bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 344: The New "Terrible Triad": Anterior Cruciate Ligament Reconstruction With Concurrent Meniscal Lateral Root and Medial Ramp Repairs
Authors: Shoemaker Evan , Tollefson Luke , Kennedy Nicholas , McGaver Rebecca Stone , Homan Morgan , Shah Ayush , Sieffert Kayla , Wulf Corey , Larson Christopher , Bjerke Brian , LaPrade Robert 
Published: August 2024

Objectives: The purpose of this paper was to compare patient reported outcomes (PROMs) between isolated anterior cruciate ligament (ACLR) and ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs and compare PROMs between different medial meniscus ramp and lateral meniscus root repair techniques. Methods: All patients with isolated (ISO) ACL reconstruction or ACL reconstruction with concomitant medial meniscus ramp and lateral meniscus root repairs with a minimum 2 years of follow-up were retrospectively evaluated. Institutional review board approval was obtained for this study. A final total of 42 ISO-ACL patients were matched based upon age, sex, and body mass index to 40 in the “terrible triad” (TT) cohorts. Outcome measures were obtained from 32 patients in the ISO cohort, and 38 patients in the TT cohort. The PROMs used for this study include the International Knee Documentation Committee (IKDC) Subjective Knee, Cincinnati, Tegner, Lysholm, Veterans RAND 12-Item Health Survey (VR-12), and Knee Injury and Osteoarthritis Outcomes Score (KOOS) questionnaire forms. T tests and chi-square goodness of fit tests were used to compare the above PROMs both pre- and postoperatively within each cohort, and between cohorts and rates of revision or reoperation. Results: The preoperative and postoperative PROMs between patients in the isolated cohort and the triad cohort demonstrated no significant differences, except for the Physical category of the VR-12, in which the triad cohort had significantly higher results (p = 0.04) (Figure 1). Both the isolated cohort and the triad cohort reported significant differences between pre- and postoperative PROMs within their own cohorts. When comparing methods of surgery, including all-inside vs. inside-out for the medial meniscus repairs and tunnel versus no-tunnel for the lateral meniscus root repairs, no significant differences were found between postoperative PROMs. Additionally, no significant difference was found in revision or reoperative rates between the triad and isolated cohorts (p = 0.374) (Figure 2), the all-inside versus inside-out medial meniscus cohorts (p = 0.267), or the tunnel vs. no-tunnel lateral meniscus cohorts (p = 0.781). Conclusions: There was no significant difference in PROMs between isolated ACLR versus ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs. While the complexity of the TT ACLR patients was more involved, PROMs and healing rates were similar and performing concurrent medial ramp and lateral root repairs at the time of ACLR should be considered.
Poster 372: ChatGPT is a Useful Tool for Patients with Acute Achilles Tendon Ruptures
Authors: Samsonov Alan , Butler James , Azam Mohammad , Rettig Samantha , Kennedy John 
Published: August 2024

Objectives: The use of web-based technology in healthcare delivery is ubiquitous. ChatGPT, a readily available artificial intelligence (AI) chatbot, has the potential to augment current practice. ChatGPT has shown rudimentary promise as a source of information for orthopaedic patients. The use of ChatGPT in foot and ankle surgery, particularly for acute Achilles tendon ruptures (AATR), has not been described. The purpose of this study was to assess the quality of information provided by ChatGPT in response to frequently asked questions about AATR. Methods: ChatGPT was posed 10 frequently asked questions about AATR in a conversational thread. Responses were recorded and no follow-up queries or clarification was obtained. The responses were subsequently graded “A,” “B,” “C,” or “F,” corresponding with “excellent response,” “adequate response needing mild clarification,” “inadequate response needing moderate clarification,” and “poor response needing severe clarification.” Results: Of the 10 responses, 2 were grade “A,” 6 were grade “B,” 1 was grade “C,” and 0 were grade “F.” Overall, ChatGPT provided good quality responses to the posed questions. Conclusions: ChatGPT responded well to questions regarding AATR, using simple language to provide responses representative of the current literature surrounding AATR. Overall, ChatGPT performed well providing good-to-great quality responses to frequently-asked questions about AATR. This study emphasized the potential role of ChatGPT as a source of information for patients who suffer AATR.
Poster 389: Patients Undergoing Revision MPFL Reconstruction Demonstrate More Pathologic Anatomy Than Those Undergoing Primary MPFL Reconstruction
Authors: Magnussen Robert , Ward Jacob , Milliron Eric , Cavendish Parker , Barker Tyler , Flanigan David 
Published: August 2024

