bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Publicly Obtained Data in Sports Medicine Research: A Systematic Review and Bibliometric Analysis
Authors: Inclan Paul M. , Kuhn Andrew W. , Troyer Stockton C. , Solomon Gary S. , Matava Matthew J. 
Published: June 2023

Background: Publicly obtained data (POD) have recently been utilized frequently by sports medicine researchers to describe injury patterns, risk factors, and outcomes in elite athletes. The relative ease of this type of research that is based solely on internet and media sources has resulted in a near exponential increase in the number of these POD studies. Purpose: To systematically review the sports medicine literature for studies based solely on POD. Study Design: Systematic review and bibliometric analysis; Level of evidence, 4. Methods: A systematic review of POD studies published since 2000 was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies of interest were those relying on publicly available injury reports or online media for data acquisition in collegiate, semiprofessional, and professional athletes. Results: There were 209 POD studies published between 2000 and 2022, with 173 (82.8%) of these studies published after 2016. Studies were published most frequently on athletes participating in North American professional leagues: National Football League (n = 69 [28.4%]), Major League Baseball (n = 56 [23.0%]), National Basketball Association (n = 37 [15.2%]), and National Hockey League (n = 33 [13.6%]). The most common injuries assessed were head injuries/concussions (n = 43 [21.1%]), anterior cruciate ligament injuries (n = 33 [16.2%]), and ulnar collateral ligament injuries (n = 23 [11.3%]). One-quarter of the studies (n = 53 [25.4%]) reported only 1 POD source, and 1 study (0.5%) reported no source. Additionally, 65 studies (31.1%) listed nonspecific POD resources or solely cited previous literature to describe the POD search methodology and data acquisition. Conclusion: POD studies are exponentially increasing in number, particularly across major North American professional sports leagues, with significant variability in the injury of interest, search methodology, and number of data sources. The accuracy of the conclusions reached based on the POD methodology appears highly variable. Given the potential impact of these publications as both contributors to current knowledge and drivers of future research, the sports medicine community should be aware of the inherent biases and limitations of POD injury studies.
Effect of Lower Extremity Torsion on Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer for Recurrent Patellofemoral Instability
Authors: Qiao Yi , Ye Zipeng , Zhang Xiuyuan , Xu Xiaoyu , Xu Caiqi , Li Yuehua , Zhao Song , Zhao Jinzhong 
Published: June 2023

Background: Increased femoral torsion (FT) or tibial torsion (TT) has been suggested to be a potential risk factor for recurrent patellofemoral instability. However, the influence of increased FT or TT on the postoperative clinical outcomes of recurrent patellofemoral instability has rarely been investigated. Purpose: To assess the effect of increased FT or TT on postoperative results in patients with recurrent patellofemoral instability after combined medial patellofemoral ligament reconstruction (MPFLR) and tibial tubercle transfer, along with the influence of other risk factors. Study Design: Cohort study; Level of evidence, 3. Methods: Out of 91 patients, the study’s analyses included 86 patients with recurrent patellofemoral instability who were treated with MPFLR and tibial tubercle transfer and enrolled between April 2020 and January 2021. FT and TT were assessed using preoperative computed tomography images. According to the torsion value of FT or TT, patients were categorized into 3 groups for each of FT and TT: group A (<20°), group B (20°-30°), and group C (>30°). Patellar height, femoral trochlear dysplasia, and the tibial tuberosity–trochlear groove (TT-TG) distance were also assessed. Patient-reported outcome scores (Tegner, Kujala, International Knee Documentation Committee [IKDC], Lysholm, and Knee injury and Osteoarthritis Outcome Score [KOOS]) were evaluated pre- and postoperatively. Clinical failure of MPFLR was recorded. Subgroup analysis was conducted to evaluate the effect of increased FT or TT on the postoperative outcomes. Results: A total of 86 patients were enrolled with a median follow-up time of 25 months. At the final follow-up, all functional scores improved significantly. Patella alta, high-grade trochlear dysplasia, and increased TT-TG distance did not have any significant effect on the postoperative functional scores. Regarding FT, subgroup analysis indicated that all functional scores of group C were lower than those of groups A and B except the KOOS knee-related Quality of Life score. For TT, group C had lower scores than group A for all functional outcomes except Tegner and KOOS Quality of Life and lower scores than group B for Kujala, IKDC, KOOS (Symptoms and Sport and Recreation subscales), Tegner, and Lysholm scores. The comparison between group A and group B, whether for FT or TT, revealed no significant differences. Conclusion: For patients with recurrent patellofemoral instability, increased lower extremity torsion (FT or TT >30°) was associated with inferior postoperative clinical outcomes after combined MPFLR and tibial tubercle transfer.
Tibial Slope on Conventional Lateral Radiographs in Anterior Cruciate Ligament–Injured and Intact Knees: Mean Value and Outliers
Authors: Weiler Andreas , Berndt Rosa , Wagner Michael , Scheffler Sven , Schatka Imke , Gwinner Clemens 
Published: June 2023

