bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Reconstruction of the Medial Patellofemoral Ligament (MPFL) and Medial Quadriceps Tendon-Femoral Ligament (MQTFL) for Patellar Instability in Children and Adolescents: Surgical Technique and Outcomes
Authors: Spang Robert C. , Tepolt Frances A. , Paschos Nikolaos K. , Redler Lauren H. , Davis Eric A. , Kocher Mininder S. 
Published: October 2018

Objectives:
A variety of surgical options exist to treat the challenging problem of recurrent patellar instability in children and adolescents. The goal of the current study is to describe a novel combined reconstruction technique of both the medial patellofemoral ligament (MPFL) and the medial quadriceps tendon-femoral ligament (MQTFL) and report patient outcomes of a single-surgeon series.

Methods:
All patients studied underwent simultaneous MPFL and MQTFL reconstruction for patellar instability using gracilis allograft. Demographic, clinical, and radiographic data were collected. Subjective outcomes were assessed for a minimum of 1 year postoperatively.

Results:
Twenty-five patients (27 knees), including 15 female and 10 male individuals with an average age of 15.0±2.2 years (range, 10.3 to 18.9), were included. Prior ipsilateral patellofemoral surgery had been performed in 6 of 25 (24%) patients. Simultaneous hemiepiphysiodesis for valgus deformity at the time of combined reconstruction was performed in 5 of 25 (20%) patients. Preoperative imaging showed a mean tibial tubercle-trochlear groove of 17.2±3.8, Caton-Deschamps Index (CDI) of 1.13±0.16, and trochlear dysplasia Dejour A/B [22/26 (85%)] or Dejour C/D [4/26 (15%)]. A total of 18 patients (19 knees, 72%) returned outcomes questionnaires at a mean 2.0±0.5 years after surgery. Mean Kujala, Pedi-IKDC, and Lysholm scores were 85.9±13.9, 81.5±15.2, and 84.3±13.5, respectively. Later revision procedure (tibial tubercle osteotomy) for recurrent patellar instability was required in 2 of 25 patients (8%) patients, and another patient reported persistent instability not requiring revision. Return to sports was possible in 10 of 13 self-reported athletes (77%) at a mean of 5.8±3.9 months (range, 2 to 15).

Conclusions:
The present study describes a combined MPFL-MQTFL reconstruction technique with favorable short-term results. Although particularly useful in the skeletally immature patient where tibial tubercle osteotomy should be avoided and patellar fixation minimized, combined reconstruction may potentially be appropriate for older patients with patellofemoral instability as well. This technique more closely recreates the native anatomy of both the MPFL and MQTFL, may decrease the risk of patellar fracture, and can be useful in the revision setting.

Level of Evidence:
Level IV.
Utilization of a Wide Array of Nonvalidated Outcome Scales in Pediatric Orthopaedic Publications: Can’t We All Measure the Same Thing?
Authors: Truong Walter H. , Price Meghan J. , Agarwal Kunal N. , Suryavanshi Joash R. , Somasegar Sahana , Thompson Micha , Fabricant Peter D. , Dodwell Emily R. 
Published: October 2018

Purpose:
Clinical changes are best evaluated with standardized, validated outcomes, including both patient-reported outcome measures and surgeon-reported outcome measures (PROMs and SROMs). The purpose of this study was to describe the spectrum of outcome measures used in pediatric orthopaedic publications over the past 10 years and to determine the proportion that are in fact age-appropriate, validated, and appropriately applied in terms of condition and population.

Methods:

The Journal of Bone and Joint Surgery, The Bone and Joint Journal, Journal of Pediatric Orthopaedics A and B, and Journal of Children’s Orthopaedics were systematically searched for studies including children aged 18 and below, over a 10-year period from January 2005 to December 2014. Economic evaluations, letters, editorials, review articles, and clinical guidelines were excluded. SROMs and PROMs used were extracted, as were details on subject age and condition for which they were used. Each outcome scale was assessed for validity, and the proportion of scales used appropriately was calculated. Cochrane-Armitage test of trend was used to determine changes in PROM and SROM utilization over the study period.

