bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Knotless Suture Tape Construct vs Screw Fixation for Lisfranc Injuries: A Cadaveric Biomechanical Study
Authors: Cardenas Cesar , McIver Natalia D. , Nelson Jessica , Ahmad Aamir , Chavez Tyler , Gross Jessica , Salas Christina , Gavin Katherine 
Published: May 2024

Background: Lisfranc injuries are often treated with open reduction and internal fixation using rigid fixation techniques. The use of flexible fixation to stabilize the Lisfranc joint is a newer technique. The purpose of this cadaveric study is to compare the amount of diastasis at the Lisfranc interval under diminished physiologic loads when treated with a knotless suture tape construct and a solid screw. Methods: Ten cadavers (20 feet) had native motion at the intact Lisfranc interval assessed at multiple increasing loads (69, 138, and 207 N). The Lisfranc ligamentous complex was then disrupted, and testing repeated to evaluate the amount of diastasis. Randomization was performed to determine the type of fixation for each cadaver: solid screw or knotless suture tape construct. Once fixation was completed, specimens were cyclically loaded for 10 000 cycles at loads, and diastasis was quantified after each load cycle to compare the interventions. Diastasis was measured using motion tracking cameras and retroreflective marker sets. A non-inferiority statistical analysis was performed. Results: Diastasis mean values were confirmed to be >2 mm for all load bearing conditions in the injury model. Posttreatment, diastasis was significantly reduced when compared to the sectioned conditions ( P < .01) for both treatment options. Non-inferiority analyses showed that the knotless suture tape construct did not perform inferior to screw fixation for diastasis at the Lisfranc interval at any of the compared load states. Conclusion: Under the loads tested, there is no significant difference in diastasis at the Lisfranc interval when treating ligamentous Lisfranc injuries with a knotless suture tape construct or solid screws. Both reduced diastasis from the injured state and were not different from the intact state. Clinical Relevance: In this cadaveric model with ligamentous Lisfranc injury, diastasis of a knotless suture tape construct is compared to solid screw fixation as tested.
Changes in Foot Width in Minimally Invasive Bunionectomy
Authors: El Masry Seif , DiGiovanni Grace M. , Boden Allison L. , Palma Joaquín , Srikumar Syian , Nguyen Joseph T. , Johnson A. Holly 
Published: May 2024

Background: Minimally invasive bunionectomy (MISB) has emerged as a popular approach to treat symptomatic hallux valgus deformity. Although previous studies focused on distal foot width changes postsurgery, this research introduces a novel midshaft measurement to evaluate proximal transverse midfoot width, aiming for a comprehensive understanding of foot changes post-MISB. Methods: A retrospective review of 44 HV patients from an institutional registry was conducted. Demographic data, surgical details, radiographs, and foot width measurements were collected. Changes in hallux valgus angle (HVA) and intermetatarsal angle (IMA) were also measured. Results: Intraclass correlation coefficients (ICCs) demonstrated good to excellent interobserver reliability (all ICCs > 0.70) for all measurements. MISB resulted in a consistent reduction in distal foot width ( P < .001). These reductions correlated with changes in HVA and IMA, suggesting that the extent of deformity correction influenced distal foot width: distal bone width decreased an average of 8 mm, P < .001). However, midshaft bony width increased an average of 4 mm, P < .001). Changes in midshaft foot width showed no correlation with HVA or IMA alterations. Conclusion: We found in this cohort of 44 patients that MISB for HV leads to an expected decrease in distal bony foot width but, on average, an increase in midshaft foot width.
Predictive Modeling for Functional Outcomes After All-Inside Arthroscopic Anterior Talofibular Ligament Repair of Chronic Ankle Instability
Authors: Chen Ziyi , Zhao Yujie , Xue Xiao’ao , Gu Xicheng , Li Yi , Hua Yinghui 
Published: May 2024

