bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Autograft Choice and Psychological Readiness to Return to Sport After ACL Reconstruction
Authors: Brinkman Joseph C. , Hassebrock Jeffrey D. , Tummala Sailesh V. , Richman Evan H. , Haglin Jack M. , Makovicka Justin L. , Poon Steven K. , Economopoulos Kostas J. 
Published: January 2025

Background: It has been demonstrated that an athlete’s psychological readiness contributes to one’s ability to successfully return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction. However, the effect of graft choice on psychological readiness is not yet understood. Purpose/Hypothesis: The purpose of this study was to evaluate the association between graft choice and an athlete’s psychological readiness to RTS. It was hypothesized that similar ACL-Return to Sport after Injury (ACL-RSI) scores would be achieved among patients who underwent ACL reconstruction with quadriceps autograft (QA), hamstring tendon autograft (HA), and bone–patellar tendon–bone (BTB) autograft. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent primary ACL reconstruction at a single institution between January 2017 and December 2018 were placed into separate cohorts depending on graft type (HA, BTB, or QA; n = 30 patients in each group), and the ACL-RSI, International Knee Documentation Committee subjective form, and Lysholm scores were compared between the different graft cohorts at 6 months postoperatively, at RTS, and at 2 years postoperatively. Also, the rate of patients who achieved an ACL-RSI score of ≥65 (predictive of return to preinjury sport at 2 years postoperatively) was calculated, as was the RTS rate and time. Results: The QA group demonstrated significantly higher ACL-RSI scores than both the HA and BTB groups at 6 months postoperatively ( P < .0001) and RTS ( P = .011). The QA group also had a higher rate of achieving ≥65 on ACL-RSI than the other groups at 6 months postoperatively ( P = .002) and RTS ( P = .024). There was no significant difference in the RTS rate between the 3 groups, although the QA group demonstrated a significantly quicker return (QA, 8.1 months; BTB, 9.6 months; HA, 10.5 months; P < .001). Conclusion: Athletes undergoing primary ACL reconstruction with QA achieved a higher mean ACL-RSI score and more often achieved a score of ≥65 at the 6-month and RTS time points compared with the HA and BTB groups. QA may afford an advantage over other grafts in terms of improved psychological readiness to RTS.
Evaluating Differences in Baseline Knee Hyperextension and Postoperative Stiffness Between Patients With Tibial Spine Fracture Versus ACL Tear
Authors: England Patrick , Yellin Joseph L. , Carter Michael V. , Guzek Ryan , Williams Brendan A. , Lawrence John T. , Ganley Theodore J. , Maguire Kathleen 
Published: January 2025

Background: While generalized ligamentous laxity is a risk factor for anterior cruciate ligament (ACL) reconstruction failure, there is a paucity of literature evaluating underlying dynamic risk factors predisposing pediatric and adolescent patients to ACL tears or tibial spine fractures. Purpose: To (1) evaluate differences in baseline knee hyperextension and postoperative knee stiffness between patients who sustained tibial spine fractures versus ACL tears and (2) determine whether there were other demographic and dynamic injury differences between these patients. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We evaluated patients aged between 9 and 17 years old who were treated at a tertiary pediatric hospital between 2012 and 2020 for a tibial spine fracture or an ACL tear. Patients in each injury group were matched based on age and physeal closure status. The demographic characteristics and pre- and postoperative clinical variables were recorded, and bivariate analysis and binomial logistic regression were performed to compare the proportion of patients with knee hyperextension— denoted as uninjured knee hyperextension >3°—between injury types and evaluate additional risk factors for injury, respectively. Results: Overall, 405 patients were included, 81 with tibial spine fractures and 324 with ACL tears. Patients with ACL tears were more likely to have increased knee hyperextension compared with those with tibial spine fractures (36% [115/324] vs 24% [19/81]; P = .047). This was also observed when controlling for age and physeal closure status. In patients aged ≤14 years with open physes, 39% with ACL tears had hyperextension versus 18% with tibial spine fractures ( P = .003). No difference was observed in the proportion of patients who developed postoperative stiffness (2.5% for ACL tears vs 6% for tibial spine fractures; P = .091). Patients with ACL tears were more likely to have sustained a noncontact mechanism of injury compared with patients with tibial spine fractures (62% [202/324] vs 39% [32/81]; P = .0002). Conclusion: Patients with ACL tears were more likely to have increased knee hyperextension and to have sustained a noncontact injury compared with those with tibial spine fractures. Postoperative knee stiffness after tibial spine fixation may be related to this baseline reduced knee extension rather than the injury itself.
Relationship Between Quadriceps Strength at 6 Months Postoperatively and Improvement in Patient-Reported Knee Function After Anterior Cruciate Ligament Reconstruction
Authors: Ishida Tomoya , Suzuki Makoto , Matsumoto Hisashi , Samukawa Mina , Kaneko Satoru , Inoue Chiharu , Aoki Yoshimitsu , Tohyama Harukazu 
Published: January 2025

