bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prognostic immune nutritional index can predict all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Ahn Sung Soo , Pyo Jung Yoon , Song Jason Jungsik , Park Yong-Beom , Lee Sang-Won 
Published: July 2023

Background: Studies have proposed that nutritional and immune-related markers are relevant with patient outcomes of various medical conditions and could be a useful indicator of patient prognostication. Objectives: This study investigated whether a prognostic immune nutritional index (PINI) at diagnosis could predict adverse clinical outcomes in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Design: A retrospective, single-centre observational cohort analysis of patients with AAV. Methods: All-cause mortality and end-stage renal disease (ESRD) were investigated outcomes during the observation period. PINI was calculated by serum albumin (g/mL) × 0.9 − monocyte count (/mm3) × 0.0007, and the optimal cut-off of PINI was obtained using a Youden index-based bootstrapping method. Cox hazard analyses were performed to identify independent predictors of patient outcomes. Results: Of the 250 eligible patients, the median age of patients was 60.0 years, and 34.0% were men. During the disease course, 33 (13.2%) died and 42 (16.8%) developed ESRD, respectively. The ideal PINI cut-offs for all-cause mortality and ESRD were set as ⩽2.47 and ⩽3.12 (sensitivity and specificity of 75.1% and 60.6% for mortality and 46.2% and 78.6% for ESRD). AAV patients with PINI ⩽2.47 and those with PINI ⩽3.12 exhibited significantly higher rates for all-cause mortality and ESRD compared to those with PINI >2.47 and >3.12. In the multivariable Cox analysis, PINI ⩽2.47 (hazard ratio [HR]: 3.173, 95% confidence interval [CI]: 1.129, 8.916, p = 0.029) was independently associated with all-cause patient mortality; however, PINI ⩽3.12 was not independently associated with ESRD (HR: 1.097, 95% CI: 0.419, 2.870, p = 0.850). Conclusion: Findings from this study demonstrated PINI could predict all-cause patient mortality in AAV, and a higher clinical attention is warranted in those with PINI ⩽2.47 at initial diagnosis.
Participatory design of an infographic to help support the care of people living with complex regional pain syndrome
Authors: Beales Darren , Ho Yi Ki , Lewin James , Loh Bianca Wen-Qi , Yusof Amirah Binte , Grieve Sharon , Ranelli Sonia , Holthouse David , Mitchell Tim , Slater Helen 
Published: July 2023

Background Complex regional pain syndrome (CRPS) can be a debilitating pain condition with enduring physical, psychological and social impacts. CRPS is often poorly understood by healthcare professionals and management needs to be tailored to each individual’s presentation. People with lived experience express difficulty in accessing reliable and meaningful information about the condition. This study aimed to co-create a trustworthy infographic to share information about the lived experience of CRPS. Methods We adopted a seven-phase, iterative, participatory methodology to co-create the infographic. Potential infographic content was obtained from qualitative work investigating the lived experience of CRPS. Online consumer engagement (people with doctor diagnosed CRPS/their family, n=20) was used to prioritise content to be included in the infographic and then potential designs were sourced. The research team narrowed the selections down to two designs which were presented to consumers online for final selection ( n=25) and refinement ( n=34). Results An infographic for understanding the lived experience of CRPS was completed using participatory design, providing a resource aligned to the needs of people with this condition. Using the Patient Education Materials Assessment Tool, the final infographic rated highly for understandability (92%) and participants indicated significant willingness to share this infographic with others (93%). Conclusion A process of participatory design was an effective and efficient process for translation of evidence gathered from qualitative research into a trustworthy resource for people with CRPS and their support people.
Using Fume Hood to Reduce Nurses’ Exposure to Particulate Matters Dispersed Into the Air During Pill Crushing
Authors: Amiri Azita , Guess LeAnn , Gilder Richard , Showalter Darlene , Hart Laura , Sattler Barbara 
Published: July 2023