Objectives: The medial patellofemoral ligament (MPFL) ligament is one of the most important medial stabilizers of the knee joint. Reconstruction of the MPFL restores knee joint stability in most appropriately selected patients with patellar dislocations. Although rare, revision procedures are performed when primary MPFL reconstruction fails. There are limited data characterizing patients who undergo revision MPFL surgery. The objective of this study is to compare demographic and imaging characteristics of patients undergoing revision MPFL reconstruction with those undergoing primary patellofemoral ligament (PFL) reconstruction. Methods: Patients who underwent MPFL reconstruction between 2008 and 2021 were included in this retrospective study. Demographic information (age, sex, body mass index [BMI]), surgical procedures, preoperative imaging (Caton-Deschamps index (CDI), tibial tuberosity to trochlear groove [TT-TG] distance, sulcus angle and depth), clinical findings (J-sign), and intra-op findings (cartilage status) were extracted from the electronic medical records. The above characteristics were compared between the primary and revision cohorts. Results: A total of 223 patients underwent MPFL reconstruction within the study period, including 30 revision and 193 primary procedures. For the revision cohort, mean patient age was 23.3 years and the population included 10 males and 20 females, with an average BMI of 29.8 kg/m2. For the primary cohort, the mean age was 23.7 years and the population included 71 males and 120 females, with an average BMI of 27.0 kg/m2. Concomitant tibial tubercle osteotomy was performed in 35 primary cases (18.3%) and in 8 revision cases (26. 7%). The mean TT-TG distance was 24.7mm in the revision group and 17.5 mm in the primary group (p = 0.022). The mean sulcus angle revision group was 145 degrees and 140 degrees for the primary group (p = 0.007). A J sign was noted in 40 % of the revision group and 25% of the primary group (p = 0.011). Articular cartilage damage was noted in the patella in 24 cases (80%) in the revision group and 61 cases (32%) of primary cases and on the trochlea in 3 cases in the revision group (10%) and 31 cases (16.2%) in the primary group. Conclusions: Patients undergoing revision MPFL surgery had a higher BMI, larger TT-TG distance and sulcus angle, and were more likely to have a J-sign than those undergoing primary surgery. Further work is necessary to characterize the outcomes of these revision procedures.
How Biofeedback With Surface EMG Can Contribute to the Diagnosis and Treatment of AMI in the Knee
Authors: Richaud Thomas , Lacaze Kevin , Fassio Alexandre , Nicolas Paul , Ourliac Maxime , Hennart Benoit , Ina Jason G. , Sonnery-Cottet Bertrand , Cavaignac Etienne 
Published: August 2024

Background: Arthrogenic muscle inhibition (AMI) is a complex neurological phenomenon that is actually very common. AMI can appear following a knee injury or knee surgery. If it is not addressed, the patient's function can be negatively affected. There is currently no specific tool for the diagnosis and treatment of AMI. Indications: Following surgery or injury to the knee, AMI causes defective activation of the quadriceps, sometimes combined with a knee extension deficit. A clinical classification of AMI has been proposed recently to help with making the diagnosis and to guide treatment. In this article, we describe how biofeedback and surface electromyography (EMG) can be used in the early diagnosis and treatment of knee AMI. Technique Description: Biofeedback is based on transformation of physiological variables into a visual or auditory signal. This allows the patient to learn how to control physical and bodily functions, which were previously considered as involuntary processes. This technique requires the use of a specific device that transforms the measured physiological signals—neuromuscular activation in this instance—into visual signals. This tool incorporates surface EMG, with electrodes connected to a measuring unit. This unit is connected to a screen that shows the neuromuscular activation in real time. Thus, EMG biofeedback can be used to help clinicians make a diagnosis and to specifically treat the AMI. Results: We have used biofeedback in patients who have a knee injury or who have undergone knee surgery. Both the therapist and patient were able to objectively see the presence of AMI using the biofeedback device. For treatment, the therapist works with a patient by providing clear instructions and increasingly more challenging goals. We show examples of how patients were able to eliminate their AMI by using biofeedback. Discussion/Conclusion: EMG biofeedback is a promising tool for the diagnosis and treatment of AMI after an anterior cruciate ligament (ACL) tear and ACL reconstruction surgery. The next steps are to define thresholds and a rehabilitation protocol that will be used in a clinical trial. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Morphology and root canal configuration of maxillary canines: a systematic review and meta-analysis
Authors: Wolf Thomas Gerhard , Rempapi Theodora , Wierichs Richard Johannes , Waber Andrea Lisa 
Published: August 2024

Abstract
Background
This study assessed the internal morphology of maxillary canines (MxC) through a systematic review of existing literature.

