bluuebunny/crossref_metadata_2025_split huggingface dataset:
OUTCOMES OF SURGICAL TREATMENT OF OSTEOCHONDRAL LESIONS OF THE ELBOW IN PEDIATRIC AND ADOLESCENT ATHLETES
Authors: Pandya Nirav K. , Bryant Jessica 
Published: March 2019

BACKGROUND Osteochondral lesions of the elbow are a difficult entity to treat in high-demand individuals. Pediatric and adolescent patients who typically present with these lesions are upper extremity athletes involved in high demand sports. There has been relatively limited examination in the literature of these patients’ ability to return to sport at midterm follow-up; particularly after non-osteochondral grafting procedures such as fixation and micro-fracture. The purpose of this study was to determine the mid-term outcomes of lesion treatment in a cohort of pediatric and adolescent patients. METHODS This was a retrospective review of a consecutive series of pediatric and adolescent patients who underwent surgical treatment for osteochondral lesions of the elbow. Patients were treated arthroscopically by a single surgeon from 2012 to 2017. All patients had confirmed osteochondral lesions of their elbow confirmed via MRI and underwent surgical intervention after failure of conservative treatment. Data including age, hand dominance, sporting activity, physeal status, imaging, intra-operative findings, procedure performed, post-operative complications, and return to sport were analyzed. RESULTS Twenty patients (twenty-two elbows) underwent surgical treatment with a mean age of 13.05 (±1.89) years with a mean follow-up 1.9 years. Fifteen males and 5 females were involved in the following sports: baseball (10), gymnastics (3), football (2), lacrosse (1), softball (2), and multi-sport (2). Sixty-three percent of the elbows had open physes at the time of surgical intervention. There were 19 capitellar lesions, 2 trochlear lesions, and 1 radial head lesion. The mean lesion size was 8.5 (±3.7) mm X 8.9 (±3.0) mm. Three patients underwent fixation, and the remainder underwent loose body removal and microfracture. No patients had any post-operative complications and all healed radiographically. One patient (4.5%) underwent a re operation due to repeat injury after gymnastics, and underwent an osteochondral autograft procedure. Thirty-percent of patients did not return to the same sport; forty-percent of baseball players and sixty-six percent of gymnasts. CONCLUSIONS / SIGNIFICANCE Osteochondral lesions of the elbow are a challenging entity to treat. Although arthroscopic intervention can be performed safely and result in radiographic healing, there is a high rate of inability to return to sport in patients involved in high impact upper extremity activity such as baseball and gymnastics with either fixation or lesion debridement /microfracture. Further treatment strategies in these patients including cartilage restoration procedures (i.e. OATS) may be warranted in this population.
REASONS PEDIATRIC ATHLETES CONTINUE TO PLAY AFTER CONCUSSION
Authors: Zynda Aaron J. , Sabatino Meagan J. , Chung Jane , Cullum Munro , Miller Shane M. 
Published: March 2019

Introduction: As sport-related concussion incidence has increased in the pediatric population, the risks of continuing to play while injured have become apparent. These risks include subsequent injury, prolonged recovery, and Second Impact Syndrome. The purpose of this study was to determine why pediatric athletes continue to play following a concussion. Methods: Prospectively collected data of subjects enrolled in the North Texas Concussion Network Registry (ConTex) between December 2015 and April 2018 was reviewed. Subjects were included in this analysis if they were diagnosed with a sport-related concussion, less than 19 years old at time of injury, reported they continued to play, and provided a reason for continuing play. Results: 258 subjects met inclusion criteria. Mean age was 13.9 years (range: 7-18 years) and 130 (50.4%) subjects were female. 142 (55%) subjects reported they continued to play following their concussion. Of those subjects who continued to play, 45 (31.7%) reported they “felt okay at the time”, 41 (28.9%) reported they wanted to “play through the injury or tough it out”, 36 (25.4%) reported they “did not realize it was a concussion”, 17 (11.9%) reported they “felt pressured to play from their coach or teammates”, and 3 (2.1%) reported they “were allowed to continue to play by an athletic trainer”. No significant differences were noted in age, gender, or sport of the pediatric athletes amongst the reasons for continuing to play. Conclusions: More than half of pediatric athletes continued to play following their concussion. Pediatric athletes most frequently continued to play because they were not experiencing symptoms at the time of the injury, wanted to play through it, and did not think their injury was a concussion. Future educational programs should take these reasons into consideration to prevent pediatric athletes from continuing to play following a concussion.
PREVENTING INJURY IN YOUTH ATHLETES (PRIYA)
Authors: Jayanthi Neeru 
Published: March 2019

