bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paper 38: Comparison of Clinical Outcomes and Return to Sport Rates Between Osteochondral Allograft Transplantation and Autologous Chondrocyte Implantation for Articular Cartilage Lesions in the Patellofemoral Joint
Authors: Triana Jairo , Hughes Andrew , Rao Naina , Li Zachary , Moore Michael , Garra Sharif , Strauss Eric , Campbell Kirk , Gonzalez-Lomas Guillem 
Published: October 2024

Objectives: The purpose of this study is to compare clinical outcomes and return to sport (RTS) rates between patients that undergo osteochondral allograft (OCA) transplantation and autologous chondrocyte implantation (ACI), or matrix-induced autologous chondrocyte implantation (MACI), for patellofemoral articular cartilage defects. Methods: A retrospective review of patients who underwent an OCA, ACI, and MACI from 2010 to 2020 with a minimum two-year follow-up was conducted. Patient-reported outcomes (PROs) collected included: Visual Analog Scale for pain and satisfaction, Knee Injury and Osteoarthritis Outcome Score (KOOS), and return to sport (RTS) status. Logistic regression controlling for age, sex, BMI, bone marrow edema, mechanism of injury, lesions size and location was used to identify predictors of worse outcomes. Results: A total of 95 patients with a mean age of 32.1 years (± 10.0) and mean BMI of 26.5 (± 5.9) were included. ACI or MACI was performed in 55 cases (57.9%) and OCA in 40 (42.1%). Satisfaction was not significantly different between groups. VAS pain scores were higher in the OCA group, but did not reach significance. Overall, KOOS pain was significantly poorer in the OCA group than the ACI/MACI group, while KOOS symptoms, KOOS sport, and KOOS QOL subscores were non-significantly different. Overall, RTS rate was 54.3.%, with no significant difference in return between OCA or ACI/MACI groups. Increasing age was associated with lower satisfaction in the OCA group and poorer outcomes in the ACI/MACI group, while larger lesion area was associated with lower satisfaction and poorer outcomes scores in the ACI/MACI group. Conclusions: Clinical outcomes and return to sport rates are similar in patients that undergo OCA or ACI/MACI for patellofemoral articular cartilage defects, except in measures of pain, where patients undergoing OCA may experience more symptoms, particularly in the setting of trochlear defects.
Poster 105: MRI Demonstrates Similar Diagnostic Value to MR Arthrogram for Determining Labral Tear Extent up to 2 Weeks Following Shoulder Dislocation
Authors: Cong Ting , Charles Shaquille , Greiner Justin , Cordle Andrew , Andrews Carol , Darwiche Sophie , Reddy Rajiv , Como Matthew , Drain Nicholas , Hughes Jonathan D , Lesniak Bryson , Lin Albert 
Published: October 2024

Objectives: The aim of this study was to determine the comparative accuracy and precision of routine Magnetic Resonance Imaging (MRI) versus magnetic resonance (MR) arthrogram in measuring labral tear size as function of time from shoulder dislocation, and to identify a time threshold after which MR arthrogram supersedes MRI in diagnostic utility. Methods: We retrospectively evaluated consecutive patients who underwent primary arthroscopic labral repair between 2012 and 2021 and completed a preoperative MRI or MR arthrogram of the shoulder within 60 days of injury, and subsequently underwent arthroscopic repair within 6 months of imaging. Arthroscopic labral tear size and location was used as standard comparison. Three musculoskeletal radiologists independently interpreted tear extent using clock-face convention. Accuracy and precision of MR labral tear measurements were defined by location and size of the tear, respectively. Accuracy and precision were compared between MRI and MR arthrogram, as a function of time from dislocation. Results: Thirty-two MRI and 65 MR arthrogram (total n=97) were independently assessed by radiologists. Multivariate analysis demonstrated that intraoperative tear size, early imaging, and arthrogram status were associated with increased MR accuracy and precision (p<0.05). Ordering surgeons preferred arthrogram for delayed imaging (p=0.018). For routine MRI, error in accuracy increased by 3.4° per day and error in precision increased by 2.3° per day (p<0.001) from time of injury. MR arthrogram, however, was not temporally influenced (Figure 1). Significant loss of accuracy and precision of routine MRI compared to MR arthrogram occurs at 2 weeks after acute shoulder dislocation. Conclusions: For determining shoulder labral tear size after acute dislocation, routine MRI has similar diagnostic value for measuring labral tear extent as MR arthrogram up to approximately 2 weeks postacute shoulder dislocation, after which it significantly loses accuracy and precision, possibly due to resolving posttraumatic effusion. MR arthrogram accuracy and precision were not temporally influenced.
Poster 314: Early Full Knee Extension Predicts Successful Return to Sport Following Anterior Cruciate Ligament Reconstruction
Authors: Drain Camila Grandberg Nicholas , Nazzal Ehab , Charles Shaquille , Steuer Fritz , Hughes Jonathan D , Musahl Volker , Lesniak Bryson 
Published: October 2024