Background: Arthroscopic anterior talofibular ligament repair (AATFLR) is a surgical strategy to treat chronic ankle instability (CAI) patients. This study identified risk factors that influenced the functional outcomes of AATFLR for CAI and developed prognostic nomogram for predicting functional outcomes in future AATFLR cases. Methods: Patients undergoing AATFLR from January 2016 to June 2022 with at least 10 months of follow-up were included in the study. The Karlsson Ankle Functional Score (KAFS) was evaluated preoperatively and at last follow-up visit. A total of 15 potential predictors including age, sex, body mass index, side affected, time from injury to surgery, sports-related injury, osteophyte, loose bodies, distal tibiofibular syndesmosis, ATFL avulsion fracture, Outerbridge classification of osteochondral lesions, postoperative immobilization method, ambulation time, walking time, and follow-up time, were recorded. We first used univariate binary logistic regression analysis to select the potential significant prognostic features, which were then subjected to the least absolute shrinkage and selection operator (LASSO) regression algorithm for final feature selection. A nomogram based on the regression model was developed to estimate the functional outcomes of patients. Models were validated internally using bootstrapping and externally by calculating their performance on a validation cohort. Results: Overall, 200 ankles fit inclusion criteria. Of these 200, a total of 185 (92.5%) ankles were eligible and divided into development (n = 121) and validation (n = 64) cohorts. Four predictors were ultimately included in the prognostic nomogram model: age, sex, sports-related injury, and postoperative immobilization method. Conclusion: We found in our cohort that the significant predictors of poorer functional outcomes of AATFLR were postoperative immobilization with lower-leg cast, female sex, non–sports-related ankle sprain, and increasing age. Prognostic nomograms were created.
Lessons From Revision Total Ankle Replacement: Tibias Fail Earlier, and Taluses Fail Later (and Fail Again)
Authors: Henry Jensen K. , Teehan Emily , Deland Jonathan , Ellis Scott J. , Demetracopoulos Constantine 
Published: May 2024

Background: The literature on survivorship and outcomes after revision total ankle replacement (TAR) in the modern era is limited. This study aimed to describe the timing to revision and survivorship after revision TAR. We hypothesized that tibial-sided failures would occur earlier after the primary TAR, and secondary revisions after failure of revision TAR would occur more due to talar-sided failures than tibial-sided failures. Methods: This is a single-institution retrospective study of TAR patients with minimum 2-year follow-up. Revision TARs (defined as exchange of tibial and/or talar components) for aseptic causes with any implant were included. Etiology of failure necessitating revision and ultimate outcomes after revision (survival of TAR revision, additional revision, conversion to fusion, and below-knee amputation [BKA]) were recorded. Results: There were 46 revision TARs, with mean age of 60.6 (range: 31-77) years and mean 3.5 years’ follow-up postrevision. Revisions for tibial failure occurred significantly earlier (n = 22, 1.3 ± 0.5 years after index procedure) than those for talar failure (n = 19, 2.3 ± 1.7 years after index procedure) or combined tibial-talar failure (n = 5, 3.4 ± 3.4 years after index procedure) ( P = .015). Revisions for tibial-only failure had better survival (95.5%) than revisions for talar or combined tibial-talar failures: 26% of talar failures and 20% of combined tibial-talar failures underwent ≥1 revisions. Of the 6 additional revisions after failure of the talar component, 1 ultimately underwent BKA, 2 were converted to total talus replacement, 2 were revised to modular augmented talar components, and 1 was treated with explant and cement spacer for PJI after the revision. Conclusion: TAR tibial failures occurred earlier than talar failures or combined tibial-talar failures. Revisions for talar failures and combined tibial-talar failures were more likely to require additional revision or ultimately fail revision treatment. This is important given the consequences of talar implant subsidence, bone necrosis, loss of bone stock, and limited salvage options.
An Open-Label Study of Subcutaneous CpG Oligodeoxynucleotide (PF03512676) in Combination with Trastuzumab in Patients with Metastatic HER2+ Breast Cancer
Authors: Quiroga Dionisia , Wesolowski Robert , Zelinskas Sara , Pinette Ashley , Benner Brooke , Schwarz Emily , Savardekar Himanshu , Johnson Courtney , Stiff Andrew , Yu Lianbo , Macrae Erin , Lustberg Maryam , Mrozek Ewa , Ramaswamy Bhuvaneswari , Carson William E. 
Published: May 2024

