bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and Frequency of Hyponatremia in Newborns
Authors: Hamayoon Sidra , Anjum Haniya , Gul Rafia , Anwer Zahid , Sidiqque Ayesha , Iqbal Fahad 
Published: May 2024

Background: Hyponatremia, defined as a serum sodium level below 135 meq/L, is a significant and often overlooked problem in neonatal intensive care unit. Local data on the severity and chronicity of hyponatremia in neonates is lacking. This study aimed to investigate the features, risk factors, and frequency of hyponatremia in infants admitted to our NICU. Objective: To determine the incidence, identifying potential risk factors, assessing its severity, as well as understanding the recovery period and the duration of hospital stay associated with hyponatremia in neonates. Study Design: Cross-sectional study. Settings: Study was conducted in Neonatal ICUs of Fatima Memorial Hospital, Lahore Pakistan. Duration: January to December 2022 (1 Year). Methods: Sample size was 300, calculated with 95% confidence interval, 10% margin of error and 5% level of significance. It was done by using formula; n=Zs (p)(1-p)/d2 by using consecutive, non-probability sampling technique. After IRB approval all neonates meeting the inclusion criteria were included in the study after seeking informed consent from parents and relevant data was collected on the predesigned proforma. Results: Among 300 neonates included in final study 42% had mild hyponatremia and 58% had moderate-severe hyponatremia. Risk of severe hyponatremia were GA 28-32+6 weeks, IUGR and APGAR-5<7. PIH increased the risk of chronic hyponatremia. Conclusion: In our study population 58% neonates had moderate to severe hyponatremia. Among 73.1% neonates born at GA 28-32+6 had moderate to severe hyponatremia. APGAR-5 of <7 and IUGR increases the risk of moderate-severe hyponatremia by 42374 and 200 times respectively. Whereas maternal PIH is associated with increased risk of chronic hyponatremia.
Gingival Health after Surgical Exposure of Impacted Maxillary Canines with Orthodontic Traction
Authors: Nazir Samar , Haider Muhammad Usman , Khan Muhammad Athar , Khan Nousheen , Hameed Marij , Bajwa Asfa 
Published: May 2024

Background: Impaction of the maxillary canines is a common clinical issue. Canine impaction may develop from a localized, systemic, or hereditary source. Interdisciplinary approaches are frequently necessary for the treatment of impacted maxillary canines. Objective: This study's objectives were to describe a surgical technique for surgically revealing a labially affected maxillary canine, elaborate on how to take care of soft tissue to promote aesthetic results, and evaluate periodontal health following the procedure. Study Design: Prospective study. Settings: CIMS institute of Medical Sciences. Duration: 24 months. Methods: A total of 53 patients who had orthodontic treatment as well as surgical exposure treatment for a unilaterally labially impacted maxillary canine were included. There was no history of periodontal disease or periodontal collapse in any of the individuals. Informed consent was gained from each patient after thorough explanations of the ambitions, potential advantages, and potential dangers of this clinical study were given to all patients. All cases' gingival health was evaluated following the conclusion of fixed orthodontic treatment. Results: There were majority 35 (66.03%) females and 18 (43.97%) males among all cases. 17 (32.1%) cases were aged between 16-20 years, 15 (28.3%) patients had age 21-25 years and 21 (39.6%) cases had age 26-30 years. On the first postoperative day, only 6 patients (13.3%) complained of minor pain, and only 2 patients complained of visible edema and inflammation in 1 patient. Four patients had gingival scars visible. In general, gingival index values were 0.39. By visual inspection or periodontal probing, significant pathologic periodontal illnesses were not found. Conclusion: We found in this study that the maintenance of dental follicles encourages soft tissue management following combined surgery and orthodontics procedures for labially impacted maxillary canines to improve periodontal health.
Determine Multilayers Coating Dispersive Properties Using Statistical Parameters
Authors: Mohammad Elham Jasim 
Published: May 2024

