bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wrist Guards/Supports in Gymnastics: Are They Helping or Hurting You?
Authors: Hart Elspeth , Whited Amy , Bae Donald S. , Bauer Andrea S. , Sugimoto Dai 
Published: October 2023

Background: The prevalence of wrist pain among gymnasts ranges from 46% to 79%. To alleviate wrist pain, gymnasts wear wrist guards/supports (WG/S). Purpose: To investigate the effect of WG/S on the wrist joint through joint moment, angles, total joint range of motion (ROM) arc, and ground-reaction force (GRF). Study Design: Controlled laboratory study. Methods: A cross-sectional study design was used to investigate 23 female gymnasts (mean ± SD: age, 12.3 ± 1.5 years; height, 143.4 ± 7.6 cm; mass, 37.7 ± 6.6 kg; body mass index, 18.6 ± 2.9) who performed back handsprings (analyzed by first half [phase 1] and second half [phase 2]) with the following 3 conditions: no WG/S, Skids/Ultimate Wrist Supports (S/UWS), and Tiger Paws (TP). Wrist joint moments, angles, total ROM arc, and GRF were examined by the 3 conditions using analysis of variance with Bonferroni correction and effect size (Cohen d). Results: For mean wrist flexion moment, both S/UWS and TP showed significantly higher values than the no-WG/S condition in landing phase 1 (S/UWS: P = .001, d = 1.30; TP: P = .019, d = 0.87). In angle comparisons in landing phase 1, no WG/S showed greater mean wrist extension angles compared with S/UWS ( P = .046; d = 0.80), but no significant differences with TP ( P = .096; d = 0.65). Also, in landing phase 1, total ROM arc of the right wrist was greater in the no-WG/S condition compared with S/UWS ( P = .018; d = 0.88), but there were no differences with TP ( P = .400; d = 0.52). Conclusion: These data show an increased wrist flexion moment using S/UWS and TP compared with the no-WG/S condition in landing phase 1 of back handsprings. Also, increased wrist extension angles and total arc ROM of the right wrist were found in the no-WG/S condition compared with S/UWS, but not with TP in landing phase 1. S/UWS may be helpful to reduce wrist joint angles, specifically wrist extension in landing phase 1, but both S/UWS and TP caused higher wrist flexion joint moment in landing phase 1. There were no differences found in GFG among the three variables. Clinical Relevance: In the first half of the back handspring, wrist guards can limit wrist extension joint angles and total arc ROM; however, an increased wrist flexion moment was found when wrist guards were worn, which may potentially lead to an increased risk of injury. Injury history, especially overuse signs/symptoms, and previous surgery on the wrist joint need to be well considered before the application or use of wrist guards. Also, the amount of time/exposure wearing wrist guards should be carefully controlled in young female gymnasts.
Utility of a Clinical Prediction Tool for Persisting Postconcussive Symptoms in a Multicenter Sample of Youth Athletes With Concussion: The Sport Concussion Outcomes in Pediatrics (SCOPE) Study
Authors: Miller Shane M. , Valovich McLeod Tamara C. , Zaslow Tracy L. , Wilson Julie C. , Master Christina L. , Snedden Traci R. , Halstead Mark E. , Grady Matthew F. , Fazekas Matthew L. , Santana Jonathan A. , Coel Rachel A. , Howell David R. 
Published: October 2023

