bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated Tibial Tubercle Fracture With and Without Combined Patellar Tendon Avulsion: Early Outcomes, Complications, and Reoperations
Authors: Schultz Rebecca J. , Amaral Jason Z. , Parham Matthew J. , Lee Tiffany M. , Kitziger Raymond L.﻿ , McKay Scott D. , Touban Basel M. 
Published: January 2025

Background:
Tibial tubercle fractures (TTF) are uncommon injuries, comprising <3% of proximal tibial fractures. Rarely, they occur in conjunction with patellar tendon avulsion (PTA). We aimed to compare reoperation rates and short-term postoperative outcomes in patients with TTF versus combined injuries.

Methods:
A retrospective review of patients presenting to a single tertiary pediatric hospital with a TTF who underwent open treatment and fixation of tibial tuberosity fractures was performed. Demographics, operative details, injury patterns, complications, and postoperative milestones were analyzed. Operative reports were reviewed to identify concomitant PTA. Outcomes analyzed included reoperation rates, weeks to full weight-bearing (FWB), full range of motion (FROM), and return to sport (RTS). Patients with <4 months of clinical follow-up were excluded from the analysis.

Results:
We identified 117 fractures in 111 patients (mean age: 13.75 ± 1.27, 5% female). One-hundred and one fractures were isolated TTF and 16 were combined TTF with PTA. There was no significant difference in secondary surgery (P=0.13) or complication rates (P=0.20). The duration in the hinged knee brace was significantly higher in the combined injury group (12.95 wk) than in the isolated injury group (9.77 wk) (P=0.0024). There was no significant difference in time to FWB (P=0.25), FROM (P=0.86) or time to RTS (P=0.40).

Conclusion:
No current postoperative guidelines exist for combined TTF and PTA. Our data suggest that combined injury can be largely managed similarly to isolated TTF. However, combined injuries may require a longer bracing period.

Level of Evidence:
Level II prognostic study.
Double Povidone-Iodine 5% Preparation Before Cataract Surgery for Endophthalmitis Prevention
Authors: Odden Jamie L. , Winters Jacob , Zlotcavitch Leonid , Mammen Alex , Romanowski Eric G. , Shanks Robert M. Q. , Dhaliwal Deepinder K. 
Published: January 2025

Objective:
To compare endophthalmitis rates after cataract extraction in patients with different preoperative prophylaxis: double povidone-iodine preparation with topical antibiotics versus a control group.

Methods:
All cases of postoperative endophthalmitis over the last 17 years were reviewed. Incidence rates of endophthalmitis for all cataract surgeries (current procedural terminology codes 66982 and 66984) performed by 26 surgeons were calculated. Cataract surgery combined with glaucoma and corneal procedures were excluded (1,347 surgeries). Incidence rates were compared for the study group (i.e., use of double povidone-iodine preparation) versus the control group. In the study group, two standard interventions were implemented: preoperative instillation of fluoroquinolone drops every 15 min for 1 hr and preoperative irrigation of conjunctival fornices and eyelashes with 10 cc of 5% povidone-iodine. In both the study and control group, povidone-iodine preparation was performed in the operating room, and postoperative fluoroquinolone drops were used.

Results:
From January 2005 to May 2022, no cases of endophthalmitis were identified out of 7,611 cataract extractions performed by three surgeons who used the double povidone-iodine preparation. Seven new cases of endophthalmitis were identified in the control group during the same time (7 out of 9,876=0.07%). Two of these cases had combined cataract surgery with endoscopic cyclophotocoagulation, and five cases had cataract surgery alone. Individual surgeon rates of endophthalmitis ranged from 0% to 0.29%.

Conclusion:
A double povidone-iodine preparation may provide more robust prophylaxis against postcataract extraction endophthalmitis than a single preparation.
Nd:YAG Laser Iridotomy Versus Surgical Iridectomy in Descemet Membrane Endothelial Keratoplasty: Comparison of Postoperative Outcome and Incidence of Ocular Hypertension
Authors: Steindor Friedrich , Hayawi Mohammed , Borrelli Maria , Strzalkowska Alicja , Menzel-Severing Johannes , Geerling Gerd 
Published: January 2025

Purpose:
To evaluate outcome and incidence of ocular hypertension after Descemet membrane endothelial keratoplasty (DMEK) and DMEK combined with cataract surgery (triple DMEK) after Nd:YAG laser iridotomy (IO) and surgical iridectomy (IE).