Abstract
Many studies about the multilayer coating have indicated the effects of reflection phase, reflection group delay (GD), and reflection group delay dispersion (GDD) characteristics. Some overlook the importance of studying complex statistical coefficients and their role in comparing the results of optical designs and realize how important information is in analyzing data. In statistics, one can learn various techniques for working with data. This paper goes into a detailed study of multilayer stacks’ dispersive properties for two mirror designs depending on MATLAB programs based on statistical parameters to evaluate the reflectance for the ZnS/MgF$${}_{2}$$ mirror. Two samples with a quarter wavelength optical thickness were prepared, specially designed for 632.8 nm He-Ne laser mirrors. For the designed mirror, the value of the reflectivity of the thirteen-layer ZnS/MgF$${}_{2}$$ mirror is 99.34$$\%$$, while for the seven-layer ZnS/MgF$${}_{2}$$ mirror is 96.57$$\%$$. This study presents greater detail on statistics and realized data topics when designing multilayer coating, including mean, median, mode, and standard deviation (STD). The reliability and accuracy of the data can be verified by calculating the standard deviation.
THE RELIABILITY AND VALIDITY OF THE BALANCE MAT
Authors: Raj Dr Isaac Selva , Nosaka Prof Ken 
Published: May 2024

BACKGROUND
Reliable and accurate postural sway assessment tools are important for monitoring the postural stability of individuals so that interventions can be evaluated, and balance ability is better assessed. The Balance Mat (PSI, ACT, Australia) is a new postural sway assessment device that is relatively cheap and highly portable, but it is yet to be scientifically validated and its reliability tested. Therefore, the aims of this project were to assess the test-retest reliability and validity of the Balance Mat (BM).

METHODS
Seventeen participants (age range 18 – 67) were recruited, and they performed nine balance tests. The reference method for obtaining balance measurements was the AMTI AccuSway-Optimized force platform (Advanced Mechanical Technology, Inc., MA, USA), which was placed below the BM so that force plate and BM data were collected simultaneously. Each participant performed two trials for each test, which were 20 seconds in duration each. From the BM software, the sway variance, mean sway distance, sway range, sway velocity, and sway path were obtained for each trial. From the force platform, the following centre of pressure (COP) measurements were obtained: standard deviation of the radial displacement of the COP; mean radial displacement of the COP; 95% confidence ellipse area; average velocity of the COP; and COP path length. Spearman’s rank-order correlation coefficient was used to test the validity and reliability of the BM.

RESULTS
For the comparison between BM and force plate data, correlation coefficients ranged from 0.63 to 0.79 (p&lt;0.001). For the test-retest reliability analyses, correlation coefficients ranged from 0.77 to 0.85 (p&lt;0.001) among the nine tests.

CONCLUSIONS
The strong to very strong positive correlations suggest that the BM is a valid and reliable tool for assessing postural sway.
CHRONIC LOW BACK PAIN: BARRIERS AND ENABLERS OF EXERCISE-BASED CLINICIANS TO IMPLEMENTING EVIDENCE-BASED PRACTICE
Authors: Walker Ms Emily , Gibbs Dr Mitchell T. , Natoli Mr Andrew , Jones Matthew D 
Published: May 2024

INTRODUCTION
Chronic low back pain (CLBP) is the leading cause of years lived with disability. Exercise, integrated with a biopsychosocial framework, is a first-line treatment for CLBP. Exercise physiologists and physiotherapists are allied health clinicians trained to provide exercise treatment through evidence-based practice (EBP). Research indicates the implementation of EBP remains low, impacting the quality of care provided to patients, which can perpetuate the impacts of CLBP. Given the role of exercise physiologists and physiotherapists in CLBP treatment, it is necessary to investigate their perceived barriers and enablers to implementing best quality care through EBP.

METHODS
Participants completed a pre-interview questionnaire, which gathered data about demographics, further education, biomedical/biopsychosocial beliefs and two patient vignettes. This data was analysed using descriptive statistics. Semi-structured interviews investigated participants’ barriers and enablers to implementing EBP. This data was analysed through reflexive thematic analysis.

RESULTS
Exercise physiologists and physiotherapists misunderstand the definition of EBP. Barriers and enablers existed at clinician-patient, workplace, and system levels, often overlapping. Barriers comprised of unpacking inaccurate messages from other healthcare professionals, patient expectations and beliefs, profit-focused business models, insufficient clinician education, and inadequate funding. Enablers encompassed upskilling with further education, a collaborative community, clinician autonomy, extended consultations, and support from other healthcare professionals.