Background: A validated clinical risk tool has been developed to identify pediatric and adolescent patients at risk of developing persisting symptoms after concussion, but has not been prospectively investigated within a sample of athletes seen after concussion by primary care sports medicine physicians and/or athletic trainers. Purpose: To determine whether a validated clinical risk prediction tool for persistent postconcussive symptoms (PPCSs) predicted which patients would develop PPCSs when obtained within 14 days of concussion among a multicenter sample of adolescent athletes. Study Design: Cohort study; Level of evidence, 2. Methods: Pediatric and adolescent patients (8-18 years of age) from 7 pediatric medical centers and 6 secondary school athletic training facilities who were diagnosed with a concussion and presented ≤14 days after concussion were enrolled as part of the Sport Concussion Outcomes in Pediatrics (SCOPE) study during their initial visit and were followed until symptom resolution. Clinical risk scores (Predicting and Preventing Post-concussive Problems in Pediatrics [5P]) and total symptom severity were obtained using the Post-Concussion Symptom Inventory at the initial visit (mean, 4.9 ± 2.9 days after concussion). Participants were then compared based on symptom resolution time: PPCS group (≥28 days to symptom resolution) and no-PPCS group (<28 days). The authors assessed the odds of developing PPCSs based on the 5P risk score using a binary logistic regression model and the utility of the clinical risk prediction tool to identify total time to symptom resolution using a Cox proportional hazards model. Results: A total of 184 participants enrolled, underwent initial evaluation, and were followed until symptom resolution (mean age, 15.2 ± 2.1 years; 35% female). The mean time to symptom resolution across the entire sample was 17.6 ± 3.7 days; 16% (n = 30) of participants developed PPCS. Those in the PPCS group had significantly greater mean initial total 5P risk scores than those in the no-PPCS group (7.9 ± 1.7 vs 5.9 ± 2.3, respectively; P < .001). After adjustment for initial symptom severity, time to assessment, and assessment setting, a higher initial total 5P risk score was associated with a significantly greater odds of developing PPCSs (adjusted odds ratio, 1.49; 95% CI, 1.07-2.08; P = .019). Furthermore, a higher 5P risk score was significantly associated with longer total symptom resolution time (hazard ratio, 0.80; 95% CI, 0.74-0.88; P < .001). Conclusion: In a multicenter sample of youth athletes seen in different outpatient health care settings, the 5P risk score accurately predicted which athletes may be at risk for developing PPCSs.
Influence of immigrant background on the outcome of total hip arthroplasty: better outcome in 280 native patients in Bosnia and Herzegovina than in 449 immigrants living in Sweden
Authors: Krupic Ferid , Manojlovic Slavko , Custovic Svemir , Fazlic Mirsad , Sadic Sahmir , Kärrholm Johan 
Published: October 2023

Background: Despite the overall success of THA, between 5 and 20% report unsatisfactory results. Several factors may cause this variable outcome. 1 of them might be ethnicity which, because of its potential social impact on living conditions, may influence quality of life too. It should be studied whether patients born and being operated in their home country Bosnia and Herzegovina (BH) had similar results as immigrants being operated in Sweden (IS). Methods: Data of 280 patients were collected prospectively from questionnaires in the BH group. Patients of the IS group were eligible if both of their parents were born outside the Nordic countries, not having Swedish as their native language. Data were gained from the Swedish Arthroplasty Registry (SAR), 449 patients were included. Outcomes were pain VAS, satisfaction VAS, EQ-VAS, and the EQ-5D. Logistic and linear regression models including age, sex, diagnosis, type of fixation, surgical incision, marital status and educational level were analysed to compare those 2 groups. Results: There were considerable differences in patient demographics between the 2 groups. Before the operation, patients in the BH group reported more problems with self-care and usual activities, even after adjustment for confounding factors ( p  < 0.0005). Patients in the IS group reported a higher EQ-VAS and more pain VAS ( p  < 0.0005), the difference in the EQ-VAS was not significant after adjustment for confounding factors ( p = 0.41). After 1 year patients in the BH group reported better scores in all dimensions of the EQ-5D ( p ⩽ 0.005) apart from self-care. After adjustment for confounding factors, patients in the BH group were more satisfied too ( p  < 0.0005). Conclusions: Immigrated patients (IS group) seemed to experience less benefit from THA 1 year after the operation despite more symptoms preoperatively. There were considerable limitations affecting the results. Nevertheless, the data are a point of concern, and it is suggested to take more multidimensional care of immigrant patients.
Effect of operative time in outcomes following surgical fixation of hip fractures: a multivariable regression analysis of 35,710 patients
Authors: Ibaseta Alvaro , Emara Ahmed , Rullán Pedro J , Santana Daniel C , Ng Mitchell K , Grits Daniel , Krebs Viktor E , Molloy Robert M , Piuzzi Nicolas S 
Published: October 2023