Results:
A total of 4614 articles were identified, of which 2251 met inclusion and exclusion criteria. In total, 259 (11.5%) of studies used a PROM, whereas 326 (14.5%) used a SROM. A total of 230 different outcome scales were identified; 115 were patient reported and 115 were surgeon reported. However, only 18.7% of SROMs and 38.3% of PROMs were applied to an age and disease-appropriate demographic. Overall, there was a significant increase in the overall utilization of PROMs during the study period (P=0.004), but no corresponding increase in pediatric-validated PROMs (P=0.164). SROM utilization did not significantly change over the study period (P=0.337).

Conclusions:
Within the field of pediatric orthopaedics, an expansive variety of outcome scales are used, many of which have not been validated in children. Improved uniformity in reporting of outcomes and use of disease and age-validated outcomes scales is essential to improve multicenter research collaboration and data quality to generate appropriate evidence-based conclusions and treatment strategies in pediatric orthopaedics.

Level of Evidence:
Level IV—systematic review.
Associations Among Pregnancy, Parturition, and Open-angle Glaucoma: Korea National Health and Nutrition Examination Survey 2010 to 2011
Authors: Lee Jae Yeun , Kim Joon Mo , Kim Seong Ho , Kim In Tae , Kim Hyun Tae , Chung Pil-Wook , Bae Jeong Hun , Won Yu Sam , Lee Mi Yeon , Park Ki Ho 
Published: October 2018

Purpose:
The purpose of this study was to investigate the association between factors associated with parturition and open-angle glaucoma (OAG) in Korean females.

Methods:
A population-based, cross-sectional survey was performed from the Korean National Health and Nutrition Examination Survey from 2010 to 2011 and enrolled postmenopausal female participants (n=1798). We obtained information on demographics, comorbidities, and health-related behaviors and performed comprehensive ophthalmic examinations. Multivariate regression analysis was used to assess the correlation between pregnancy and delivery and the prevalence of OAG in all enrolled subjects.

Results:
The prevalence of OAG among study participants was 6.42%. There was a significant difference in the number of deliveries and age at first delivery between the OAG group and the nonglaucoma group. In multiple linear regression models adjusted for age, hypertension, and intraocular pressure only pregnancy 1 was associated with higher risk of OAG compared with pregnancy 2 (P=0.023). Subjects who had 3 or 4 deliveries were at higher risk of OAG compared with subjects with 2 deliveries (P=0.027). An age at first delivery of 16 to 20 years or 21 to 23 years was associated with increased OAG risk compared with the reference group (P<0.05).

Conclusions:
A history of three or more deliveries and an age at first delivery younger than 23 years were associated with increased risk of OAG. These results suggest that changes or events during the period from pregnancy to delivery affect the development of glaucoma.
A Prospective Evaluation of the Repeatability and Reliability of New Steady-state Pattern Electroretinogram Parameters
Authors: Gillmann Kevin , Mansouri Kaweh , Rao Harsha L. , Ouabas Adel , Chaudhary Ankita , Bravetti Giorgio E. , Mermoud André 
Published: October 2018

Purpose:
The purpose of this study was to determine the repeatability and reproducibility of a new Pattern Electroretinography (PERG) device in healthy subjects.

Methods:
A total of 40 eyes of 20 healthy subjects (45.6±6.8 y, 70% female) were enrolled in this prospective study. Steady-state PERG were recorded using the Diopsys NOVA (Diopsys Inc., NJ) to obtain the Magnitude, MagnitudeD, MagnitudeD/Magnitude Ratio, and Signal to Noise Ratio. Subjects underwent 2 “contrast sensitivity” protocols with the same electrodes and 2 after changing electrodes, by a single examiner. Eyes were stimulated separately using high and low contrast patterns. The same examination was repeated by a different operator following the same protocol 6 months after the baseline measures. Repeatability and reproducibility of the readings were calculated using intraclass correlation coefficient (ICC). A Bland-Altman plot was used to analyze the agreement between measures.

Results:
ICC of Magnitude, MagnitudeD, MagnitudeD/Magnitude ratio, and SNR were 0.87, 0.81, 0.36, and 0.81, respectively between measures taken with the same electrodes (repeatability). After changing electrodes, ICC of the Magnitude, MagD, MagD/Mag ratio, and SNR were 0.79, 0.85, 0.51, and 0.83, respectively during the same session as baseline measures, and 0.87, 0.85, 0.40, and 0.76 when repeated after 6 months (reproducibility). The variability of MagD/Mag ratio increased with successive test repetitions.