Methods
Research articles up to June 2024 were retrieved from five electronic databases (MEDLINE via PubMed, Embase, Scopus, LILACS, and Cochrane). Predefined search terms and keywords were used, and potential studies were identified by cross-referencing and bibliographies of the selected articles reviewed.

Results
Two hundred studies were identified, 73 duplicates were removed, 127 records were screened, and 113 were removed after consultation of title and abstract. After full-text consultation and hand searching, finally 22 studies were included. Using the method for describing the root canal configuration (RCC) of Briseño Marroquín et al. (2015) and Vertucci (Ve) (1984), the most frequently reported RCC of MxC were 1–1-1/1 (Ve I, 75.4–100%), 2–2-1/1 (Ve II, 0.1–20%), 1–2-1/1 (Ve III, 0.1–11.6%), 2–2-2/2 (Ve IV, 0.1–0.4%), 1–1-2/2 (Ve V, 0.1–2.4%), 2–1-2/2 (Ve VI, 0.5–1.2%), and 1–2-1/2 (Ve VII, 0.1–0.2%). The meta-analysis of six studies (Europe/Asia) showed that a significantly higher number of RCC of 2–2-1/1 (Ve II) (OR [95%CI] = 1.34 [0.53, 3.41]), 1–2-1/1 (Ve III) (OR [95%CI] = 2.07 [1.01, 4.26]), and 1–1-2/2 (Ve V) (OR [95%CI] = 2.93 [1.07, 8.07]), were observed in males, and 2–2-2/2 (Ve IV) (OR [95%CI] = 0.08 [0.00, 4.00]) in females. No sex differences in the RCC of 1–1-1/1 (Ve I) and 1–2-1/2 (Ve VII) were observed.

Conclusions
Cone beam computed tomography is the most frequently used method for research on the RCC of MxC. Despite the high prevalence of type 1–1-1/1 (Ve I) RCC in MxC, clinicians should remain vigilant for more complex and sex-differentiated patterns in up to 25% of cases to prevent endodontic treatment complications or failures.
Trait impulsivity is associated with an increased risk of type 2 diabetes incidence in adults over 8 years of follow-up: results from the NutriNet-Santé cohort
Authors: Gómez-Martínez Carlos , Paolassini-Guesnier Pauline , Fezeu Léopold , Srour Bernard , Hercberg Serge , Touvier Mathilde , Babio Nancy , Salas-Salvadó Jordi , Péneau Sandrine 
Published: August 2024

Abstract
Background
Type 2 diabetes is one of the most prevalent and preventable diseases worldwide and impulsivity, a psychological trait characterized by making quick decisions without forethought, has been suggested as a key feature for health-related conditions. However, there have been no studies examining the relationships between impulsivity and the incidence of type 2 diabetes and our aim was to assess the prospective association between trait impulsivity and the risk of developing type 2 diabetes.

Methods
A prospective observational study design was conducted between May 2014 and February 2023 within the NutriNet-Santé cohort. A web-based platform was used to collect data from the French adult population, with voluntary enrollment and participation. Of the 157,591 adults (≥ 18 years old) participating in the NutriNet-Santé study when impulsivity was assessed, 109,214 participants were excluded due to prevalent type 1 or 2 diabetes or missing data for impulsivity or follow-up data for type 2 diabetes. Trait impulsivity, and the attention, motor, and non-planning subfactors, were assessed at baseline using the Barratt Impulsiveness Scale 11. Incident type 2 diabetes was ascertained through follow-up. Medical information was reviewed by NutriNet-Santé physician experts to ascertain incident diabetes cases based on the ICD-10. Cox regression models, using hazard ratios and 95% confidence intervals (HR [95% CI]), were performed to evaluate associations between impulsivity per 1 standard deviation increment and type 2 diabetes risk, adjusting by recognized confounders.

