bluuebunny/crossref_metadata_2025_split huggingface dataset:
HAMSTRING MORPHOLOGY AND STRENGTH REMAIN ALTERED 2 YEARS FOLLOWING A HAMSTRING GRAFT IN ACL RECONSTRUCTION
Authors: Vertullo Christopher J. , Konrath Jason M. , Kennedy Benjamin , Bush Hamish , Barrett Rodney S. , Lloyd David G. 
Published: May 2017

Background: The hamstring graft used in anterior cruciate ligament (ACL) reconstruction has been shown to lead to changes to the semitendinosus and gracilis musculature. This study further evaluated the effect of the surgery on hamstring muscle morphology and knee muscle strength at 2 years post-surgery. Hypotheses: (1) Loss of donor muscle size would significantly correlate with knee muscle strength deficits (2) Loss of donor muscle size would be greater for muscles that do not experience tendon regeneration, and (3) Morphological adaptations would also be evident in non-donor knee muscles. Study Design: Cross sectional evaluation. Methods: 20 participants (14 male, 6 female, 29 ± 7 years, 82 ± 15 kg) that had undergone a hamstring graft in ACL reconstruction at least two years previously, underwent bilateral MRI and subsequent strength testing. Muscle and tendon volumes, peak CSA’s and lengths were determined for 12 muscles and 6 functional muscle groups of the surgical and contralateral limbs. Peak isokinetic concentric strength was measured in knee flexion/extension and internal/external tibial rotation. Results: Only 50% of the patients regenerated both the semitendinosus and gracilis tendons. The regenerated tendons were longer with larger volume and CSA compared to the contralateral side. Deficits in semitendinosus and gracilis muscle size were greater for tendons that did not regenerate. In addition, combined hamstrings (semitendinosus, semimembranosus, biceps femoris) and combined medial knee muscles (semitendinosus, semimembranosus, gracilis, vastus medialis, medial gastrocnemius, sartorius) on the surgical side were reduced in volume by 12% and 10% respectively. A 7% larger volume was observed in the surgical leg for the biceps femoris and corresponded with a lower internal/external tibial rotation strength ratio. The difference in volume, peak CSA and length of the semitendinosus and gracilis correlated significantly with the deficit in knee flexion strength with Pearson correlations of 0.51, 0.57 and 0.61 respectively. Conclusion: The muscle-tendon properties of the semitendinosus and gracilis are substantially altered following harvesting, and these alterations may contribute to knee flexor weakness in the surgical limb. These deficits are more pronounced in tendons that do not regenerate and are only partially offset by compensatory hypertrophy of other hamstring muscles. Clinical Relevance: Surgeons should consider muscle retraction of the hamstring following tendon harvest in their choice of graft option for ACL reconstruction.
Arthroscopic assessment of patellofemoral tracking predicts patellar instability
Authors: Kejriwal Ritwik , Annear Peter 
Published: May 2017

Objectives: Surgical management of patellar instability includes proximal realignment procedure such as MPFL reconstruction. The decision to add a distal realignment procedure of tibial tubercle transfer is based on severity of patellar instability judged on either TTTG distance or arthroscopic patellofemoral tracking. We set out to validate our use of arthroscopic patellofemoral tracking for patellar instability management algorithm by analyzing its reproducibility and whether it correlates with patellar instability. Methods: A prospective observational study was carried out at Perth Orthopaedic and Sports Medicine Centre. Patient clinical presentations were divided into three groups - patellofemoral instability, patellofemoral pain, and no patellofemoral symptoms. Standard technique included low flow arthroscopy with single anterolateral viewing portal. Height of the fluid bag and presence of a knee holder was recorded. Knee flexion angle where patella first centrally engages in the trochlear groove was defined as Patellofemoral Congruent Angle (PCA). PCA was estimated by the primary surgeon and the angle was confirmed using a sterile goniometer. A second surgeon, blinded to the initial assessment, then repeated the measurements. Surgeon estimation error, interobserver reliability, and correlation with clinical presentation was analysed. Results: 57 knees were assessed for interobserver reliability. Intra-class correlation was 0.994 between surgeon’s estimate and goniometer reading. Intra-class correlation was 0.992 between the two surgeon’s readings suggesting a very high correlation. 157 patients had their PCA recorded and compared with their diagnosis. Mean PCA was 40 degrees in normal patients, and 118 degrees in patellar instability (p-value <0.001). Conclusion: Arthroscopic assessment of patellofemoral tracking is reproducible and correlates with patellar instability. A cut-off value of 40 degrees is recommended to differentiate normal tracking from abnormal.
The Role of Tibial Osteotomy in the Outcome of Meniscus Allograft Transplantation
Authors: Myers Peter , Mahmoud Ahmed , Young Jamie 
Published: May 2017