Background: Prolonged operative time is a risk factor for increased morbidity and mortality after open reduction and internal fixation (ORIF) of hip fractures. However, the quantitative nature of such association, including graduated risk levels, has yet to be described. This study outlines the graduated associations between operative time and (1) healthcare utilisation, and (2) 30-day complications after ORIF of hip fractures. Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried (January 2016–December 2019) for all patients who underwent ORIF of hip fractures ( n = 35,710). Demographics, operative time, fracture type, and comorbidities were recorded. Outcomes included healthcare utilisation (e.g., prolonged length of stay [LOS>2 days], discharge disposition, 30-day readmission, and reoperation), inability to weight-bear (ITWB) on postoperative day-1 (POD-1), and any 30-day complication. Adjusted multivariate regression models evaluated associations between operative time and measured outcomes. Results: Operative time <40 minutes was associated with lower odds of prolonged LOS (odds ratio [OR] 0.77), non-home discharge (OR 0.85), 30-day readmission (OR 0.85), and reoperation (OR 0.72). Operative time ⩾80 minutes was associated with higher odds of ITWB on POD-1 (OR 1.17). Operative time ⩾200 minutes was associated with higher odds of deep infection (OR 7.5) and wound complications (OR 3.2). The odds of blood transfusions were higher in cases ⩾60 minutes (OR1.3) and 5-fold in cases ⩾200 minutes (OR 5.4). The odds of venous thromboembolic complications were highest in the ⩾200-minute operative time category (OR 2.5). Operative time was not associated with mechanical ventilation, pneumonia, delirium, sepsis, urinary tract infection, or 30-day mortality. Discussion: Increasing operative time is associated with a progressive increase in the odds of adverse outcomes following hip fracture ORIF. While a direct cause-effect relationship cannot be established, an operative time of <60 minutes could be protective. Perioperative interventions that shorten operative time without compromising fracture reduction or fixation should be considered.
Intelligent proportional-integral-derivate controller using metaheuristic approach via crow search algorithm for vibration suppression of flexible plate structure
Authors: Syafiqah Shaari Aida Nur , Hadi Muhamad Sukri , Abdul Wahab Abdul Malek , Ab Talib Mat Hussin , Yatim Hanim Mohd , Mat Darus Intan Zaurah , Tokhi M Osman 
Published: October 2023

Proportional-integral-derivate (PID) controller has gained popularity since the advancement of smart devices especially in suppressing the vibration on flexible structures using different approaches. Such structures required accurate and reliable responses to prevent system failures. Swarm intelligence algorithm (SIA) is one of the optimization methods based on nature that managed to solve real-world problems. Crow search is a well-known algorithm from the SIA group that can discover optimum solutions in both local and global searches by utilizing fewer tuning parameters compared to other methods. Hence, this study aimed to simulate a PID controller tuned by SIA via crow search for vibration cancellation of horizontal flexible plate structures. Prior to that, an accurate model structure is developed as a prerequisite for PID controller development. After the best model is achieved, the proportional-integral-derivative-crow-search (PID-CS) performance was compared to a traditional tuning approach known as the Ziegler Nichols (ZN) to validate its robustness. The result revealed the PID-CS outperformed the proportional-integral-derivative-Ziegler Nichols (PID-ZN) with attenuation values of 44.75 and 42.74 dB in the first mode of vibration for single sinusoidal and real disturbances, respectively. In addition, the value of mean squared error (MSE) for PID-ZN and PID-CS for single sinusoidal disturbance are 0.0167 and 0.0081, respectively. Meanwhile, PID-ZN and PID-CS achieved 2.3981 × 10−4 and 2.3737 × 10−4 when they were exerted with real disturbance. This proves that the PID-CS is more accurate compared to the PID-ZN as it achieved the lowest MSE value.
Peri-procedural decrease in hemoglobin following mechanical thrombectomy for ischemic stroke
Authors: Chen Huanwen , Ahmad Ghasan , Phipps Michael S. , Colasurdo Marco , Miller Timothy R. , Cherian Jacob , Wozniak Marcella A. , Tran Quincy K. , Gandhi Dheeraj , Chaturvedi Seemant , Jindal Gaurav 
Published: October 2023