Affiliation: Emory Sports Medicine Center & Emory University School of Medicine, Atlanta, GA Background: To compare the incidence of re-injury after lower extremity (LE) injury and the days missed following LE injury in high school athletes who use a criteria-based single leg hop test (SLHT) to determine return-to-play (RTP) versus those that do not utilize a criteria-based method. Methods: Prospective cohort analysis of athletic exposures (AE), injuries, re-injuries, and RTP duration between two high schools during the 2017-2018 fall season. One school (SLHT school) utilized the SLHT to determine RTP after LE injuries. The other school (control school) did not utilize a criteria-based method. Athletes were excluded if they sustained a fracture, high-grade ligament tear, or injury requiring surgery. Incidence rates (IR) of LE injuries, re-injuries, and average RTP duration after LE injury were calculated for each school. Results: At the time of submission, there were 66,100 AEs with 41 LE injuries (LE injury IR = 6.2 per 10,000 AEs, 95% CI 4.6-8.4) at the SLHT school and 45,342 AEs with 34 LE injuries (7.7 per 10,000 AEs, 95% CI 5.5-10.8) at the control school (p=0.34). The average RTP duration after LE injury was 12.3 days at the SLHT school and 12.7 days at the control school (p=0.12). There were no re-injuries after LE injury at the SLHT school, and 1 at the control school. Conclusions: There was no statistically significant difference between LE injury rates or RTP duration between the control and intervention schools. There was only 1 re-injury after LE injury that occurred at the control school. Significance: The SLHT does not appear to influence reinjury risk in RTP progression, however it does not add any additional days missed on RTP compared to control school with no criteria-based progression. We will continue to monitor for differences prospectively for another year of exposures. Acknowledgements This study was supported by a grant from the AMSSM Foundation and a grant from the Emory University Department of Orthopaedics.
FLEXOR HALLUCIS LONGUS TENOLYSIS/TENOSYNOVECTOMY IN DANCERS
Authors: Barchi Elizabeth I. , Rose Donald , Swensen Stephanie , Espiritu-McKay Tracy 
Published: March 2019

Purpose: The purpose of this study was to report on a series of dancers who had undergone Flexor Hallucis Longus (FHL) tenolysis/tenosynovectomy after having failed conservative management. Methods: Institutional human subjects committee approval was obtained prior to initiating this study. This study is a retrospective case series of 58 dancers and 63 ankles who underwent FHL tenolysis/tenosynovectomy via an open posteromedial approach by a single surgeon between 1993-2017. All patients were interviewed and charts reviewed retrospectively. Collected variables included: pre-operative and post-operative pain levels, time to return to dance, and subjective satisfaction with the procedure. Average age, primary dance form, level of dance were determined. Results: Average pre-operative pain level decreased significantly post-operatively. Average time to return to dance was 7.1 weeks. There was a 98% return to dance at some level while 97% of patients returned to dance symptom-free. There were no neurovascular or other major complications. Minor complications included superficial wound infection (3.1%) and hypertrophic scar (4.8%). Over 97% of dancers considered the procedure a success and 98% of dancers would repeat the procedure. Conclusions: This is one of the largest series reported of isolated FHL tenolysis/tenosynovectomy in dancers who have failed non-operative management. Satisfactory pain relief and return to dance with a low complication rate may be expected from this surgical procedure. The results of this study can be used to help dancers and their providers make informed decisions about treatment in isolated FHL tendinitis.
USE OF A WASHER DOES NOT AFFECT THE RATE OF IMPLANT REMOVAL OR ELBOW MOTION AFTER FIXATION OF MEDIAL EPICONDYLE FRACTURES
Authors: Patel Neeraj M. , Gajewski Christopher R. , Ascoli Anthony M. , Lawrence J. Todd 
Published: March 2019

