bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quadriceps injuries
Authors: Plastow Ricci , Raj Rhody D. , Fontalis Andreas , Haddad Fares S. 
Published: December 2023

Injuries to the quadriceps muscle group are common in athletes performing high-speed running and kicking sports. The complex anatomy of the rectus femoris puts it at greatest risk of injury. There is variability in prognosis in the literature, with reinjury rates as high as 67% in the severe graded proximal tear. Studies have highlighted that athletes can reinjure after nonoperative management, and some benefit may be derived from surgical repair to restore function and return to sport (RTS). This injury is potentially career-threatening in the elite-level athlete, and we aim to highlight the key recent literature on interventions to restore strength and function to allow early RTS while reducing the risk of injury recurrence. This article reviews the optimal diagnostic strategies and classification of quadriceps injuries. We highlight the unique anatomy of each injury on MRI and the outcomes of both nonoperative and operative treatment, providing an evidence-based management framework for athletes.Cite this article: Bone Joint J 2023;105-B(12):1244–1251.
WORK-LIMITING INJURIES SUSTAINED BY ATHLETES IN THE WORLD'S HARDEST RACE
Authors: Ferguson D , Cuthbert R , Acquaah F , Cornelissen J , Jeyaseelan L 
Published: December 2023

IntroductionThe Tour de France, commonly recognised and the hardest physical endurance event on the planet, is an iconic cycling competition with a history of ever impressive performances and increasingly notable injuries. This study aims to methodologically catalogue and analyse injuries sustained by professional riders over a span of six years and understand the operative workload created by this prestigious race. (2018–2023).MethodsData was gathered from multiple publicly available sources, including pro-cycling stats, news articles, team press releases and independent medical reports. Each injury was categorized by year, rider, and injury type.ResultsFrom 2018–2023, there was a significant diversity in both injured body part and mechanism of injury. Of the 124 recorded race ending incidents clavicle fractures accounted 19.4%, laceration/contusions 12.1%, patella fractures 10.5% and elbow fractures 7.3%. Othernotable other body areas undergoing surgical intervention were hand fractures 5.6%, pelvic fractures 2.4% and femoral fracture 1.6%. At a mean of 20.67 injuries per tour, this accounts for almost exactly one race ending injury per day where an athlete finishes the day on the operating table, rather than the team bus.DiscussionThe Tour de France's rigorous challenges are mirrored in its injury statistics. Over six years, clavicle fractures were most prevalent, likely due to cyclists' instinct to brace during crashes. Lacerations, contusions, and patella fractures also featured prominently. Alarmingly, each race stage averaged an injury severe enough for surgical intervention. This data highlights the imperative need for enhanced protective measures, race regulations, and medical preparedness to protect these elite athletes.
ADDITIONAL MCL SURGERY DOES NOT AFFECT OUTCOMES AFTER ACL RECONSTRUCTION BUT ADDITIONAL POSTEROLATERAL SURGERY DOES IN ELITE ATHLETES
Authors: Jones M , Pinheiro VH , Laughlin M , Borque K , Williams A 
Published: December 2023

IntroductionTo evaluate career length after surgical treatment of combined ACL + medial collateral ligament (MCL) and ACL +posterolateral corner (PLC) surgeries in all elite athletes. Secondly, in a subgroup of male professional footballers to determine career length and competition level after ACL+MCL or ACL+PLC reconstructions and compare this to a cohort who underwent isolated ACL reconstruction (ACL-R) alone.MethodsA consecutive cohort of elite athletes undergoing combined ACL+MCL surgery and combined ACL+PLC surgery between February 2001 and October 2019 were analysed. A subgroup of male footballers from this population was compared to a previously identified cohort of male, professional footballers having had primary ACL reconstruction without other ligament surgery. A minimum 2-years follow-up was required. Outcome measures were career length and competition level.ResultsNinety-eight elite athletes were included, 50 had ACL+PLC and 48 had ACL+MCL surgeries. The timeline for return to play (RTP)was significantly longer for ACL+PLC injuries (12.8 months) as compared to ACL+MCL injuries (11.1 months, p=.019). On average, career length after surgery of an athlete in the ACL+PLC group was 4.8 years and for the ACL+MCL group 4.2 years (n.s.). In the subgroup analysis of footballers, a significantly lower number of players with combined ACL+PLC surgery were able to RTP (88%, p=.003) compared to 100%for ACL+MCL surgery and 97% for isolated ACL reconstruction, as well as requiring almost 3 months longer RTP timeline (12.9±4.2 months= .002) when compared to isolated ACL (10.2 ± 3.9 months) and combined ACL+MCL groups (10.0+2.4 months). However, career length and competition level were not significantly different between groups.ConclusionThe addition of MCL surgery to ACL-R did not affect RTP time and rate in elite athletes, nor competition level in male professional footballers compared to ACL-R alone. Moreover, the career length after successful RTP following combined ACL+MCL or ACL+PLC surgeries were the same. However, professional footballers with combined ACL+PLC surgery return at a lower rate and require a longer RTP time when compared to the ones with isolated ACL-R or combined ACL+MCL surgery. For the factors assessed in this study additional MCL surgery to ACL-R alone did not alter outcome from that with ACL-R in professional soccer players.
QUANTIFYING ANTERIOR MEDIAL ROTATIONAL STABILITY IN ANTERIOR CRUCIATE LIGAMENT-INJURED PATIENTS WITH ASSOCIATED COLLATERAL INVOLVEMENT
Authors: Allott N. , Banger M. , Korgaonkar J. , Thomas R. , McGregor A. 
Published: December 2023