Methods:
This is a single-center, retrospective cohort study of patients who underwent DMEK or triple DMEK surgery at the Department of Ophthalmology, University Hospital Düsseldorf, Germany, from January 2018 to June 2020 and had received either a prophylactic preoperative IO or an intraoperative IE. Patient demographic data; best corrected visual acuity; central corneal thickness; intraocular pressure (IOP); endothelial cell density; and complications such as occurrence of early postoperative IOP elevation, macular edema, rebubbling rate, and incidence of glaucoma were analyzed.

Results:
A total of 75 patients were included in each study arm with a follow-up of 22.04 ± 12.8 months. Best corrected visual acuity significantly increased postoperatively in both cohorts without significant differences. Early postoperative IOP elevation due to pupillary block was significantly more common in eyes with IO (33.3%, n = 25) than with IE (2.67%, n = 2, P < 0.001). The incidence of de novo glaucoma was 5.34% in both cohorts without significant differences in prevalence at the last follow-up (YAG IO cohort: 17.3%, IE cohort: 14.7%, P > 0.05). Rebubbling was required in 16% (n = 12) of eyes in each cohort (P > 0.999).

Conclusions:
Postoperative pupillary block after DMEK occurs significantly more often after preoperative Nd:YAG laser iridotomy compared with surgical intraoperative iridectomy but does not negatively affect long-term visual outcome or glaucoma incidence after DMEK.
Is There a Difference Between Seropositive and Seronegative Sjögren Disease Dry Eye?
Authors: Mohamed-Noriega Karim , Riega-Torres Janett , Ramírez-Paura Aldo Noé , Martínez-Delgado José Francisco , Álvarez-González Oscar Eduardo , Velasco-Sepúlveda Braulio H. , Morales-Wong Fernando , Garza-Elizondo Mario Alberto , Galarza-Delgado Dionicio Ángel , Mohamed-Hamsho Jesús 
Published: January 2025

Purpose:
The study aims to compare dry eye disease (DED) prevalence and severity between seropositive and seronegative Sjögren disease (SjD).

Methods:
Prospective, consecutive, comparative cross-sectional cohort study. A total of 160 eyes of 80 patients with SjD by The American College of Rheumatology and the European League Against Rheumatism 2016 criteria were included: 55 seropositive and 25 seronegative SjD. Associated SjD was excluded. Patients had dry eye tests performed. Generalized estimating equations were used to account for intereye correlation of the same participant.

Results:
Mean age was 52.2 ± 12.7, 96.3% were women, no differences were observed between groups (P > 0.05). Seronegative SjD had positive minor salivary gland biopsy more often (100% vs. 82%, P = 0.024), but with lower focus score (2.0 ± 1.2 vs. 4.1 ± 3.5, P = 0.006) than seropositive SjD group. DED prevalence was similar in seropositive and seronegative SjD (92.7% and 84%; P = 0.088). Only noninvasive break-up time (NIBUT) average was significantly reduced in seropositive SjD (6.6 ± 3.2 vs. 8.8 ± 2.4, P = 0.011), and the rest of the evaluated DED tests were not significant. In the seropositive group, nonstatistically significant trends toward more severe DED signs, including matrix metalloproteinase-9, osmolarity, Schirmer I without anesthesia, fluorescein tear break-up time, NIBUT first, and Sicca Ocular Staining Score, were observed. Both groups were highly symptomatic in ocular surface disease index score (43 ± 23 vs. 46 ± 30, P = 0.779) and had a reduction in quality of life in National Eye Institute visual health questionnaire-25 test (72 ± 21 vs. 70 ± 24, P = 0.650).

Conclusions:
Patients with seropositive SjD showed significantly reduced NIBUT and a trend of more severe DED signs. Patients with seronegative and seropositive SjD were similarly highly symptomatic, experienced important reductions in vision-related quality of life, and had similar DED prevalence.
Autoantibodies cause nociceptive sensitization in a mouse model of degenerative osteoarthritis
Authors: Guo Tian-zhi , Shi Xiaoyou , Li Xuanying , Li Wen-Wu , Wei Tzuping , Sahbaie Peyman , McAllister Tiffany N. , Angst Martin S. , Clark J. David , Kingery Wade S. 
Published: January 2025