Background: Pill crushing is a common practice in patient care settings. Crushing pills can disperse particulate matter (PM) into indoor air. The PM is a widespread air pollutant composed of microscopic particles and droplets of various sizes and may carry active and/or inactive ingredients nurses can inhale. This study aimed to quantify PM sizes and concentration in indoor air when pills are crushed and examine the role of a fume hood in reducing particulate pollution. Methods: Two scenarios (with and without a fume hood) representing nurses’ pill-crushing behaviors were set up in a positive-pressure cleanroom. Two acetaminophen tablets (325 mg/tablet) were crushed into powder and mixed with unsweetened applesauce. The PM sizes and concentrations were measured before and during crushing. Results: Different sizes of PM, including inhalable, respirable, and thoracic particles, were emitted during medication crushing. The total count of all particle sizes and mass concentrations of particles were significantly lower during crushing when a fume hood was used ( p = .00). Conclusion: Pill crushing increases PM and should be considered a workplace safety health hazard for nurses. Healthcare professionals should work under a fume hood when crushing pills and wear proper protective equipment. The findings of significant particulate pollution related to pill crushing suggest that further research is warranted.
Poster 145: A Biomechanical Comparison of All-Inside versus Trans-tibial Meniscal Root Repair Techniques
Authors: Pasic Nicholas , Dragoo Jason 
Published: August 2023

Objectives: To evaluate the biomechanical characteristics of an all-inside meniscal root repair procedure versus transtibial repair Methods: Nine paired cadaveric knees were prepared with pressure mapping sensors and underwent pressure testing to obtain peak pressures, average pressures, and femorotibial contact area in both the medial and lateral compartments. Testing was performed in three states: meniscus intact, meniscal root cut, and following meniscal root repair with all-inside repair technique. Additionally, testing was completed on eight pairs of cadaveric knees to compare stiffness and maximal load to failure between all-inside and transtibial meniscal root repair techniques. Results: In the medial compartment, there were significant increases in both median peak pressures (p=0.017) and median average pressures (p=0.047) in the root cut state compared to the intact state (+636 kilopascal (kPA) [246-1026 95% confidence interval (95%CI)] and +190 kPA [49-330 95%CI] respectively). All-inside meniscal root repair restored median peak pressures and median average pressures to approach that of the intact meniscus (p=0.293; +311 kPA [-79-701 95%CI] and p=0.171; +137 kPA [-3-277 95%CI] respectively). In the lateral compartment, there were also significant increases in both median peak pressures (p=0.025) and median average pressures (p=0.05) in the root cut state compared to the intact state (+718 kPA [246-1191 95%CI] and +203 kPA [51-355 95%CI]) respectively). All-inside meniscal root repair restored median peak pressures and median average pressures to be not significantly different from the intact state (p=0.399; +322 kPA [-150-795 95%CI] and p=0.97; +18 kPA [- 134-171 95%CI] respectively). There was no difference between repair techniques regarding load to failure (p=0.896). Conclusions: All-inside meniscal root repair restores median peak and average pressures that approach that of the native, intact meniscus. Compared to a transtibial meniscal root repair technique, all-inside repair demonstrated equivalent load to failure.
Poster 160: Arthroscopic Anatomic Glenoid Reconstruction Does Not Affect Subscapularis Muscle Compared To Latarjet
Authors: PEÑA JOSE CASTILLO DE LA , Sparavalo Sara , Ma Jie , Remedios Sarah , Hoyt Benjamin , Riccio Cory , Kilcoyne Kelly , Dickens Jonathan , Wong Ivan 
Published: August 2023