Objectives: Meniscal allograft transplantation (MAT) is indicated to relieve pain and improve function and hopefully to delay the onset of osteoarthritis in patients with meniscus deficiency. The purpose of this study was to compare the effect of perioperative cartilage status on survivorship and whether this is influenced by a concurrent tibial osteotomy. Methods: We reviewed a consecutive series of 45 MATs in 42 patients with a minimum post-surgical time of four years. Patients were divided into two groups using the Outerbridge Cartilage Score (OSC) to group 1 (minimal cartilage damage of grade 0-2) and group 2 (severe cartilage damage of grade 3-4). Pre- and post-operative outcome scores were collected using the Lysholm, Tegner, Oxford Knee Score (OKS) and International Knee Documentation Committee (IKDC) subjective knee form. Survival end points were transplant removal and knee arthroplasty. Results: The mean post-surgical follow-up for patients in group 1 (n=14, age 32.0 +/- 9.8) and group 2 (n=31, age 36.2 +/- 10) was 10.6 years (SD +/-3.35) and 7.1 (SD+/-3.34) respectively. There was no significant difference in the mean age between the two groups (p-value 0.221, CI -2.62 to 11). Patients in group 1 demonstrated no failures of the MAT over the time frame evaluated. Group 2 (n=31) had a 74.2% survival of MATs. The clinical outcomes improved in all groups with no significant difference between group 1 and group 2. Those patients in the osteotomy group did not have a statistically significant different survival (Mantel-cox test p-value of 0.922) or clinical outcome. Conclusion: Patient with minimal cartilage status have improved MAT survivorship but both groups benefit clinically. Tibial osteotomy, when indicated, does not influence the outcome of MAT.
Creation of an Australian Osteotomy Knee Registry Datasheet Instrument using a Modified Delphi Method
Authors: Vertullo Christopher J. 
Published: May 2017

Background: In 2015, the Australian Knee Society(AKS) agreed to initiate and fund an Australian Knee Osteotomy Registry (AKOR) in 2015 in conjunction with the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). A concise and robust dataset was required to proceed to AKOR preliminary site trialing. Study Design: Modified Delphi consensus building. Methods: Seven participants who were orthopaedic surgeons, AKS members and AKOR working group members performed a four round modified Delphi consensus building electronic non-blinded questionnaires using Google Sheets, a cloud-based spreadsheet. Round 1 involved the attribute rating using 0-10 of surgeon assessed utility of 41 initial datasheet instrument questions with 168 stem options. Surgeons could comment on each question or stem, giving comments on their rating and or proposing new variations or additions. Round 1 questions were based on the Swedish HTO Registry dataset with additional questions from surgeon interview. Questions and or stems with a mean utility rating of less than 2 were excluded. Questions and or stems with a mean utility raking of 8 or greater were accepted. Questions and or stem with a mean utility ranking of between 8 and 2 were included in subsequent rounds. Surgeons comments and votes were non-blinded. New or alternative questions or stems could be proposed by any surgeon during the process and voted on in the next round. This process was repeated until dataset consensus was achieved. Results: A final dataset of 32 questions was created after 4 rounds. Consensus was reached on the following items; patients demographics, hospital, state, surgeon’s code, date, primary or re-operation, diagnosis at primary procedure, diagnosis at re-operation, type of primary osteotomy, type of re-operation, form of fixation, bone graft, coincidental surgery, approach to correction calculation, pre-operative status of ACL, pre-operative status of PCL, previous knee surgery, preoperative mechanical axis, planned post-operative mechanical axis, preoperative fixed flexion deformity, pre-operative Ahlbäck grading of knee OA. Questions that had a final utility rating less than 10 included; coincidental surgery, approach to correction calculation, pre-operative Ahlbäck grading of knee OA, planned post-operative mechanical axis and preoperative fixed flexion deformity. Conclusion: The final AKOR dataset requires pragmatic validation prior to nation-wide implementation. Questions with low final attribute rating may not be included in the final instrument after validatation.
Results of medial patella stabilization surgery at 11-14 years, with realignment surgery according to an algorithmic approach
Authors: Paterson Roger , Balasubramaniam Pradeep 
Published: May 2017

