bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin C as a Potential Prophylactic Measure Against Frozen Shoulder in an In Vivo Shoulder Contracture Animal Model
Authors: Feusi Oscar , Fleischmann Thea , Waschkies Conny , Pape Hans-Christoph , Werner Clément M.L. , Tiziani Simon 
Published: May 2023

Background: Frozen shoulder is a common, painful, and movement-restricting condition. Although primary frozen shoulder is idiopathic, secondary frozen shoulder can occur after trauma or surgery. Prophylactic and therapeutic options are often unsatisfactory. Vitamin C (ascorbic acid) is a potent physiological antioxidant and likely inhibits the activation of nuclear factor κB, which plays a decisive role in inflammatory reactions. Hypothesis: Because of its anti-inflammatory effects, vitamin C may be valuable in the prevention of secondary frozen shoulder. Study Design: Controlled laboratory study. Methods: An in vivo shoulder contracture model was conducted by fixation of the right proximal limb of Sprague-Dawley rats. A treatment group (n = 8) receiving vitamin C orally was compared with a control group (n = 9) without vitamin C. The primary outcome was capsular thickness at the shoulder joint measured on magnetic resonance imaging (MRI) examination. Further histological examination was performed but was not statistically analyzed because of variability of the cutting plane through the glenoid. Results: Vitamin C treatment resulted in less thickening of the axillary fold of the operated shoulder at 2 of the 3 locations measured on MRI compared with untreated controls (insertion to the glenoid, P = .074; insertion to the humerus, P = .006; middle of the axillary recess, P = .008). The observed structural changes in histological examination corroborated the significant changes obtained from the MRI measurements. Conclusion: Prophylactic vitamin C seemed to reduce the thickening of the axillary recess in secondary frozen shoulder in this preclinical study. Clinical Relevance: Vitamin C may be helpful as a noninvasive therapeutic measure to prevent secondary frozen shoulder (eg, within the context of surgery in the shoulder region or immobilization) or to treat primary frozen shoulder at an early stage. Further studies are required to evaluate the effect of this treatment in humans and the necessary dosage in humans.
Extension of Tibial Spine Fractures Beyond the Tibial Spine: An MRI Analysis of 54 Patients
Authors: Cirrincione Peter M. , Salvato Damiano , Chipman Danielle E. , Mintz Douglas N. , Fabricant Peter D. , Green Daniel W. 
Published: May 2023

Background: To the authors’ knowledge, no previous study has thoroughly described the anteroposterior dimensions of tibial spine fractures (TSFs) on 3-dimensional imaging. The extension of TSFs into weightbearing regions of the tibial plateau, posterior extension within the epiphysis, and potential association between fracture size and patient age may have implications for treatment strategies and clinical outcomes. Hypothesis: TSF fragments would commonly involve weightbearing regions of the tibial plateau, would be larger in younger patients, and would extend more posteriorly than the anatomic footprint of the tibial spine. Study Design: Case series; Level of evidence, 4. Methods: Consecutive magnetic resonance imaging studies obtained between 2012 and 2020 in patients 5 to 18 years of age at the time of imaging for TSFs were included, measured, and classified via the Green and Tuca grading system. Anteroposterior fracture dimensions were measured and normalized to anteroposterior midepiphyseal length, as was fracture height to epiphyseal height. Extension into the weightbearing surface of the tibial plateau was recorded. Intraclass correlation coefficient and kappa values were calculated. Mean fracture bed size was compared using independent-samples t tests between older and younger patients based on median age and sex. Results: Of 54 TSFs, 1 (2%), 28 (52%), and 25 (46%) were grades 1, 2, and 3, respectively. Fracture beds spanned 45% of the anteroposterior midepiphysis, and 54% of the TSF beds extended to the posterior third of the epiphysis. Younger and female patients, on average, had larger anteroposterior dimensions to TSF beds ( P = .018 and .006, respectively). The medial and lateral weightbearing surfaces of the tibial plateau were affected 57% and 25% of the time, respectively. Conclusion: This study demonstrated that TSF beds were larger in younger patients, extended to the posterior third of the epiphysis in 54% of cases, and should be examined carefully for extension into weightbearing regions of the tibial plateau. In pediatric patients, the TSF often involves more of the tibial plateau than the anatomic footprint of the tibial spine, and clinicians should be aware of the potential for extension posteriorly and into the weightbearing surfaces.
Complete Restoration of Native Glenoid Width Improves Glenohumeral Biomechanics After Simulated Latarjet
Authors: Rauck Ryan C. , Brusalis Christopher M. , Jahandar Amirhossein , Lamplot Joseph D. , Dines David M. , Warren Russell F. , Gulotta Lawrence V. , Kontaxis Andreas , Taylor Samuel A. 
Published: May 2023