Background: Understanding the factors associated with poor recovery over time after anterior cruciate ligament reconstruction (ACLR) helps clinicians identify patients who are at risk and targets for an intervention. Purpose: To determine the factors associated with improvement in subjective knee function from 6 to 12 months after ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 91 patients undergoing primary unilateral ACLR were included. Subjective knee function was assessed using the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) at 6 and 12 months postoperatively. Isokinetic knee strength (quadriceps and hamstring) and Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI) scale scores were also assessed. Patients were included in the poor recovery group if their improvement in the IKDC-SKF score from 6 to 12 months was <15.5 points (minimal detectable change) and their IKDC-SKF score at 12 months was <90 points (maximum, 100 points). The IKDC-SKF score, knee strength, and the ACL-RSI score were compared between the poor recovery and good recovery groups with and without propensity score matching. Matched variables included age, sex, and IKDC-SKF score at 6 months after ACLR. In addition, logistic regression analysis was performed to identify factors that discriminated between the poor recovery and good recovery groups. Results: There were 32 participants (35%) allocated to the poor recovery group. Before propensity score matching, the poor recovery group had a significantly older age, lower IKDC-SKF scores at 6 and 12 months, and a lower limb symmetry index (LSI) for quadriceps strength at 6 months. After propensity score matching, the LSI for quadriceps strength at 6 months was significantly different between the poor recovery and good recovery groups (73.0 ± 17.4 vs 83.3 ± 18.2, respectively; P = .039). Logistic regression analysis showed that a lower LSI for quadriceps strength at 6 months was significantly associated with poor recovery of the IKDC-SKF score (odds ratio, 0.96 [95% CI, 0.93-0.98]), and receiver operating characteristic curve analysis identified 80.9% as a cutoff value of the LSI for quadriceps strength with 75.0% sensitivity and 61.0% specificity. Conclusion: A lower LSI for quadriceps strength at 6 months postoperatively was associated with poor recovery of the IKDC-SKF score from 6 to 12 months after ACLR, even after adjusting for confounders.
Evaluation of Thigh Muscle Strength in Adolescent Patients After Anterior Cruciate Ligament Reconstruction With Lateral Extra-articular Tenodesis or Anterolateral Ligament Reconstruction
Authors: Weaver Adam P. , Harkey Matthew S. , Pacicca Donna M. , Crepeau Allison E. , Brown Matthew J. , Werner Brian C. , Diduch David R. , Kuenze Christopher 
Published: January 2025