Background: The use of a washer to supplement screw fixation can prevent fragmentation and penetration during the surgical treatment of medial epicondyle fractures. However, concerns may arise regarding screw prominence and the need for subsequent implant removal. The purpose of this study is to evaluate the impact of washer utilization on the need for hardware removal and elbow range of motion (ROM). Methods: All surgically-treated pediatric medial epicondyle fractures over a 7-year period were queried for this retrospective case-control study. Patients were only included if their fracture was fixed with a single screw with or without a washer. Per institutional protocol, implants were not routinely removed after fracture healing. Hardware removal was performed only if the patient experienced a complication or implant-related symptoms that were refractory to non-operative management. Full ROM was considered flexion beyond 130 degrees and less than a 10-degree loss of extension. Univariate analysis was followed by creation of Kaplan-Meier (one minus survival) curves in order to analyze the time until full ROM was regained after surgery. Curves between patients with and without a washer were compared with a log rank test. Results: Of the 137 patients included in the study, the mean age was 12.2±2.3 years and 85 (62%) were male. A total of 31 (23%) patients ultimately underwent hardware removal. A washer was utilized in 90 (66%) cases overall. There was not an increased need for subsequent implant removal in these patients compared to those that underwent screw fixation alone (p=0.11). The mean BMI of patients that underwent hardware removal (19.1±2.5) was similar to that of children who did not (20.4±3.5, p=0.06). When analyzing a subgroup of 102 athletes only, there was similarly no difference in the rate of implant removal if a washer was used (p=0.64). Overall, 107 (78%) patients regained full ROM at a mean of 13.9±9.7 weeks after surgery (Figure 1). There was no statistically significant difference in the proportions of patients with and without a washer that achieved full ROM (p=0.46). Full ROM was achieved at a mean of 14.1±11.0 weeks in those with a washer compared to 13.6±6.2 weeks in those without one (p=0.21). Conclusions: Use of a washer did not affect the need for subsequent implant removal or elbow ROM after fixation of pediatric medial epicondyle fractures, even in thinner patients or competitive athletes. If there is concern for fracture fragmentation or penetration, a washer can be included without concern that future unplanned surgeries may be required.
Prospective Randomized Comparison of Capsule Management Techniques During Hip Arthroscopy
Authors: Economopoulos Kostas John , Kweon Christopher Y. 
Published: March 2019

Objectives: Capsular management during hip arthroscopy remains controversial. Studies evaluating this topic consist mostly of retrospective comparative reviews of prospectively gathered data on a large series of patients. The purpose of this study was to perform a prospective randomized trial to comparatively assess three commonly performed capsule management techniques. It was hypothesized that capsular closure during hip arthroscopy would result in superior outcomes compared to non-closing capsulotomy management techniques. Methods: Patients undergoing hip arthroscopy were randomly assigned into three groups at the time of surgery: 1) T-capsulotomy without closure (TC), 2) interportal capsulotomy without closure (IC), and 3) interportal capsulotomy with closure (CC). Inclusion criteria included patients with labral tear on advanced imaging, cam lesion with alpha angle greater than 55 degrees, center-edge angle less than 40 degrees, and Tönnis grade 0 or 1. Patients younger than 18, older than 55, or those with signs of clinical hip hypermobility or radiographic dysplasia were excluded from the trial. All patients underwent labral repair and femoral osteoplasty. Modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS) was obtained preoperatively and at intervals up to 2 years. Other outcomes obtained included need for future hip surgery. Results: 50 patients were randomly allocated into each group. Patient demographics, preoperative patient-reported outcomes (PROs) and radiographic measures of impingement were similar between all three groups. Revision hip arthroscopy was performed in 5 TC patients, 2 IC patients and 0 CC patients (p=0.17). Conversion to hip arthroplasty occurred in 4 patients in the TC group, none in the IC or CC groups (p=0.48). All three groups showed increased PRO scores postoperatively compared to preoperative values (p<0.01). The CC group when compared to the TC group demonstrated superior mHHS (86.2 vs 76), HOS-ADL (85.6 vs 76.8), and HOS-SSS (74.4 vs 65.3) at the final 2 year follow up (p<0.001). The IC group demonstrated more modest improvements in outcomes compared to the TC group. The CC group showed greater improvement in HOS-SSS compared to the IC group at early follow up (65.6 vs 55.1, p>.001) that was not maintained at 2 years (74.4 vs 71.4, p=.28). Conclusion: Patients undergoing capsular closure during hip arthroscopy showed improved patient-reported and surgical outcomes compared to those with unrepaired T-capsulotomy or interportal capsulotomy. These results suggest that repair after capsulotomy may be a favorable arthroscopic capsule management technique, especially in respect to optimizing postoperative activities of daily living.
Predictors of Persistent Postoperative Pain at Minimum Two-years After Arthroscopic Treatment of Femoroacetabular Impingement
Authors: Stone Austin V. , Malloy Philip , Neal William H. , Beck Edward , Waterman Brian Robert , Bush-Joseph Charles A. , Nho Shane Jay 
Published: March 2019