Background: The amount of glenoid width that must be restored with a Latarjet procedure in order to reestablish glenohumeral stability has not been determined. Purpose/Hypothesis: The purpose of this article was to determine the percentage of glenoid width restoration necessary for glenohumeral stability after Latarjet by measuring anterior humeral head translation and force distribution on the coracoid graft. The hypothesis was that at least 100% of glenoid width restoration with Latarjet would be required to maintain glenohumeral stability. Study Design: Controlled laboratory study. Methods: Nine cadaveric shoulders were prepared and mounted on an established shoulder simulator. A lesser tuberosity osteotomy (LTO) was performed to allow accurate removal of glenoid bone. Coracoid osteotomy was performed, and the coracoid graft was sized to a depth of 10 mm. Glenoid bone was sequentially removed, and Latarjet was performed using 2 screws to reestablish 110%, 100%, 90%, and 80% of native glenoid width. The graft was passed through a subscapularis muscle split, and the LTO was repaired. A motion tracking system recorded glenohumeral translations, and force distribution was recorded using a TekScan pressure sensor secured to the glenoid face and coracoid graft. Testing conditions included native; LTO; Bankart tear; and 110%, 100%, 90%, and 80% of glenoid width restoration with Latarjet. Glenohumeral translations were recorded while applying an anteroinferior load of 44 N at 90° of humerothoracic abduction and 0° or 45° of glenohumeral external rotation. Force distribution was recorded without an anteroinferior load. Results: Anterior humeral head translation progressively increased as the proportion of glenoid width restored decreased. A marked increase in anterior humeral head translation was found with 90% versus 100% glenoid width restoration (10.8 ± 3.0 vs 4.1 ± 2.6 mm, respectively; P < .001). Greater glenoid bone loss also led to increased force on the coracoid graft relative to the native glenoid bone after Latarjet. A pronounced increase in force on the coracoid graft was seen with 90% versus 100% glenoid width restoration ( P < .001). Conclusion: Anterior humeral head translation and force distribution on the coracoid graft dramatically increased when <100% of the native glenoid width was restored with a Latarjet procedure. Clinical Relevance: If a Latarjet is unable to fully restore the native glenoid width, surgeons should consider alternative graft sources to minimize the risk of recurrent instability or coracoid overload.
Sufficient Metaphyseal Bone for Wedge Removal and Fixation Hardware During Supratuberosity Tibial Deflexion Osteotomy in Knees With Excessive Posterior Tibial Slope
Authors: Demey Guillaume , Giovannetti de Sanctis Edoardo , Mesnard Guillaume , Müller Jacobus H. , Saffarini Mo , Dejour David H. 
Published: May 2023