Objectives CpG ODN is a Toll-like receptor 9 agonist with immunotherapeutic potential for many cancer types, including aggressive breast cancers. There is strong interest in utilizing CpG ODN as an adjuvant to improve clinical efficacy of current treatments and immunogenicity of breast cancers not traditionally responsive to active immunotherapy, such as those that are human epidermal growth factor receptor 2 (HER2)-positive. This study aimed to study the efficacy and safety of combination CpG ODN plus anti-HER2 antibody trastuzumab treatment in patients with advanced/metastatic breast cancer. Methods This single-arm, open-label phase II clinical trial treated patients (n = 6) with advanced/metastatic HER2-positive breast cancer with weekly subcutaneous CpG ODN and trastuzumab. Patients may have received any number of prior therapies to be enrolled (most enrolled at median 1 prior line of chemotherapy). Peripheral blood was collected at baseline and weeks 2, 6, 12, and 18 for immune analyses. Six patients were enrolled and 50% achieved stable disease (SD) response. Results Median PFS was 8.3 months. Three of the six patients enrolled opted to stop treatment due to tolerability issues. Multiplex assay for cytokine measurements revealed significantly higher VEGF-D levels at week 2 compared to baseline. Peripheral blood mononuclear cells analyzed by flow cytometry showed a significant increase in monocytic MDSC between weeks 6 and 12. Patients with progressive disease tended to have higher levels of week 6 monocytic MDSC and PD-1+ T cells than patients with SD. NK cell populations did not significantly change throughout treatment. Conclusions CpG ODN and trastuzumab treatment of metastatic HER2 + breast cancer was safe but was not tolerable for all patients. This combination did induce potentially predictive immune profile changes in treated patients with metastatic HER2 + breast cancer, the significance of which needs to be further explored.
Influential factors on the echogenicity of peripheral venous catheters: Insights from an experimental phantom study
Authors: Slosse Côme , Hossu Gabriela , Micard Emilien , Hani Hind , Ambroise-Grandjean Gaëlle , Bouaziz Hervé 
Published: May 2024

Introduction: Ultrasound-guided placement of peripheral venous catheters requires appropriate equipment. Among the devices used, peripheral venous catheters have different structure and properties. This study aimed to define the impact of these different factors on the echogenicity of peripheral venous catheters. Method: An open comparative study was conducted from September 2022 to May 2023. Thirteen devices were introduced in a standardized manner along the longitudinal and transverse axes with the help of guides into a phantom at different angles. Two criteria defined the echogenicity of these devices: the surface occupied by the device in the image (composite criterion: length and diameter of the device and angle of insertion) and its brightness (average of the pixel intensity of gray). Sixty-five ultrasound images were recorded and postprocessed twice (blinded to the previous measurement) by an expert operator, for reproducibility purposes. Results: The intra-observer reproducibility of all measurements was excellent, with an intra-class coefficient of >0.90 over the entire dataset. On the longitudinal axis, echogenicity was significantly influenced by insertion angle ( p = 0.009), device length ( p = 0.006), and the interaction of cannula component and insertion angle ( p = 0.007). On the transverse axis, no factors significantly influenced the device’s echogenicity. Discussion: The echogenicity of a device is an essential component of successful ultrasound-guided peripheral venous catheter placement. Optimizing catheter intrinsic factors such as components of the cannula and length, and extrinsic factor like the insertion angle should be considered in their design and use to reduce puncture failure rates.
Evaluation of arteriovenous fistula maturation and early prediction of clinical eligibility, using ultrasound: The Fistula Maturation Evaluation (FAME) Study
Authors: Giannikouris Ioannis E , Spiliopoulos Stavros , Giannakopoulos Triantafyllos , Katsanos Konstantinos , Passadakis Ploumis , Georgiadis George 
Published: May 2024