Objectives: The Latarjet technique has been the gold standard treatment for glenoid bone loss following anterior shoulder instability due to its low recurrence rate, but other techniques including arthroscopic anatomic glenoid reconstruction (AAGR) have shown similar outcomes with fewer complications. The Latarjet requires a subscapularis split or take-down for placement of the coracoid, which may compromise post-operative subscapularis quality and strength. The AAGR is a subscapularis-sparing technique that obviates the need for a subscapularis split by using a far medial (Halifax) portal for graft placement. The purpose of this study was to compare subscapularis muscle changes before and after surgery between Latarjet and AAGR patients. Methods: This study was a retrospective analysis of patients treated surgically with AAGR and Latarjet that had pre- and post-operative CT scans. Patients’ charts were reviewed to obtain demographic information, as well as CT scan cross-sectional area measurements of the subscapularis muscle on pre- and post-surgery scans. We used a pre-existing validated formula (volume=[0.06(A+C)]-13.02) for calculating the volume of the subscapularis pre- and post-operatively based on the cross-sectional area of the muscle. Results: Our cohort included 40 patients in each group with pre- and post-operative CT scans. On average, patients had a CT scan one year post-operatively. Pre-operatively, patients were estimated to have similar subscapularis volumes (p>0.05). We found that the change in medial area of the subscapularis muscle was significantly higher in the Latarjet group (-325.8 mm2) compared to the AAGR group (-73.2 mm2) (p<0.05). We found that AAGR patients had a 3% increase in subscapularis volume post-operatively, while the Latarjet patients had 3% decrease in volume (p<0.05) Conclusions: The AAGR technique is subscapularis-sparing both in surgical technique and structural outcomes, resulting in comparable subscapularis cross-sectional area and volume pre- and post- operatively. Latarjet using a subscapularis split results in lower subscapularis medial volumetric area.
Poster 174: Arthroscopic rotator cuff repair with bioinductive patch achieves equivalent patient- reported outcomes at 1 year
Authors: Burdick Gabriel , Fathima Bushra , Gaudiani Michael , Wolternik Trevor , Haan Jager , Kasto Johnny , Kolowich Patricia , Muh Stephanie , Castle Joshua 
Published: August 2023

Objectives: To compare patient reported outcomes, range of motion (ROM), and complications of patients undergoing arthroscopic rotator cuff repair (RCR) augmented with a bioinductive patch compared to standard repair. Methods: A retrospective review of patients undergoing primary arthroscopic rotator cuff repair with and without bioinductive bovine collagen patch augmentation for supraspinatus/infraspinatus tears from 2016 to 2021 at a single institution was performed. Patients were excluded based on the following criteria: age <18 years, open or mini-open rotator cuff repair, prior surgery of the affected shoulder (except diagnostic arthroscopy), rheumatological disease, active infection, or cancer. Patients who underwent RCR augmented with a collagen patch were matched 1:1 to those undergoing standard rotator cuff repair based on tear thickness and size. The electronic medical record was used to obtain patient demographics, range of motion (ROM), and assess for complications. MRI or ultrasound was used to confirm tear and classify size using the DeOrio and Cofield classification of small (<1cm), medium (1-3cm), large (3-5cm), and massive (>5cm). In addition, Patient Reported Outcome Information System (PROMIS) scores were recorded at preoperative, 6 weeks, 3 months, 6 months, and 1 year postoperative time points. Results: Fifty-four patients underwent RCR with patch augmentation and were matched to 54 controls. No significant differences were found between groups in terms of age (56.7 ± 9.0 patch vs. 59.3 ± 8.5 years control, p=0.12), sex, smoking, diabetes, degenerative vs. traumatic tears (50% vs. 50.9%, p=1.0), partial vs. full thickness (38.9% vs. 25.5%, p=0.2), as well as tear size (p=0.8). ROM in forward flexion (FF) and abduction (ABD) were significantly increased at 1 year compared to controls (FF 162 +/- 22 vs. 148 +/- 26 degrees, p<0.01; ABD 137 +/- 37 vs. 117 +/- 40, p=0.047). No differences were seen for PROMIS- UE, but PROMIS-PI scores were significantly lower in the patch group at 6 months (55.2 +/- 8.0 vs. 61.9 +/- 2.0, p<0.01) and 1 year (56.0 +/- 7.5 vs. 62.1 +/- 3.6, p<.01). The patch group had 7 retears compared to 0 controls (13.0% vs 0%, 2/7 for subscapularis tears not augmented) and 1 biceps tenodesis rupture, with 5 requiring revision surgery. Conclusions: Bioinductive patch augmentation for RCR demonstrated increased ROM, but equivalent physical function after 1 year. [Table: see text][Table: see text]
Poster 198: Forward flexion can reliably be measured with a front-facing camera used for at-home physical therapy
Authors: Denard Patrick , Higgins Laurence , Gobezie Reuben , Shishani Yousef 
Published: August 2023

