bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 210: Flexible Athletes with Borderline Hip Dysplasia Achieve Successful and Similar Outcomes after Hip Arthroscopy Compared to Flexible Athletes without Borderline Hip Dysplasia
Authors: Wright-Chisem Joshua , Vogel Michael J. , Alvero Alexander B. , Jan Kyleen , Nho Shane J. 
Published: October 2024

Objectives: To compare minimum 2-year patient-reported outcomes and achievement of clinically significant outcomes in flexibles athletes with and without borderline hip dysplasia (BHD) undergoing primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) with capsular plication. Methods: Data was prospectively collected for patients undergoing primary hip arthroscopy for FAIS with borderline hip dysplasia (BHD), defined as a lateral center edge angle (LCEA) of 18° to 25°, with primary participation in a sport with high flexibility requirement including dance, gymnastics, figure skating, yoga, cheerleading, and martial arts. These patients were matched 1:2 to flexible athletes with an LCEA >25° controlling for age, sex, body mass index (BMI) and follow up duration. Preoperative and minimum 2-year postoperative patient-reported outcomes included: Hip Outcome Score (HOS) Activities of Daily Living, HOS Sports Scale, International Hip Outcome Score 12, modified Harris Hip Score, and Visual Analog Scale for Pain. Cohort-specific Minimal Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS) were calculated and compared between groups. Results: Fifty-two flexible athletes with BHD were matched to 104 flexible athletes without BHD. Similar sport participation (45% dance vs. 41%, p=0.874) and level of competition (74% vs. 74% recreational, p=0.877) were observed. Preoperative LCEA (22.2° ± 1.6 vs. 31.5° ± 3.9, p < 0.001) and Tönnis angle (10.9 °± 3.7 vs. 5.8° ± 4.4, p < 0.001) differed significantly between groups. Capsular plication was performed in all cases (100% and 100%, p = 1.000). Both groups achieved significant improvement in all PROs (p ≤ 0.001) with no differences in PROs between groups (p ≥ 0.147). High MCID (95.7%, 94.8%) and PASS (71.7%, 72.2%) achievement for any PRO was observed with no differences between groups (p ≥ 0.222). Conclusions: Flexible athletes with BHD achieve successful and similar outcomes to those without BHD after primary hip arthroscopy for FAIS with capsular plication.
Poster 238: Accuracy, Safety, and Cost of Patient-Specific Cutting Guides for Alignment-Correcting Osteotomy
Authors: Savage-Elliott Ian , Li Zachary I. , Rao Naina , Triana Jairo , Garra Sharif , Ranawat Anil S. , Alaia Michael J. , Jazrawi Laith M. 
Published: October 2024