Background: There has been increased interest in lateral extra-articular procedures, such as anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET), to reduce anterolateral rotation instability of the knee after anterior cruciate ligament reconstruction (ACLR). Despite promising surgical outcomes with these techniques, their impact on knee strength recovery is unknown. Hypothesis: Patients undergoing lateral extra-articular procedures at the time of ACLR would have impaired thigh muscle strength at 6 to 9 months after surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Adolescent patients who had undergone primary unilateral ACLR with lateral extra-articular augmentation between 2017 and 2023 were identified. Patients were included if they were aged between 12 and 20 years at the time of surgery and had completed an isokinetic strength assessment at 6 to 9 months after surgery. A total of 104 participants (mean age, 16.5 ± 1.7 years; 63 female) were included in this analysis: 25 who underwent ACLR+ALLR, 17 who underwent ACLR+LET, and 62 who underwent isolated ACLR. Isokinetic knee extension and flexion strength normalized to body weight, as well as the bilateral limb symmetry index (LSI), were assessed. One-way analysis of variance and analysis of covariance were used to compare differences between surgical techniques. Results: After adjusting for age, graft type, and time since surgery, the ACLR+LET (1.36 ± 0.52 N·m/kg) and ACLR+ALLR (1.61 ± 0.53 N·m/kg) groups had significantly less involved limb knee extension strength ( P = .025), uninvolved limb knee extension strength ( P = .046), and LSI for knee extension strength ( P = .040) compared to the isolated ACLR group. There were no differences between the 3 groups regarding involved limb knee flexion strength ( P = .222) or uninvolved limb knee flexion strength ( P = .984), but the isolated ACLR group displayed a greater LSI for knee flexion strength (96.6% ± 17.8%; P = .012). Conclusion: The addition of lateral extra-articular procedures at the time of ACLR was associated with decreased quadriceps strength at 6 to 9 months after ACLR. While lateral extra-articular procedures may enhance knee rotary stability after ACLR, prolonged rehabilitation may be needed to re-establish adequate quadriceps strength before return to sports.
Integration of social work into specialist palliative home service
Authors: Wartchow Janice Lee , Bär Stefan , Alt-Epping Bernd , Gerlach Christina 
Published: January 2025

Background: The specialist palliative home service (SAPV) federal framework contract for adults, to be enacted in Germany until 2028, does not legally mandate the hiring of a third professional group beyond specialist nurses and physicians, although palliative care embraces the psychosocial dimension and an interprofessional approach. Objectives: This article aims to explore the role of medical staff in integrating social work (SW) into SAPV. Design: Qualitative case study. Methods: The study utilised theoretical and qualitative quota sampling to explore barriers to integrating SW into SAPV-teams, ensuring diverse perspectives. Sequential analysis was applied to uncover collective interpretations, generating and validating interpretive hypotheses directly from the data. Results: Four physicians and four nurses from the SAPV-team based at Heidelberg University Hospital participated. The medical staff’s attributions to SW significantly impact its integration into SAPV. Their perception of the SW profession determines the extent and manner of its integration into daily practices. Attributions on SW in SAPV as determined by nurses and physicians were social-medical knowledge, counselling, being a core competence in SAPV and similarities to the profession of psychologists. In the examined case, the integration was effective, and there was a desire for an increased presence of SW because there is still a lack of their working hours, and the medical staff wished for the social workers’ presence during home visits. Conclusion: This study highlights that SAPV requires SW to be effective, nonetheless, not being considered in the new federal contract to allocate resources. Possible barriers against the integration of SW within the real-world clinical practice of palliative care should be further investigated in future studies by involving social workers’ and healthcare managers’ experiences and strategies to understand why the employment of social workers in SAPV is progressing slowly and inform strategies to enhance their integration.
Important factors in municipality-based pediatric palliation from healthcare professionals’ perspective: A qualitative study
Authors: Skjærseth Kristin , Preminger Natalie , Hauken May Aasebø 
Published: January 2025

Background: Municipality-based pediatric palliative care (PPC) is recommended to promote the quality of life for the child and family by enabling them to stay at home as much as possible. However, municipality-based PPC presents complex challenges and places significant demands on healthcare professionals. Yet, it remains an underexplored field. Objectives: Semi-structured and individual interviews with 16 healthcare professionals with experiences from PPC were conducted and transcribed. Data was analyzed using systematic text condensation. Results: To increase the knowledge base and understanding of important factors for municipality-based PPC from healthcare professionals’ perspective. Design: A qualitative method with an interpretive descriptive design was applied. Methods: The bridging theme “Establishing a sense of security and predictability for the family and healthcare professionals” emerged from the analysis. This was elaborated by three main themes: (1) “A comprehensive approach to the family,” (2) “Establishing and maintaining a dedicated, multidisciplinary pediatric palliative team in the municipality,” and (3) “Collaboration and communication between involved services.” Each main theme was further elaborated by subthemes. Conclusion: The importance of establishing security and predictability in municipality-based PPC was emphasized. To achieve this, holistic support for the entire family and ensuring sufficient competence in the municipality seem crucial. Establishing municipality PPC teams is proposed, and the need for early referral, routines for collaboration, and a designated coordinator appear to be key systemic factors. Registration and reporting guidelines: The study is registered in the institutional system for research project (RETTE ID: R2082), and the study is reported according to the COREQ checklist for qualitative studies.
Assessing and comparing compassionate communities benefits across cities in diverse cultural contexts: a step toward the identification of the most important ones
Authors: González-Jaramillo Valentina , Krikorian Alicia , Tripodoro Vilma , Jorge Margarita , Orellana Sebastián , López Francy , Vélez Maria Clara , Noguera Tatiana , Montilla Silvina , Felber Sibylle , Zambrano Sofía C. , Eychmüller Steffen 
Published: January 2025