Introduction: The study of time-related alterations of ultrasound-determined parameters during maturation, and the assessment of time to hemodynamic maturation, enabling early prediction of clinical eligibility, of hemodialysis autologous arteriovenous fistulae (AVF). Methods: This is an observational, prospective, study of only AVF-eligible patients referred for access creation, from 02/2019 to 02/2022 (ClinicalTrials.gov identifier: NCT0473687). Brachial artery diameter (dBA), access flow volume (FV), non-augmented efferent vein diameter (dEV), resistivity index (RI), and efferent vein total wall thickness (tEV), were assessed by ultrasound. Measurements were conducted daily in the first week and repeated on days 14, 21, 30, 60, and 90, postoperatively. The primary endpoint included the documentation of serial changes of flow and structural parameters related to AVF maturation in the first 90 days of the post-operative period and maturation early prediction. Secondary endpoints included the determination of factors affecting maturation. Results: One hundred one participants (mean age, 67 ± 6 years; 76 males) were enrolled. Average dBA and FV reached maximum on day 60 (5.64 ± 0.85 mm) and 90 (1.172 ± 617 mL/min), respectively. Day 7 values of dBA (5.48 ± 0.73 mm) and FV (1.039 ± 531 mL/min) did not alter significantly during the follow-up period. Parameters indicative of clinical functionality, dEV (5.82 ± 0.90 mm) and tEV (0.493 ± 0.10 mm), reached approximately 90% of maximum (6.66 ± 1.42 mm and 0.526 ± 0.11 mm), by day 14. RI reached minimum on day 30 (0.46 ± 0.09), without significant changes after day 2 (0.48 ± 0.09, p = 0.284). A significant correlation was identified, between day 7 FV and day 60 dEV ( r = 0.40, p = 0.0002). A FV cut-off value ⩾657.51 mL/min, on day 7, predicted successful fistula maturation with 85% sensitivity and 100% specificity. Multivariate analysis identified female gender, age >75, diabetes, and wrist access as independent predictors of decreased values of maturation parameters. Conclusion: Hemodynamic maturation is completed by the first postoperative week, while AVF is clinically functional, by the second. FV can be used for early prediction of maturation.
In-silico approach to characterize the structure and function of a hypothetical protein of Monkeypox virus exploring Chordopox-A20R domain-containing protein activity
Authors: Hosen Md Iqbal , Mia Md Easin , Islam Md Nur , Khatun Most Ummay Salma , Emon Tanvir Hossain , Hossain Md Anwar , Akter Farzana , Kader Md Abdul , Jeba Sadia Hossain , Faisal ASM , Miah Md Abunasar 
Published: May 2024

Background: Monkeypox has emerged as a noteworthy worldwide issue due to its daily escalating case count. This illness presents diverse symptoms, including skin manifestations, which have the potential to spread through contact. The transmission of this infectious agent is intricate and readily transfers between individuals. Methods: The hypothetical protein MPXV-SI-2022V502225_00135 strain of monkeypox underwent structural and functional analysis using NCBI-CD Search, Pfam, and InterProScan. Quality assessment utilized PROCHECK, QMEAN, Verify3D, and ERRAT, followed by protein-ligand docking, visualization, and a 100-nanosecond simulation on Schrodinger Maestro. Results: Different physicochemical properties were estimated, indicating a stable molecular weight (49147.14) and theoretical pI (5.62) with functional annotation tools predicting the target protein to contain the domain of Chordopox_A20R domain. In secondary structure analysis, the helix coil was found to be predominant. The three-dimensional (3D) structure of the protein was obtained using a template protein (PDB ID: 6zyc.1), which became more stable after YASARA energy minimization and was validated by quality assessment tools like PROCHECK, QMEAN, Verify3D, and ERRAT. Protein-ligand docking was conducted using PyRx 9.0 software to examine the binding and interactions between a ligand and a hypothetical protein, focusing on various amino acids. The model structure, active site, and binding site were visualized using the CASTp server, FTsite, and PyMOL. A 100 nanosecond simulation was performed with ligand CID_16124688 to evaluate the efficiency of this protein. Conclusion: The analysis revealed significant binding interactions and enhanced stability, aiding in drug or vaccine design for effective antiviral treatment and patient management.
Experimental increase in lexical frequency improves morphological computation of Spanish
Authors: Durand-López Ezequiel M. , Garrido-Pozú Juan J. 
Published: May 2024