Objectives: To evaluate predictors for persistent postoperative pain following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). We hypothesized that patients with chronic preoperative pain, smokers, and those with co-morbid mental health disease would have greater persistent postoperative pain. Methods: Patients undergoing hip arthroscopy for FAIS were identified in a prospectively collected database with a minimum of two-year follow-up with patient reported outcomes (PROs). Previous open hip surgery and diagnoses other than FAIS were excluded. Patients were grouped by VAS-Pain scores as limited (≤30) and persistent (>30). Patient factors and outcomes were analyzed with univariate and correlation analyses to build a logistic regression to identify predictors of postoperative pain. Results: The limited pain (n=514) and persistent pain (n=174) groups totaled 688 patients (449 females). The persistent pain group was significantly older with a greater proportion of revision arthroscopy, worker’s compensation cases, smokers, hypertension, a history of a psychiatric diagnosis and preoperative narcotic use. Both collegiate sport participation [odds ratio (OR) -6.09 (95% CI: -1.23--30.3, p=0.027) and frequent running (OR -1.75, 95% CI: -1.09--2.81; p=0.021) decreased risk for pain. Smokers were 2.22 times more likely to have persistent pain (p=0.032; 95% CI: 1.07-4.46). A history of anxiety and depression is associated with 2.87 greater risk for persistent pain (p=0.030; 95% CI: 1.11-7.45). Conclusion: Independent predictors for persistent postoperative pain include current smoking and mental health history positive for anxiety and depression. Running as a primary form of exercise and high-level athletic participation are protective against persistent pain. Additional risk factors for increased pain include increased age, workers’ compensation claim, previous comorbid disease treated with surgery, and decreased preoperative PROs. Our analysis demonstrated significant improvements in both pain and functional PROs in both the limited pain and persistent pain groups; however, those with persistent pain demonstrated significantly inferior PROs.
RETRACTED ARTICLE: Nuciferine inhibits the progression of glioblastoma by suppressing the SOX2-AKT/STAT3-Slug signaling pathway
Authors: Li Zizhuo , Chen Yaodong , An Tingting , Liu Pengfei , Zhu Jiyuan , Yang Haichao , Zhang Wei , Dong Tianxiu , Jiang Jian , Zhang Yu , Jiang Maitao , Yang Xiuhua 
Published: March 2019

Abstract
Background
Nuciferine (NF), extracted from the leaves of N. nucifera Gaertn, has been shown to exhibit anti-tumor and anti-viral pharmacological properties. It can also penetrate the blood brain barrier (BBB). However, the mechanism by which NF inhibits glioblastoma (GBM) progression is not well understood. We aimed to determine the anti-tumor effect of NF on GBM cell lines and clarify the potential molecular mechanism involved.

Methods
U87MG and U251 cell lines were used in vitro to assess the anti-tumor efficacy of NF. Cytotoxicity, viability, and proliferation were evaluated by MTT and colony formation assay. After Annexin V-FITC and PI staining, flow cytometry was performed to evaluate apoptosis and cell cycle changes in NF-treated GBM cells. Wound healing and Transwell assays were used to assess migration and invasion of GBM cells. Western blot analysis, immunofluorescence staining, immunohistochemistry, and bioinformatics were used to gain insights into the molecular mechanisms. Preclinical therapeutic efficacy was mainly estimated by ultrasound and MRI in xenograft nude mouse models.