IntroductionAnterior tibial translation (ATT) is assessed in the acutely injured knee to investigate for ligamentous injury and rotational laxity. Specifically, there is a growing recognition of the significance of anterior medial rotary laxity (AMRI) as a crucial element in assessing knee stability. Anterior cruciate ligament (ACL) injuries are often accompanied with medial collateral ligament (MCL) damage. It has been suggested that Deep MCL (dMCL) fibres are a primary restraint in rotational displacement. This research aims to quantify the difference in rotational laxity of patients with ACL and MCL injuries to deem if the Feagin-Thomas test can robustly capture metrics of AMRI. 2.MethodsAMRI was assessed using the Feagin-Thomas test in 7 isolated ACL (iACL) injured participants, 3 combined ACL and superficial fibre MCL (sMCL) injuries, 5 combined ACL and deep fibre MCL injuries, and 21 healthy controls. Displacement values were recorded using an optical motion capture (OMC) system and bespoke processing pipeline which map and model the knee's anterior displacement values relative to the medial compartment. Since absolute values (mm) of rotational laxity vary dependant on the person, values were recorded as a proportion of the rotational laxity obtained from the subject's contralateral leg. Values were compared between each patient group using an ANOVA test and Tukey's honesty significant difference post hoc test. 3.ResultsThe healthy control group had a median proportion of 0.97 (3SF), whilst the iACL was 1.12 (3SF), a 12% increase in rotational laxity in the injured leg. The sMCL group yielded a result of 1.64 (3SF), a 64% increase in rotational laxity in the injured leg; finally, dMCL resulted in a proportion of rotational laxity of 1.90 (3SF), a 90% increase in rotational laxity [table 1]. Whilst all groups showed differences in the increase of rotational laxity, dMCL was significantly different from the healthy control group (P value 0.0041). 4.ConclusionACL injuries with MCL involvement led to an increase in anterior medial rotary laxity and this is more evident in patients where deep MCL fibres are involved. The Feagin-Thomas test appears to be sensitive in detecting differences in AMRI and should be considered when performing comprehensive clinical knee examination.For any figures or tables, please contact authors directly.
EXTRA-ARTICULAR KNEE LIGAMENT RECONSTRUCTIONS USING LIGAMENT AUGMENTATION AND RECONSTRUCTION SYSTEM (LARS) SYNTHETIC GRAFTS IN ELITE ATHLETES
Authors: Jones M , Pinheiro VH , Church S , Ball S , Williams A 
Published: December 2023