Conclusions:
Mag, MagD, and SNR were repeatable and reproducible, whereas the MagD/Mag ratio was less repeatable and reproducible. These results suggest that the former parameters are sufficiently reliable to be used in clinical practice.
Concussion Burden, Recovery, and Risk Factors in Elite Youth Ice Hockey Players
Authors: Schneider Kathryn J. , Nettel-Aguirre Alberto , Palacios-Derflingher Luz , Mrazik Martin , Brooks Brian L. , Woollings Kaikanani , Blake Tracy , McKay Carly , Lebrun Constance , Barlow Karen , Taylor Kirsten , Lemke Nicole , Meeuwisse Willem H. , Emery Carolyn A. 
Published: October 2018

Objective:
To examine rates of concussion and more severe concussion (time loss of greater than 10 days) in elite 13- to 17-year-old ice hockey players.

Methods:
This is a prospective cohort study (Alberta, Canada). Bantam (13-14 years) and Midget (15-17 years) male and female elite (top 20% by division of play) youth ice hockey players participated in this study. Players completed a demographic and medical history questionnaire and clinical test battery at the beginning of the season. A previously validated injury surveillance system was used to document exposure hours and injury during one season of play (8 months). Players with a suspected ice hockey–related concussion were referred to the study sport medicine physicians for assessment. Time loss from hockey participation was documented on an injury report form.

Results:
Overall, 778 elite youth ice hockey players (659 males and 119 females; aged 13-17 years) participated in this study. In total, 143 concussions were reported. The concussion incidence rate (IR) was 17.60 concussions/100 players (95% CI, 15.09-20.44). The concussion IR was 1.31 concussions/1000 player-hours (95% CI, 1.09-1.57). Time loss of greater than 10 days was reported in 74% of cases (106/143), and 20% (n = 28) had time loss of greater than 30 days.

Conclusions:
Concussion is a common injury in elite youth ice hockey players. In this study population, a large proportion of concussions (74%) resulted in a time loss of greater than 10 days, possibly reflecting more conservative management or longer recovery in youth athletes.
Velopharyngeal incompetence: role in paediatric swallowing deficits
Authors: Swibel Rosenthal Laura H. , Walsh Kathleen , Thompson Dana M. 
Published: October 2018

Purpose of review
The purpose of this manuscript is to highlight the latest advances in diagnosis and management of velopharyngeal incompetence (VPI) as it pertains to swallowing deficits in children. This is timely and relevant as otolaryngologists are often amongst the first to diagnose and treat VPI. Although nasal regurgitation of a bolus is frequently transient, persistent problems can be associated with other swallowing problems and other significant medical problems. Furthermore, velopharyngeal incompetence has implications for speech production.

Recent findings
Persistent VPI associated with a swallowing deficit can be an isolated anomaly with or without a cleft palate or submucous cleft palate. VPI may be secondary to a cranial neuropathy, esophageal abnormality or associated with another airway anomaly, any of which may further contribute to dysphagia. Findings of additional anomalies may be suggestive of a syndrome. Workup should explore these potential causes. When velopharyngeal incompetence is associated with dysphagia, fiberoptic endoscopic evaluation of swallow (FEES) and videofluoroscopic swallow study (VFSS) can be helpful in diagnosis and management. The advantages and disadvantages of FEES and VFSS have been well delineated over the past few years. Similarly, nasopharyngoscopy and fluoroscopy are increasingly used in diagnosis and management of VPI that is associated with hypernasal resonance disorders.

Summary
Concurrent medical diagnoses or syndrome manifestations are often associated with or contribute significantly to the cause of dysphagia in children with VPI. As VPI can be a sign of brainstem vagal neuropathy, the clinician should investigate by imaging the CNS if other correlative symptoms of dysphagia and examination findings are present. Endoscopy is advocated for evaluation of vocal fold function. Fluoroscopy is best for further assessment of airway protection or safety of swallow. And, whenever indicated, additional workup is recommended to determine an underlying cause of the swallowing disorder.
Update on sinus disease in children with cystic fibrosis: advances in treatment modalities, microbiology, and health-related quality-of-life instruments
Authors: Gallant Jean-Nicolas , Mitchell Margaret B. , Virgin Frank W. 
Published: October 2018

Purpose of review
There is a lack of consensus with regards to the diagnosis and treatment of sinus disease in children with cystic fibrosis. Here, we review literature from the past 18 months in order to highlight the way forward in this contentious field.