Background: Tibial deflexion osteotomy (TDO) is sometimes indicated for revision anterior cruciate ligament (ACL) reconstruction in knees with posterior tibial slope (PTS) ≥12° and aims to decrease PTS to around 5°. When planning TDO, measuring the anterior tibial metaphyseal height (aHt) could help ascertain whether the available metaphyseal bone would be sufficient to create the wedge and leave adequate residual bone. Purpose: To (1) determine whether, compared with knees with normal native PTS (<12°), aHt is greater in knees with excessive native PTS (≥12°), and (2) verify if, aiming to decrease PTS to 5°, supratuberosity TDO in knees with excessive native PTS could be performed without tibial tuberosity osteotomy, leaving a minimum of 15 mm of residual bone for fixation staples or plates. Study Design: Cross-sectional study; Level of evidence, 3. Methods: True lateral radiographs of 350 consecutive patients scheduled for ACL reconstruction were digitized to measure PTS, tibial medial plateau length, tibial anterior and posterior metaphyseal heights and inclinations, and patellar height. Measurements were compared between knees with PTS <12° and those with ≥12°. The wedge height required for supratuberosity TDO was estimated for knees with excessive PTS, aiming for a target PTS of 5°, to determine the proportion of knees that would have residual aHt <15 mm. Results: A total of 326 knees had adequate true lateral radiographs. The mean PTS was 9.8°± 3.1° (range, 1°-20°) and exceeded 12° in 83 (25%) knees. There were no significant differences between knees with normal versus excessive PTS when comparing aHt (30.7 ± 4.5 mm vs 31.6 ± 4.9 mm; P = .270) and medial tibial plateau length (43.1 ± 5.4 mm vs 43.3 ± 5.6 mm; P = .910). Setting the target mPTS at 5° for supratuberosity TDO, the mean residual aHt was 25.0 ± 4.4 mm, and 7 (8%) knees had a residual aHt <20 mm, of which only 1 (1%) had residual aHt <15 mm. Setting the target mPTS at 0°, the mean residual aHt was 21.3 ± 4.2 mm, and 36 (43%) knees had a residual aHt <20 mm, of which only 4 (5%) had residual aHt <15 mm. Conclusion: aHt was not significantly different between knees with normal versus excessive PTS. Estimation of the wedge height required for supratuberosity TDO to reduce excessive PTS to 5° revealed sufficient metaphyseal bone for wedge removal in all knees. Furthermore, 99% of knees would have sufficient residual bone (aHt, ≥15 mm) to accommodate fixation staples or plates, without the need for tibial tuberosity osteotomy.
Real-world treatment patterns of immunosuppressants in Adults with systemic lupus erythematosus: A claims database analysis in the United States
Authors: Birt Julie , Delbecque Laure , O’brien Daniel , Wu Jianmin , Vasey Joseph , Dean Alex , Sudaria Theresa , Vadhariya Aisha 
Published: May 2023

Objective To explore initiation, persistence, and adherence to second-line prescribed treatments for SLE, specifically regarding the immunosuppressants azathioprine, methotrexate, and mycophenolate (conventional DMARDs), and belimumab (a biologic). Methods Clinical and insurance records were obtained for 801 patients with SLE who initiated treatment with azathioprine, belimumab, methotrexate, or mycophenolate between July 2015 and June 2019. The date of initiation defined the index date, with a 6-month pre-index and 12-month post-index period. Patient characteristics (age, gender, race, sex, ethnicity, geographic region of the US, diagnosing specialty, and type of insurance) and treatment patterns were tabulated overall and by each index medication. Logistic regression was used to model predictors of persistence for the entire sample and for each treatment cohort. Findings Approximately one-third of patients initiated methotrexate (n = 282, 35.2%) or mycophenolate (n = 258, 32.2%), with the remaining receiving azathioprine (n = 173, 21.6%) or belimumab (n = 88, 11.0%). 30% of patients were persistent with their index immunosuppressant therapy over the 12-month follow-up. The most common non-persistent treatment pattern was discontinuation which occurred in 55% of patients and was highest in the mycophenolate (58%) and lowest in the azathioprine (47%) groups. In total, 17% of patients switched to a different immunosuppressant, which was highest for the belimumab (25%) group. The average time to discontinuation was over 3 months and average time to switch was about 5 months, with patients receiving azathioprine tending to have shorter and belimumab having longer times to discontinuation or switch. Predictors of persistence were limited. Patients under the care of rheumatologists versus primary care and having higher co-morbidity assessed by CCI were associated with non-persistence for the overall sample. Race, number of SLE-related medications, census region, sex, and age were not found to be significantly related to non-persistence of immunosuppressants in this study.
Protective Effects of Safflor Yellow A Against H2O2-induced Oxidative Stress Injury in PC12 Cells via Nrf2/HO-1 Pathway
Authors: Chen Hui , Gu Sichun , You Yi , Xie Anjie , Lu Yiying , Wang Changde 
Published: May 2023

