bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Clinical Outcomes and Knee Stability in Remnant-Preserving ACL Reconstruction Versus Standard ACL Reconstruction: A Systematic Review and Meta-analysis
Authors: Allende Felicitas , Allahabadi Sachin , Sachdev Divesh , Gopinatth Varun , Saad Berreta Rodrigo , LaPrade Robert F. , Chahla Jorge 
Published: March 2024

Background: Anterior cruciate ligament reconstruction (ACLR) is one of the most frequently performed procedures in sports medicine, and undesirable outcomes still may range from 3-18%. One technique that has been explored to improve outcomes is preservation of the ACL remnant tibial stump, as opposed to stump debridement, at the time of reconstruction. Purpose: To review current high-level evidence and compare remnant-preserving anterior cruciate ligament reconstruction (ACLR) versus standard ACLR in terms of clinical outcomes and measures of knee stability. Hypothesis: ACLR with remnant preservation would result in improved clinical outcomes and knee stability measures. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic review of randomized controlled trials (RCTs) and cohort studies comparing remnant-preserving ACLR with standard ACLR with a minimum level of evidence of 2 was performed. Extracted data were summarized as general information, surgical characteristics, postoperative clinical outcomes, knee stability, graft evaluation, tunnel assessment, and postoperative complications. When feasible, a meta-analysis was performed. Results: Seven RCTs and 5 cohort studies met the inclusion criteria. In total, 518 patients underwent remnant-preserving ACLR and 604 patients underwent standard ACLR. Ten studies performed the reconstruction with hamstring tendon (HT) autografts, 1 study with HT and bone–patellar tendon–bone autografts, and 1 study with HT and tibialis anterior allografts. On meta-analysis, remnant-preserving ACLR provided comparable outcomes with respect to International Knee Documentation Committee grades or Tegner scores. Even though there was a significant improvement in Lysholm scores (mean difference, −1.9; 95% CI, −2.89 to −0.91; P = .0002) with the remnant-preserving technique, this did not exceed previously reported minimal clinically important difference values. Remnant-preserving ACLR demonstrated superior knee stability in terms of patients achieving negative pivot shift when compared with the control group (88.89% vs 79.92%; P = .006). Although there was a significant improvement in the side-to-side difference in anterior tibial translation favoring remnant preservation ( P = .004), the mean difference was 0.51 mm. Conclusion: Remnant-preserving ACLR, primarily with HT autografts, results in comparable clinical outcome scores and significantly improved knee stability relative to standard ACLR without remnant preservation without increasing the complication rate. Further studies will help clarify if remnant-preserving ACLR also has benefits in terms of enhancing graft integration and maturation, improving proprioception, limiting tunnel enlargement, and reducing complications.
A Comparative Biomechanical Study of Alternative Medial Collateral Ligament Reconstruction Techniques
Authors: Shatrov Jobe , Bonacic Bartolin Petra , Holthof Sander R. , Ball Simon , Williams Andy , Amis Andrew A. 
Published: March 2024

Background: There is little evidence of the biomechanical performance of medial collateral ligament (MCL) reconstructions for restoring stability to the MCL-deficient knee regarding valgus, external rotation (ER), and anteromedial rotatory instability (AMRI). Hypothesis: A short isometric reconstruction will better restore stability than a longer superficial MCL (sMCL) reconstruction, and an additional deep MCL (dMCL) graft will better control ER and AMRI than single-strand reconstructions. Study Design: Controlled laboratory study. Methods: Nine cadaveric human knees were tested in a kinematics rig that allowed tibial loading while the knee was flexed-extended 0° to 100°. Optical markers were placed on the femur and tibia and displacements were measured using a stereo camera system. The knee was tested intact, and then after MCL (sMCL + dMCL) transection, and loaded in anterior tibial translation (ATT), ER, varus-valgus, and combined ATT + ER (AMRI loading). Five different isometric MCL reconstructions were tested: isolated long sMCL, a short construct, each with and without dMCL addition, and isolated dMCL reconstruction, using an 8 mm–wide synthetic graft. Results: MCL deficiency caused an increase in ER of 4° at 0° of flexion ( P = .271) up to 14° at 100° of flexion ( P = .002), and valgus laxity increased by 5° to 8° between 0° and 100° of flexion ( P < .024 at 0°-90°). ATT did not increase significantly in isolated MCL deficiency ( P > .999). All 5 reconstructions restored native stability across the arc of flexion apart from the isolated long sMCL, which demonstrated residual ER instability ( P≤ .047 vs other reconstructions). Conclusion: All tested techniques apart from the isolated long sMCL graft are satisfactory in the context of restoring the valgus, ER, and AMRI stability to the MCL-deficient knee in a cadaveric model. Clinical Relevance: Contemporary MCL reconstruction techniques fail to control ER and therefore AMRI as they use a long sMCL graft and do not address the dMCL. This study compares 5 MCL reconstruction techniques. Both long and short isometric constructs other than the long sMCL achieved native stability in valgus and ER/AMRI. Double-strand reconstructions (sMCL + dMCL) tended to provide more stability. This study shows which reconstructions demonstrate the best biomechanical performance, informs surgical reconstruction techniques for AMRI, and questions the efficacy of current popular techniques.
Rates of Subjective Failure After Both Isolated and Combined Posterior Cruciate Ligament Reconstruction: A Study From the Norwegian Knee Ligament Registry 2004-2021
Authors: Moatshe Gilbert , LaPrade Christopher M. , Fenstad Anne Marie , Persson Andreas , LaPrade Matthew , Martin R. Kyle , Engebretsen Lars , LaPrade Robert F. 
Published: March 2024