Background: An increased tibial slope (TS) has been identified as a risk factor for anterior cruciate ligament (ACL) injury and graft failure after ACL reconstruction. However, different imaging modalities are used to determine the TS, resulting in divergent values. Consequently, no reference values and no consensus on thresholds can be reached, which in turn is mandatory for indicating correction osteotomies when facing outlier TS. Purpose: To determine the mean values of the TS and the incidence of their outliers in large cohorts of patients with ACL-injured and noninjured knees and to determine the feasibility of measuring TS on conventional lateral radiographs (CLRs). Study Design: Cross-sectional study; Level of evidence 3. Methods: TS of ACL-injured knees (n = 1000, group A) and ACL-intact knees (n = 1000, group B) was measured by 3 experienced examiners. Medial TS was measured on CLRs using the technique of Dejour and Bonnin. Patients with radiographs with poor image quality, osteoarthritis, previous osteotomies, or nondigital radiographs were excluded. The intra- and interrater reliability was calculated using the intraclass correlation coefficient. Results: The mean TS was significantly higher in group A than in group B (10.04°± 3° [range, 2°-22°] vs 9.02°± 2.9° [range, 1°-18°], respectively; P < .001). Significantly more participants in group A had TS larger than 12° (≥12°, 32.2% vs 19.8%, P < .001; ≥13°, 20.9% vs 11.1%, P < .001; ≥14°, 13.5% vs 5.7%, P < .001; ≥15°, 8% vs 2.7%, P < .001; ≥16°, 3.7% vs 1.4%, P = .0005), respectively. In contrast, significantly more participatns in group B had TS 8° or less (≤8°, 32.1% vs 42.7%, P < .001; ≤7°, 20% vs 30.9%, P < .001; ≤6°, 12.4% vs 19.8%, P < .001; ≤5°, 6.6% vs 12%, P = .0003; ≤4°, 2.8% vs 5.3%, P = .0045). The intraclass correlation coefficient revealed a good to excellent reliability throughout measurements. Conclusion: Median values for the TS were 9° for uninjured and 10° for ACL-injured knees on CLRs. Notwithstanding its statistical significance, this finding might be negligible in clinical practice. However, a significantly larger number of outliers were found in the ACL-injured group exceeding a TS of 12° and demonstrating an incremental proportion with increasing TS, serving as a potential threshold for correction osteotomy. Furthermore, CLRs in the largest cohort to date exhibited high reproducibility, proving the feasibility of CLRs as a routine measurement for TS.
Reversal Effect of Saikosaponin A and Saikosaponin B on Doxorubicin-resistant Breast Cancer Cells and its Mechanism
Authors: Wang Dan , Ji Duochun , Wu Danni , Wang Like , Yu Chunyan , Li Chun , Gai Xiaodong 
Published: June 2023

Background One of the key factors limiting the effectiveness of chemotherapy treatment for malignancies is multidrug resistance (MDR). The MDR phenotype is related to P-glycoprotein (P-gp) expression and function. The main triterpenoid saponins generated from Bupleurum chinense DC (BCDC), saikosaponin A (SSa), has been found to have anti-tumor potential. Saikosaponin B (SSb) has the potential for utility in combination with anticancer drugs as the secondary saikosaponins. Objective In this study, we looked into the impact of SSa and SSb on doxorubicin (Dox)-resistant breast cancer cells and its underlying mechanisms. Materials and Methods Dox-resistant breast cancer cells (MCF-7ADR) and MCF-7 cells were used in the study. The experimental cells were divided into a different concentration SSa administration group, a different concentration SSb administration group, and a control group, and the related biochemical parameters of MCF-7 and MCF-7ADR cells were detected. Results We discovered that SSa and SSb both suppressed MCF-7 and MCF-7ADR cell proliferation in a dose-dependent manner. Additionally, SSa at 2.5 and 5.0 µg/mL and SSb at 3.0 and 7.0 µg/mL could significantly enhance the cytotoxicity of Dox and reverse MDR in MCF-7ADR cells. The combination of Dox and SSa or SSb induced obvious synergistic effects. SSa and SSb could increase the sensitivity of MCF-7ADR cells to Dox by decreasing P-gp expression, increasing intracellular accumulation, and delaying the drug efflux of rhodamine 123 (Rh123, a P-gp substrate). Additionally, SSa and SSb both induced G1-phase arrest in MCF-7ADR cells in the presence of Dox. Conclusion According to the study, SSa and SSb may be novel MDR reversal medicines for breast cancer chemotherapy and have significant therapeutic significance for MDR during tumor therapy.
Impulsivity and Aggression Among Male Delinquent Adolescents Residing in Observation Homes—A Descriptive Correlation Study from East India
Authors: Srinivasan P. , Rentala Sreevani , Kumar Pragya 
Published: June 2023