Objectives: To report long term outcomes of patella stabilization surgery, and describe an algorithmic approach to realignment and other ancillary surgery Methods: Retrospective observational series All 49 consecutive cases of medial retinacular plication, usually with Medial Patello-Femoral Ligament (MPFL) reconstruction using a redundant local graft, for patella instability, by a single surgeon from 2001 to 2005 were sent a questionnaire, and followed up by phone. Realignment and other surgery was included as indicated by the senior author’s algorithmic criteria. Nine patients were not contactable, and four chose not to participate, leaving 29 patients with 35 operated knees who are the subject of this study. Results: Tegner-Lysholm scores were 77% excellent or good (mean 90 +/− 10, 61-100). Kujala scores were: mean 90 +/− 13, 34-100. The re-dislocation rate was 11% (4 knees, 2 of 9 after plication without MPFL reconstruction). Five knees had further surgery (3 revisions, 1 loose body, 1 arthrofibrosis). The worst results were in those who first came to surgery before skeletal maturity, with 6 of those 10 having fair or poor final outcomes. Only two others had fair or poor results. Conclusion: Chondral damage at a young age was the key factor contributing to poor results. At minimum 11 year follow-up, the re-dislocation rate after MPFL reconstruction, (plus re-alignment as indicated), was 2 of 26 (8%). A redundant local graft, with zero donor site morbidity, is adequate for reconstruction of the MPFL, which is more reliable than plication alone, even when the MPFL is felt to have a sound femoral attachment.
Injury Prevention at North Queensland Cowboys 2012 - 2015
Authors: Maguire John 
Published: May 2017

Objectives: Review injury rates at North Queensland Cowboys and compare this to the league in general and finishing position. Methods: Injury statistics and surveillance body. Review shoulder and knee injury statistics from 2012 – 2016. Comparisons to rest of the competition and finishing position for the various seasons. Results: It has long been thought that to win premierships, injury rates are important. In 2012 North Queensland Cowboys finished in eight position. The injury rates at this time were high. 2011 signify high injury rates which led us to introduce prevention strategies for knee and shoulder injury based on FIFA 11+ format. There has been a significant decline in injury rates such that by 2015 we had the least injuries in the competition. This corresponds to finishing the season as premiers. During this period the only significant knee injuries occurred in players that were new to our system. Conclusion: The injury prevention strategies have worked well at our club. Significantly reducing our serious injury rates.
Comparison of Outcomes between Hamstring Autograft and Synthetic (LARS) ACL Reconstructions
Authors: Woods K.R. , McGrath T.M. , Waddington G. , Scarvell J.M. , Ball N. , Adams R. , Creer R. , Smith D. 
Published: May 2017

Objectives: This study compared the short term (24 month) clinical outcomes in a prospective, comparative case series of participant selected hamstring autograft and synthetic (LARS) ACL reconstructions. Methods: 64 ACL reconstructed participants (32 hamstring,32 LARS), completed a “goal-oriented” rehabilitation protocol. They were assessed for joint laxity (KT1000), clinical outcome (IKDC Knee Examination) and activity (Tegner Activity Scale-TAS) pre-operatively and at 12,16,20 and 24 weeks, and at 12 and 24 months post-operatively. Results: KT 1000 results did not differ significantly between the 2 treatment groups at 24 months. Differences were noted in joint laxity measurements between the 2 groups at varying time points. The LARS group had immediate stability of the joint at 12 weeks followed by a gradual increase in laxity over the follow-up period, while the hamstring group showed an increase in laxity up to 16-20 weeks, followed by a gradual decrease over the follow-up period. The LARS group had significantly higher TAS scores in the early post-operative period, but there was no significant difference between the 2 groups at 12 months and beyond. At 24 months, 32 of the hamstring group and 30 of the LARS group achieved IKDC Scores “A” or “B”. There were 5 reported graft failures (15.6%) in the LARS group between 7 and 22 months post-op, and none in the hamstring group. Conclusion: ACL reconstruction using synthetic (LARS) grafts produced earlier return of some activities compared to autograft reconstructions, but this difference was no longer evident by 12 months post-op. When the substantially differing failure rates are taken into consideration, this early benefit does not appear to justify their use in place of autografts for ACL reconstruction.
Incidence of Total Knee Replacement after Knee Arthroscopy over the age of 50 years.
Authors: Robinson Mr Tony , Robertson Ms Tracy 
Published: May 2017