Background: Outcomes after posterior cruciate ligament (PCL) reconstruction (PCLR) have been reported to be inferior to those of anterior cruciate ligament reconstruction. Furthermore, combined ligament injuries have been reported to have inferior outcomes compared with isolated PCLR. Purpose/Hypothesis: The purpose of this study was to report on PCLR outcomes and failure rates and compare these outcomes between isolated PCLR and multiligament knee surgery involving the PCL. The hypothesis was that combined PCL injury reconstruction would have higher rates of subjective failure and revision relative to isolated PCLR. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with primary PCLR with or without concomitant ligament injuries registered in the Norwegian Knee Ligament Registry between 2004 and 2021 were included. Knee injury and Osteoarthritis Outcome Score (KOOS) totals were collected preoperatively and at 2 years and 5 years postoperatively. The primary outcome measure was failure, defined as either a revision surgery or a KOOS Quality of Life (QoL) subscale score <44. Results: The sample included 631 primary PCLR procedures, with 185 (29%) isolated PCLR procedures and 446 (71%) combined reconstructions, with a median follow-up time of 7.3 and 7.9 years, respectively. The majority of patients had poor preoperative knee function as defined by a KOOS QoL score <44 (90.1% isolated PCLR, 85.7% combined PCL injuries; P = .24). Subjective outcomes improved significantly at 2- and 5-year follow-up compared with preoperative assessments in both groups ( P < .001); however, at 2 years, 49.5% and 46.5% had subjective failure (KOOS QoL <44) for isolated PCLR and combined PCLR, respectively ( P = .61). At 5 years, the subjective failure rates of isolated and combined PCLR were 46.7% and 34.2%, respectively ( P = .04). No significant difference was found in revision rates between the groups at 5 years (1.9% and 4.6%, respectively; P = .07). Conclusion: Patients who underwent PCLR had improved KOOS QoL scores relative to their preoperative state. However, the subjective failure rate was high for both isolated and multiligament PCLR. Within the first 2 years after surgery, patients who undergo isolated PCLR can be expected to have similar failure rates to patients who undergo combined ligament reconstructions.
A new biomarker panel for differential diagnosis of cholangiocarcinoma: Results from an exploratory analysis
Authors: Köhler Bruno , Bes Marta , Chan Henry Lik-Yuen , Esteban Juan Ignacio , Piratvisuth Teerha , Sukeepaisarnjaroen Wattana , Tanwandee Tawesak , Thongsawat Satawat , Mang Anika , Morgenstern David , Swiatek-de Lange Magdalena , Dayyani Farshid 
Published: March 2024