Abstract
Previous preclinical and translational studies suggest that tissue trauma related to bony fracture and intervertebral disk disruption initiates the formation of pronociceptive antibodies that support chronic musculoskeletal pain conditions. This study tested this hypothesis in the monosodium iodoacetate (MIA) mouse model of osteoarthritis (OA) and extended the findings using OA patient samples. Monosodium iodoacetate was injected unilaterally into the knees of male and female wild-type (WT) and muMT mice (lacking B cells) to induce articular cartilage damage. Repeated nociceptive behavioral testing was performed, and serum was collected for antibody isolation and passive transfer experiments. Serum antibodies collected from patients with OA were tested in MIA-treated muMT mice. Biochemical analyses were performed on knee joint tissues. Monosodium iodoacetate–treated WT mice developed chronic ipsilateral hindlimb allodynia, hyperalgesia, and unweighting, but these pain behaviors were absent in MIA-treated muMT mice, indicating that cartilage injury–induced pain is B-cell dependent. IgM accumulation was observed in the knee tissues of MIA-treated mice, and intra-articular injection of IgM from MIA-treated mice into MIA-treated muMT mice caused nociceptive sensitization. Similarly, intra-articular injection of IgM from patients with OA was pronociceptive in muMT MIA mice and control subject IgM had no effect. Monosodium iodoacetate–injected joints demonstrate elevated levels of complement component 5a (C5a) and C5a receptor blockade using intra-articular PMX-53–reduced sensitization. These data suggest that MIA-treated mice and patients with OA generate pronociceptive antibodies, and further support the pronociceptive autoimmunity hypothesis for the transition from tissue injury to chronic musculoskeletal pain.
Comparison of the Effect of the White Noise and Sound Reduction on Behavioral Responses of Premature Infants Under Noninvasive Ventilation
Authors: Mohseni Hasti , Ramezani Monir , Saki Azadeh , Poor-Alizadeh Nasim 
Published: January 2025

Background:
With the increasing survival rates of premature infants and their associated respiratory problems, noninvasive ventilation has gained popularity in neonatal intensive care units. On the other hand, this equipment can be stressful for infants. Objective: This study aimed to compare the effects of white noise and sound reduction on the behavioral responses of premature infants under noninvasive ventilation. Methods: This study was a randomized controlled crossover trial. Forty-two infants who met the inclusion criteria received white noise and noise reduction in a randomized sequence with a 30-minute washout period between conditions. During the noise reduction condition, infants were placed in the fetal position with earplugs. During the white noise condition, nature sounds from the White Noise Baby Sleep app were played into the incubator. Infant behavioral responses were recorded using the Anderson Behavioral State Scale on 3 consecutive days before, during, and after the intervention. Results: The independent t test showed no statistically significant difference between the 2 groups at baseline. The repeated measures analysis of variance test showed that the mean behavioral response scores of preterm infants in the sound reduction group and the white noise group differed significantly across the 3 stages on all 3 days. However, the results of mixed-effects model indicated that the sound reduction group experienced a significant decrease in behavioral response compared to the white noise group. Conclusion: Therefore, the present study suggests that sound reduction is a more effective nonpharmacological method for improving behavioral responses and reducing restlessness of premature infants under noninvasive ventilation.
Postural crisis in patients undergoing canalith repositioning procedures for posterior canal benign paroxysmal positional vertigo: A systematic review and meta-analysis
Authors: Kim Yee-Hyuk , Park Hee-Jun , Yoo Jae-Ho 
Published: January 2025

Background:
The Epley or Semont maneuver is performed for posterior canal benign paroxysmal positional vertigo (PC-BPPV). The postural crisis indicates the phenomenon that the patient experiences severe dizziness, is unable to maintain the sitting posture, and suddenly falls backward or sideways on the examination table when returning to the sitting position, which is the final step of the canalith repositioning procedure (CRP). The postural crisis increases the risk of falls during CRP. This meta-analysis aimed to determine the incidence of postural crisis among patients who underwent CRP for PC-BPPV.

Methods:
Literature searches were conducted on PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar. The random-effects model was utilized based on the results of the heterogeneity using the Tau2 test and I2 statistic.

Results:
We included 5 nonrandomized studies that reported the total number of cases of CRP for PC-BPPV and postural crisis. In each study, postural crisis occurred in 4.0% to 14.9% of the subjects. Of a total of 1177 cases, the incidence of postural crisis in all CRP cases was 10% (95% confidence interval = 6%–15%).