Objectives: The purpose of this study was to determine the cost, accuracy of radiographic correction, and safety with respect to complication rates and fluoroscopic usage in patient-specific cutting guides (PSCG) osteotomies compared to an age- and body mass index (BMI)-matched group of controls using standard cutting guides (SCG). Methods: Patients were retrospectively reviewed between 2017 and 2022 at a single urban academic institution. Patients undergoing high tibial osteotomy (HTO) or distal femoral osteotomy (DFO) with PSCG (Bodycad 3d, Quebec, Canada) were identified. Traditional osteotomies were selected for the SCG group using propensity matching based on age, sex, BMI, osteotomy type. All procedures were performed by 1 of 2 fellowship-trained sports orthopaedic surgeons. Procedure time, fluoroscopy time, tourniquet time, and concomitant procedures were extracted from operative notes. Blinded, 2-reader hip-knee-ankle (HKA), posterior tibial slope (PTS) and mechanical axis deviation (MAD) measurements were performed on pre- and postoperative weightbearing radiographs for each procedure. Intraclass correlation coefficients (ICCs) were calculated to determine the reliability between the intended intraoperative correction of HKA and/or PTS the measured result on postoperative radiographs. A time-driven activity-based costing (TDABC) analysis was performed to compare costs of PSCG versus SCG. Results: Forty-two patients were included in the final analysis. Each group was 47.6% female, with 11 HTOs and 10 DFOs performed in each group. Final HKA (2.7° vs 1.9°, p = 0.355), PTS (1.6° vs 2.6°, p = 0.794) and MAD (10.2 vs 5.8 mm, p = 0.214) did not significantly differ between SCG and PSCG groups (MAD seems higher for SCG. The ICC between the intended and measured HKA correction was 0.841 (good) in the PSCG group and 0.623 (moderate) in the SCG group. PSCG osteotomies averaged 18.5 minutes less (p = 0.392) and required 16.7 minutes less tourniquet time (p = 0.121). Fluoroscopy time was significantly lower in the PSCG group compared to SCG (99 vs 43 seconds, p < 0.001), as well as radiation dose (7.8 vs 2.9 mGy, p = 0.013). TDABC analysis demonstrated a base cost of $21,067 for PSCG and $23,896 for SCG. When the cost of the cutting guide and pre-operative imaging were included, PSCG was $2,829 more expensive than SCG. There was a lower, though non-statistically significant, rate of hinge fractures (9.5% vs 33.3%, p = 0.130) and return to the OR (4.8% vs 19.0%, p = 0.343) when comparing PSCG and SCG groups. Conclusions: Both traditionally guided osteotomies and PSCG-guided osteotomies accurately corrected lower extremity malalignment. Utilization of PSCG resulted in similar procedure times and cost. PSCG required less fluoroscopy and resulted in less radiation to conventional osteotomy and trended toward a decreased rate of postoperative complications.
Poster 249: Distal Femoral Coronal Realignment Osteotomies Alter CT-Measured Tibial Tuberosity to Trochlear Groove (TT-TG) Distance in Addition to Mechanical Axis Deviation – A Cadaveric Study
Authors: Tauberg Brandon M. , Williams Derrick , Aboulafia Alexis H. , Haidar Layla , Mansour Alfred A. 
Published: October 2024

Objectives: Patellar tracking has been shown to be affected by limb alignment. Many patients with underlying valgus deformity with patellar instability have elevated tibial tuberosity–trochlear groove (TT-TG) measurements. Correction of limb alignment improves Q-angle, however, its effect on TT-TG as measured by computed tomography (CT) has yet to be demonstrated. We hypothesize that changing the limb alignment as measured by mechanical axis deviation (MAD) through a distal femoral osteotomy (DFO) would also cause a change in TT-TG distance as measured by CT. Methods: Lateral distal femoral osteotomies were performed on 5 cadaveric specimens (10 limbs) and fixed with an external fixator. The native MAD and baseline TT-TG were measured using a CT scanogram. Subsequent scans were then performed altering the MAD using calibrated radiolucent wedges in 5 mm increments (0-25 mm) on a single side, using the contralateral limb as the control. Repeat measurements of MAD and TT-TG were obtained, and once completed, original alignment was restored, and the contralateral limb was taken through the same protocol with the opposite limb serving as the control. Measurements were performed by two independent observers and averages obtained. Linear regression models were created, and statistical analysis of variance was performed. Results: A CT-scanogram that measured TT-TG distances were significantly altered by changes in limb alignment. According to our linear regression model, each 1° of MAD alteration resulted in TT-TG change of approximately 0.4 mm. With every 5° change in limb alignment, the TT-TG changed by approximately 2 mm (Figure 1). Altering MAD from 6° valgus to 7° varus decreased the TT-TG mean from 14.3 mm to 7.7 mm, p < 0.05. Conclusions: Changes in coronal limb alignment through a distal femoral corrective osteotomy produce significant changes in TT-TG in addition to correcting MAD in a cadaveric model. These findings should be considered when determining appropriate corrective procedures for patients with valgus alignment and patellar instability. [Figure: see text]
Poster 269: Radiographic Outcome of Meniscal Root Repairs: Evaluating Osteoarthritic Progression Over Two Years
Authors: Flanigan David C. , Magnussen Robert A. , Kaeding Christopher C. , Barker Tyler , Burnett Zachary , Cavendish Parker A. , Milliron Eric , Kashyap Anjali 
Published: October 2024