Results
Of the 48,377 individuals studied (women 77.6%; age at baseline = 50.6 year ± 14.5 years), 556 individuals developed type 2 diabetes over a median follow-up of 7.78 (IQR: 3.97–8.49) years. Baseline impulsivity was associated with an increased risk of type 2 diabetes incidence (HR = 1.10 [1.02, 1.20]). The motor impulsivity subfactor was positively associated with type 2 diabetes risk (HR = 1.14 [1.04, 1.24]), whereas no associations were found for attention and non-planning impulsivity subfactors.

Conclusions
Trait impulsivity was associated with an increased type 2 diabetes risk, mainly driven by the motor impulsivity subfactor. If these results are replicated in other populations and settings, trait impulsivity may become an important psychological risk factor to be considered in the prevention of type 2 diabetes.

Cohort registration
Name of registry: The NutriNet-Santé Study. A Web-based Prospective Cohort Study of the Relationship Between Nutrition and Health and of Dietary Patterns and Nutritional Status Predictors.
Cohort registration number: NCT03335644.
Date of registration: October 11, 2017.
URL: https://clinicaltrials.gov/ct2/show/NCT03335644
Impact of proton pump inhibitor use on clinical outcomes in East Asian patients receiving clopidogrel following drug-eluting stent implantation
Authors: Kim Ju Hyeon , Hong Soon Jun , Cha Jung-Joon , Lim Subin , Joo Hyung Joon , Park Jae Hyoung , Yu Cheol Woong , Ahn Tae Hoon , Jeong Young-Hoon , Kim Byeong-Keuk , Chang Kiyuk , Park Yongwhi , Song Young Bin , Ahn Sung Gyun , Suh Jung-Won , Lee Sang Yeub , Cho Jung Rae , Her Ae-Young , Kim Hyo-Soo , Kim Moo Hyun , Shin Eun-Seok , Lim Do-Sun 
Published: August 2024

Abstract
Background
Concomitant use of clopidogrel and proton pump inhibitor (PPI) is common, but PPI may reduce the antiplatelet effects of clopidogrel in patients undergoing percutaneous coronary intervention (PCI). We evaluated the impact of PPI use on clinical outcomes in post-PCI patients, by incorporating P2Y12 reaction unit (PRU) and CYP2C19 genotyping results.

Methods
From a multicenter registry of patients who underwent PCI with drug-eluting stent implantation and received clopidogrel-based dual antiplatelet therapy (DAPT), patients who were prescribed a PPI at the time of PCI (PPI users) were compared to those who were not (non-users). The primary outcome included all-cause death, myocardial infarction, stent thrombosis, or cerebrovascular accident at 12 months. Major bleeding (Bleeding Academic Research Consortium [BARC] types 3–5) and gastrointestinal (GI) bleeding (BARC types 3–5) were important secondary outcomes. The adjusted outcomes were compared using a 1:1 propensity-score (PS) matching and competing risk analysis.

Results
Of 13,160 patients, 2,235 (17.0%) were prescribed PPI, with an average age of 65.4 years. PPI users had higher on-treatment PRU levels than non-users. After PS matching, the primary outcome occurred in 51 patients who were PPI users (cumulative incidence, 4.7%) and 41 patients who were non-users (cumulative incidence, 3.7%; log-rank p = 0.27). In carriers of both CYP2C19 loss-of-function alleles, PPI use was linked to an increased risk of the primary outcome (hazard ratio, 3.22; 95% confidence interval, 1.18–8.78). The incidence of major bleeding and GI bleeding (BARC types 3–5) was comparable between PPI users and non-users in the PS-matched cohort.

Conclusions
In post-PCI patients receiving clopidogrel-based DAPT, PPI use was not linked to an increased risk of adverse cardiac and cerebrovascular events, but there was a small but significant increase in on-treatment PRU. Future research using a more individualized approach would further elucidate these interactions and guide evidence-based clinical practices.
Reducing asthma attacks in disadvantaged school children with asthma: study protocol for a type 2 hybrid implementation-effectiveness trial (Better Asthma Control for Kids, BACK)
Authors: Huebschmann Amy G. , Wagner Nicole M. , Gleason Melanie , Brinton John T. , Brtnikova Michaela , Brewer Sarah E. , Begum Anowara , Armstrong Rachel , DeCamp Lisa Ross , McFarlane Arthur , DeKeyser Heather , Coleman Holly , Federico Monica J. , Szefler Stanley J. , Cicutto Lisa C. 
Published: August 2024

Abstract
Background
Asthma is a leading cause of children’s hospitalizations, emergency department visits, and missed school days. Our school-based asthma intervention has reduced asthma exacerbations for children experiencing health disparities in the Denver Metropolitan Area, due partly to addressing care coordination for asthma and social determinants of health (SDOH), such as access to healthcare and medications. Limited dissemination of school-based asthma programs has occurred in other metropolitan and rural areas of Colorado. We formed and engaged community advisory boards in socioeconomically diverse regions of Colorado to develop two implementation strategy packages for delivering our school-based asthma intervention — now termed “Better Asthma Control for Kids (BACK)" — with tailoring to regional priorities, needs and resources.

