bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcomes After Arthroscopic Hip Labral Repair Using Looped Versus Pierced Suture Techniques
Authors: Sawyer Gregory A. , Briggs Karen K. , Dornan Grant J. , Ommen N. Dawn , Philippon Marc J. 
Published: May 2015

Background: With an improved understanding of the importance of the labrum, labral repair is replacing labral debridement as a component of hip arthroscopy for femoroacetabular impingement. Labral repair can be performed by passing suture limbs either around (looped) or through (pierced) the labral tissue. Purpose: To determine whether there is any clinical difference between these different labral repair techniques. Study Design: Cohort study; Level of evidence, 3. Methods: A prospective data registry was queried for patients who underwent primary hip arthroscopy with labral repair from 2009 to 2011. Patients older than 18 years who had undergone labral repair were included in the study. Exclusion criteria included previous hip surgery, avascular necrosis, joint space less than 2 mm, and labral reconstruction or augmentation. Patients were grouped based upon the 3 labral repair techniques: looped, pierced, or combined. Statistical equivalence testing was performed to evaluate the primary outcome measure, the Hip Outcome Score–activities of daily living subscale (HOS-ADL). Other measures included the HOS–sport subscale (HOS-Sport), modified Harris hip score (mHHS), Short Form–12 (SF-12), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and patient satisfaction with outcome (1-10 scale; 10 = very satisfied). Results: Preoperative scores improved in the looped group (HOS-ADL, from 68 to 91; mHHS, from 64 to 83; HOS-Sport, from 51 to 81; and WOMAC, from 23 to 9), the pierced group (HOS-ADL, from 64 to 89; mHHS, from 62 to 83; HOS-Sport, from 46 to 77; and WOMAC, from 34 to 12), and the combined group (HOS-ADL, from 64 to 89; mHHS, from 63 to 83; HOS-Sport, from 52 to 79; and WOMAC, from 26 to 12). Median patient satisfaction in all groups was 9.0. The 3 labral repair groups were shown to be statistically and clinically equivalent ( P < .05) with respect to the validated HOS-ADL to within a clinically irrelevant threshold at mean 36-month follow-up. In addition, there were no differences in secondary outcome measures or in the revision rate (looped, 7% [14/209], pierced, 8% [5/65], and combined, 6% [5/83]). Conclusion: This study showed equivalent HOS-ADL outcomes between looped, pierced, and combined labral repairs. Secondary outcome measures, including failure and revision rates, were not significantly different among the groups. Thus, suture type did not influence outcomes.
Sex Influences the Biomechanical Outcomes of Anterior Cruciate Ligament Reconstruction in a Preclinical Large Animal Model
Authors: Kiapour Ata M. , Fleming Braden C. , Proffen Benedikt L. , Murray Martha M. 
Published: May 2015

Background: The risk of anterior cruciate ligament (ACL) injury is 2 to 10 times greater in women than men. While the effect of sex on injury risk is well established, its effects on surgical outcomes remain controversial. Purpose/Hypothesis: To investigate whether the biomechanical outcomes of ACL reconstruction are affected by sex using an established porcine model that displays similar sex-specific differences in knee anatomy and ligament structural properties to humans. The hypothesis was that there will be sex differences in ACL reconstruction outcomes with regard to the graft structural properties, knee laxity, and cartilage damage. Study Design: Controlled laboratory study. Methods: A total of 41 adolescent Yucatan minipigs (23 male, 18 female) underwent unilateral ACL transection and ACL reconstruction using sex-matched bone–patellar tendon–bone allografts (with or without additional bioenhancement). Graft biomechanical and histological properties, knee laxity, and cartilage damage were assessed after 15 weeks. A 2-factor analysis of variance was used to investigate the effect of sex on all the measured outcomes after adjusting for the treatment effect. Results: After 15 weeks of healing, female pigs had a significantly lower mean normalized graft yield load (by 18.5% ± 7.7%; P = .023) and linear stiffness (by 11.9% ± 5.6%; P = .043) compared with male pigs. Female pigs had significantly greater side-to-side differences in anteroposterior knee laxity at 30° (by 1.4 ± 0.6 mm; P = .028) and 90° (by 1.8 ± 0.8 mm; P = .032). Female pigs had a lower graft vascular density (by 0.8 ± 0.3 [analog scoring]; P = .021) with similar cellular and collagen-based histologic scores in both sexes ( P > .6). Female pigs also had a significantly larger area of cartilage damage (by 43.3 ± 14.8 mm2; P = .014) after conventional ACL reconstruction compared with their male counterparts. Conclusion: Female pigs had significantly worse outcomes (ie, graft structural properties, knee laxity, and cartilage damage) compared with male pigs in this translational model after 15 weeks of healing. Clinical Relevance: These data suggest that further optimization of ACL injury treatments may be needed to accommodate each sex instead of using a “one fits all” approach to improve surgical outcomes, decrease incidence of reinjury, and decrease posttraumatic osteoarthritis risk after ACL reconstruction.
Effect of l-lysine-assisted surface grafting for nano-hydroxyapatite on mechanical properties and in vitro bioactivity of poly(lactic acid-co-glycolic acid)
Authors: Liuyun Jiang , Lixin Jiang , Chengdong Xiong , Lijuan Xu , Ye Li 
Published: May 2015