IntroductionTo determine if elite athletes can return to professional sport after MCL or posterolateral (PLC) reconstruction using LARS ligaments. The secondary aims are to demonstrate the safety and efficacy of LARS by reporting sport longevity, subsequent surgeries, and complications.MethodsA retrospective review of all extra-articular knee ligament reconstructions, utilising a LARS synthetic ligament, by 3 sports knee surgeons between 2013 and 2020 was undertaken. All elite athletes aged over 16 years and a minimum of 2 years post reconstruction were included. No LARS were used for ACL reconstructions, and they were excluded if a LARS ligament was used for a PCL reconstruction. Return to play (RTP) was defined as competing at professional level or national/ international level in amateur sport.ResultsSixty-four (84.2%) MCL reconstructions and 12 (15.8%) PLC reconstructions were included. 52 (68.4%) underwent concomitant autograft cruciate(s) reconstruction including 6 (7.8%) bicruciate reconstructions. The mean age was 25.1 years (SD +/− 4.50). 35 (46.1%) were footballers and 35 (46.1%) were rugby players. Sixty-seven athletes (88.2%) returned to elite sport, 7 (9.2%) did not RTP and RTP status was unknown for 2 (2.6%) (Figure 1). 65 out of 67 (97.0%) RTP at the same/higher Tegner level. 56 (83.6%) and 20 (57.1%) were still playing at 2- and 5-years post-surgery Six (7.9%) players required further surgery due to irritation from the metal fixation implants. One had an inflammation adjacent to the synthetic material at the femoral end and the other cases involved the tibial staples. All six cases were able to RTP. One athlete, following bicruciate /MCL surgery had the LARS removed due to laxity. There was one MCL re-rupture, sustained while jumping, 4 years after returning to football.ConclusionsUtilising LARS in extra-articular knee ligament reconstructions allows 88.2% of athletes with a variety of knee ligament injuries to return to elite sport. The results compare well regarding RTP, complication, and revision rates with the published evidence for other types of MCL and PLC grafts. This, coupled with 57% of athletes still playing 5 years post-surgery suggests the LARS is safe and effective in these cases.For any figures or tables, please contact authors directly.
MID-TERM OUTCOMES OF TROCHLEOPLASTY IN THE TREATMENT OF SEVERE TROCHLEAR DYSPLASIA
Authors: Sharma N , George A , Hampton M , Barnett A 
Published: December 2023

IntroductionTrochleoplasty is an effective surgical procedure for patients with severe trochlear dysplasia and recurrent patella instability. Previous work has suggested patients demonstrate early improvements in knee function and quality of life. However, concerns regarding longer term outcomes due to the development of stiffness and patellofemoral osteoarthritis remain a concern for these patients. Our aim was to assess mid-term patient-reported outcome and quality of life measures for trochleoplasty performed at a single centre for severe trochlear dysplasia.MethodsRetrospective review of 28 knees (23 patients) having undergone trochleoplasty for severe trochlear dysplasia were reviewed. Due to the non-parametric nature of the data, median and interquartile range (IQR) were determined for pre-operative and mid-term follow-up scores. Statistically significant differences between groups were assessed using paired Wilcoxon-signed rank test with statistical significance set at p<0.05. Data were analysed using a statistical software package (IBM® SPSS® Statistics 26.0).ResultsMedian time from surgery to follow-up for all patients in the series was 5.3 years (IQR 3.9 – 7.0 years). Median pre-operative Kujala score improved from 57.0 (IQR 45 – 66) to 96.3 (IQR 83 -100). Median pre-operative IKDC score improved from 42.6 (IQR 35.9 – 51.3) to 92.6 (IQR 71.6 – 98.7). Median EQ-5D score also improved from 0.691 (IQR 0.414 – 0.727) to 1.000 (IQR 0.8178 – 1.000). Improvement in Kujala scores, IKDC scores and EQ-5D were all statistically significant with p<0.001 in all domains.DiscussionOur data suggests patients experience significant improvements in knee function and quality of life following trochleoplasty surgery for severe dysplasia. We demonstrate an absolute improvement in scores at a mean of 5.3 years follow-up of 39.3 points for Kujala, 50 for IKDC and 0.309 for EQ-5D. Minimal clinically important differences (MCID) have been reported to be in the region of 10 for the Kujala score, 8.8–15.6 for IKDC and 0.085 for EQ-5D. Our data shows improvements which far exceed the published MCID, suggesting trochleoplasty confers a large treatment effect and patients benefiting from sustained improvements in knee function and overall quality of life at mid-term follow-up.ConclusionFollowing trochleoplasty for severe trochlear dysplasia, patient reported outcomes demonstrate continued improvements in knee function and quality of life at mid-term (5-year) follow-up. There is a large absolute treatment effect which likely impacts on both physical and psychological wellbeing for these patients. Continued surveillance of patient reported outcomes in this clinically complex cohort is indicated.
40  W of supercontinuum generated by a self-pulsed pump-sharing oscillator-amplifier
Authors: Abbouab Clara , Malleville Marie-Alicia , Leconte Baptiste , Jamier Raphaël , Genier Etienne , Morin Philippe , Roy Philippe 
Published: December 2023