Recent findings
Most of the literature (from the past 18 months) on sinus disease in pediatric cystic fibrosis focused on treatment approaches, bacteriology and immunology, and health-related quality-of-life (HRQOL) instruments. Quality studies have demonstrated that functional endoscopic sinus surgery (FESS) is as safe in children with or without cystic fibrosis; that the microbiology of the paranasal sinus in children with cystic fibrosis is different than that of their lungs; and, that HRQOL instruments may prove useful in determining sinonasal disease severity in children with cystic fibrosis.

Summary
Medical and surgical approaches appear to be viable in the treatment of sinonasal disease in pediatric cystic fibrosis; the microbiology and immunology of pediatric cystic fibrosis is proving more complex and nuanced than initially believed; and, HRQOL instruments show promise in reconciling differences between observable and clinically relevant sinus disease in pediatric cystic fibrosis patients.
Vocal fold nodules in children
Authors: Mudd Pamela , Noelke Carolyn 
Published: October 2018

Purpose of review
Vocal nodules are a common presentation in children, representing the most common cause of dysphonia.

Recent findings
Children with siblings, ADHD, and of male sex are most likely to be affected. Female children, however, tend to have more likely progression into adolescence. Quality-of-life indices can aid in screening for vocal nodules whereas stroboscopy, and possibly, ultrasound are required for definitive diagnosis.

Summary
Management has not significantly changed over time and should begin with conservative behavioral and environmental modifications along with voice therapy in those more severely impacted. Though immediate outcomes vary somewhat depending on management direction, the overall prognosis seems to be good even with lack of intervention. It is most critical to ensure a definitive diagnosis, and offer management therapies that are appropriate for the level of impact the vocal nodules have on communication and voice production in the child.
Female athletes: managing risk and maximizing benefit
Authors: Cleary Shannon , Chi Victoria , Feinstein Ronald 
Published: October 2018

Purpose of review
The purpose of this review is to provide an updated summary on the unique aspects of caring for female youth and adolescent athletes.

Recent findings
Recent research on female athletes has led to a better understanding of injuries and conditions that are more likely to occur in female youth and adolescent athletes, including the frequency and severity of concussions, musculoskeletal injury such as involving the anterior cruciate ligament, and the female athlete triad. Social factors, such as the growing pressure to specialize in a sport particularly at an early age, also put young female athletes at risk for issues such as overuse injuries. Researchers continue to explore the benefits of athletic participation that extend beyond physical fitness.

Summary
Female participation in youth sports has increased dramatically during the past 50 years. This has led to greater research on how to manage risks and maximize benefits for young female athletes, although there is still much to be learned. Providers should educate patients, parents, and coaches on both the increased risks for female athletes and ways to provide better support and accessibility of youth sports to all children.
Infections after xenotransplantation
Authors: Nellore Anoma 
Published: October 2018

Purpose of reviewXenotransplantation offers a solution for the global shortage of available organs. However, cross-species transplantation and immunosuppression raises concerns about transmission of zoonotic infections to the recipient as well as to the public.Recent findingsHere, we review the major infections of concern after xenotransplantation, risks of their transmission, diagnostic, therapeutic as well as prevention modalities for these infections after xenotransplantation. This review is particularly timely in light of recent advances in porcine genome editing technology that allow removal of retroviral sequences.SummaryWe cannot appreciate the full risk of infections after xenotransplantation in absence of clinical trials. However, there are guidelines for strict microbiologic monitoring and reporting, infectious diagnostic assay development, breeding and quarantine of graft source animals to limit infectious transmission.
Lung bioengineering: advances and challenges in lung decellularization and recellularization
Authors: Uriarte Juan J. , Uhl Franziska E. , Rolandsson Enes Sara E. , Pouliot Robert A. , Weiss Daniel J. 
Published: October 2018

Purpose of review
Bioengineering the lung based on its natural extracellular matrix (ECM) offers novel opportunities to overcome the shortage of donors, to reduce chronic allograft rejections, and to improve the median survival rate of transplanted patients. During the last decade, lung tissue engineering has advanced rapidly to combine scaffolds, cells, and biologically active molecules into functional tissues to restore or improve the lung's main function, gas exchange. This review will inspect the current progress in lung bioengineering using decellularized and recellularized lung scaffolds and highlight future challenges in the field.