CONCLUSIONS
Multi-level barriers and enablers affect exercise physiologists and physiotherapists use of EBP. Similar barriers and enablers between professions suggest systemic influences outweigh profession-specific influences. To improve the implementation of EBP, both clinician factors and deeper systemic factors must be addressed.
THE PHYSICAL AND MENTAL HEALTH BENEFITS OF PARTICIPATING IN A LUNGS IN ACTION COMMUNITY EXERCISE MAINTENANCE PROGRAM FOLLOWING REHABILITATION
Authors: Grainger Ms Kristal , Cooke A/Prof Julie , Halloran Ms Emma , Spencer A/Prof Lissa , Cox Dr Narelle , Adsett Dr Julie , Roberts Ms Mary , Williams Associate Professor Andrew 
Published: May 2024

INTRODUCTION AND AIM
Lungs in Action (LIA), a signature program of Lung Foundation Australia (LFA) is a community exercise program for people with chronic lung and cardiac conditions. Facilitated by Exercise Physiologists, Physiotherapists and Fitness Instructors, LIA supports patients to maintain the benefits achieved in pulmonary or cardiac rehabilitation. This research aimed to determine the holistic health benefits of participation in LIA through a national participant evaluation, concurrently with functional outcome measures over a 3-month period.

METHODS
A convenience sample of LIA participants completed an online health questionnaire (Qualtrics) that incorporated the EQ-5D-5L Health Questionnaire, demographics and structured health and wellbeing questions at baseline. A follow-up health questionnaire was undertaken 3-months post baseline. Concurrently, LIA Instructors conducted functional assessments of muscular strength (30sec Sit to Stand (30STS)), mobility, and balance (Timed Up and Go (TUG)) at baseline and 3-months post, to assess if physiological adaptations were evident.

RESULTS
108 LIA participants (60±8 years; F=72) consented to complete the baseline questionnaire with n=61 (60±7 years; F=41) completing the 3-month post questionnaire. There were significant improvements in EQ-5D-5L anxiety domain (MD±SD; 0.18±0.22; p=0.04) and overall health rating (EQ-VAS) (MD±SD; 5.62±2.72; p=0.02). 74 participants (60±7 years; F=52) who attended an average of 11±6 classes over the 3-month interval, completed functional testing at both timepoints. There was a significant decrease in time to complete the TUG (MD±SD; -0.81±1.41 sec; p&lt;0.0001) and increase in repetitions for the 30sSTS (MD±SD; 1.68±2.76 reps; p&lt;0.0001).

CONCLUSION
Results indicate an increase in functional capacity, overall health, and a decrease in anxiety over the 3-month period. These benefits may relate to improved independence and activities of daily living.
A RANDOMIZED CONTROLLED TRIAL ASSESSING A BRACE-FREE AND ACCELERATED WEIGHT-BEARING PROTOCOL AFTER SURGICAL REPAIR OF ACUTE PROXIMAL HAMSTRING TENDON AVULSIONS
Authors: Ebert Dr Jay , Edwards Dr Peter , Cecchi Dr Steven , Aujla Mr Randeep , Annear Mr Peter , Ricciardo Mr Brendan , D’Alessandro Mr Peter 
Published: May 2024

INTRODUCTION & AIMS
Proximal hamstring tendon avulsion from the ischial tuberosity is a significant injury, with surgical repair advocated. After surgery, limited data exists regarding the optimal rehabilitation regime with extensive variation in published protocols. This study investigated patient outcomes following a traditionally conservative (CR) versus accelerated (AR) rehabilitation regimen after proximal hamstring tendon repair.

METHODS
This prospective randomized controlled trial (RCT) allocated 50 patients undergoing proximal hamstring tendon repair to either a braced, partial weight-bearing rehabilitation regime (CR=25) or an accelerated, unbraced regime, that permitted full weight-bearing as tolerated (AR=25). Patients were evaluated pre-operatively and at 3, 6 and 12 months post-surgery, via patient-reported outcome measures (PROMs) including the Lower Extremity Functional Scale (LEFS), Perth Hamstring Assessment Tool (PHAT) and 12-item Short Form Health Survey (SF-12). The single (SHD), triple (THD) and triple crossover (TCHD) hop tests were assessed at 6 and 12 months, as was peak isometric hamstring strength and peak isokinetic knee extensor and flexor torque.

RESULTS
All PROMs improved (p&gt;0.05) and, while the AR group reported a significantly better Physical Component Score for the SF-12 at 3 months (p=0.022), as well as a lower severity of hamstring pain at 12 months (p=0.032), there were no other group differences. Peak isometric hamstrings strength and peak isokinetic quadriceps and hamstrings torque symmetry were all comparable between groups (p&gt;0.05). While the AR group demonstrated significantly better (p=0.009) limb symmetry for the THD at 6 months, no other hop test differences were seen between groups. Three re-injuries have been observed (CR=2, AR=1).