Objectives: To identify predictive factors for successful return to sport (RTS) following anterior cruciate ligament reconstruction (ACL-R) with quadriceps tendon (QT) autograft. Methods: Data was retrospectively collected on consecutive patients who underwent ACL-R with QT autograft at a single institution between 2010-2020. Patient demographics, knee range of motion (ROM), injury characteristics, and intraoperative data were collected from the electronic medical record. Full RTS was defined as the patient returning to their prior level of sport and the presence of a clinical documentation of no further complications. Univariate and multivariate cox regression were utilized to conduct time-to-event analyses to identify predictors of early RTS clearance by surgeon. Additionally, both logistic regression analysis and generalized estimating equations were used to identify significant predictors of successful full RTS. STATA 16SE software was utilized for all analyses with statistical significance set to p < 0.05. Results: A total of 307 patients were included, consisting of 176 males (57.3%) and 131 females (42.7%), with an average of 20.7 ± 7.1 years of age and 14.5 ± 8.9 months follow-up. Ten patients (3.3%) were professional/semi-professional athletes, 38 (12.4%) were collegiate athletes, 144 (46.9%) were high school athletes (46.9%), and 115 (37.5%) were recreational athletes. Complete knee extension was achieved by 64.1% of patients at 6 weeks postoperatively, by 77.7% at 3 months, by 84.4% at 6 months, and by 84.7% at 1 year. Full knee extension at 3 (HR: 1.55, 95% CI: 1.13–2.12, p = 0.007) and 6 months (HR: 1.49, 95% CI: 1.05–2.12, p = 0.025) postoperatively were predictors of a higher rate of RTS clearance. Moreover, patients who achieved full knee extension at 3 months follow-up had a greater rate of RTS (1.02/person-years) compared to patients who did not achieve full knee extension at 3 months (0.83 per person-years). When considering RTS, only full knee extension at 4-6 weeks (OR:2.02, 95% CI:1.02–4.03, p = 0.045) and at 3 months (OR:2.36, 95% CI: 1.12–4.99, p = 0.024) postoperatively were predictive of successful RTS. No other significant predictors were identified. Conclusions: Restoration of full knee extension was strongly associated with higher rates of both surgeon clearance and successful RTS. The role of full knee extension in the ability to regain strength at 6 months, as measured by limb symmetry indices, after ACL-R has been previously described. While both ROM and strength play crucial roles in the rehabilitation process, achieving full ROM typically precedes restoration of full strength. Lack of full extension 3 months postoperatively may require further investigation and serves as a possible opportunity for a goal metric to maximize RTS rates and minimize complications after ACL-R.
Poster 349: Tobramycin-Soaked Grafts for the Prevention of Infection Following Anterior Cruciate Ligament Reconstruction: A Retrospective Review of Infection Rate
Authors: Flanigan David , Magnussen Robert , Kaeding Christopher , Stoodley Paul , Barker Tyler , Cavendish Parker , Milliron Eric , Burnett Zachary , Davis Madeleine 
Published: October 2024