Results
NF inhibited the proliferation, mobility, stemness, angiogenesis, and epithelial-to-mesenchymal transition (EMT) of GBM cells. Additionally, NF induced apoptosis and G2 cell cycle arrest. Slug expression was also decreased by NF via the AKT and STAT3 signaling pathways. Interestingly, we discovered that NF affected GBM cells partly by targeting SOX2, which may be upstream of the AKT and STAT3 pathways. Finally, NF led to significant tumor control in GBM xenograft models.

Conclusions
NF inhibited the progression of GBM via the SOX2-AKT/STAT3-Slug signaling pathway. SOX2-targeting with NF may offer a novel therapeutic approach for GBM treatment.
Gender and survival of critically ill patients: results from the FROG-ICU study
Authors: Hollinger Alexa , Gayat Etienne , Féliot Elodie , Paugam-Burtz Catherine , Fournier Marie-Céline , Duranteau Jacques , Lefrant Jean-Yves , Leone Marc , Jaber Samir , Mebazaa Alexandre , Arrigo Mattia ,   On behalf of the FROG ICU study investigators, Cariou Alain , Deye Nicolas , Duranteau Jacques , Guidet Bertrand , Jaber Samir , Jacob Laurent , Lefrant Jean-Yves , Leone Marc , Lu Qin , Mebazaa Alexandre , Montiel Virginie , Rennuit Isabelle , Samain Emmanuel , Sharshar Tarek , Tesniere Antoine , Vieillard-Baron Antoine , Wolff Michel 
Published: March 2019

Abstract
Purpose
Few studies analyzed gender-related outcome differences of critically ill patients and found inconsistent results. This study aimed to test the independent association of gender and long-term survival of ICU patients.

Materials and methods
FROG-ICU was a prospective, observational, multi-center cohort designed to investigate the long-term mortality of critically ill adult patients. The primary endpoint of this study was 1-year mortality after ICU admission of women compared to men.

Results
The study included 2087 patients, 726 women and 1361 men. Women and men had similar baseline characteristics, clinical presentation, and disease severity. No significant difference in 1-year mortality was found between women and men (34.9% vs. 37.9%, P = 0.18). After multivariable adjustment, no difference in the hazard of death was observed [HR 0.99 (95% CI 0.77–1.28)]. Similar 1-year survival between women and men was found in a propensity score-matched patient cohort of 506 patients [HR 0.79 (95% CI 0.54–1.14)].

Conclusion
Women constituted one-third of the population of critically ill patients and were unexpectedly similar to men regarding demographic characteristics, clinical presentation, and disease severity and had similar risk of death at 1 year after ICU admission.
Trial registration ClinicalTrials.gov NCT01367093; registered on June 6, 2011.
The effects of celebrity-brand congruence and publicity on consumer attitudes and buying behavior
Authors: Min Jae Han Jay , Chang Hyo Jung Julie , Jai Tun-Min Catherine , Ziegler Morgan 
Published: March 2019

AbstractMarketers use celebrity endorsements to make advertisements believable and to enhance consumer recognition of the brand name. However, once a direct link has been formed from a celebrity to a brand, the negative information about the celebrity may reflect on to the endorsed brand. Applying the S-O-R model and the balance theory, the purpose of this study is to investigate the effects of celebrity-brand congruence and publicity on consumers’ attitudes toward the celebrity and brand as well as their buying intention. A survey of a 2 (congruence vs. incongruence) × 2 (positive vs. negative publicity) experimental design was conducted for this study. A total of 120 female Millennial consumers answered the survey and 105 surveys with usable data were collected. The mean age of the participants was 24 years old (SD = 3.28). Results found that the celebrity-brand congruence and publicity play a significant role in consumer behavior related to attitudes toward the celebrity and brand/product, as well as buying intention. Thus, retail marketers need to allocate more investigation into celebrity endorsements that match with brand image that can lead to long-term, positive partnerships.