Background Safflor yellow (SY) is a water-capacitive component of dried flowers, mainly from safflor in the safflower family, which contains a large amount of bruthin A, or Safflor yellow A (SYA) for short. Studies have reported the protective effects of SYA against oxidative stress injury in nerve cells. Materials and Methods In this study, H2O2-treated PC12 cells were used as experimental materials to explore how SYA plays a protective role against nerve cells after oxidative stress and to analyze the molecular mechanism of SYA. PC12 cells were treated with H2O2 and SYA solution. Cell proliferation is then detected with Cell Counting Kit-8 (CCK-8). The detection method is 5-(and 6)-chloromethyl-2′,7′-dichloro-dihydrofluorescein diacetate (CM-H2DCF-DA) staining reactive oxygen species (ROS). Levels of apoptosis-related proteins, including Bcl2-associated X protein (Bax), B-cell lymphoma (Bcl-2), caspase-3, and cleaved caspase-3, and oxidative stress regulators, namely, nuclear factor erythroid-2-related actor 2 (Nrf2) and heme oxygenase 1 (HO-1), were detected by western blotting. Results The CCK-8 assay results showed that the survival rate of H2O2-induced PC12 cells was significantly increased after SYA treatment. Fluorescence microscopy (CM-H2DCF-DA staining) indicated that SYA decreased H2O2-induced apoptosis in PC12 cells by reducing intracellular ROS. Western blotting analysis showed that SYA upregulated the expression of Nrf2, HO-1, and Bcl-2 and downregulated the expression of Bax, caspase 3, and cleaved caspase-3 in H2O2-induced PC12 cells. Conclusion SYA does protect the nerve cells from oxidative stress damage. Its mechanism of action is mainly related to whether the Nrf2/HO-1 pathway is activated.
Functional adaptability in playing style: A key determinant of competitive football performance
Authors: He Qixiang , Araújo Duarte , Davids Keith , Kee Ying Hwa , Komar John 
Published: May 2023

Purpose The present study examined the relationship between playing style adaptability and team match performance indicators throughout the season. Three playing style adaptability metrics were analysed, namely, (1) flexibility (i.e., exhibiting a wide range of playing styles), (2) reactivity (i.e., adapting playing style based on opposition) and (3) imposition (i.e., executing predetermined playing style regardless of opposition). Methods Team playing styles were derived through a clustering analysis of 21,708 matches played in the top five male European leagues from 2014/15 to 2019/20. Spearman’s correlation was utilized to assess the association between the three playing style adaptability metrics and four team match performance indicators (e.g., shots taken in opposition penalty box; shots conceded in own penalty box; goals scored; goals conceded; and total wins). Results Playing style flexibility was positively associated with both offensive and defensive match performance indicators and win frequency. Conversely, playing style reactivity and imposition were negatively associated with these team match performance indicators. Conclusions Our results suggest that the capacity to exhibit a wide range of playing styles throughout a season is associated with greater team performance. Furthermore, it is possible that high performing teams are capable of functionally switching between playing style reactivity and imposition, depending on match dynamics.
Examining the Impact of Physical Activity on Sleep Quality in Children With ADHD
Authors: Liu Hok Ling Venus , Sun Fenghua , Tse Choi Yeung Andy 
Published: May 2023

Objective: Sleep problems have been commonly observed in children with attention deficit hyperactivity disorder (ADHD). The aim of current study was to investigate the impact of physical activity on sleep quality in young adolescent with attention deficit hyperactivity disorder. Method: A total of 33 children diagnosed with attention deficit hyperactivity disorder (mean age = 10.12 years) were randomized into intervention group and control group respectively. Mention the intervention detail here. Four specific sleep parameters, including sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset, were assessed before and after the intervention period in both groups. Results: Results revealed the significant improvements in sleep efficiency, sleep onset latency and wake after sleep onset in the intervention group but not in the control group. Conclusion: Current findings highlight the benefits of PA on enhancing sleep quality among children with ADHD.
Ultrasound based tip location of femorally inserted central catheters into the inferior vena cava: A comparison between the transhepatic and the subcostal view
Authors: Annetta Maria Giuseppina , Marche Bruno , Mercurio Giovanna , Pittiruti Mauro 
Published: May 2023

Background: Intraprocedural catheter tip location is currently recommended. Intracavitary EGC and ultrasound are the preferred methods of tip location for catheters with their tip in the superior vena cava or in the right atrium. Though, the best method of intraprocedural tip location for catheters with their tip in the inferior vena cava is still uncertain. One possibility is to visualize the subdiaphragmatic inferior vena cava by ultrasound, using either the transhepatic or the subxiphoid view. Methods: In this prospective study, we compared two different ultrasound windows for the visualization of the inferior vena cava (transhepatic vs subxiphoid) for the purpose of localizing the catheter tip during the insertion of femorally inserted central catheters. Results: We studied 249 consecutive insertions of central catheters via the superficial femoral vein. Intraprocedural location of the catheter tip was performed by ultrasound, using both transhepatic and subxiphoid view. Visualization of the inferior vena cava was possible only in 81 cases (32.5%) with the subxiphoid view, but it was always possible in all 249 cases with the transhepatic view. The catheter tip was localized in 15 patients out of 81 with the subxiphoid view (18.5%); the transhepatic view allowed the visualization of the tip in all 249 patients. Conclusions: The applicability of the subxiphoid window has several limitations, both in terms of visualization of the inferior vena cava and localization of the catheter tip. The transhepatic view should be the preferred method for intraprocedural ultrasound localization of the catheter tip in the inferior vena cava.
Rationale and trial design of NATALEE: a Phase III trial of adjuvant ribociclib + endocrine therapy versus endocrine therapy alone in patients with HR+/HER2− early breast cancer
Authors: Slamon Dennis J. , Fasching Peter A. , Hurvitz Sara , Chia Stephen , Crown John , Martín Miguel , Barrios Carlos H. , Bardia Aditya , Im Seock-Ah , Yardley Denise A. , Untch Michael , Huang Chiun-Sheng , Stroyakovskiy Daniil , Xu Binghe , Moroose Rebecca L. , Loi Sherene , Visco Frances , Bee-Munteanu Valerie , Afenjar Karen , Fresco Rodrigo , Taran Tetiana , Chakravartty Arunava , Zarate Juan Pablo , Lteif Agnes , Hortobagyi Gabriel N. 
Published: May 2023