Objectives: Root tears account for 10-21% of meniscal injuries, defined as radial tears occurring within 1 cm of the meniscal attachment horn. Menisci play a critical role in load transmission and shock absorption, with the goal of surgical intervention to retain knee functionality over time. While meniscal root repairs demonstrate better clinical outcomes to meniscectomies, total knee replacements, or non-surgical intervention, current literature suggests progression of knee osteoarthritis following repair. The purpose of this study is to evaluate osteoarthritic impacts, specific to joint space narrowing (JSN) and Kellgren Lawrence grades, through pre- and post-operative radiographs of root repair patients. We hypothesize root repair radiographs will demonstrate both anatomic narrowing of joint space and increased KL Grades over a 2-year follow-up. The purpose of this study was to evaluate osteoarthritic impacts of meniscal root repairs by using standardized protocol to measure JSN and KL Grades through pre- and postoperative patient radiographs. Methods: Patients who underwent meniscal root repairs during the study period of 2012 to 2022 at our academic center were identified. Inclusion criteria included patients who received a weightbearing preoperative, 1-year postoperative, and/or 2-year postoperative radiograph. Joint space and KL scores, including evaluation of osteophytes, sclerosis, and definite deformity of boney ends, were assessed by two separate independent readers with protocol consistent with previously published grading scale literature. Results: Forty-nine patients (35 females and 12 males) with an average age of 47.7 (± 9.06) years and BMI of 32.73 (±6.75) underwent meniscal root repairs and proper imaging during the study period. Preliminary data indicates significant (p <.005) medial joint space narrowing across medial, lateral, and bilateral repairs from preoperative measurements (4.79 ± 0.7 mm) to 1-year postoperative (4.24 ± 0.7 mm), as well as 2-year postoperative (4.24± 1.0 mm). Over 2-year follow-up, 47.4% patients went on to hold the same KL grade, 44.7% patients increased by 1 grade, 7.9% patients increased by 2 grades, and two patients were converted to arthroplasty (i.e. 1 total knee, 1 unicompartmental). Overall, KL scores demonstrate an average 51.9% increase in pre-op grading (1.29 ± 0.4) to 2-year post-op grading (1.96 ± 0.29) respectively. Conclusions: Radiographic images of meniscal root repairs indicate mild progression of osteoarthritic knee characteristics over a 2-year follow-up. Quantified joint space narrowing was shown in most patients and over 50% had an increase in Kellgren Lawrence grade. Despite successful repair in most patients, osteoarthritic progression occurs in post patients.
Poster 284: The Effect of Pressurized Carbon Dioxide Lavage on Osteochondral Allograft Preparation: A Comparative Study
Authors: Atzmon Ran , Chang Wen-Teh , Chan Calvin , Lin Kenneth M. , Cole Brian J. , Abrams Geoff D. , Sherman Seth L. 
Published: October 2024

Objectives: Osteochondral allografts (OCA) transplantation is often utilized for treating osteochondral lesions of the knee due to limited cartilage regenerative capabilities. The use of concentrated bone marrow aspirate (cBMA) has gained traction as a method to enhance OCA incorporation and healing. Pulse lavage and pressurized carbon dioxide lavage are cleaning methods used during OCA preparation to rid native marrow elements and improve graft porosity, but their isolated and combined effects are not fully understood. This study aimed to assess the impact of incorporating pressurized carbon dioxide lavage as an adjunct to pulse lavage during OCA preparation. Our hypothesis was that adding pressurized carbon dioxide lavage would enhance the OCA absorption capacity for liquid-based materials like cBMA. Methods: OCA plugs were harvested from medial hemi-condyles. The plugs were divided into two groups: one group underwent pulse lavage alone, and the other group underwent pulse lavage followed by pressurized carbon dioxide lavage (sequential group). The plugs were weighed before and after each cleaning step and a liquid dye solution with consistency similar to cBMA was added by dripping over the cancellous portion of the graft. Next, the liquid content was determined by centrifugation and spectrophotometry. Results were analyzed statistically. Results: Thirty-four OCA plugs with a 14 to 18 mm diameter were harvested. After the cleaning phase, the sequential group showed a significant weight reduction of 107 ± 21.92% (p < 0.0001) and subsequent weight gain of 96.32 ± 18.99% (p < 0.0001) after the cleaning and dye-dripping procedures. In contrast, the pulse lavage-only group exhibited minimal weight loss and a small  weight gain of 10.55 ± 3.86% after the dye-dripping procedure. Conclusions: Adding pressurized carbon dioxide lavage to reduce marrow elements and improve graft porosity significantly improved the OCA cleaning process and created more vacant space enhancing OCA absorption capacity for orthobiologic agents such as cBMA. The study findings highlight the potential of incorporating pressurized carbon dioxide lavage as an adjunct to pulse lavage during OCA preparation. These findings may contribute to the surgical procedure of incorporating cBMA or other orthobiologics to promote the integration and healing of OCA plugs.
A Virtual Reality Anatomy Model of the Temporal Bone in ORL Residency Training—Gain or Gadget?
Authors: Everad Friederike , Albrecht Tobias , Kromeier Jan , Heermann Stephan , von Schnakenburg Philip , Hildenbrand Tanja , Speck Iva , Knopf Andreas , Offergeld Christian 
Published: October 2024