Objectives: This paper will look at the incidence of Total Knee Replacement in patients over the age of 50 years over an 8 year period. All patients had a symptomatic medial meniscal tear and moderate bi-compartmental osteo-arthritis. Hypothesis: Incidence of Total Knee Replacement in these patients increases with age and length of follow up. Methods: A total of 411 patients met this criteria with 357 contactable by telephone. Patients were asked regarding Total Knee Replacement and other surgical intervention. Results: Of the total of 357 patients contacted, 78 (22%) patients were referred for Total Knee Replacements over this 8 year period. Conclusion: The incidence of Total Knee Replacement correlates with age but not with follow up.
Functional evidence for derivation of systemic histiocytic neoplasms from hematopoietic stem/progenitor cells
Authors: Durham Benjamin H. , Roos-Weil Damien , Baillou Claude , Cohen-Aubart Fleur , Yoshimi Akihide , Miyara Makoto , Papo Matthias , Hélias-Rodzewicz Zofia , Terrones Nathalie , Ozkaya Neval , Dogan Ahmet , Rampal Raajit , Urbain Fanny , Le Fèvre Lucie , Diamond Eli L. , Park Christopher Y. , Papo Thomas , Charlotte Frédéric , Gorochov Guy , Taly Valérie , Bernard Olivier A. , Amoura Zahir , Abdel-Wahab Omar , Lemoine François M. , Haroche Julien , Emile Jean-François 
Published: May 2017

Key Points
BRAF V600E mutations are detectable in hematopoietic stem and progenitors in adults with histiocytosis. Transplantation of CD34+ cells from histiocytosis patients can give rise to genetically and phenotypically accurate xenografts.
Thymic epithelial cells require p53 to support their long-term function in thymopoiesis in mice
Authors: Rodrigues Pedro M. , Ribeiro Ana R. , Perrod Chiara , Landry Jonathan J. M. , Araújo Leonor , Pereira-Castro Isabel , Benes Vladimir , Moreira Alexandra , Xavier-Ferreira Helena , Meireles Catarina , Alves Nuno L. 
Published: May 2017

Key PointsTEC-intrinsic ablation of p53 predominantly affects medullary TECs, altering their RANK-driven differentiation and transcriptome. Loss of p53 in TECs couples disrupted thymopoiesis to altered T-cell homeostasis and tolerance.
Improving End-of-Life Care: Palliative Care Embedded in an Oncology Clinic Specializing in Targeted and Immune-Based Therapies
Authors: Einstein David J. , DeSanto-Madeya Susan , Gregas Matthew , Lynch Jessica , McDermott David F. , Buss Mary K. 
Published: May 2017

Purpose: Patients with advanced cancer benefit from early involvement of palliative care. The ideal method of palliative care integration remains to be determined, as does its effectiveness for patients treated with targeted and immune-based therapies. Materials and Methods: We studied the impact of an embedded palliative care team that saw patients in an academic oncology clinic specializing in targeted and immune-based therapies. Patients seen on a specific day accessed the embedded model, on the basis of automatic criteria; patients seen other days could be referred to a separate palliative care clinic (usual care). We abstracted data from the medical records of 114 patients who died during the 3 years after this model’s implementation. Results: Compared with usual care (n = 88), patients with access to the embedded model (n = 26) encountered palliative care as outpatients more often ( P = .003) and earlier (mean, 231 v 109 days before death; P < .001). Hospice enrollment rates were similar ( P = .303), but duration was doubled (mean, 57 v 25 days; P = .006), and enrollment > 7 days before death—a core Quality Oncology Practice Initiative metric—was higher in the embedded model (odds ratio, 5.60; P = .034). Place of death ( P = .505) and end-of-life chemotherapy (odds ratio, 0.361; P = .204) did not differ between the two arms. Conclusion: A model of embedded and automatically triggered palliative care among patients treated exclusively with targeted and immune-based therapies was associated with significant improvements in use and timing of palliative care and hospice, compared with usual practice.
Living with a leaky skin: upregulation of ion transport proteins during sloughing
Authors: Wu Nicholas C. , Cramp Rebecca L. , Franklin Craig E. 
Published: May 2017