Conclusion:
BPPV is the most common among peripheral vestibular diseases, usually occurring in the posterior semicircular canal. Therefore, 10% of cases with CRP for PC-BPPV is significant. When performing CRP for PC-BPPV, considering that the postural crisis related to increasing the risk of falls may occur, preparations for the phenomenon should be made in advance.
Different treatment for humeral shaft fractures: A network meta-analysis
Authors: Guo Jiankuo , Ma Hua 
Published: January 2025

Background:
The main treatment methods for humeral shaft fractures include minimally invasive plate osteosynthesis (MIPO), intramedullary nailing (IMN), open reduction and internal fixation (ORF), and non-operative treatment (NonOP). However, the optimal treatment plan remains unclear. This article utilizes a network meta-analysis to compare the therapeutic effects of MIPO, IMN, ORF, and NonOP for the treatment of humeral shaft fractures.

Methods:
We searched electronic databases, including the PubMed, Embase, The Cochrane Library, and the Web of Science Databases, from inception to June 1, 2024. The “Risk of Bias Assessment” tool recommended by the Cochrane Collaboration was used to evaluate the quality of the included literature. RevMan 5.4 software and R software with gemtc package was used for the graphical representation and data analysis of the network meta-analysis.

Results:
A total of 23 randomized controlled trials were finally included. The results indicated that the efficacy of disabilities of the arm, shoulder and hand score was significantly higher in the MIPO group than in the open reduction and internal fixation (ORIF) group (weighted mean difference = 4.7, 95% confidence intervals, 1.8–7.75). IMN was associated with a decrease of the constant-Murley scores score than NonOP (weighted mean difference = ‐4.4, 95% confidence intervals, ‐8.7 to ‐0.068). IMN, MIPO, and ORIF was associated with a decrease of the fracture healing time than NonOP. The difference for nonunion rate and iatrogenic radial nerve injuries between any 2 groups was not statistically significant (P > .05).

Conclusion:
The evidence from current meta-analysis indicated that ORIF provides the best recovery effects for upper limb and shoulder joint function after the treatment of humeral shaft fractures, with the drawback of a relatively higher incidence of complications. To ensure the reliability of this study’s results, more high-quality randomized controlled trials are needed in the future to verify these findings.
Monocyte count as an independent predictor of high thrombus burden in ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis
Authors: ul Hussain Hassan , Ashok Kumar Kanwal , Zahid Marium , Husban Burney Muhammad , Asif Muqaddus , Tayyaba Rehan Syeda , Abbasher Hussien Mohamed Ahmed Khabab , Ullah Irfan 
Published: January 2025

Background:
Due to the lack of a prior comprehensive review and meta-analysis, the relationship between monocyte count and thrombus load in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) has not been adequately established.

Methods:
This was a systematic review and meta-analysis of multiple cohorts (retrospective and prospective) and cross-sectional studies.
We queried electronic databases (PubMed, Google Scholar, and Cochrane Central) from their inception to April 2022. The included studies had patients who had undergone PCI treatment and were classified using thrombolysis in myocardial infarction thrombus grading. Dichotomous outcomes from the studies were presented as odds ratios with 95% confidence intervals while means ± standard deviation were presented for continuous outcomes. Means ± standard deviation of monocyte levels and odds ratios were pooled using an inverse variance-weighted random-effects model. I² statistics are used to evaluate heterogeneity across studies and subgrouping was performed to reduce the heterogeneity.

Results:
Five eligible studies, consisting of 1426 patients were included, out of which 776 had a high thrombus burden. Pooled results after subgroup analysis showed a significant relationship between raised monocyte count and high thrombus burden (odds ratios = 1.44; 95% confidence interval = 1.06–1.96; P = .02; I2 = 71%). Post-subgroup pooled analysis revealed a statistically significant correlation between high thrombus burden and raised monocyte count.

Conclusion:
STEMI patients with a high thrombus burden show an increased monocyte count. A high monocyte count upon admission is a major indication of increased intracoronary thrombus burden in STEMI patients with PCI procedures.
Effects of physical activity on patients with posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials
Authors: Yuan Zhichao , Peng Chenggen , Yang Linlin , Chen Houjin 
Published: January 2025

Background:
Although it is often known that physical activity can effectively reduce anxiety and despair, differing results have been found for patients with posttraumatic stress disorder (PTSD) symptoms. This study sought to comprehensively examine how physical activity affected the quality of sleep, anxiety, sadness, and PTSD in individuals suffering from PTSD.