Introduction Diagnosis of cholangiocarcinoma (CCA) can be challenging due to unclear imaging criteria and difficulty obtaining adequate tissue biopsy. Although serum cancer antigen 19-9 and carcinoembryonic antigen have been proposed as potential diagnostic aids, their use remains limited by insufficient sensitivity and specificity. This exploratory analysis aimed to identify individual- and combinations of serum biomarkers to distinguish CCA from hepatocellular carcinoma (HCC) and chronic liver disease (CLD) controls using samples from a published study. Methods This prospective, multicenter, case-control study included patients aged ≥18 years at high-risk of HCC. Serum and ethylene diamine tetraacetic acid-plasma samples were collected prior to any treatment and confirmed diagnosis of HCC or CCA. Fourteen biomarkers (measured by electrochemiluminescence immunoassays or enzyme-linked immunosorbent assays) were subjected to univariate analysis and 13 included in a multivariate analysis (per selected combinations and exhaustive search). Results Overall, 55 CCA, 306 HCC, and 733 CLD control samples were analyzed. For distinguishing CCA from HCC, alpha-fetoprotein and matrix metalloproteinase-2 (MMP-2) showed the best individual performance (area under the curve (AUC) 86.6% and 84.4%, respectively); tissue inhibitor of metalloproteinase-1 (TIMP-1) was most able to distinguish CCA from CLD (AUC 94.5%) and from HCC  +  CLD (AUC 88.6%). The combination of MMP-2 and TIMP-1 was the best-performing two-marker panel, with AUC >90% for all comparisons. Conclusion MMP-2 and TIMP-1 are promising biomarkers that could support differential diagnosis of CCA. Incorporating these assays into the diagnostic algorithm could provide additional diagnostic information in a non-invasive, rapid manner, and could supplement existing diagnostic methods.
Hybridations des relations homme-nature et changements de pratiques de consommation : une analyse au prisme des ontologies de Descola
Authors: Marchais Dorian , Roux Dominique , Arnould Eric 
Published: March 2024

Résumé Cette recherche examine comment les individus se connectent à la nature et comment différentes perceptions de continuité ou de discontinuité avec des non-humains influencent leurs habitudes de consommation. En s’appuyant sur la remise en question de la distinction traditionnelle entre nature et culture proposée par Descola en 2005, cette étude met à l’épreuve empiriquement le concept d’« hybridité ontologique » introduit par les auteurs. A l’aide de données qualitatives recueillies auprès de 25 consommateurs, l’analyse révèle le processus par lequel des ontologies non-naturalistes pénètrent l’ontologie dominante, qui sert d’arrière-plan critique à ces infiltrations. Sous l’impulsion d’événements déclencheurs, ces infiltrations produisent des ontologies hybrides à l’origine de changements dans les pratiques de consommation. Nous discutons les perspectives offertes par ces infiltrations ontologiques pour le marketing et la société dans son ensemble.
Knowledge, Attitude and P erception Towards Gestational Diabetes Mellitus Among Pregnant Women Attending Antenatal Clinic in University College Hospital, Ibadan
Authors: Bada Basirat Moboluwaduro , Ojewale Lucia Yetunde , Akingbade Oluwadamilare 
Published: March 2024

Introduction The International Diabetes Federation has identified the emergence of gestational diabetes mellitus (DM) (GDM) as an underappreciated threat to maternal and child health. Adequate knowledge, a positive attitude towards prevention, and a positive perception of its danger could motivate pregnant women to take preventive measures. However, there is a dearth of literature on these among women attending antenatal clinics at UCH. This study, therefore aimed to assess pregnant women’s knowledge about GDM, report their attitudes and determine their perception towards GDM. Methods A cross-sectional study assessed the knowledge, attitude and perception towards GDM. A total of 300 pregnant women registered with and attending the antenatal clinic in University College Hospital (UCH), were selected using a random sampling technique. A self-structured questionnaire using a GDM Knowledge Questionnaire and previous research questions on Perception and Attitude was used to collect data from participants. Data were analysed using Statistical Package for Social Sciences 20.0 and hypotheses were tested using chi-square at 0.05 level of significance. Results The mean age of the pregnant women was 30.60 ± 5.88 years. A little over one-fifth of the participants were knowledgeable about GDM. Three-quarters of the participants demonstrated a positive attitude while just a little over half had a positive perception of GDM. A significant association exists between participants’ knowledge about GDM and belief about screening for diabetes during pregnancy ( p = .006). There was a significant association between participants’ attitude and their perception of GDM ( p = .000). A direct significant association was also found between participants’ knowledge and their perceived risk of developing GDM ( p = .000). Discussion While most of the pregnant women had poor knowledge about GDM, more than half of the pregnant women had positive attitudes towards GDM. A little over average possesses a positive perception towards GDM. Healthcare providers should intensify efforts in formulating appropriate methods to increase awareness with emphasis on the risks associated with GDM.
Health-Related Quality of Life in Mexican Children and Adolescents with Non-Syndromic Craniosynostosis
Authors: Moreno-Villagómez Julieta , Castillo-Mimila Miguel , Yáñez-Téllez Guillermina , Prieto-Corona Belén , García-Méndez Antonio 
Published: March 2024