Background: Aggression and crime are connected and highly reported among juveniles in recent times as compared to adults, which ends up in delinquency. It is not just aggression that dominates but the associated impulsiveness also plays a vital role. This study was intended to assess impulsivity and aggression, and their relationship among male delinquent adolescents residing in observation homes. Methods: A quantitative research approach with the nonexperimental descriptive correlation design was adopted. One hundred and seventy-nine male delinquent adolescents residing in 2 observation homes in the state of Bihar, India, were selected by convenience sampling technique. The standardized Buss & Perry Aggression questionnaire, and Barratt Impulsiveness scale were used for collecting the data regarding impulsivity and aggression among male delinquent adolescents. Results: The data were analyzed with descriptive statistics for a description of sample characteristics, and research variables, inferential statistics such as Pearson correlation for correlation, t-test, and ANOVA for the association, and stepwise regression for predictors. Aggression and impulsivity were significantly correlated, there was a significant association of impulsivity with educational status and history of substance use, and the mother’s occupation, educational status, and substance use had predicted the impulsivity. Conclusion: The study concluded that impulsivity and aggression are measurable constructs among male delinquent adolescents, and both were found to be positively correlated. This study had provided initial evidence by filling the gap in the literature to understand the relationship between impulsivity and aggression among juvenile delinquents.
Proximal radiolucent lines around fully hydroxyapatite-coated tapered femoral stems: should we be concerned?
Authors: Berliner Zachary P , Jawad Muhammad Umar , Matzko Chelsea , Cooper H John , Rodriguez Jose A , Hepinstall Matthew S 
Published: June 2023

Introduction: Radiolucent lines occasionally develop around the proximal aspect of fully hydroxyapatite (HA)-coated tapered femoral stems after total hip arthroplasty (THA). It was hypothesised that distal wedging of stems may predispose to proximal radiolucent line formation, which may negatively impact clinical outcome. Methods: All primary THA performed with a collarless fully HA-coated stem that had a minimum of 1 year of radiographic follow-up were identified in a surgical database ( n = 244). Radiographic measures of proximal femoral morphology and femoral canal fill at the middle and distal thirds of the stem were analysed for association with the presence of proximal radiolucent lines. Linear regression was used to explore any association between radiolucent lines and patient reported outcome measures (PROMs), available in 61% of patients. Results: Proximal radiolucent lines developed in 31 cases (12.7%) at final follow-up. Dorr A femoral morphology and increased canal-fill at the distal ⅓ of the stem correlated with the development of radiolucent lines ( p < 0.001). No correlation was observed between pain or PROMs and the presence of proximal radiolucent lines. Discussion: We observed an unexpectedly high incidence of proximal femoral radiolucent lines about collarless fully HA coated stems. Distal-only implant wedging in Dorr A bone may compromise proximal fixation. Although this finding did not correlate with short-term outcomes, the long-term clinical impact requires further study.
Outcomes of the Ankura Stent Graft for Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm
Authors: Tigkiropoulos Konstantinos , Abatzis-Papadopoulos Manolis , Papoutsis Ioakeim , Sidiropoulou Katerina , Stavridis Kyriakos , Karamanos Dimitrios , Lazaridis Ioannis , Saratzis MD Nikolaos 
Published: June 2023