Methods
In this proposed type 2 hybrid implementation-effectiveness trial, where the primary goal is equitable reach to families to reduce asthma disparities, we will compare two different packages of implementation strategies to deliver BACK across four Colorado regions. The two implementation packages to be compared are: 1) standard set of implementation strategies including Tailor and Adapt to context, Facilitation and Training termed, BACK-Standard (BACK-S); 2) BACK-S plus an enhanced implementation strategy, that incorporates network weaving with community partners and consumer engagement with school families, termed BACK-Enhanced (BACK-E). Our evaluation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, including its Pragmatic Robust Implementation Sustainability Model (PRISM) determinants of implementation outcomes. Our central hypothesis is that our BACK-E implementation strategy will have significantly greater reach to eligible children/families than BACK-S (primary outcome) and that both BACK-E and BACK-S groups will have significantly reduced asthma exacerbation rates (“attacks”) and improved asthma control as compared to usual care.

Discussion
We expect both the BACK-S and BACK-E strategy packages will accelerate dissemination of our BACK program across the state – the comparative impact of BACK-S vs. BACK-E on reach and other RE-AIM outcomes may inform strategy selection for scaling BACK and other effective school-based programs to address chronic illness disparities.

Trial registration
Clinicaltrials.gov identifier: NCT06003569, registered on August 22, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06003569.
Move-PCD—a multi-center longitudinal randomized controlled superiority trial on the effect of a 6-month individualized supported physical activity (PA) program on quality of life (QoL) in children, adolescents, and adults with primary ciliary dyskinesia
Authors: Hoffmann Anna Teresa , Mai Anna , Baum Klaus , Schlegtendal Anne , Maier Christoph , Stein Julien , Tokic Marianne , Dillenhöfer Stefanie , Lücke Thomas , Timmesfeld Nina , Brinkmann Folke 
Published: August 2024

Abstract

Background
Primary ciliary dyskinesia (PCD) is a rare genetical disease with malfunction of the motile cilia leading to impaired muco-ciliary clearance in the respiratory tract. There is no cure for PCD, only supportive therapy aimed at minimizing the progression of the disease and improving the patient’s quality of life (QoL). Physical activity (PA) is one of these recommended supportive therapies for people with PCD (pwPCD). However, there is no scientific evidence to support this recommendation. In addition, regular medical advice to increase PA remains largely ineffective in pwPCD.

Methods
To test the main hypothesis, that an individualized and supported PA program leads to a better QoL 6 months after randomization (QoL-PCD questionnaire) compared to usual recommendation in pwPCD, 158 pwPCD aged 7 to 55 years are to be included in this multi-center randomized controlled trial (RCT). After the screening visit, a 1:1 randomization stratified by age group and FEV1 will be performed. A QoL-PCD questionnaire, motor test, and lung function will be carried out at regular intervals in both groups. PA is recorded in both groups using activity trackers during the study period. The main aim of the trial is to estimate the difference in the change of QoL between the groups after 6 months. Therefore, our full analysis set consists of all randomized patients and analysis is performed using the intention-to-treat principle. Statistical software R (http://www.r-project.org) is used. Ethical approvement without any reservations: RUB Bochum Ethics Committee (No. 23–7938; December 4, 2023). Recruitment start: March 2024.

Discussion
Limitations result from the rarity of PCD with its broad disease spectrum and the large age range. These are reduced by stratified randomization and the measurement of the individual change in QoL as primary endpoint. In our view, only a PA program tailored to individual needs with close contact to trainers offers the chance to meet personal needs of pwPCD and to establish PA as a pillar of therapy in the long term. The study protocol explains all procedures and methods of recruitment, implementation of the study visits and intervention, measures for patient and data safety, and for minimizing risks and bias.

Trial registration
German Clinical Trials Register (DRKS) 00033030. Registered on December 7, 2023. Update 10 July 2024.

Study protocol version 10
Version 1.2; 12 June 2024