OBJECTIVES Virtual reality (VR) appears to be a promising educational tool for otorhinolaryngology (ORL) residency training, as it allows for safe and effective practice immediate feedback and potential improvements in patient outcomes. Despite these advantages, VR has not yet been incorporated into residency training in ORL, which may be due to limited availability or validation and skepticism toward incorporation of new training methods. This study investigates whether a VR model of the temporal bone improves learning success for ORL residents in comparison to standard plastic models and whether it depends on surgeon's experience. We also included a subjective evaluation of the learning experience with both models. METHODS ORL residents and specialists at 2 German university hospitals were tested on their knowledge of temporal bone anatomy after training with either VR or standard plastic models. In addition, we compared knowledge of the temporal bone anatomy before- and after-VR training. Lastly, a subjective survey on the benefits and limitations of VR was conducted to assess participants’ views on this new technology. RESULTS About 85% of the participants considered VR to be better than conventional models and agreed that VR was a useful tool for teaching complex anatomy. Objective evaluation showed significant improvement in knowledge after using VR (before/after comparison), especially in participants with a higher level of preexisting knowledge. Direct comparison to conventional plastic models showed no superiority of the VR model. CONCLUSION VR models in ORL are not only appealing and motivating for residents, but also objectively improve their anatomical knowledge, especially in advanced residency. In addition, VR—in contrast to the plastic model—offers opportunities for further development and optimization.
Exploring Factors Influencing Parent-Adolescent Communication on Sexual and Reproductive Health (SRH)—A Qualitative Study from Bengaluru, India
Authors: Likith R S  
Published: October 2024

Background: Sexuality and reproductive health have remained a topic of taboo and disgust in India, owing to its deep-rooted cultural, traditional and religious practices. Lack of right sources of information and negligible communication about sexual and reproductive health (SRH) with trusted adults encourages adolescents to rely on unsafe sources, both online and offline, which could lead to detrimental consequences on their physical and mental health. Methods: This study utilizes a qualitative descriptive design to explore the factors influencing parent-adolescent communication on SRH. It focuses on mothers of adolescent children (10–19 years) from Urban Bengaluru. Data is collected through in-depth interviews of mothers and thematic analysis is performed on the data collected. Results: The qualitative analysis identified five core themes: Knowledge about SRH and gender-based needs, cultural and traditional influences, role of family, role of partner and inhibition of children. The perspectives of parents provided scope for what could be done to facilitate healthy and open communication. Conclusion: This study portrays the factors that hinder free communication between parents and adolescents about SRH. Suggestions for breaking the taboo pertaining to sexuality conversations and future studies have also been mentioned.
Study of Attitude Toward Homosexuality Among the Health Professionals
Authors: Patel Vishal K. , Joshi Vaibhav M. , Patel Falguni B. , Barot Anand , Sharma Vivek , Prajapati Ronak 
Published: October 2024