We demonstrate an all-fiber supercontinuum (SC) source delivering up to 40 W of average power ranging from 750 to 2200 nm. The laser source is based on a self-Q-switched pump-sharing oscillator-amplifier. The self-Q-switched master oscillator generates giant pulses, amplified in the high-power stage. Finally, a passive fiber acts as a nonlinear stage, improving the spectrum flatness as well as the spectral broadening. To the best of our knowledge, this is the first time that a pump-sharing oscillator-amplifier is used for SC generation and is based on the use of a submeter Ytterbium-doped fiber length inside the oscillator.
An 18-month meditation training selectively improves psychological well-being in older adults: A secondary analysis of a randomised controlled trial
Authors: Schlosser Marco , Klimecki Olga M. , Collette Fabienne , Gonneaud Julie , Kliegel Matthias , Marchant Natalie L. , Chételat Gaël , Lutz Antoine ,   for the Medit-Ageing Research Group
Published: December 2023

Objectives
As the world population is ageing, it is vital to understand how older adults can maintain and deepen their psychological well-being as they are confronted with the unique challenges of ageing in a complex world. Theoretical work has highlighted the promising role of intentional mental training such as meditation practice for enhancing human flourishing. However, meditation-based randomised controlled trials in older adults are lacking. We aimed to investigate the effects of meditation training on psychological well-being in older adults.

Methods
This study presents a secondary analysis of the Age-Well trial (ClinicalTrials.gov: NCT02977819), which randomised 137 healthy older adults (age range: 65 to 84 years) to an 18-month meditation training, an active comparator (English language training), or a passive control. Well-being was measured at baseline, mid-intervention, and 18-month post-randomisation using the Psychological Well-being Scale (PWBS), the World Health Organisation’s Quality of Life (QoL) Assessment psychological subscale, and composite scores reflecting the meditation-based well-being dimensions of awareness, connection, insight, and a global score comprising the average of these meditation-based dimensions.

Results
The 18-month meditation training was superior to English training on changes in the global score (0.54 [95% CI: 0.26, 0.82], p = 0.0002) and the subscales of awareness, connection, insight, and superior to no-intervention only on changes in the global score (0.54 [95% CI: 0.26, 0.82], p = 0.0002) and awareness. Between-group differences in psychological QoL in favour of meditation did not remain significant after adjusting for multiple comparisons. There were no between-group differences in PWBS total score. Within the meditation group, psychological QoL, awareness, insight, and the global score increased significantly from baseline to 18-month post-randomisation.

Conclusion
The longest randomised meditation training conducted to date enhanced a global composite score reflecting the meditation-based well-being dimensions of awareness, connection, and insight in older adults. Future research is needed to delineate the cognitive, affective, and behavioural factors that predict responsiveness to meditation and thus help refine the development of tailored meditation training.
Epidemiological, clinical and laboratory profile of patients presenting with severe acute respiratory syndrome (SARS-CoV-2) in Ethiopia
Authors: Gize Addisu , Kassa Melkayehu , Ali Solomon , Tadesse Yosef , Fantahun Bereket , Habtu Yitagesu , Yesuf Aman 
Published: December 2023

Introduction
Data regarding patients presenting with severe acute respiratory syndrome (SARS-CoV-2) illness have not adequately been documented which provides distinct insights into low-resource settings like Ethiopia. Thus, the study aimed to compare epidemiological, clinical and laboratory profiles of patients presenting with acute respiratory syndrome illness in Addis Ababa Ethiopia.

Methods
We used a comparative cross-sectional study design among patients with SARS-CoV-2 illness at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia from October 2020 to September 2021. Using a structured questionnaire a consecutive sampling technique was applied to collect socio-demographic data. Additionally, nasal swabs were collected to confirm SARS-CoV-2 infection using a Real-Time Polymerase Chain Reaction. Blood samples were also collected from the participants for laboratory profiles (hematological tests like; white blood cell count, hematocrit, and platelet count; and biochemical and enzymatic tests like; aspartate transaminase (AST), creatinine, etc) analysis. Data were entered and analyzed using SPSS version 23.0 and p-values ≤0.05 were considered as statistically significant.