Aims/Objectives: The present study investigates whether lexical frequency can be increased experimentally, and whether an increase in lexical frequency facilitates L2 morphological processing. Design: English L2 learners of Spanish were randomly assigned to either a treatment or control group. Both groups completed a pre/post lexical decision task containing L2 words with either two or three morphemes, and a pre/post lexical frequency task. In addition, the treatment group completed four sessions in which they read texts containing low frequency words. Data/analysis: Linear mixed models and Bayes factors were used to analyze participants’ performance. Findings/Conclusions: Both groups took significantly longer to process morphologically complex words with three than with two morphemes at pretest. While this pattern was observed also at posttest for the control group, the treatment group took roughly the same to process both types of words following training. Taken together, the findings suggest that an increased exposure to low-frequency L2 words switches learners’ morphological computation strategies from decomposition to whole word processing. Originality: While previous cross-sectional studies have assessed the role of frequency on L2 morphological decomposition, this has not been confirmed by longitudinal data. Significance/Implications: The results support hybrid word recognition models claiming that frequency modulates morphological computation.
‘I don’t want him to always be so far behind’: Parental perceptions of child independence in the context of extreme prematurity; a qualitative study
Authors: Suonpera Emmi , Gallagher Katie , Marlow Neil , Lanceley Anne 
Published: May 2024

This study addresses the paucity of research on parents of extremely preterm adolescents (born <27 weeks of gestation) and their experiences within the framework of parental determinism. We conducted semi-structured interviews with twenty-two mothers and one father. Data were analysed thematically, revealing three overarching themes and eight subthemes shaping parental accounts. These themes centred on parental ambitions for their children, their perceptions of their child’s abilities, and the parenting behaviours employed to support parental aspirations. Parents’ actions were influenced by their ambitions and the belief that they could impact their child’s future independence. While some parents adopted ‘trusting’, non-intensive parenting behaviours, those anticipating challenges for their child’s future independence resorted to intensive parenting practices. These findings align with the concept of parental determinism, emphasising the perceived causal link between present parental actions and future child outcomes. In the context of extreme prematurity, a nuanced understanding of parental perceptions regarding their child’s future independence aligned with a delicate balance between hope and realistic aspiration is crucial for enhancing parental support and well-being.
A phenomenological understanding of the intersectionality of ageism and racism among older adults: Interpersonal experiences
Authors: Steward Andrew T , De Fries Carson M , Dunbar Annie Zean , Trujillo Miguel , Zhu Yating , Hasche Leslie 
Published: May 2024

Summary This qualitative, phenomenological study explored the lived experience of the intersectionality of ageism and racism among older adults, with a focus on interpersonal experiences. Fifteen participants 60+ years of age (M = 67, SD = 7.45) in the U.S. Mountain West identifying as Black, Latino(a), Asian-American/Pacific Islander, or Indigenous engaged in a 1-hour interview. A three-cycle, inductive coding process involved five coders who independently coded interviews and engaged in critical discussion to resolve disagreements. An audit trail, member checking, and peer debriefing enhanced credibility. Findings The results detail four umbrella themes and nine subthemes. The subthemes demonstrate experiences of the intersectionality of ageism with racism reflected through (1) increased disrespect, (2) cultural differences in respect for elders, (3) tokenization, (4) physical appearance, (5) being ignored or discriminated against due to others’ discomfort, (6) intersecting experiences of pity, hate, and violence, (7) unspoken bias (including racial profiling), (8) microaggressions: questioning intelligence/ability, and (9) microaggressions: slurs. Multiple themes highlighted how ageism may be racialized through stereotypes related to mental (in)capability. Applications Social work practitioners and researchers can apply the findings from this study to explore interventions aimed at reducing interpersonal, racialized ageist microaggressions related to mental incapability. At the community level, anti-racism and anti-ageism initiatives should collaborate by applying an enhanced understanding of the ways ageism and racism intersect through pity, hate, and violence particularly in public settings such as shopping centers. The findings from this study can also help shape policies aimed at reducing racial profiling and hate crimes toward older adults of color.