It is promising and challenging to study surface modification for nano-hydroxyapatite to improve the dispersion and enhance the mechanical properties and bioactivity of poly(lactic acid- co-glycolic acid). In this paper, we designed an effective new surface grafting with the assist of l-lysine for nano-hydroxyapatite, and the nano-hydroxyapatite surface grafted with the assist of l-lysine (g-nano-hydroxyapatite) was incorporated into poly(lactic acid- co-glycolic acid) to develop a series of g-nano-hydroxyapatite/poly(lactic acid- co-glycolic acid) nano-composites. The surface modification reaction for nano-hydroxyapatite, the mechanical properties, and in vitro human osteoblast-like cell (MG-63) response were characterized and investigated by Fourier transformation infrared, thermal gravimetric analysis, dispersion test, electromechanical universal tester, differential scanning calorimeter measurements, and in vitro cells culture experiment. The results showed that the grafting amount on the surface of nano-hydroxyapatite was enhanced with the increase of l-lysine, and the dispersion of nano-hydroxyapatite was improved more, so that it brought about better promotion crystallization and more excellent mechanical enhancement effect for poly(lactic acid- co-glycolic acid), comparing with the unmodified nano-hydroxyapatite. Moreover, the cells’ attachment and proliferation results confirmed that the incorporation of the g-nano-hydroxyapatite into poly(lactic acid- co-glycolic acid) exhibited better biocompatibility than poly(lactic acid- co-glycolic acid). The above results indicated that the new surface grafting with the assist of l-lysine for nano-hydroxyapatite was an ideal novel surface modification method, which brought about better mechanical enhancement effect and in vitro bioactivity for poly(lactic acid- co-glycolic acid) with adding higher g-nano-hydroxyapatite content, suggesting it had a great potential to be used as bone fracture internal fixation materials in future.
Isolation, characterization, and in vitro evaluation of bovine rumen submucosa films of collagen or chitosan-treated collagen
Authors: Gopal Shankar K , Udhaya Kumar S , Sowndarya S , Suresh Babu P , Rose C 
Published: May 2015

Bovine rumen is hitherto considered as an inedible waste of meat industry. The rumen tissues can be used as an alternative source of collagen to produce biocompatible materials for clinical application. In an effort to develop a functional biomaterial from the inedible mammalian tissues, this study aims to isolate and characterize bovine rumen submucosa. Initially, the rumen tissue was sequentially processed using chemical and enzymatic treatment to decellularize, neutralize, stabilize, and to produce a native collagen matrix which is referred as collagen film (COL-F). Thus, prepared matrix was treated with 1% (w/v) chitosan solution to produce a hybrid film which is referred as collagen–chitosan film (COL/CS-F). The comparative study includes the evaluation of physical, chemical, and biological properties of the biofilms prepared. The surface topology of COL-F exhibited a continuous collagenous network with fibrous nature, while the chitosan treatment provided smooth plain surface to the parent film. Incorporation of chitosan in COL-F increased the tensile properties, as well as the thermal stability and durability of the films. The Fourier Transform Infrared spectroscopy results revealed the presence of respective amide peaks, which corresponds to protein (collagen), and the evidence of collagen–chitosan interlinking. The submucosa layer was electrophoretically found to have type I collagen. The X-ray diffraction data showed the presence of amorphous and crystalline peak which attributes to the triple helical structure of collagen in the films. Cytotoxicity studies on the films were performed in vitro using human keratinocytes. The results of cell viability and proliferation demonstrated that COL-F and COL/CS-F exhibit good biocompatibility and therefore can augment cell infiltration and proliferation. However, enhanced cellular activity was observed on the chitosan treated COL-F. These observations demonstrate that the biofilms prepared in this study can be used as an alternative functional biomaterial in tissue engineering.
Rivaroxaban in antiphospholipid syndrome (RAPS) protocol: a prospective, randomized controlled phase II/III clinical trial of rivaroxaban versus warfarin in patients with thrombotic antiphospholipid syndrome, with or without SLE
Authors: Cohen H , Doré C J , Clawson S , Hunt B J , Isenberg D , Khamashta M , Muirhead N 
Published: May 2015