Background: As Compassionate Communities (CCs) are developing worldwide, there is a growing need to systematically assess if they are having the expected effects on the community. Although having a single strategy would be ideal in terms of standardization and comparison, due to the inherent heterogeneity of CCs, it is not known how feasible this would be. Objectives: To assess the feasibility of creating a general strategy, based on the results of a series of focus groups conducted across three diverse CCs, to guide the evaluation of already existing programs and the development of new ones. Design: Focus groups in three cities, including different types of stakeholders, were conducted to identify potential outcomes (benefits) from CCs, as the base of a general strategy to assess CCs. Methods: We coded the discussions and built a list of the outcomes mentioned. Then, we merged those similar enough into a more general one that encompassed the others. We extracted from reviews all the CCs outcomes that have been measured. We merged the outcomes from the focus groups and the reviews and built a single list. Results: We obtained a final list of 46 outcomes; 44 were reported from the focus groups, and two more were added from the reviews. Of the 44 from the focus groups, 22 (50%) were present in the three CCs, 14(32%) were present in two CCs, and the remaining 8 (18%) were present only in one compassionate community. There were outcomes commonly reported both in the three CCs and in the literature reviews related to training the general community in compassion and end-of-life topics, facilitating the development of community networks, and generating public spaces for social integration. Conclusion: Half of the identified outcomes were reported in the three CCs. This indicates the feasibility of creating a single strategy but also reflects the need to leave room to include other aspects specific to each community according to its context in the assessment.
Demographic and clinical characteristics of older people with multimorbidity accessing primary healthcare in Malawi: A cross-sectional study
Authors: Kwaitana Duncan , Jafali James , Bates Maya Jane , van Breevoort Dorothee , Mildestvedt Thomas , Meland Eivind , Umar Eric 
Published: January 2025

Background Multimorbidity is a growing global concern, affecting patient outcomes and healthcare costs. In low- and middle-income countries, data on multimorbidity in primary care beyond prevalence is limited. Our study explored the demographic and clinical characteristics of multimorbidity among older people attending primary health care in Malawi. Methods We conducted a cross-sectional analysis on medical records from 15,009 older patients aged ≥50 years across three hospitals in Malawi (one tertiary, two district). Data from 2019-2021 was analyzed using R statistical software to examine patterns of multimorbidity (two or more chronic conditions). Outcome estimates were adjusted for sex, age, location, and year of clinic visit. Results The overall prevalence of multimorbidity, defined across 17 recorded chronic conditions, was 19.6%. Among the 2,941 cases of multimorbidity, 2,708 (92.0%) involved two chronic conditions, while 233 (8.0%) involved three. While most conditions increased steadily in prevalence with age, diabetes followed a different pattern, with higher prevalence among individuals aged 50–59 years (53.9%) and 60–69 years (52.4%) compared to those 70 years and older (40.3%). After adjusting for clinic visit year, gender, and study location, individuals aged 70 years and older were significantly less likely to have multimorbidity compared to those aged 50–59 years (AOR = 0.57, 95% CI: 0.52–0.62, p < 0.001). Conclusion The study revealed a wide range of multimorbidity combinations among older people attending primary health care. Strategies to address multimorbidity in older people should include efforts to identify other, less common clusters of chronic conditions.
Sodium butyrate regulates macrophage polarization by TGR5/β-arrestin2 in vitro
Authors: Liu Miao , Xie Wen-jie , Zhang Xu , Wu Wei , Li Guang , Wang Lu 
Published: January 2025

Abstract

Background
Macrophages play an important role in the pathogenesis of ulcerative colitis (UC). We will explore the effects of sodium butyrate (SB) on macrophage function.