Objective: The purpose of this retrospective cohort study is to report outcomes of endovascular aortic repair (EVAR) with the novel endograft, Ankura (Lifetech Scientific, Shenzen, China). Methods: We identified all patients who underwent elective EVAR with Ankura stent graft in a tertiary unit from January 2015 to November 2021. Patients with ruptured infrarenal and juxtarenal aortic aneurysms were excluded from the study. All patients were anatomically suitable according to the instructions for use (IFU). Follow-up (FU) included computed tomography angiography (CTA) at 1 month, 12 months, and yearly thereafter if endoleak (EL) was not present. Primary outcomes included technical success (primary and secondary) and 30-day overall mortality and morbidity. Secondary outcomes included late overall and aneurysm-related mortality as well as influence of suprarenal fixation of the endograft on renal function at 12 months using eGFR (CKI-EPI formula). Results: The Ankura endograft was successfully implanted in 116 patients (mean age=71.1 years, 96.5% male). Mean aneurysm diameter was 62.3 mm. Median FU was 34 months (2-72 months). Primary and secondary technical success were 95.7% and 100%, respectively. Overall type I EL was 5% (2 proximal, 3 distal) and type II EL was 13%. Thirty days mortality and morbidity were 0% and 5.2%, respectively. All-cause mortality during FU was 13.9% (n=16); aneurysm-related mortality was 2.6% (n=3). Limb endograft patency was 100%. Freedom from reintervention was 98.2% at 2 years, and 97.4% at 4 and 6 years respectively. There was a statistically significant difference between preoperative (73.69 mL/min/1.73 m2) and postoperative (66.66 mL/min/1.73 m2) eGFR at 12 months (p<0.001). Conclusion: Ankura endograft has demonstrated an efficacious durability with low aneurysm-related mortality and high iliac limb patency rate. Elective EVAR is associated with significant decline in renal function at 12 months in our study. Larger series studies are necessary to evaluate long-term safety and efficacy of Ankura endograft. Clinical Impact Ankura stent graft is a novel PTFE endograft with suprarenal fixation for infrarenal aneurysm repair. This retrospective cohort study of 116 patients provide a first “picture” of Ankura safety and efficacy in a European tertiary vascular center. High technical success rate, low aneurysm related mortality and high limb patency rate are the main findings of the study with a negative impact of suprarenal fixation on kidney function during follow up.
Investigation of Combined Carotid Endarterectomy and Coronary Artery Bypass Graft Surgery Outcomes and Adverse Event Risk Factors in the Vascular Quality Initiative
Authors: Penton Ashley , Lin Jonathan , Kolde Grant , DeJong Matthew , Blecha Matthew 
Published: June 2023

Objective The purpose of this study was to investigate outcomes of simultaneous CEA and CABG utilizing the Vascular Quality Initiative (VQI). Additionally, we seek to investigate risks for both perioperative and long-term mortality and adverse neurological outcomes. Methods All carotid endarterectomies in the VQI between January 2003 and May 2022 were queried. We identified 171,816 CEA in the database. We extracted 2 cohorts from these CEA. The first group was patients who underwent simultaneous carotid endarterectomy (CEA) and coronary artery bypass (CABG) (N = 3137). The second group encompassed patients who underwent CABG or percutaneous coronary artery angioplasty/stent within 5 years of ultimately undergoing CEA (N = 27,387). We investigated the following outcomes in a multivariable fashion: 1. Risks for mortality in long term follow-up for both cohorts combined; 2. Risks for ischemic event in the cerebral hemisphere ipsilateral to the CEA site after index hospital admission in follow up for both cohorts combined. Tertiary outcomes are also investigated in the manuscript. Results On multivariable analysis, patients undergoing simultaneous combined CEA and CABG had equivalent long-term survival to patients who underwent coronary revascularization within 5 years of ultimately undergoing CEA. Five-year survival is noted to be 84.5% vs 86% with a Cox regression non-significant P-value (.203). Significant multivariable risks for reduced long term survival (P < .03 for all) included: advancing age (HR 2.48/year); smoking history (HR 1.26); Diabetes (HR 1.33); history of CHF (HR 1.66); history of COPD (HR 1.54); baseline renal insufficiency at the time of surgery (HR 1.30); anemia (HR1.64); lack of preoperative aspirin (HR 1.12); and lack of preoperative statin (HR 1.32); lack of patch placement at CEA site (HR 1.16); perioperative MI (HR 2.04); perioperative CHF (1.66); perioperative dysrhythmia (HR 1.36); cerebral reperfusion injury (HR 2.23); perioperative ischemic neurological event (HR 2.48); and lack of statin at discharge (HR 2.04). Amongst patients with documented neurological status in follow up, combined CEA and CABG had over 99% freedom from ischemic cerebral event ipsilateral to the CEA site after discharge. Conclusions Combined CEA and CABG provides excellent long-term mortality prevention in patients with co-existing severe coronary and carotid atherosclerosis. Simultaneous CEA and CABG provides equivalent stroke prevention and long-term survival to both a cohort of patients undergoing coronary revascularization within 5 years of CEA and patients undergoing isolated CEA or CABG in the literature. The two most impactful modifiable risk factors towards long-term stroke and mortality prevention for patients undergoing simultaneous CEA-CABG are patch placement at CEA site and adherence to statin medication therapy.
Target users’ acceptance of a pharmacist-led prescribing service for pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV)
Authors: MacDonald Calum B. , Murphy Andrea L. , Isenor Jennifer E. , Ramsey Tasha D. , Furlotte Kirk , Smith Alesha J. , Bishop Andrea , Kelly Deborah V. , Woodill Lisa , Booker Connor , Wilby Kyle John 
Published: June 2023

Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) is a highly effective way to reduce virus transmission. There have been increasing calls to improve access to PrEP in Canada. One way to improve access is by having more prescribers available. The objective of this study was to determine target users’ acceptance of a PrEP-prescribing service by pharmacists in Nova Scotia. Methods: A triangulation, mixed-methods study was conducted consisting of an online survey and qualitative interviews underpinned by the Theoretical Framework of Acceptability (TFA) constructs (affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness and self-efficacy). Participants were those eligible for PrEP in Nova Scotia (men who have sex with men or transgender women, persons who inject drugs and HIV-negative individuals in serodiscordant relationships). Descriptive statistics and ordinal logistic regression were used to analyze survey data. Interview data were deductively coded according to each TFA construct and then inductively coded to determine themes within each construct. Results: A total of 148 responses were captured by the survey, and 15 participants were interviewed. Participants supported pharmacists’ prescribing PrEP across all TFA constructs from both survey and interview data. Identified concerns related to pharmacists’ abilities to order and view lab results, pharmacists’ knowledge and skills for sexual health and the potential for experiencing stigma within pharmacy settings. Conclusion: A pharmacist-led PrEP-prescribing service is acceptable to eligible populations in Nova Scotia. The feasibility of PrEP prescribing by pharmacists should be pursued as an intervention to increase access to PrEP.
Mechanical thrombectomy with intra-arterial thrombolysis versus mechanical thrombectomy alone in patients with acute ischemic stroke: A systematic review and meta-analysis
Authors: Qureshi Adnan I , Lodhi Abdullah , Akhtar Iqra N , Ma Xiaoyu , Kherani Danish , Kwok Chun Shing , Ford Daniel E , Hanley Daniel F , Hassan Ameer E , Nguyen Thanh N , Spiotta Alejandro M , Zaidi Syed F 
Published: June 2023

Background: There is conflicting evidence as to whether intra-arterial thrombolysis (IAT) adds benefit in patients with acute stroke who undergo mechanical thrombectomy (MT). Methods: We conducted a systematic review to identify studies that evaluate IAT in patients with acute stroke who undergo MT. Data were extracted from relevant studies found through a search of PubMed, Scopus, and Web of Science until February 2023. Statistical pooling with random effects meta-analysis was undertaken to evaluate odds of functional independence, mortality, and near-complete or complete angiographic recanalization with IAT compared to no IAT. Results: A total of 18 studies were included (3 matched, 14 unmatched, and 1 randomized). The odds ratio (OR) for functional independence (modified Rankin Scale: 0–2) at 90 days was 1.14 (95% confidence interval (CI): 0.95–1.37, p = 0.17, 16 studies involving 7572 patients) with IAT with moderate between-study heterogeneity (I2 = 38.1%). The OR for functional independence with IAT was 1.28 (95% CI: 0.92–1.78, p = 0.15) in studies that were either matched or randomized and 1.24 (95% CI: 0.97–1.58, p = 0.08) in studies with the highest quality score. IAT was associated with higher odds of near-complete or complete angiographic recanalization (OR: 1.65, 95% CI: 1.03–2.65, p = 0.04) in studies that were either matched or of randomized comparisons. Conclusion: Although the odds of functional independence appeared to be higher with IAT and MT compared with MT alone, none of the results were statistically significant. A prominent effect of the design and quality of the studies was observed on the association between IAT and functional independence at 90 days.