Introduction The current mainstay of the treatment of thrombotic antiphospholipid syndrome (APS) is long-term anticoagulation with vitamin K antagonists (VKAs) such as warfarin. Non-VKA oral anticoagulants (NOACs), which include rivaroxaban, have been shown to be effective and safe compared with warfarin for the treatment of venous thromboembolism (VTE) in major phase III prospective, randomized controlled trials (RCTs), but the results may not be directly generalizable to patients with APS. Aims The primary aim is to demonstrate, in patients with APS and previous VTE, with or without systemic lupus erythematosus (SLE), that the intensity of anticoagulation achieved with rivaroxaban is not inferior to that of warfarin. Secondary aims are to compare rates of recurrent thrombosis, bleeding and the quality of life in patients on rivaroxaban with those on warfarin. Methods Rivaroxaban in antiphospholipid syndrome (RAPS) is a phase II/III prospective non-inferiority RCT in which eligible patients with APS, with or without SLE, who are on warfarin, target international normalized ratio (INR) 2.5 for previous VTE, will be randomized either to continue warfarin (standard of care) or to switch to rivaroxaban. Intensity of anticoagulation will be assessed using thrombin generation (TG) testing, with the primary outcome the percentage change in endogenous thrombin potential (ETP) from randomization to day 42. Other TG parameters, markers of in vivo coagulation activation, prothrombin fragment 1.2, thrombin antithrombin complex and D-dimer, will also be assessed. Discussion If RAPS demonstrates i) that the anticoagulant effect of rivaroxaban is not inferior to that of warfarin and ii) the absence of any adverse effects that cause concern with regard to the use of rivaroxaban, this would provide sufficient supporting evidence to make rivaroxaban a standard of care for the treatment of APS patients with previous VTE, requiring a target INR of 2.5.
Evaluation of Absorbable and Nonabsorbable Sutures for Repair of Achilles Tendon Rupture With a Suture-Guiding Device
Authors: Kocaoglu Baris , Ulku Tekin Kerem , Gereli Arel , Karahan Mustafa , Turkmen Metin 
Published: May 2015

Background: The purpose of this study was to compare the functional and clinical results of Achilles tendon repairs with an Achilles tendon suture-guiding device using nonabsorbable versus absorbable sutures. We hypothesized that the absorbable suture would have clinical results comparable to those of the nonabsorbable suture for Achilles tendon repair with an Achilles tendon suture-guiding system. Methods: From January 2010 to September 2013, 48 consecutive patients who had sustained a spontaneous rupture of the Achilles tendon underwent operative repair with an Achilles tendon suture-guiding device using 2 different suture types. All ruptures were acute. The patients were divided equally into 2 groups according to suture type. In the nonabsorbable suture group, No. 2 braided nonabsorbable polyethylene terephthalate sutures were used, and in the absorbable suture group, braided absorbable polyglactin sutures were used. The average age of the patients was 38 years (range, 28-50 years). Functional outcome scores and complications were evaluated. Results: All patients had an intact Achilles repair after surgery. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot clinical outcome scores were 98 (range, 90-100) in the nonabsorbable suture group and 96.8 (range, 87-100) in the absorbable suture group. All patients returned to their previous work. The absorbable suture group had fewer postoperative complications (0%) than the nonabsorbable suture group (12.5%) ( P < .05). Conclusion: Use of an absorbable suture in the treatment of Achilles tendon repair by an Achilles tendon suture-guiding system was associated with a lower incidence of suture reaction; however, functionally the results were not notably different from those using a traditional nonabsorbable suture. We conclude that repair with absorbable sutures is appropriate for Achilles tendon ruptures. Level of Evidence: Level II, prospective comparative study.
First-year doctors’ attitudes and beliefs relating to quality improvement and patient safety
Authors: Dahill Mark , Bethune Rob , Carson-Stevens Andrew , Soo Eleanor , Finucane Katherine , Watson Joanne , Woodhead Tricia , VanHamel Clare 
Published: May 2015

