectively registered at German Clinical Trials Register (WP1: DRKS00031304, 19/06/2023; WP5: DRKS00034641, 10/07/2024; WP6: DRKS00034642; 10/07/2024).
Risk of sarcopenia, frailty and malnutrition as predictors of postoperative delirium in surgery
Authors: Moellmann Henriette Louise , Alhammadi Eman , Boulghoudan Soufian , Kuhlmann Julian , Mevissen Anica , Olbrich Philipp , Rahm Louisa , Frohnhofen Helmut 
Published: November 2024

Abstract
Background
The risk factors for postoperative delirium are numerous and complex. One approach to identifying patients at risk is to evaluate their nutritional status. The aim of this prospective study is to better understand nutrition as a potential risk factor for postoperative delirium.

Methods
A comprehensive preoperative assessment (Clinical Frailty Scale (CFS), the SARC-F questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF)) were carried out as a prospective clinical study on 421 patients (70+) from 4 different surgical disciplines. Postoperatively, patients are examined daily for the presence of delirium using the 4AT screening tool (Arousal, Attention, Abbreviated Mental Test − 4, Acute change), the Nursing Delirium Screening Scale (NuDesc) and the Confusion Assessment Method (CAM) with its adaptation for the intensive care unit (CAM-ICU).

Results
If there were indications of frailty or sarcopenia in the CFS or SARC-F, the association with delirium was increased 5.34-fold (OR of 5.34 [95% CI: 2.57;11.1]) and 5.56-fold (OR of 5.56 [95% CI: 2.97;10.4]) respectively. Delirium also occurred significantly more frequently with the risk of malnutrition or manifest malnutrition (MNA-SF) than with a normal nutritional status.

Conclusions
Patients’ preoperative and nutritional status significantly impact the risk of developing postoperative delirium. Factors such as frailty, sarcopenia and possible malnutrition must be considered when implementing an effective and targeted preoperative assessment.

Trail registration
German Clinical Trials Registry at https://www.drks.de/DRKS00028614, Registered 25 March 2022.
MRI-based radiomic and machine learning for prediction of lymphovascular invasion status in breast cancer
Authors: Zhang Cici , Zhong Minzhi , Liang Zhiping , Zhou Jing , Wang Kejian , Bu Jun 
Published: November 2024

Abstract
Objective
Lymphovascular invasion (LVI) is critical for the effective treatment and prognosis of breast cancer (BC). This study aimed to investigate the value of eight machine learning models based on MRI radiomic features for the preoperative prediction of LVI status in BC.

Methods
A total of 454 patients with BC with known LVI status who underwent breast MRI were enrolled and randomly assigned to the training and validation sets at a ratio of 7:3. Radiomic features were extracted from T2WI and dynamic contrast-enhanced (DCE) of MRI sequences, the optimal feature filter and LASSO algorithm were used to obtain the optimal features, and eight machine learning algorithms, including LASSO, logistic regression, random forest, k-nearest neighbor (KNN), support vector machine, gradient boosting decision tree, extreme gradient boosting, and light gradient boosting machine, were used to construct models for predicating LVI status in BC. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity were used to evaluate the performance of the models.

Results
Eighteen radiomic features were retained to construct the radiomic signature. Among the eight machine learning algorithms, the KNN model demonstrated superior performance to the other models in assessing the LVI status of patients with BC, with an accuracy of 0.696 and 0.642 in training and validation sets, respectively.

Conclusion
The eight machine learning models based on MRI radiomics serve as reliable indicators for identifying LVI status, and the KNN model demonstrated superior performance.This model offers substantial clinical utility, facilitating timely intervention in invasive BC and ultimately aiming to enhance patient survival rates.
A randomized trial of MONOFIX® vs. V-loc™ for resection bed suture during robotic partial nephrectomy
Authors: Han Jang Hee , Jung Gyoohwan , Kim Jung Kwon , Byun Seok-Soo , Seo Seong II , Hong Sung-Hoo , Kwak Cheol , Jeong Chang Wook 
Published: November 2024

Abstract
Background
To evaluate the clinical efficacy and safety of Monofix®-PDO compared to V-Loc™ for tumor bed suturing during robotic-assisted laparoscopic partial nephrectomy (RAPN).