Methods:
The Cochrane Library, PubMed, Web of Science, EMBASE, and Scopus databases in English were examined. Included were all randomized controlled trials (RCTs) that examined physical activity as a psychosocial remedy for PTSD sufferers. By the time of the meta-analysis search (February 2024), we had 12 RCT studies that met the eligibility requirements.

Results:
The study’s findings demonstrated that physical activity improved sleep quality (standardized mean differences [SMD] = −0.38, 95% CI [−0.59, −0.18], Z = 3.65, P = .0003), anxiety (SMD = −0.26, 95% CI [−0.47, −0.06], Z = 2.5, P = .01), depression (SMD = −0.19, 95% CI [−0.37, −0.01], Z = 2.09, P = .04), and PTSD (SMD = −0.34, 95% CI [−0.50, −0.17], Z = 3.99, P < .0001). Each intervention ≤ 60 (SMD = −0.52, I2 = 0%, P < .00001), frequency of interventions ≤ 2 per week (SMD = −0.44, I2 = 7%, P = .0004), intervention cycles > 10 (SMD = −0.46, I2 = 8%, P < .0001), and the yoga group (SMD = −0.44, I2 = 7%, P = .0004) had the best impact, according to subgroup analyses. Veterans with PTSD responded most significantly to physical activity (SMD = −0.60, I2 = 0%, P = .002).

Conclusions:
It was discovered that people with PTSD can benefit from physical activity as an adjuvant method to enhance their PTSD, anxiety, despair, and sleep quality. Yoga has been found through research to help the symptoms of people with PTSD more than other sports. Due to limitations such as small sample size and some heterogeneity in this meta-analysis, further confirmation through more scientific and objective RCTs is needed in order to obtain definitive conclusions on physical activity for patients with PTSD.
Impact of lifestyle interventions on reproductive and psychological outcomes in women with polycystic ovary syndrome: A systematic review
Authors: Mohamed Amal H. , Albasheer Osama , Ghoniem Manar Ahmed , Abdalghani Nagla , Ayish Fatma , Abdelwahab Siddig Ibrahim , Abdelmageed Maha Murtada , Hakami Ahlam Mohammed S. , Khormi Ali Hassan , Altraifi Ahmed Abdallah , Medani Isameldin , Chourasia Uma , Ali Suhaila A. , Abdelmola Amani , Ahmed Anas E. 
Published: January 2025

Background:
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting ≈8% to 13% of women of reproductive age. PCOS has multifaceted effects that extend beyond reproductive health. Women with PCOS are at an elevated risk for various metabolic conditions, including obesity, type 2 diabetes, and cardiovascular disease, as well as psychological challenges, such as anxiety, depression, and reduced quality of life. This systematic review examined the effectiveness of lifestyle interventions, including dietary, exercise, and behavioral modifications, in improving reproductive outcomes, mental well-being, and quality of life in women with PCOS.

Methods:
A comprehensive search was conducted using MEDLINE, EMBASE, Cochrane Library, and Web of Science databases, identifying observational and interventional studies published in English through December 2022. Studies were evaluated for methodological quality and categorized according to the type of lifestyle intervention and outcome measures.

Results:
Of the 24 studies reviewed, with 16 focusing on reproductive outcomes, 4 on quality of life, and 4 on combined outcomes, encompassing 1373 participants with the mean age in the included studies ranged from 21.7 to 36.5 years. Dietary modifications, either alone or in combination with exercise, resulted in significant improvements in reproductive health, including a 5% reduction in body weight (P < .001), increased menstrual regularity, higher pregnancy rates, and decreased testosterone levels (P < .01). Exercise interventions further contributed to positive outcomes; a 20-week exercise program improved ovulation rates by 49.1% and significantly reduced testosterone and free androgen indices (P < .001). In addition, structured exercise programs increased menstrual regularity by 60% and reduced body mass index and testosterone levels.

Conclusion:
This review underscores the efficacy of integrated lifestyle interventions, including dietary, exercise, and behavioral approaches, in improving reproductive health, psychological well-being, and quality of life in women with PCOS. These findings highlight the potential of comprehensive nonpharmacological management strategies to address the multifaceted health challenges posed by PCOS. Future research should prioritize long-term studies to assess sustained outcomes and examine personalized intervention strategies that account for the clinical diversity and heterogeneity of PCOS presentations.