Background: Despite the level of awareness of homosexuality is in the increasing trend, health professionals lack a positive attitude toward homosexuality. Aim: The purpose of this study was to determine the level of attitudes toward homosexuality among health professionals. Subject and Methods: This was a cross-sectional study conducted among 600 health professionals. The attitude toward homosexuality questionnaire was used to assess the attitude of health professionals toward homosexuality. A descriptive analysis, Mann–Whitney U test, and Kruskal Wallis test were used to analyze the data. Observations: The mean score for attitude toward homosexuality questionnaire was 73.04 + 23.39 among the participants. The males had lesser degree of positive attitude compared to higher degree of positive attitude of females toward homosexuality. Participants from rural areas had neutral attitudes, and participants from the urban areas had positive attitudes toward homosexuality. Participants living in nuclear families had positive attitudes toward homosexuality, and participants living in joint families had negative attitudes toward homosexuality. Participants with heterosexual orientation had negative attitudes toward homosexuality. Conclusion: Overall, health professionals had a lesser degree of positive attitude toward homosexuality; they require sensitization to upgrade their positive attitude toward homosexuality for better doctor–patient relationship.
The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review
Authors: Burge Angela T. , Gadowski Adelle M. , Romero Lorena , Vagheggini Guido , Spathis Anna , Smallwood Natasha E. , Ekström Magnus , Holland Anne E. 
Published: October 2024

BackgroundIn adults with serious respiratory illness, fatigue is prevalent and under-recognised, with few treatment options. The aim of this review was to assess the impact of graded exercise therapy (GET) on fatigue in adults with serious respiratory illness.MethodsElectronic databases were searched to identify randomised controlled trials (RCTs) testing GET (involving incremental increases in exercise from an established baseline) in adults with serious respiratory illness. The primary outcome was fatigue and secondary outcomes were health-related quality of life (HRQoL) and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data.Results76 RCTs were included with 3309 participants, most with a diagnosis of COPD or asthma. Reductions in fatigue measured by the Chronic Respiratory Disease Questionnaire fatigue domain score were demonstrated following GET consisting of aerobic with/without resistance training (mean difference (MD) 0.53 points, 95% CI 0.41–0.65, 11 RCTs, 624 participants) and GET using resistance training alone (MD 0.58 points, 95% CI 0.21–0.96, two RCTs, 82 participants) compared with usual care. Although the mean effect exceeded the minimal important difference, the lower end of the confidence intervals did not always exceed this threshold so the clinical significance could not be confirmed. GET consistently improved HRQoL in people with a range of chronic respiratory diseases on multiple HRQoL measures. No serious adverse events related to GET were reported.ConclusionGET may improve fatigue alongside consistent improvements in HRQoL in people with serious respiratory illness. These findings support the use of GET in the care of people with serious respiratory illness.
An investigative study on Yersinia enterocolitica in animals, humans and dried milk in New Valley Governorate, Egypt
Authors: Sotohy Sotohy A. , Diab Mohamed Said , Ewida Rania M. , Aballah Allaa , Eldin Nehal K. Alm 
Published: October 2024

Abstract
Background
Yersiniosis is one of the most significant intestinal disorders caused by Yersinia enterocolitica and affects both humans and animals. This study aimed to investigate the prevalence of Y. enterocolitica in New Valley Governorate, Egypt in animals, humans, fresh milk and dried milk. Additionally, this study analyzed the presence of virulence genes, including ail and Yst in tested isolates and conducted a phylogenetic analysis to determine the genetic similarity between human, and animal Y. enterocolitica isolates. Finally, the antimicrobial resistance patterns of the isolates were examined.

Results
Among the 982 samples examined, the prevalence of Y. enterocolitica based on ISO10273-2017 was 11.7% in animal samples including 12.8% of animal faeces, and 10.4% in milk samples. Moreover, the prevalence of Y. enterocolitica was 13.2% in human stool, and 9.5% in dried milk samples. The molecular characterization of the six randomly selected isolates showed that the 16S rRNA, ail and Yst genes were found in 50, 33.3 and 100% of the examined Y. enterocolitica isolates, respectively. Phylogenetic analysis of animal and human isolates based on the 16S rRNA gene revealed a high degree of similarity between the isolates. All the tested animal and human Y. enterocolitica isolates (100%) were resistant to ampicillin and cefotaxime, but highly sensitive to norfloxacin.

Conclusions
The high prevalence of Y. enterocolitica in animal and human samples with high degrees of genetic similarity poses a threat to public and animal health. Animal faeces, milk and milk powder represent the main sources of Y. enterocolitica infection in humans. Additionally, high levels of antibiotic resistance of Y. enterocolitica can cause public health hazards by leading to the failure of disease prevention and treatment programs in humans and animals.