CONCLUSION
After proximal hamstring repair surgery, post-operative outcomes following an accelerated rehabilitation regimen were largely comparable to a traditionally conservative
A RANDOMIZED CONTROLLED TRIAL OF AUTOLOGOUS TENOCYTE INJECTION VERSUS CORTICOSTEROID INJECTION FOR SYMPTOMATIC PARTIAL THICKNESS ROTATOR CUFF TEARS
Authors: Ebert Dr Jay , Edwards Dr Peter , Zheng Prof Ming Hao , Fitzpatrick Dr Jane , Hughes Mr Jeff , Breidahl Dr William , Wang Prof Allan 
Published: May 2024

BACKGROUND
Symptomatic supraspinatus tears are difficult to treat, causing persistent subacromial impingement symptoms. Clinical studies of Autologous Tenocyte Injection (ATI) have shown that cultured tenocytes can synthesize extracellular matrix and facilitate healing of damaged tendon tissue. This randomized controlled trial (RCT) investigated the efficacy of ATI compared to corticosteroid injection (CS), combined with a graded rehabilitation program, in patients with symptomatic tendinopathy and partial thickness cuff tears.

METHODS
Eligible participants with a duration of symptoms &gt;6 months were recruited and randomized to receive ATI to the interstitial tear or CS to the subacromial bursa in a 2:1 ratio, under ultrasound guidance, followed by a rehabilitation protocol. Assessments were undertaken pre-treatment and at 1, 3, 6 and 12 months post-treatment, including the Constant Score, Visual Analogue Pain Scale (VAS) and American Shoulder and Elbow Surgeons Assessment (ASES). Magnetic resonance imaging (MRI) was performed at baseline, 6 and 12 months.

RESULTS
Thirty participants were enrolled (ATI=19, CS=11). The ATI group performed significantly better in the Constant Score at 1 (p=0.020, ATI=81.8, CS=67.6), 6 (p=0.026, ATI=84.9, CS=71.1) and 12 (p=0.024, ATI=86.5, CS=65.4) months, reported better (p&lt;0.05) VAS scores at all post-treatment timepoints and reported better ASES scores at all timepoints including 6 (p=0.012, ATI=88.6, CS=74.0) and 12 (p&lt;0.01, ATI=93.3, CS=62.9) months. A total of 7 of 11 CS participants withdrew from the trial between 6 and 12 months due to worsening pain. These patients were subsequently offered and underwent ATI, with 6 and 12 month improvements similar to the primary ATI group.

CONCLUSION
ATI resulted in a significantly better and sustained reduction in pain, and improvement in shoulder function, compared with CS. This is the first Level 1 study using ATI to treat supraspinatus tears.
AN INVESTIGATION OF SEX-BASED DIFFERENCES IN PHYSICAL AND PSYCHOLOGICAL RECOVERY, AND RETURN TO SPORT, FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Authors: Kneebone Miss Liza , Ebert Dr Jay , Edwards Dr Peter , Blackah Mr Nic 
Published: May 2024

INTRODUCTION & AIMS
Despite the increasing rate of anterior cruciate ligament (ACL) tears and surgical reconstruction (ACLR), little is known about the post-operative recovery in males versus females. Understanding differences in the recovery between sexes will assist in better tailoring rehabilitation, return to sport (RTS) and counselling pathways. This study investigated sex-based differences in the physical and psychological recovery of both females and males after ACLR.

METHODS
This study recruited 104 patients (49 females, 55 males) undergoing ACLR. Patients were assessed pre-operatively and at 6, 12 and 24 months post-surgery, via patient-reported outcome measures (PROMs) including the International Knee Documentation Committee (IKDC) form, the Tegner Activity Scale (TAS) and the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) score. Patients embarked on an assessment of peak isokinetic knee extensor (PKET) and flexor (PKFT) torque and a 4-hop performance battery. Limb Symmetry Indices (LSIs) were calculated. The incidence of RTS was investigated.

RESULTS
All PROMs significantly improved (p&lt;0.05), though females reported significantly lower ACL-RSI (p=0.002) and IKDC (p=0.007) scores. While no sex-based differences were observed in hop test LSIs, males demonstrated significantly higher mean LSIs for PKET at 6 (p=0.037) and 24 (0.047) months, and PKFT at 6 (p=0.007) and 12 (p=0.002) months. At 24-months post-surgery, a significantly greater (p=0.030) percentage of male patients had returned to pivoting sports.