Objectives: Accurate assessment of shoulder range of motion (ROM) is important for both initial evaluation and evaluating rehabilitation progress. Recently, digital platforms have been developed which assess ROM with the use of a front-facing camera available on smartphones. Such tools allow ROM to be objectively assessed and monitored remotely but require validation. The purpose of this study was, therefore, to compare forward flexion (FF) measured with a digital health platform (PT Genie, Orlando, Fl) ( Figure 1) to in-office measurements with a hand-held digital goniometer (Halo Medical Devices, Australia) ( Figure 2) Methods: A prospective evaluation was performed on consecutive patients evaluated in a single shoulder specialist practice. Thirty -two consecutive patients, including 16 males and 16 females, aged 58.5 ± 17.4 years (range 24-80) participated in the study. All participants completed 3 consecutive FF efforts measured first with a digital goniometer, followed by 3 consecutive FF efforts measured with the front-facing camera. All digital goniometer measurements were recorded by the same examiner. All measurements using the front-facing camera were obtained with an iPhone 11 running iOS 15.4.1, and the PT Genie platform ( Figure 1). The mean from the 3 measurements was calculated and the mean differences between the two measurement options were then compared using the simple Student t- test. Analysis was completed using SPSS version 17 (SPSS Inc., Chicago). Results: For both the digital goniometer and front-facing camera groups there were no significant differences within the 3 measurements (p > 0.05). Mean FF measured with the digital goniometer was 120.1° ± 24.7° (range 71.7° - 164.7°) compared to 123.5° ± 26.0° (range 74.7° – 173.0°) with the front- facing camera, for a difference of 3.4° between groups (p<0.001). Conclusions: These findings suggest that the measurement of FF is comparable between a digital goniometer and a front-facing camera. While small differences were seen between the methods, the differences are not likely clinically relevant, and more importantly, the findings were internally consistent. These preliminary findings help in establishing the use of such an application for remote physical therapy. Further study is needed to assess other planes of range of motion and obtain data in a larger cohort.
Poster 204: Changes in Elbow Stress and Ball Velocity During Reduced Effort Pitching: A Marker-Based Motion Capture Analysis
Authors: Fiegen Anthony , Nezlek Stuart , Loushin Stacy , Christoffer Daniel , Verhoeven Martijn , Kaufman Kenton , Camp Christopher 
Published: August 2023

Objectives: Baseball pitchers often participate in throwing programs that involve throwing at reduced effort levels to gradually increase the amount of stress experienced across the elbow. It is currently unknown how reduced effort pitching compares to maximum effort with respect to elbow stress and ball velocity. The purpose of this study is to determine whether elbow stress and ball velocity correlate with reduced effort pitching, whether elbow stress and ball velocity decrease proportionally while throwing at a reduced effort, and to assess intrathrower reliability. Methods: Ten healthy male high school baseball pitchers threw 5 pitches from a regulation pitching mound at 3 effort levels: maximum effort, 75% effort, and 50% effort. Elbow stress, specifically elbow varus torque, was calculated for all pitches using a marker-based 3D motion capture system. Ball velocity was measured using a Doppler radar gun. Intrathrower variability was calculated for each effort level. Results: Elbow stress and ball velocity decreased with reduced effort throws (p<0.001 and p=0.003, respectively). However, the reductions in elbow stress and ball velocity were not proportional. At 75% effort throws, elbow stress decreased only 19% and ball velocity decreased only 10%. At 50% effort throws, elbow stress decreased only 25% and ball velocity decreased only 15%. Intrathrower reliability was excellent for elbow stress and ball velocity, with intraclass correlation coefficients all greater than or equal to 0.80. Conclusions: Pitching at a reduced effort level resulted in decreased elbow stress and ball velocity. However, for every 25% reduction in perceived effort, elbow stress decreased by a mean of 13% and ball velocity decreased 8%. When baseball pitchers attempt to throw at a reduced effort of maximum, throwing metrics do not decrease proportionately. While pitching at a reduced effort of maximum decreases elbow stress and ball velocity, the decrease is not proportional, subjecting the elbow to more stress than intended. This has significant clinical importance to pitchers, coaches, and medical professionals in the setting of injury prevention and return to sport. [Table: see text]
Poster 211: Prolonged Opioid Use Following Distal Radius Fracture Fixation: Who is at Risk?
Authors: Runge William , Gabig Andrew , Karzon Anthony , Cooke Hayden , Gottschalk Michael , Suh Nina , Wagner Eric 
Published: August 2023