Background Peri-procedural blood loss and hemodilution occur in patients undergoing mechanical thrombectomy (MT) for ischemic stroke; however, its relationships with thrombectomy passes, procedure times, and clinical outcomes are unknown. Methods Consecutive patients undergoing MT for anterior circulation large-vessel occlusion ischemic strokes were identified at a Comprehensive Stroke Center. Clinical information, modified treatment in cerebral ischemia (mTICI) scores, and modified Rankin Scores (mRS) at 90 days were prospectively collected from 2012 to 2021. Hemoglobin measurements before and after MTs were collected retrospectively via chart review, and changes were quantified. Patients with new-onset severe anemia (defined as post-MT hemoglobin less than 10g/dL) were identified. Modified Rankin scale (mRS) at 90 days was used to measure clinical outcomes. Results Four-hundred and forty-five patients were identified. Hemoglobin decreased 1.27 ± 1.05 g/dL after MT on average. Greater number of thrombectomy passes and longer procedure times were associated with larger decreases in hemoglobin ( p < 0.001 and p = 0.002, respectively). 11.5% (51 of 445) of patients had new-onset severe anemia, and this incidence was significantly higher with more thrombectomy passes (6.4% for one pass, 11.9% for two passes, and 17.4% for three or more passes; p = 0.010). In multivariable analyses, new-onset severe anemia was associated with significantly higher odds of 90-day poor outcomes (mRS 3-6, OR 2.70 [95%CI 1.12–6.51], p = 0.027) and death (OR 2.73 [95%CI 1.06–7.04], p = 0.037) compared to mild post-MT anemia. Conclusions More thrombectomy passes and longer procedure times were significantly associated with larger peri-procedural decreases in hemoglobin. Patients with new-onset hemoglobin less than 10 g/dL are at risk of poor outcomes.
Lekgotla Discussion as a Decolonized Qualitative Methodology: A Lesson From a Workshop Conducted to Formulate and Verify the Strategies in Botlokwa Village, Limpopo, South Africa
Authors: Rasweswe Melitah Molatelo 
Published: October 2023

Introduction This study used Lekgotla discussion with Batlokwa women to formulate and verify the strategies to empower the women with traditional and cultural dysmenorrhea or pain period knowledge. The Lekgotla discussion is an open forum in which indigenous communities in Sub-Saharan Africa use to debate and reach agreements on community raised issues. It has the potential to identify issues that affect community day-to-day lives and reach consensus to effect changes. Purpose To present Lekgotla discussion workshop as a decolonized qualitative research methodology. Methods The study was qualitative, using a Lekgotla discussion process among women with a variety of experience in both Indigenous and Western dysmenorrhea knowledge. Participants were purposively selected to participate in a Lekgotla discussion. The snowballing was also used, whereby the recruited participants were asked to assist in identifying and referring potential participants to the researcher, who contacted them for potential inclusion in the study. The process was repeated until a required sample was reached. A facilitator was selected by the participants to facilitate the discussion and summarizes the inputs once all the participants have raised their ideas and there was no newer information was shared. The debates and dialogues were analysed by the researcher and experts using content data analysis. Results The Lekgotla discussion followed a workshop process and was divided into four steps: 1) Arrival and Welcome, 2) Engaging participants, 3) Reaching consensus on the strategies to empower Batlokwa women with dysmenorrhea knowledge, 4) Verification and refinement of the strategies to empower Batlokwa women with dysmenorrhea knowledge. Conclusion The success of applying the process of Lekgotla discussion proved that the indigenous epistemologies are increasingly accepted to achieve research objectives.
Race and Area of Deprivation Index Predict Outcomes of Endoscopic Sinus Surgery for Chronic Sinusitis
Authors: Hentati Firas , Kim Jaehee , Hoying David , D’Anza Brian , Rodriguez Kenneth 
Published: October 2023

Objective The purpose of this study is to characterize the presentation, outcomes, and barriers to care for White and non-White patients undergoing endoscopic sinus surgery (ESS). Background ESS is often successful in providing long-term relief for patients suffering from chronic rhinosinusitis (CRS). Literature that uses robust measures of socioeconomic status (SES) and barriers to care to assess ESS outcomes is limited. Methods A retrospective matched cohort study of patients who underwent ESS for CRS between 1/1/2015 and 6/1/2021 at a single tertiary care academic center was conducted. White and non-White patients were matched 1-to-1 by sex and age (± 5 years). SES was evaluated using the area of deprivation index (ADI). Results Of the 298 patients included in the study, 149 are White and 149 are non-White, 111 (37.2%) have CRS with nasal polyposis (CRSwNP), 141 (47.3%) had allergic rhinitis, 90 (30.2%) had asthma and 22 (7.4%) required revision ESS. Non-White patients were 3.62 times more likely to present with CRSwNP (95% confidence interval [CI] 2.2-5.96) and had 2.87 times increased odds for requiring revision ESS than age and sex-matched White patients (95% CI 1.090-7.545). The median ADI for non-White (6.00) patients was higher than for White patients (3.00) ( P < .001) and 21.5% more non-White patients presented with Medicaid ( P < .001). Conclusion Non-White patients undergoing ESS for CRS are more likely to present from areas with fewer resources and be underinsured. Using robust measures of SES, such as ADI, may allow for care to be tailored to patients with barriers to care.
Bayesian multilevel multivariate logistic regression for superiority decision-making under observable treatment heterogeneity
Authors: Kavelaars Xynthia , Mulder Joris , Kaptein Maurits 
Published: October 2023