Objectives: Infection can be a devastating complication of anterior cruciate ligament (ACL) reconstruction. Soaking or wrapping grafts in vancomycin solution has been adopted by many surgeons to prevent infection following ACL reconstruction. Recent meta-analysis demonstrated a significant reduction in the incidence of deep infection in vancomycin-soaked grafts to be 0.09% compared to 0.74% for nontreated grafts.1 Tobramycin may provide an alternative for patients with vancomycin allergies or if vancomycin is not available. The purpose of this study is to evaluate the incidence of deep and superficial infection following ACL reconstruction in young patients with tobramycin-soaked grafts as well as characterize potential risk factors for infection. We hypothesize that tobramycin-soaked grafts result in a low deep infection rate, comparable to that of vancomycin-soaked grafts published in the literature. Methods: A total of 812 consecutive patients under age 20 who underwent ACL reconstruction at an academic medical center between 2010 and 2020 with tobramycin-soaked grafts were identified. Retrospective chart review was performed to identify postsurgical superficial and deep wound infections, as well as other pertinent surgical characteristics. The incidence of infection in this tobramycin wrap cohort was compared to the incidence of infection of vancomycin wraps as published in the literature. Results: Superficial wound infections occurred in 24 patients (2.96%) and 0 deep joint infections were identified in the tobramycin wrap cohort. The incidence of infection was 3.16% in 728 patients who received prophylactic perioperative intravenous Cefazolin and 1.23% infection incidence in 81 patients who received prophylactic perioperative Clindamycin (p = 0.30). In addition, no significant difference in incidence of superficial infection was found with patient age, sex, body mass index, or graft type. Conclusions:  Tobramycin-soaked ACL grafts demonstrate a low infection risk comparable to that of vancomycin-soaked ACL grafts. The type of prophylactic IV antibiotic used in this young cohort did not impact the incidence of superficial wound infection. Further work with larger and older cohorts is needed to better characterize risk factors for postoperative infection following ACL reconstruction for all ages and comorbidities.
Poster 369: Medial and Lateral Posterior Tibial Slope in the Skeletally Immature: A Cadaveric Study
Authors: Okoro Sylvester , Taylor Vanessa , Troyer Stockton , Alayleh Amin , Ellis Henry , Yen Yi-Meng , Tompkins Marc , Ganley Ted , Shea Kevin 
Published: October 2024

Objectives: Increased knee posterior tibial slope (PTS) angle is risk factor for primary and secondary ACL injury. Adult biomechanical research indicates that decreasing the PTS may reduce ACL injuries, and osteotomy techniques have been developed to alter tibia slope to reduce risk of re-injury. Pediatric and adolescent athletes have the highest rates of primary and secondary ACL injury, and many in this age group may have abnormal PTS angle. The purpose of this study was to evaluate PTS in medial and lateral tibial plateaus in large database of CT scans, and to develop normative PTS data in this age group. Methods: IRB approval was waived, as the specimens were donated for research, no genetic information was collected, and there were no plans for family contact. 83 pediatric knee CT scans, ranging from ages 1 to 12, were analyzed using OsiriX imaging software. The PTS was evaluated at two distinct points on sagittal CT sections: (1) At the medial tibia plateau and 2) lateral tibial plateau, both aligned with the central part of on a coronal view of the medial femoral and lateral femoral condyles respectively condyle. Results: The average medial PTS angle was 6.56° ± 3.84° and 6.81° ± 3.62° for the lateral PTS. There was not a significant statistical difference between the medial and lateral PTS (P = 0.6632, determined using an independent-samples t-test and analysis of variance). When plotting the age versus PTS, we observed a positive correlation with the medial PTS (R2 = 0.0385) and a negative correlation with the lateral PTS (R2 = 0.0393). Conclusions: The data demonstrate variability in medial and lateral pediatric PTS and provides normative values for pediatric PTS values. For pediatric patients undergoing ACL surgeries, consideration of increased PTS values that are associated with higher rates of recurrent ACL injury may influence surgical treatment techniques. Correction of increased PTS to lower ACL injury risk is performed in adults with major corrective osteotomy surgery, but such procedures have not been performed in children due to osteotomy-induced damage to growth plates. Due to open growth plates, pediatric patients may be treated with minimally invasive guide growth procedures to lower PTS, with minimal complication risk. Guided growth procedures have a long history of successful alignment correction in the coronal plane. Future animal and clinic studies may also demonstrate the safety and effectiveness of guided growth sagittal plane correction as applied to increased PTS. PTS developmental anatomy and its relationship to ACL injury is crucial for surgical advancements, including the use of low risk guided growth interventions to reduce PTS and ACL injury in pediatric patients with high risk of recurrent injury.
Advancing Excellence in Transgender Health: An International Professional Development Conference on Affirming Care for Transgender and Gender Diverse People
Authors: Mitnick Sarah , Goldhammer Hilary , Thompson Julie , Bruno Jack , Dunn Mason , Reisner Sari L. , Keuroghlian Alex S. 
Published: October 2024