Background: Ribociclib has demonstrated a statistically significant overall survival benefit in pre- and postmenopausal patients with hormone receptor positive/human epidermal growth factor receptor 2 negative (HR+/HER2−) advanced breast cancer. New Adjuvant Trial with Ribociclib [LEE011] (NATALEE) is a trial evaluating the efficacy and safety of adjuvant ribociclib plus endocrine therapy (ET) versus ET alone in patients with HR+/HER2− early nonmetastatic breast cancer (EBC). Methods/design: NATALEE is a multicenter, randomized, open-label, Phase III trial in patients with HR+/HER2− EBC. Eligible patients include women, regardless of menopausal status, and men aged ⩾18 years. Select patients with stage IIA, stage IIB, or stage III disease (per the anatomic classification in the AJCC Cancer Staging Manual, 8th edition) with an initial diagnosis ⩽18 months prior to randomization are eligible. Patients receiving standard (neo)adjuvant ET are eligible if treatment was initiated ⩽12 months before randomization. Patients undergo 1:1 randomization to ribociclib 400 mg/day (3 weeks on/1 week off) +ET (letrozole 2.5 mg/day or anastrozole 1 mg/day [investigator’s discretion] plus goserelin [men or premenopausal women]) or ET alone. Ribociclib treatment duration is 36 months; ET treatment duration is ⩾60 months. The primary end point is invasive disease-free survival. Discussion: The 36-month treatment duration of ribociclib in NATALEE is extended compared with that in other adjuvant cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor trials and is intended to maximize efficacy due to longer duration of CDK4/6 inhibition. Compared with the 600-mg/day dose used in advanced breast cancer, the reduced ribociclib dose used in NATALEE may improve tolerability while maintaining efficacy. NATALEE includes the broadest population of patients with HR+/HER2− EBC of any Phase III trial currently evaluating adjuvant CDK4/6 inhibitor treatment. Trial registration: ClinicalTrials.gov identifier: NCT03701334 ( https://clinicaltrials.gov/ct2/show/NCT03701334 )
Assessing academic productivity of U.S. otolaryngology departments using the h(5) index
Authors: Desai Deesha , Grosse Philip J , Snyderman Carl H 
Published: May 2023

Objectives: We aim to examine the h(5) index of U.S. otolaryngology programs to help assess current academic productivity. Methods: A total of 116 otolaryngology departments with residency programs were included. Our primary outcome was the h(5) index, calculated cumulatively for faculty MDs, DOs, and PhDs within the department. Audiologists and clinical adjunct faculty were excluded. This was calculated over a 5-year period (2015–2019) using Elsevier’s database SCOPUS. Faculty affiliation within SCOPUS was confirmed by cross-referencing department websites. The h(5) indices were calculated and then correlated with other publication metrics, including total publications by department and publications in major otolaryngology journals. Results: The h(5) index was highly correlated positively with other metrics of academic productivity, including total publications and publications in top 10 otolaryngology journals. Greater variability in data was noted as the h(5) index increased. Similar trends were observed when the h(5) was compared to the number of residents accepted per year. Rankings of departments by Doximity and US News and World Report were positively correlated with h(5) though they remained weaker when compared to other correlations. Conclusions: h(5) indices are a valuable tool to objectively assess academic productivity for otolaryngology residency departments. They are a better indicator of academic productivity than national rankings.