In the current environment of culture change and financial pressure on the National Health Service, quality improvement initiatives are heralded as new vehicles for workplace evolution. Foundation Year One doctors encounter many of the problems impinging on quality, and their enthusiasm and number make them an indispensable resource and critical mass for improvement. In response to the increasing importance of quality improvement training, and as part of an ongoing project to embed quality improvement education in the Severn Deanery region, this paper describes the evolution of a questionnaire tool to assess the attitudes and beliefs of a cohort of new Foundation Year One doctors. An electronic survey was developed and validated to address each aim of quality care. The survey was sent by email to every Foundation Year One doctor in the Severn Deanery. New Foundation Year One doctors’ attitudes are overwhelmingly positive towards quality improvement and patient safety; however, universally, they do not feel valued and listened to. In addition, they do not feel that their previous medical education has fully equipped them to improve the quality and safety of the care they deliver to their patients. Foundation Year One doctors represent a large, intelligent and enthusiastic workforce and in an environment where quality is now accepted as paramount, harnessing their potential through better quality improvement training could prove advantageous to all National Health Service stakeholders.
Forefoot Deformity in Rheumatoid Arthritis
Authors: Dave Malhar H. , Mason Lyndon W. , Hariharan Kartik 
Published: May 2015

All reported rheumatoid arthritis (RA) forefoot deformities in the literature thus far have arisen from shoe wearing populations. Our aim in this study was to compare hallucal deformities seen in a shod population with an unshod population. A population comparison was undertaken in 2 specialized foot and ankle units, one in India and one in the United Kingdom. In the shod population, there was 1 hallux varus deformity, 10 without hallucal deformity, and 90 hallux valgus deformities. In contrast, in the unshod population, there were 19 hallux varus deformities and 6 hallux valgus deformities. There was great variability in the lesser toe deformity seen. In the shod population, it was most common to see dorsal subluxation or dislocation, with the fifth toe in a varus position. In the unshod population, the most common lesser toe deformity seen was varus deviation or dislocation. Instability of the metatarsophalangeal joint in the rheumatoid foot predisposes it to significant deformity. In the non–shoe wearing population, intrinsic muscle forces and weight bearing forces are the most likely determinants of the deformity, with hallux varus being a more common presenting problem. In the shod population, the external forces of shoe wear dictate the direction of deformity. Levels of Evidence: Prognostic, Level III: Case control study
Allograft Reconstruction of the Lisfranc Ligament
Authors: Weglein Daniel G. , Andersen Clark R. , Morris Randal P. , Buford William L. , Panchbhavi Vinod K. 
Published: May 2015

For Lisfranc injuries, screw fixation of the medial and middle columns is currently the standard of treatment. The purpose of this study was to biomechanically evaluate the use of allograft for a severed Lisfranc ligament compared to standard screw fixation and the intact condition. Six pairs of fresh-frozen cadaveric lower extremities were prepared with reflective marker arrays and cyclically loaded to simulate partial weight bearing under 4 sequential testing conditions: (1) intact ligament, (2) disrupted ligament, (3) tendon allograft reconstructed ligament, and (4) rigid screw fixation. The relative displacement between the medial cuneiform and the second metatarsal was assessed via motion analysis. A mixed model analysis of variance was used to determine the significance (α = .05) of displacement differences. Mean displacements and 95% confidence intervals for each condition were as follows: (1) intact 9.1 (7.1-11.2) mm, (2) cut ligament 9.4 (7.4-11.5) mm, (3) allograft fixation 8.8 (6.8-10.9) mm, and (4) screw fixation 8.2 (6.2-10.3) mm. There were no significant differences among the specimens according to condition. Allograft fixation provided adequate strength and stability and did not differ significantly compared to intact or screw fixation. Levels of Evidence: Level V: Bench testing
Incidence and Severity of Foot and Ankle Injuries in Men’s Collegiate American Football
Authors: Lievers W. Brent , Adamic Peter F. 
Published: May 2015