OBJECTIVE Increasing workforce capacity to provide knowledgeable, skilled, and affirming care for transgender and gender diverse people is critical to reduce health inequities; however, few clinicians receive sufficient training on this topic. This article describes Advancing Excellence in Transgender Health (AETH), an annual international conference that offers continuing professional development on evidence-based medical and behavioral healthcare for transgender and gender diverse people across the lifespan. METHODS Registration data and post-conference evaluation data were descriptively analyzed to assess conference reach, participant satisfaction, and participant intentions to change practice. RESULTS Between 2015 and 2022, AETH trained 2677 participants from all US states and 24 countries. Based on post-conference evaluations, 2017-2022, participant satisfaction was high (mean ≥4.4 on a 5-point scale) on all measures, including meeting learning objectives, quality of presentations, and relevance to practice. Participants reported intentions to: implement new information or skills (86.7%); create or revise protocols, policies, and/or procedures (63.2%); and seek additional information (64.2%). To increase equity, the conference waives fees for transgender and gender diverse participants and offers free online sessions. The conference also holds sessions specifically for transgender and gender diverse participants to promote opportunities for community-building, self-care, and professional networking. CONCLUSION The broad reach of AETH demonstrates a large demand for more continuing professional development on transgender and gender diverse healthcare. This conference has expanded the availability of training designed to increase and enhance clinical workforce capacity to meet the health needs of transgender and gender diverse communities in the US and across the world.
Meta-analysis of genome-wide association studies of stable warfarin dose in patients of African ancestry
Authors: Asiimwe Innocent G. , Blockman Marc , Cavallari Larisa H. , Cohen Karen , Cupido Clint , Dandara Collet , Davis Brittney H. , Jacobson Barry , Johnson Julie A. , Lamorde Mohammed , Limdi Nita A. , Morgan Jennie , Mouton Johannes P. , Muyambo Sarudzai , Nakagaayi Doreen , Ndadza Arinao , Okello Emmy , Perera Minoli A. , Schapkaitz Elise , Sekaggya-Wiltshire Christine , Semakula Jerome R. , Tatz Gayle , Waitt Catriona , Yang Guang , Zhang Eunice J. , Jorgensen Andrea L. , Pirmohamed Munir 
Published: October 2024

Abstract
Warfarin dose requirements are highly variable because of clinical and genetic factors. Although genetic variants influencing warfarin dose have been identified in European and East Asian populations, more work is needed to identify African-specific genetic variants to help optimize warfarin dosing. We performed genome-wide association studies (GWASs) in 4 African cohorts from Uganda, South Africa, and Zimbabwe, totaling 989 warfarin-treated participants who reached stable dose and had international normalized ratios within therapeutic ranges. We also included 2 African American cohorts recruited by the International Warfarin Pharmacogenetics Consortium (n = 316) and the University of Alabama at Birmingham (n = 199). After the GWAS, we performed standard error-weighted meta-analyses and then conducted stepwise conditional analyses to account for known loci in chromosomes 10 and 16. The genome-wide significance threshold was set at P &lt; 5 × 10−8. The meta-analysis, comprising 1504 participants, identified 242 significant SNPs across 3 genomic loci, with 99.6% of these located within known loci on chromosomes 10 (top SNP: rs58800757, P = 4.27 × 10−13) and 16 (top SNP: rs9925964, P = 9.97 × 10−16). Adjustment for the VKORC1 SNP -1639G&gt;A revealed an additional locus on chromosome 2 (top SNPs rs116057875/rs115254730/rs115240773, P = 3.64 × 10−8), implicating the MALL gene, that could indirectly influence warfarin response through interactions with caveolin-1. In conclusion, we reaffirmed the importance of CYP2C9 and VKORC1 in influencing warfarin dose requirements, and identified a new locus (MALL), that still requires direct evidence of biological plausibility.
Impaired lung function and associated risk factors in children born prematurely: a systematic review and meta-analysis
Authors: van Boven Menne R. , Hutten Gerard J. , Richardson Rianne , Königs Marsh , Leemhuis Aleid G. , Onland Wes , Terheggen-Lagro Suzanne W.J. , Oosterlaan Jaap , van Kaam Anton H. 
Published: October 2024