Objective Assess the Health-Related Quality of Life in children and adolescents with non-syndromic craniosynostosis and compare it with participants without craniosynostosis. Design Non-experimental, cross-sectional design. Setting The assessment was done remotely and the instrument was sent via chat or email. Patients/Participants Participants (ages 8–17) with non-syndromic craniosynostosis (n = 27) and without craniosynostosis (n = 26). Main Outcome Measure(s) We used an adapted version for the Mexican population of the Health-Related Quality of Life Questionnaire for Children and Adolescents -KIDSCREEN-52. Results All scores were in the average clinical range and both groups scored similarly in all domains except those with craniosynostosis were significantly lower in the Social Support and Peers domain (rpb = 0.48). Conclusions Children and adolescents with non-syndromic craniosynostosis reported similar Health-Related Quality of Life as the control group, except for the Social Support domain, which should be investigated in future studies.
Clinical Experience With a Less Invasive Surgical Transparotid Approach and Trapezoidal Plate for Neck and Base Condylar Fractures: A Retrospective Study
Authors: Cortez Fuentes Carlos , Astorga Mori Felipe , Valladares Pérez Salvador , Gahona Gutiérrez Osvaldo , Sepúlveda Troncoso Gerson , Dallaserra Albertini Matias , Vargas Buratovic Juan Pablo 
Published: March 2024

Study Design This is a retrospective observational study. Objective To evaluate the clinical outcomes after an open reduction and internal fixation (ORIF) of condylar neck and base fractures (CNBFs) with a trapezoidal shape plate in patients using a less invasive transparotid approach. Methods Fifteen patients with condylar fractures were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen Craniomaxillofacial (AOCMF) classification system, treated by ORIF with a trapezoidal plate. All patients were evaluated by clinical examination (pain, occlusion, and mandibular dynamics) and imaging through computed axial tomography. Postoperative evaluations considered a favourable clinical outcome of fragment stability, stable occlusion, absence of pain, and regular mouth opening ranges. In addition, any signs of local infection, malocclusion, facial nerve damage, or failure of the fixation system were recorded. Results According to the AOCMF classification for condylar fractures, eight fractures affected the condylar base and seven involved the condylar neck. No patients presented pain or joint sounds in the TMJ. All patients obtained a buccal opening greater than or equal to 35 mm. Two patients showed postoperative malocclusion which was corrected by intermaxillary elastics therapy. In addition, two patients had transient paresis during the postoperative period. One of them had paresis of the frontal and buccal branches of the facial nerve while the second patient had paresis of the zygomatic and buccal branches. Conclusions Using trapezoidal miniplates provides functionally stable fixation for neck and base condylar fractures and allows for a less invasive surgical transparotid approach (2 cm extension). They also reduce the amount of osteosynthesis material and are easier to adapt and fix in the author’s opinion.
Working as a “Token”: Different Perspectives on the Role of International Faculty in Korean Universities
Authors: Song Inyoung , Kim Yangson 
Published: March 2024

Purpose This study examined the factors influencing the tokenization of international faculty in Korean universities. It also explored how domestic faculty and staff perceive the role of international faculty and the process by which they adapt to the Korean education system. Design/Approach/Methods The study used a qualitative design. Universities were arranged by region and objectives (research-oriented, teaching-oriented, or combined teaching and research) for sampling, and in-depth interviews were conducted with three groups: international faculty, Korean faculty, and Korean staff. Findings First, Korean faculty and staff expressed low expectations of international faculty based on their different definitions of internationalization. Second, these low expectations resulted in role encapsulation, limiting the functions of international faculty. In addition, although Korean universities compete to hire international faculty, they do not provide them with adequate support post-hire. The burden of this lack of support is often passed on to Korean faculty, instilling a negative perception of international faculty. Originality/Value Using the framework of tokenism, this study analyzed Korean universities’ efforts to hire international faculty as part of university internationalization; it determined whether the latter ultimately became major actors in the internationalization strategy.
Pharmacokinetics, pharmacodynamics, efficacy, and safety of ravulizumab in pediatric paroxysmal nocturnal hemoglobinuria
Authors: Chonat Satheesh , Kulagin Alexander , Maschan Alexey , Bartels Marije , Buechner Jochen , Punzalan Rowena , Richards Michael , Ogawa Masayo , Hicks Eden , Yu Ji , Baruchel André , Kulasekararaj Austin G. 
Published: March 2024

Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disease of uncontrolled terminal complement activation leading to intravascular hemolysis, thrombotic events and increased morbidity and mortality. This phase 3, open-label, single-arm, multicenter study evaluated ravulizumab treatment in eculizumab-naive or -experienced pediatric patients (aged &lt;18 years) with PNH over a 26-week primary evaluation period (PEP) and 4-year extension period (EP). Patients included in the study received weight–based intravenous ravulizumab dosing. Primary end points were pharmacokinetic and pharmacodynamic parameters to confirm complement component 5 (C5) inhibition by ravulizumab; secondary end points assessed the efficacy (including percentage change in lactate dehydrogenase levels over time) and safety of ravulizumab. Thirteen patients, 5 (38.5%) eculizumab-naive and 8 (61.5%) eculizumab-experienced, were enrolled. Ravulizumab Ctrough levels were above the pharmacokinetic threshold of 175 μg/mL in the PEP and EP except in 1 patient. At the end of the study, pre- and post-infusion mean ± standard deviation serum ravulizumab concentrations were 610.50 ± 201.53 μg/mL and 518.29 ± 109.67 μg/mL for eculizumab-naive and eculizumab-experienced patients, respectively. After the first ravulizumab infusion, serum-free C5 concentrations were &lt;0.5 μg/mL in both cohorts until the end of the study (0.061 ± 0.021 μg/mL and 0.061 ± 0.018 μg/mL for eculizumab-naive and eculizumab-experienced patients, respectively). Compared with baseline, ravulizumab improved and maintained efficacy outcomes in both groups. Ravulizumab had an acceptable safety profile with no new safety signals identified, and provided immediate, complete, and sustained terminal complement inhibition, translating to clinical benefit for pediatric patients with PNH. This trial was registered at www.ClinicalTrials.gov as #NCT03406507.
Sirtuins in intervertebral disc degeneration: current understanding
Authors: Shen Jianlin , Lan Yujian , Ji Ziyu , Liu Huan 
Published: March 2024

Abstract
Background
Intervertebral disc degeneration (IVDD) is one of the etiologic factors of degenerative spinal diseases, which can lead to a variety of pathological spinal conditions such as disc herniation, spinal stenosis, and scoliosis. IVDD is a leading cause of lower back pain, the prevalence of which increases with age. Recently, Sirtuins/SIRTs and their related activators have received attention for their activity in the treatment of IVDD. In this paper, a comprehensive systematic review of the literature on the role of SIRTs and their activators on IVDD in recent years is presented. The molecular pathways involved in the regulation of IVDD by SIRTs are summarized, and the effects of SIRTs on senescence, inflammatory responses, oxidative stress, and mitochondrial dysfunction in myeloid cells are discussed with a view to suggesting possible solutions for the current treatment of IVDD.

Purpose
This paper focuses on the molecular mechanisms by which SIRTs and their activators act on IVDD.

Methods
A literature search was conducted in Pubmed and Web of Science databases over a 13-year period from 2011 to 2024 for the terms “SIRT”, “Sirtuin”, “IVDD”, “IDD”, “IVD”, “NP”, “Intervertebral disc degeneration”, “Intervertebral disc” and “Nucleus pulposus”.

Results
According to the results, SIRTs and a large number of activators showed positive effects against IVDD.SIRTs modulate autophagy, myeloid apoptosis, oxidative stress and extracellular matrix degradation. In addition, they attenuate inflammatory factor-induced disc damage and maintain homeostasis during disc degeneration. Several clinical studies have reported the protective effects of some SIRTs activators (e.g., resveratrol, melatonin, honokiol, and 1,4-dihydropyridine) against IVDD.

Conclusion
The fact that SIRTs and their activators play a hundred different roles in IVDD helps to better understand their potential to develop further treatments for IVDD.

Novelty
This review summarizes current information on the mechanisms of action of SIRTs in IVDD and the challenges and limitations of translating their basic research into therapy.