Objectives: Opioid pain medication is most commonly prescribed after distal radius fracture fixation, and there is high variability in the quantity and duration prescribed. Comorbidities including substance use and depression have been associated with higher consumption habits and increased sizes of postoperative opioid prescriptions has been previously linked to increasing risk of chronic opioid use and opioid use disorder. The purpose of this study was to investigate opioid prescription patterns after distal radius fracture fixation and identify patient specific risk factors for increased postoperative opioid consumption. Methods: A retrospective review of 34,629 opioid-naïve patients was conducted. Demographic, comorbidity, complication data and prescription pharmacy claims were analyzed. Patients were sorted according to the number of postoperative prescription refills of opioid pain medication. Results: Seventy-three percent of patients required no additional refills outside the perioperative window. Twenty percent required additional refill prescriptions and 6.4% of patients continued to fill opioid medication beyond 6-months postoperatively. Multiple factors increased the risk for increased opioid use including medical and surgical complications, substance use, diabetes,cardiovascular disease, and obesity. Patients with longer duration of opioid use postoperatively had higher rates of medical and surgical complications. Perioperative prescription quantities were 62.9, 78.6, 83.3 tablets for No Refill, Refill, and Prolonged Use groups, respectively. Conclusions: Many patient-specific factors for prolonged opioid consumption after distal radius fracture fixation can be identified prior to prescribing postoperative pain management. Patients most at risk for prolonged opioid use can be targeted for alternative pain management options. Surgeons should take a more patient specific approach in prescribing opioid medication after distal radius fracture fixation. [Table: see text][Table: see text][Table: see text][Table: see text]
Poster 266: Outcomes of Surgical Stabilization for Recurrent Patellar Instability in Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 6 years Mean Follow Up
Authors: Marigi Erick , Wasserburger Jory , Smith John-Rudolph , Stuart Michael , Camp Christopher , Krych Aaron 
Published: August 2023

Objectives: The purpose of this study was to assess return to play (RTP), patient-reported outcomes (PRO), and reoperation rates following patellofemoral stabilization surgeries (PSS) for recurrent patellar instability (RPI) in a cohort of competitive wrestlers. Methods: All competitive wrestlers with a history of an RPI and subsequent PSS at a single institution between 2000 and 2020 were identified. Primary PSS ranged from MPFL reconstruction (n = 31; 50%) or MPFL repair (n = 22; 33.5%), and other PSS (n = 9; 14.5%) in the form of tibial tubercle osteotomy (TTO), lateral retinaculum release (LRR), and medial retinaculum reefing (MRR). Exclusion criteria included revision PSS, or concomitant anterior cruciate ligament reconstruction or multi ligament knee injury. All patients were contacted for determination of reinjury rates, current sport status, and PROs. Surgical failure defined as subsequent patellar dislocation despite operative management or need for secondary PSS. Results: Ultimately, 62 knees in 56 wrestlers were included at a mean follow-up time of 6.6 years (range, 2.0 – 18.8 years). RTP occurred in 55.3% of wrestlers at a mean of 8.8 ± 6.7 months. Among the PSS no differences were observed between rates of RTP (P = .676), postoperative pain (P = .176), Tegner activity level (P = .801), International Knee Documentation Committee (P = .378), Lysholm (P = .402), or Kujala scores (P = .370). Recurrent patellar instability was the most common complication in 21% of knees. Among PSS types, MPFL reconstruction had the lowest rate of RPI (6.5% vs. 27.3% vs. 55.6%; P = .005), and surgical failure (9.7% vs. 31.8% vs. 55.6%; P = .008). Kaplan-Meier survivorship free from surgical failure of the entire cohort was 91.9% at 1 year, 77.7% at 5 years, and 65.7% at 15 years. MPFL reconstruction had the highest survivorship when compared to MPFL repair and other PSS up to 10 years after the index surgery (90.3% vs. 64.1% vs. 27.8%; P = .048). Conclusions: Recurrent patellar instability remains a concern for competitive wrestlers after PSS. MPFL reconstruction may serve as a more durable surgical treatment option with lower rates of RPI and failure when compared to other PSS up to 10 years after surgery. [Table: see text]