BackgroundImmature lung development and respiratory morbidity place preterm-born children at high risk of long-term pulmonary sequelae. This systematic review and meta-analysis aims to quantify lung function in preterm-born children and identify risk factors for a compromised lung function.MethodsWe searched MEDLINE, Embase, Cochrane Library, Web of Science and Scopus for relevant studies published on preterm cohorts born since 1990. Studies comparing forced expiratory volume in 1 s (FEV1) in preterm-born children aged ≥5 years to term-born controls or normative data were included. Study quality was assessed using the Newcastle–Ottawa Scale for cohort studies. Standardised mean differences in FEV1and secondary spirometry outcomes per study were pooled using meta-analysis. The impact of different demographic and neonatal variables on studies’ FEV1effect sizes was investigated by meta-regression analyses. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework.ResultsWe identified 42 studies with unique cohorts including 4743 preterm children and 9843 controls. Median gestational age in the studies was 28.0 weeks and age at assessment ranged from 6.7 to 16.7 years. Preterm children had lower FEV1than controls (−0.58sd, 95% CI −0.69– −0.47sd, p<0.001) resulting in a relative risk of 2.9 (95% CI 2.4–3.4) for abnormal outcome, with high certainty of evidence. FEV1was significantly associated with gestational age, birthweight, bronchopulmonary dysplasia and invasive mechanical ventilation in univariate meta-regression analyses (R2=36–96%).ConclusionThis systematic review shows robust evidence of impaired lung function in preterm-born children with a high certainty of evidence.
Migration of cervical spine screws to the sacral canal: a case report
Authors: Fang Miao , Zeng Yong , Song Yueming 
Published: October 2024

AbstractCervical open door laminoplasty is widely used in multilevel decompression, which is a motion-sparing decompression treatment option for multilevel cervical myelopathy. Implant distance migration in cervical laminoplasty has not been reported. A 61-year-old woman underwent cervical laminoplasty, three months postoperatively, she experienced left shoulder pain and left upper limb pain, and underwent cervical magnetic resonance imaging, which showed no abnormalities. She gradually developed dizziness, headache, unstable walking, incomplete urinary incontinence, and fluctuating neck lumps. The X-ray showed that the screws of the C7 lateral mass had disappeared and migrated to the sacral canal. The patient underwent cerebrospinal leakage repair and removal of the screws in the spinal canal. Displacement of fixators implanted into the spinal canal after cervical laminoplasty is a rare complication that can cause permanent neurological injury.
2q31 microdeletion syndrome with the velocardiofacial phenotype and review of the literature: a case report
Authors: Candelo Estephania , Giraldo-Ocampo Sebastian , Nevado Julian , Lapunzina Pablo , Pachajoa Harry 
Published: October 2024

Abstract
Background
The 2q31 deletion results in a distinct phenotype characterized by varying degrees of developmental delay, short stature, facial dysmorphism, and variable limb defects. Dysmorphic features include microcephaly, downslanting palpebral fissures, a long and flat philtrum, micrognathia, and dysplastic, low-set ears. To date, comparative genomic hybridization has identified this deletion in 38 patients. Consequently, additional patients with comprehensive clinical data are required to fully understand the spectrum of clinical manifestation associated with a deletion in the 2q31 cytoband.

Case presentation
We present the case of an 8-year-old female patient with clinical features of velocardiofacial syndrome, which include facial dysmorphism, congenital heart disease (persistent truncus arteriosus and ostium secundum-type atrial septal defect), and a seizure syndrome. Array comparative genomic hybridization revealed a non-continous deletion spanning cytobands 2q31.1-to 2q31.3, confirming a diagnosis of 2q31 microdeletion syndrome. The patient has undergone supportive therapies for swallowing and speech. Additionally, we provide a review of the literature on previous cases to give context.

Conclusion
In this report, we present the first documented case of a complex, discontinuous deletion spanning in the 2q31-2q32 regions. This case contributes to our understanding of the phenotypic and mutational spectrum observed in individuals with deletions in these cytobands. It underscores the significance of employing high-resolution techniques and comprenhensive analysis in diagnosing patients with complex phenotypes. Such approaches are crucial for differentiating this condition from more common microdeletion syndromes, such as the 22q11 deletion syndrome.