Background: American football is an extremely physical game with a much higher risk of injury than other sports. While many studies have reported the rate of injury for particular body regions or for individual injuries, very little information exists that compares the incidence or severity of particular injuries within a body region. Such information is critical for prioritizing preventative interventions. Purpose: To retrospectively analyze epidemiological data to identify the most common and most severe foot and ankle injuries in collegiate men’s football. Study Design: Descriptive epidemiology study. Methods: Injury data were obtained from the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) for all foot and ankle injuries during the 2004-2005 to 2008-2009 seasons. Injuries were analyzed in terms of incidence and using multiple measures of severity (time loss, surgeries, medical disqualifications). This frequency and severity information is summarized in tabular form as well as in a 4 × 4 quantitative injury risk assessment matrix (QIRAM). Results: The rate of foot and ankle injuries was 15 per 10,000 athletic exposures (AEs). Five injuries were found to be responsible for more than 80% of all foot and ankle injuries: lateral ankle ligament sprains, syndesmotic (high ankle) sprains, medial ankle ligament sprains, midfoot injuries, and first metatarsophalangeal joint injuries. Ankle dislocations were found to be the most severe in terms of median time loss (100 days), percentage of surgeries (83%), and percentage of medical disqualifications (94%), followed by metatarsal fractures (38 days, 36%, and 49%, respectively) and malleolus fractures (33 days, 41%, and 59%, respectively). Statistical analysis suggests that the 3 measures of severity are highly correlated ( r > 0.94), thereby justifying the use of time loss as a suitable proxy for injury severity in the construction of the QIRAM. Conclusion: Based on the QIRAM analysis, the 5 highest risk injuries were identified based on both incidence and severity (ankle dislocations, syndesmotic sprains, lateral ankle ligament sprains, metatarsal fractures, and malleolus fractures). A better understanding of the relative incidence and severity of these injuries will allow coaches, trainers, and researchers to more effectively focus their preventative interventions.
Suppression of SOX7 by DNA methylation and its tumor suppressor function in acute myeloid leukemia
Authors: Man Cheuk Him , Fung Tsz Kan , Wan Haixia , Cher Chae Yin , Fan August , Ng Nelson , Ho Christa , Wan Thomas S. K. , Tanaka Toshiyuki , So Chi Wai Eric , Kwong Yok Lam , Leung Anskar Y. H. 
Published: May 2015

Key PointsSOX7 expression is silenced in common myeloid malignancies. SOX7 interacts directly with β-catenin and regulates the Wnt pathway in acute myeloid leukemia.
Tumor indoleamine 2,3-dioxygenase (IDO) inhibits CD19-CAR T cells and is downregulated by lymphodepleting drugs
Authors: Ninomiya Soranobu , Narala Neeharika , Huye Leslie , Yagyu Shigeki , Savoldo Barbara , Dotti Gianpietro , Heslop Helen E. , Brenner Malcolm K. , Rooney Cliona M. , Ramos Carlos A. 
Published: May 2015

Key PointsTumor IDO inhibits CD19-CART activity, likely via induction of the kynurenine pathway, whose metabolites directly inhibit T cells. Fludarabine and cyclophosphamide, frequently used before CART administration, downregulate IDO expression in lymphoma cells.
Supercapacitor electrode with a homogeneously Co3O4-coated multiwalled carbon nanotube for a high capacitance
Authors: Tao Li , Shengjun Li , Bowen Zhang , Bei Wang , Dayong Nie , Zeng Chen , Ying Yan , Ning Wan , Weifeng Zhang 
Published: May 2015

Abstract
Cobalt oxide (Co3O4) was homogeneously coated on multiwalled carbon nanotube through a simple chemical deposition method and employed in supercapacitor electrodes. SEM image indicated the uniform distribution of Co3O4 nanoparticles on the surface of the multiwalled carbon nanotube. A maximum specific capacitance of 273 Fg−1 was obtained at the charge–discharge current density of 0.5 Ag−1. After 500 cycles of continuous charge–discharge process, about 88% of the initial capacity could be retained.