Methods
The targets of butyric acid were identified using SwissTargetPrediction database and surface plasmon resonance (SPR). Limited proteolysis mass spectrometry (Lip-MS) was used to further investigate the binding sites of butyric acid with its targets and molecular docking was employed to simulate their binding modes. Macrophage polarization model was established with lipopolysaccharide (LPS) in vitro. Takeda G protein-coupled receptor 5 (TGR5) and β-arrestin2 expression and macrophage polarization markers were detected with or without SB.

Results
TGR5 was identified as the target of butyric acid. Moreover, the amino acid regions 275–286 and 321–330 of TGR5 (GPBAR1 [275–286] and GPBAR1 [321–330]) were the potential binding regions for butyric acid. Based on molecular docking analysis, butyric acid formed effective hydrogen-bonding interactions with ASP-284 and TYR-287 of TGR5. In cell experiments, LPS inhibited the expression of TGR5, β-arrestin2, IL-10, ARG1, and CD206 and increased the expression of IL-1β, iNOS, and CD86, while SB reversed the effect of LPS. SBI-115, a TGR5 antagonist, and knockdown of β-arrestin2 inhibited the effect of sodium butyrate. INT-777, a TGR5 agonist, reversed the inhibitory effect of knockdown of β-arrestin2.

Conclusion
SB inhibited M1-like polarization and promoted M2-like polarization induced by LPS via TGR5/β-arrestin2 in RAW264.7 cells and TGR5 was the target of SB.
Defective Slc7a7 transport reduces erythropoietin compromising erythropoiesis
Authors: Giroud-Gerbetant Judith , Sotillo Fernando , Hernández Gonzalo , Ruano Irene , Sebastián David , Fort Joana , Sánchez Mayka , Weiss Günter , Prats Neus , Zorzano Antonio , Palacín Manuel , Bodoy Susanna 
Published: January 2025

Abstract

Background
Lysinuric protein intolerance is a rare autosomal disorder caused by mutations in the Slc7a7 gene that lead to impaired transport of neutral and basic amino acids. The gold standard treatment for lysinuric protein intolerance involves a low-protein diet and citrulline supplementation. While this approach partially improves cationic amino acid plasma levels and alleviates some symptoms, long-term treatment is suggested to be detrimental and may lead to life-threatening complications characterized by a wide range of hematological and immunological abnormalities. The specific cause of these hematopoietic defects—whether intrinsic to hematopoietic cells or driven by external factors—remains unclear. Given the limitations of current citrulline-based treatments and the unknown role of SLC7A7 in red blood cell production, there is an urgent need to investigate the pathways affected by SLC7A7 deficiency.

Methods
We employed total inducible and cell type-specific Slc7a7 knockout mouse models to determine whether the hematological abnormalities observed in LPI are due to the loss of Slc7a7 function in hematopoietic cells. We analyzed erythropoiesis in these mice and performed bone marrow transplantation experiments to assess the role of Slc7a7 in erythroblasts and myeloid cells. The statistical significance of differences between groups was evaluated via standard statistical tests, including Student’s t test and ANOVA.

Results
Whole-body Slc7a7 knockout mice presented impaired erythropoiesis. However, this defect was not replicated in mice with Slc7a7 deficiency restricted to erythroblasts or myeloid cells, suggesting that the observed hematopoietic abnormalities are not due to intrinsic Slc7a7 loss in these cell types. Additionally, bone marrow transplants from control mice did not rescue the hematopoietic defects in Slc7a7-deficient mice, nor did the transplantation of Slc7a7-deficient cells induce defects in control recipients. Further investigation indicated that defective erythropoiesis is linked to impaired erythropoietin production in the kidney and subsequent iron overload.

Conclusions
The hematopoietic defects in the Lysinuric protein intolerance mouse model are not caused by intrinsic Slc7a7 loss in hematopoietic cells but rather by impaired erythropoietin production in the kidney. This finding opens potential avenues for therapeutic strategies targeting erythropoietin production to address hematological abnormalities in humans with lysinuric protein intolerance.