CONCLUSION
This study demonstrates the disparity between sexes in physical and psychological recovery, as well as RTS status, in community-level patients undergoing ACLR. The development and implementation of enhanced post-operative patient-centered care may be warranted tailored to sex, encompassing rehabilitation, education, and counseling after ACLR to promote increased engagement in rehabilitation.
A RANDOMIZED CONTROLLED TRIAL EVALUATING AN ACCELERATED WEIGHT-BEARING REHABILITATION PATHWAY AFTER MATRIX-INDUCED AUTOLOGOUS CHONDROCYTE IMPLANTATION FOR SYMPTOMATIC KNEE CARTILAGE DEFECTS
Authors: Ebert Dr Jay , Edwards Dr Peter , Zheng Prof Ming Hao , Klinken Dr Sven , Wood Prof David , Janes Mr Greg 
Published: May 2024

INTRODUCTION & AIMS
Matrix-induced autologous chondrocyte implantation (MACI) has demonstrated encouraging outcomes in treating symptomatic knee cartilage lesions which, if untreated, can progress toward early osteoarthritis. Rehabilitation is imperative to optimize outcome, though has been traditionally conservative. This study investigated the long-term outcomes of an accelerated return to full weight bearing (WB) after MACI.

METHODS
This prospective randomized controlled trial (RCT) allocated 35 patients (37 knees) to a 6-week (n=18) or 8-week (n=19) return to full WB after MACI. Patients were evaluated pre-operatively and at 1, 2, 5 and ≥10 years, via patient-reported outcome measures (PROMs) including the Knee Osteoarthritis Outcome Score (KOOS). Single limb hop capacity and peak knee extensor and flexor torque were assessed, with limb symmetry indices (LSIs) calculated. Magnetic resonance imaging (MRI) evaluated repair tissue, while a validated MRI composite graft score was calculated.

RESULTS
While the 6-week WB group reported significantly better 1-year KOOS Quality of Life scores, no other differences (p&gt;0.05) in PROMs existed. The peak knee extensor torque LSI significantly improved (p&lt;0.0001) over time, with mean LSIs of 100.8 (6-week) and 99.1 (8-week) at ≥10 years. No group differences (p&gt;0.05) were observed in hop LSIs. A non-significant decline (p&gt;0.05) was observed for the MRI composite score from 1-year to final ≥10-year review and, apart from a significant group effect (p=0.028) for graft tissue intensity in favor of the 6-week group suggesting repair tissue more reflective of native cartilage, no other MRI-based differences (p&gt;0.05) existed. At ≥10-years, no grafts on MRI had failed, though 3 patients (6-week n=1, 8-week n=2) had progressed toward knee arthroplasty.

CONCLUSION
The 6-week accelerated rehabilitation program provided comparable clinical and MRI-based outcomes beyond 10 years post-surgery, without jeopardizing the graft.
A RANDOMIZED CONTROLLED TRIAL INVESTIGATING FUNCTIONAL RECOVERY AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING A SINGLE VERSUS DOUBLE TENDON HARVEST
Authors: Ebert Dr Jay , Edwards Dr Peter , Lawless Dr Adam , Leys Mr Toby , D’Alessandro Mr Peter 
Published: May 2024

INTRODUCTION & AIMS
Anterior cruciate ligament (ACL) tears are common. While surgical reconstruction (ACLR) is commonly advocated and a hamstring autograft is the popular choice, hamstring tendon harvest has been linked to reduced hamstring strength and ongoing donor site pain. While traditional surgical techniques required a harvest of both semitendinosus/gracilis tendons, modern harvesting and fixation methods permit a shorter, broader harvest of semitendinosus only. This study investigated donor site pain, strength and functional recovery in patients undergoing ACLR via a single (ST) versus dual (DT) tendon hamstring harvest.

METHODS
This prospective randomized controlled trial (RCT) allocated 138 patients to ACLR with one of the two hamstring tendon graft options (ST=71, DT=67) followed by a structured rehabilitation program. Patients were assessed pre-surgery and at 3, 6, and 12 months, with a range of patient-reported outcome measures (PROMs) including a validated donor-site morbidity score. Graft laxity, peak isokinetic knee extensor and flexor strength and a 6-hop performance battery were assessed. Limb Symmetry Indices (LSIs) were calculated.

RESULTS
All PROMs significantly improved (p&lt;0.0001) and were largely similar between groups (p&gt;0.05), apart from significantly less graft morbidity reported in the ST group (p=0.001). No group differences were observed for knee laxity or LSIs for hop measures (p&gt;0.05), nor the LSIs for peak knee flexor (p=0.113) or extensor (p=0.286) torque.

CONCLUSION
While the ST ACLR group reported significantly less harvest site morbidity, no other subjective or functional differences were observed in patients undergoing ACLR with either a single or dual hamstring tendon autograft harvest.