Recent findings
Lung decellularization and recellularization protocols have provided researchers with tools to progress toward functional lung tissue engineering. However, there is continuous evolution and refinement particularly for optimization of lung recellularization. These further the possibility of developing a transplantable bioartificial lung.

Summary
Bioengineering the lung using recellularized scaffolds could offer a curative option for patients with end-stage organ failure but its accomplishment remains unclear in the short-term. However, the state-of-the-art of techniques described in this review will increase our knowledge of the lung ECM and of chemical and mechanical cues which drive cell repopulation to improve the advances in lung regeneration and lung tissue engineering.
Incidence and Characteristics of Neonatal Herpes: Comparison of Two Population-Based Data Sources, New York City, 2006–2015
Authors: Lao Steven , Flagg Elaine W. , Schillinger Julia A. 
Published: October 2018

BackgroundNeonatal herpes (nHSV) is a potentially fatal disease caused by herpes simplex virus (HSV) infection during the neonatal period. Neonatal herpes simplex virus infections are not nationally notifiable, and varying incidence rates have been reported. Beginning in 2006, New York City (NYC) required reporting of nHSV infections and conducted case investigations. We compared the use of administrative hospital data with active surveillance to monitor trends in nHSV infection.MethodsWe compared the incidence and characteristics of nHSV cases as measured using population-based surveillance and administrative hospital discharge data collected between 2006 and 2015. Surveillance cases were defined as laboratory-confirmed HSV infections in NYC-resident infants aged 60 days or younger at diagnosis. Administrative cases were defined as NYC-resident infants aged 60 days or younger at hospital admission whose records included an HSV diagnosis. Neonatal herpes cases after ritual Jewish circumcision with direct orogenital suction were excluded.ResultsThere were 107 surveillance cases (9.9 per 100,000 live births) and 131 administrative cases (12.1 per 100,000 live births). Incidence was highest in infants born to non-Hispanic black mothers aged 20 years or younger (surveillance, 57.2 per 100,000 live births; administrative data, 31.2 per 100,000 live births). The distribution of cases by year did not significantly differ across data sources. Surveillance cases had a higher case-fatality rate (18.7%) compared with administrative cases (8.4%;P= 0.019).ConclusionsAdministrative hospital data can be used to measure the incidence of nHSV infection and describe disease burden across population subgroups in jurisdictions where nHSV reporting is not required. However, administrative data may underascertain nHSV case fatality.
Is Occupational Therapy After Hip Fracture Surgery Effective in Improving Function?
Authors: Lee Sang Yoon , Jung Se Hee , Lee Shi-Uk , Ha Yong-Chan , Lim Jae-Young 
Published: October 2018

Abstract

Objective
The aim of the study was to evaluate whether occupational therapy (OT) improves activities of daily living and overall physical functioning of patients after hip fracture surgery.

Data Sources
The data sources are PubMed-Medline, Embase, and Cochrane Library databases.

Review Methods
We searched for randomized controlled trials comparing occupational therapy with comprehensive postoperative care (without occupational therapy) after hip fracture surgery. A pairwise meta-analysis using fixed- and random-effects models was performed. The primary outcome of interest was performance of activities of daily living assessed in any manner. The secondary outcomes were other functional parameters: (1) physical function; (2) health perception and emotion; and (3) fall occurrence. Effect sizes were computed as standardized mean differences with 95% confidence intervals.

Results
Five randomized controlled trials including a total of 524 participants were retrieved. There was a trend toward improvement in activities of daily living, physical function, and fall occurrence, and these changes were not significant. However, health perception and patient emotions improved significantly in the occupational therapy group (standardized mean difference = 0.391, 95% confidence interval = 0.104 to 0.678, P = 0.008).

Conclusions
Occupational therapy after hip fracture surgery seems to improve overall function. Indeed, the positive effects of occupational therapy on health perception and emotions were evident. Therefore, occupational therapy can be suggested in comprehensive rehabilitation programs after hip fracture surgery.