Results
Of the total 413 participants presenting with SARS-CoV-2 illness, 250 (60.5%) participants tested positive for COVID-19 disease. COVID-19 patients were less likely to use an alcohol-based method of hand washing (12.5% vs 87.5%; p = 0.048). The COVID-19 patients had a higher proportion of headache (67.3% vs 32.7%, p = 0.001), sore throat (72.5% vs 27.5%, p = 0.001), and loss of sense of taste (74.4% vs 25.6%, p = 0.002). Patients with COVID-19 have significantly higher neutrophil than their counterparts (68.2% vs 31.8%; p = 0.001). Similarly, creatinine (64.9% vs 35.1%, p = 0.001) from renal function and alkaline phosphatase (66.8% vs 33.2%, p = 0.046) in the liver function tests were significantly higher in the COVID-19 patients.

Conclusion
Our findings suggest the need to substantially consider headache, sore throat, and loss of taste as potential clinical diagnostic symptoms for early screening and testing. Elevation of neutrophil, creatinine, alkaline phosphatase profiles are also used for potential diagnostic biomarkers in screening and testing suspected patients.
Associations of serum DNA methylation levels of chemokine signaling pathway genes with mild cognitive impairment (MCI) and Alzheimer’s disease (AD)
Authors: Zou Ting , Zhou Xiaohui , Wang Qinwen , Zhao Yongjie , Zhu Meisheng , Zhang Lei , Chen Wei , Abuliz Pari , Miao Haijun , Kabinur Keyimu , Alimu Kader 
Published: December 2023

Objective
To investigate the associations of serum DNA methylation levels of chemokine signaling pathway genes with Alzheimer’s disease (AD) and mild cognitive impairment (MCI) in elderly people in Xinjiang, China, and to screen out genes whose DNA methylation could distinguish AD and MCI.

Materials and methods
37 AD, 40 MCI and 80 controls were included in the present study. DNA methylation assay was done using quantitative methylation-specific polymerase chain reaction (qMSP). Genotyping was done using Sanger sequencing.

Results
DNA methylation levels of ADCY2, MAP2K1 and AKT1 were significantly different among AD, MCI and controls. In the comparisons of each two groups, AKT1 and MAP2K1’s methylation was both significantly different between AD and MCI (p < 0.05), whereas MAP2K1’s methylation was also significantly different between MCI and controls. Therefore, AKT1’s methylation was considered as the candidate serum marker to distinguish AD from MCI, and its association with AD was independent of APOE ε4 allele (p < 0.05). AKT1 hypermethylation was an independent risk factor for AD and MAP2K1 hypomethylation was an independent risk factor for MCI in logistic regression analysis (p < 0.05).

Conclusion
This study found that the serum of AKT1 hypermethylation is related to AD independently of APOE ε4, which was differentially expressed in the Entorhinal Cortex of the brain and was an independent risk factor for AD. It could be used as one of the candidate serum markers to distinguish AD and MCI. Serum of MAP2K1 hypomethylation is an independent risk factor for MCI.
Análisis de la dispensación de medicamentos utilizados en la farmacoterapia del insomnio desde 2015 a 2022 en el ámbito de la farmacia comunitaria
Authors: Cubero de Blas Lucía , Parra Astorgano Lola 
Published: December 2023

El insomnio es una consulta recurrente en farmacia comunitaria (FC) y nuestra hipótesis afirma que durante los últimos años se han producido cambios en el perfil de dispensación de los medicamentos y complementos alimenticios (MCA) cuya única indicación es el tratamiento del insomnio. Así, el estudio describe la dispensación de MCA desde 2015 a 2022, a partir de la actividad asistencial de tres FC de Castilla y León. Para ello, se analizaron las dispensaciones que requieren prescripción médica (MCR) y las de indicación y complementos alimenticios (MSR). Se recogieron 32 875 registros que mostraron un aumento del 52 % de la dispensación de MCA (R2 = 0,97), sin cambios en el perfil del uso de MCR, pero con el aumento en la dispensación de melatonina como complemento alimenticio, desde el 10 % de MSR en 2015 hasta el 51 % en 2022, de acuerdo con la importancia creciente de la administración exógena de esta hormona como principio activo de indicación farmacéutica. Estos resultados sugieren un cambio en el tipo de dispensación hacia la demanda de indicación en insomnio, reforzando el papel asistencial del farmacéutico comunitario para prevenir, tratar y a dar visibilidad a la mala calidad del sueño como un problema de salud pública.