ABSTRACT
Amphibian skin is a multifunctional organ providing protection from the external environment and facilitating the physiological exchange of gases, water and salts with the environment. In order to maintain these functions, the outer layer of skin is regularly replaced in a process called sloughing. During sloughing, the outermost layer of the skin is removed in its entirety, which has the potential to interfere with skin permeability and ion transport, disrupting homeostasis. In this study, we measured, in vivo, the effects of sloughing on the cutaneous efflux of ions in toads Rhinella marina kept in freshwater conditions. We also measured transepithelial potential, cutaneous resistance, active ion transport and the distribution, abundance and gene expression of the key ion transport proteins sodium–potassium ATPase (NKA) and epithelial sodium channel (ENaC) during sloughing. We hypothesised that the increase in transepithelial efflux of ions during sloughing is a consequence of increased permeability and/or a reduction in the abundance or expression of cutaneous ion transport proteins, resulting in disruption of internal ion homeostasis. There was a significant increase in sodium and chloride efflux during sloughing in R. marina. However, although in vitro skin resistance decreased after sloughing, active sodium transport increased commensurate with an increase in NKA and ENaC protein abundance in the skin. These changes in skin function associated with sloughing did not affect the maintenance of internal electrolyte homeostasis. These results suggest that during sloughing, amphibians actively maintain internal homeostasis by increasing cutaneous rates of ion uptake.
High Performance Anode for Direct Cellulosic Biomass Fuel Cells Operating at Intermediate Temperatures
Authors: Hibino Takashi , Kobayashi Kazuyo , Lv Peiling , Nagao Masahiro , Teranishi Shinya 
Published: May 2017

Abstract
Cellulosic biomass resources have considerable potential as a renewable energy source that can be used for the cogeneration of electricity and heat. The utilization of these resources generally requires three major systematic processes: gasification, gas processing, and gas utilization. If a power generator could operate using wood resources directly as fuels, then this system could be significantly simplified, thereby reducing initial equipment cost and enhancing application flexibility. An intermediate-temperature fuel cell could possibly realize such an operation; however, the fuel-cell characteristics, especially the catalytic activity of the Pt/C anode, are not sufficient at present. In this study, we attempted to improve the anode activity by alloying Pt with other metals, followed by optimization of the alloy in terms of its atomic ratio and content. The resulting PtFe/C anode yielded higher power densities (37–42 mW cm−2) and energy densities (125–169 Wh kg−1) at 250 °C for fuels composed of cypress, tissue paper, and cotton, compared to those obtained using the Pt/C anode, despite its smaller Pt loading.
RNA substrate length as an indicator of exosome interactions in vivo
Authors: Delan-Forino Clémentine , Schneider Claudia , Tollervey David 
Published: May 2017

Background: The exosome complex plays key roles in RNA processing and degradation in Eukaryotes and Archaea. Outstanding structural studies identified multiple pathways for RNA substrates into the exosome in vitro, but identifying the pathway followed by individual RNA species in vivo remains challenging. Methods: We attempted to address this question using RNase protection. In vivo RNA-protein crosslinking (CRAC) was applied to the exosome component Rrp44/Dis3, which has both endonuclease and exonuclease activity. During CRAC, the exosome was purified under native conditions and subjected to RNase digestion, prior to protein denaturation and cDNA cloning. The resulting high-throughput sequence reads were stratified by length of the cDNA sequence. This should reflect RNA fragment lengths, and therefore the RNA region that was protected by exosome binding. We anticipated major read lengths of ~30nt and ~10nt, reflecting the “central channel” and “direct access” routes to the Rrp44 exonuclease active site observed in vitro. Results: Unexpectedly, no clear peak was observed at 30nt, whereas a broad peak was seen around 20nt. The expected ~10nt peak was seen, and showed strong elevation in strains lacking exonuclease activity. Unexpectedly, this peak was suppressed by point mutations in the Rrp44 endonuclease active site. This indicates that the short fragments are degraded by the exonuclease activity of Rrp44, but also suggests that at least some may be generated by endonuclease activity. Conclusions: The absence of 30nt protected fragments may reflect obligatory binding of cofactors at the entrance to the exosome central channel in vivo. The presence of ~20nt fragments apparently indicates an access route not yet reported from in vitro studies. Confident mapping of 10nt reads is challenging, but they are clearly derived from a subset of exosome targets. In particular, pre-rRNA species, which are major exosome targets, are strongly disfavored for the generation of short reads.