AbstractBackgroundIn medical, social, and behavioral research we often encounter datasets with a multilevel structure and multiple correlated dependent variables. These data are frequently collected from a study population that distinguishes several subpopulations with different (i.e., heterogeneous) effects of an intervention. Despite the frequent occurrence of such data, methods to analyze them are less common and researchers often resort to either ignoring the multilevel and/or heterogeneous structure, analyzing only a single dependent variable, or a combination of these. These analysis strategies are suboptimal: Ignoring multilevel structures inflates Type I error rates, while neglecting the multivariate or heterogeneous structure masks detailed insights.MethodsTo analyze such data comprehensively, the current paper presents a novel Bayesian multilevel multivariate logistic regression model. The clustered structure of multilevel data is taken into account, such that posterior inferences can be made with accurate error rates. Further, the model shares information between different subpopulations in the estimation of average and conditional average multivariate treatment effects. To facilitate interpretation, multivariate logistic regression parameters are transformed to posterior success probabilities and differences between them.ResultsA numerical evaluation compared our framework to less comprehensive alternatives and highlighted the need to model the multilevel structure: Treatment comparisons based on the multilevel model had targeted Type I error rates, while single-level alternatives resulted in inflated Type I errors. Further, the multilevel model was more powerful than a single-level model when the number of clusters was higher. A re-analysis of the Third International Stroke Trial data illustrated how incorporating a multilevel structure, assessing treatment heterogeneity, and combining dependent variables contributed to an in-depth understanding of treatment effects. Further, we demonstrated how Bayes factors can aid in the selection of a suitable model.ConclusionThe method is useful in prediction of treatment effects and decision-making within subpopulations from multiple clusters, while taking advantage of the size of the entire study sample and while properly incorporating the uncertainty in a principled probabilistic manner using the full posterior distribution.
Molecular analyses of ADAMTS-1, -4, -5, and IL-17 a cytokine relationship in patients with ulcerative colitis
Authors: Buran Tahir , Batır Muhammet Burak , Çam Fethi Sırrı , Kasap Elmas , Çöllü Fatih , Çelebi Hamide Betül Gerik , Şahin Mustafa 
Published: October 2023

Abstract
Background
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that develops due to the impaired immune response in genetically susceptible individuals, and its etiopathogenesis is not fully elucidated. IL-17 A is a cytokine that is produced by a type of immune cell called Th17 cells and is involved in the immune response and inflammation. On the other hand, ADAMTS-1, -4, and − 5 are enzymes that are involved in the breakdown of extracellular matrix proteins, including proteoglycans, which are important components of the intestinal wall. This study aimed to evaluate the relationship between interleukin 17 (IL-17 A) cytokine, which plays a role in the pathogenesis of ulcerative colitis, and the inflammation-controlled a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-1, -4, and − 5 protein members.

Methods
Bowel tissue samples and blood serum from 51 patients with UC and 51 healthy controls were included in this study. mRNA expression levels of the ADAMTS-1, -4, -5, and IL-17 A were analyzed by RT-qPCR, and immunohistochemical analyses were performed to evaluate ADAMTS-1, -4, -5, and IL-17 A proteins in tissue samples. In addition, ELISA analysis determined serum levels of the ADAMTS-1, -4, -5, and IL-17 A.

Results
RT-qPCR results reveal that the expression of ADAMTS-1, -4, -5, and IL-17 A genes in the UC tissue samples were significantly high according to the control tissue samples. Also, ADAMTS-1, -4, -5, and IL-17 A proteins revealed enhanced expression pattern UC groups according to the control. Also, ADAMTS-1, -4, -5, and IL-17 A protein showed cytoplasmic localization patterns in both control and UC groups. The serum levels of ADAMTS-1,-5, and IL-17 A were significantly higher in UC samples than in the control group.

Conclusions
We observed a positive correlation between the ADAMTS-1, -5 and IL17A cytokine expression in UC samples. These results provide a new understanding of controlling crucial ADAMTS family protein members by IL-17 A cytokines with UC.