Methods
A randomized, controlled, multicenter, single-blinded trial was conducted across four tertiary institutions. Patients with T1-2 stage renal masses scheduled for RAPN were enrolled. The exclusion criteria included patients not deemed in need of bed suturing, those with a history of prior chemotherapy or immunotherapy, and those with severe systemic diseases or high bleeding tendencies. A total of 174 patients participated and were subjected to permuted block randomization (T1a vs. others), resulting in 88 patients in the V-Loc™ group and 86 in the Monofix®-PDO group. The primary outcome was the resection bed suture time. The secondary outcomes were total suture use time, warm ischemia time, console time (for efficacy), estimated blood loss, hemoglobin change, and 90-day treatment-related adverse events (for safety). All patients were scheduled for follow-up visits for up to three months postoperatively.

Results
The primary outcome, resection bed suture time, did not significantly differ between the V-Loc™ and Monofix®-PDO groups (4.8 ± 2.6 vs. 4.5 ± 2.6 min, p = 0.531). Secondary outcomes, including total suture used time (5.3 ± 2.8 vs. 4.8 ± 2.6 min, p = 0.289) and warm ischemic time (15.6 ± 5.5 vs. 15.4 ± 5.4 min, p = 0.834), were comparable between the two groups. In terms of safety outcomes, changes in serum hemoglobin levels did not show significant differences on postoperative days 1, 3, and 14 (P = 0.537, 0.353, and 0.840, respectively). No device-related adverse events were observed during the 90-day follow-up period in either group.

Conclusions
Monofix®-PDO demonstrated non-inferior to V-Loc in terms of both safety and efficacy in patients undergoing RAPN. This trial is registered on cris.nih.go.kr as KCT0006809 (Registration date: 02/19/2021).
In vivo evaluation of the enamel wear of primary molar against four types of crowns using the intra-oral scanner
Authors: Amer Diana Mohamed , Abdellatif Abeer Mostafa 
Published: November 2024

Abstract
Background
Primary tooth wear is a common phenomenon that affects chewing ability, dental sensitivity, aesthetics, and occlusion. This study was conducted to compare the antagonistic enamel wear of primary molars opposed to four different crown materials.

Methods
Forty lower second primary molars of children aged 4–8 years were allocated into 4 groups: Group 1 (n = 10): received stainless steel crowns; Group 2 (n = 10): received prefabricated commercially available zirconia crowns (NuSmile®); Group 3 (n = 10): received locally manufactured zirconia crowns created via the CAD/CAM system; and Group 4 (n = 10): received locally manufactured hybrid ceramic (Vita Enamic®) crowns created via the CAD/CAM system. All the crowns were cemented with resin-modified glass ionomer cement. The upper arch was scanned with a 3D intraoral scanner immediately (baseline), 6 months, and 1 year after crown cementation to evaluate the wear of the natural enamel of the antagonistic primary molar. The resultant scans were compared via Exocad software to measure the amount of linear wear of the mesiopalatal cusp of the primary upper second molar.

Results
The analysed data revealed statistically significant differences between the studied groups. The highest mean wear was detected in the CAD/CAM zirconia crown group, followed by the NuSmile zirconia crown group and then the CAD/CAM hybrid crown group, and the lowest mean wear was detected for the stainless-steel crown group.

Conclusion
Compared with stainless steel crowns, aesthetic crowns cause more wear in the antagonistic primary molar enamel. CAD/CAM zirconia crowns induce the greatest amount of wear, followed by NuSmile zirconia crowns. The CAD/CAM hybrid crown is an aesthetic tooth-coloured crown that causes less wear of the opposing enamel than zirconia crowns do.

Trial registration
The ClinicalTrials.gov Protocol Registration and Results System (PRS) has this RCT registered as (NCT06456879) on 07/06/2024.