bluuebunny/crossref_metadata_2025_split huggingface dataset:
Return to Sport and Graft Failure Rates After Primary Anterior Cruciate Ligament Reconstruction With a Bone–Patellar Tendon–Bone Versus Hamstring Tendon Autograft: A Systematic Review and Meta-analysis
Authors: Connors John Patrick , Cusano Antonio , Saleet Jayson , Hao Kevin A. , Efremov Kristian , Parisien Robert L. , Seil Romain , Li Xinning 
Published: January 2025

Background: Anterior cruciate ligament (ACL) tears are frequent injuries in athletes that often require surgical reconstruction so that patients may return to their previous levels of performance. While existing data on patient-reported outcomes are similar between bone–patellar tendon–bone (BTB) and hamstring tendon (HT) autografts, the literature regarding return to sport (RTS), return to previous levels of sport activity, and graft failure rate remains limited. Purpose: To compare rates of RTS, return to previous activity levels, and graft retears among athletes undergoing primary ACL reconstruction using a BTB versus HT autograft. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: The MEDLINE, Embase, and Cochrane Library databases were queried, and studies reporting on RTS after primary ACL reconstruction using a BTB or HT autograft were included. Exclusion criteria included revision reconstruction, ACL repair, quadriceps tendon autografts, allografts, graft augmentation, or double-bundle autografts. Rates of RTS, return to previous levels of activity, and retears were extracted and analyzed across included studies. Results: A total of 33 articles met inclusion criteria, with a patient cohort of 4810 athletes. The overall RTS rate for all athletes was 80.4% (95% CI, 75.3%-84.6%) at a mean follow-up of 35.7 months, with 54.6% (95% CI, 48.5%-60.6%) returning to preinjury levels of activity. No significant difference was found between BTB and HT autografts with respect to rates of RTS, return to preinjury activity levels, or reruptures. The overall RTS rate in patients after primary ACL reconstruction with a BTB autograft was 83.3% (95% CI, 77.0%-88.2%), with 56.1% (95% CI, 49.3%-62.7%) returning to preinjury levels of activity. Conversely, the overall RTS rate in patients after primary ACL reconstruction with an HT autograft was 77.9% (95% CI, 70.3%-84.0%), with 53.5% (95% CI, 42.8%-63.9%) returning to preinjury levels of activity. The overall graft rerupture rate for the entire patient cohort was 3.6% (95% CI, 2.5%-5.1%), for patients with BTB grafts was 3.2% (95% CI, 1.9%-5.3%), and for patients with HT grafts was 4.4% (95% CI, 2.8%-6.8%). Conclusion: Primary ACL reconstruction using BTB autografts demonstrated similar rates of RTS, return to previous activity levels, and reruptures compared with reconstruction using HT autografts.
A Descriptive Analysis of the Seasonal Patterns of Bone Stress Injury Incidence in Division I Collegiate Distance Runners
Authors: Wolff Axel , Kurina Lianne M. , Sainani Kristin L. , Tenforde Adam S. , Nattiv Aurelia , Fredericson Michael 
Published: January 2025

Background: A bone stress injury (BSI) is a common overuse injury in collegiate athletes, particularly cross-country and track and field runners. Limited work describes the seasonality of BSIs or the differences in rates and anatomic locations of BSIs in collegiate runners. Purpose: To describe seasonally related trends in anatomic locations of BSIs in National Collegiate Athletic Association (NCAA) Division I male and female middle- and long-distance runners. Study Design: Descriptive epidemiological study. Methods: Data from a 7-year prospective study of 2 NCAA Division I cross-country and track and field programs characterized BSIs over the years 2013 to 2020. Femoral neck, pelvic, sacral, lumbar spine, and calcaneal BSIs were considered trabecular-rich. All remaining BSIs were classified as cortical-rich. Total athlete-years of follow-up were calculated by subtracting the number of days an athlete was unable to run from the number of total study participation days. Annual incidence rates were calculated by dividing the number of BSIs by the total athlete-years of follow-up for that year, and monthly incidence rates were calculated by dividing the number of BSIs in a given month by the total athlete-years of follow-up for that month. Results: Participants included 221 collegiate distance runners (114 female, 107 male). There were 154 BSIs across 482 total athlete-years, resulting in an incidence rate of 32 BSIs per 100 athlete-years. The female BSI rate was more than double that of the male BSI rate: 45 versus 20 BSIs per 100 athlete-years, respectively. The highest monthly BSI rates occurred during competitive months, with the lowest monthly BSI rates occurring during noncompetitive months. Tibial and femoral shaft BSI rates peaked during the early competitive phases of each season, whereas metatarsal BSI rates remained relatively constant. Cortical-rich BSI rates varied by sex and seasonal phase, whereas trabecular-rich BSI rates remained relatively consistent. Conclusion: BSIs were common in collegiate distance runners, especially among female athletes, with higher rates during the competitive phases of the running season. Tibial and femoral shaft BSI rates were highest during the competitive phases and lowest during the noncompetitive phases, while metatarsal BSI rates remained consistent throughout the season. Cortical-rich BSI rates varied by seasonal phase and sex, whereas trabecular-rich BSI rates were relatively constant.
Particle concentration and size effect on mechanical properties of natural-hydroxyapatite reinforced high-density polyethylene composite
Authors: Baye Tertaraw M , Mekonone Samuel T 
Published: January 2025

High-density polyethylene (HDPE), which can be recycled up to ten times, is combined with natural hydroxyapatite (n-HAp) derived from waste cow bones to create polymer composite materials. This study assesses how variations in n-HAp concentration and particle size affect the mechanical properties of recycled HDPE (rHDPE). The methodology involved synthesizing n-HAp from cow bones, followed by shredding, and pelletizing rHDPE. Composites were produced via compression molding by incorporating n-HAp at concentrations of 0%, 10%, 20%, 30%, and 40% by weight, with particle sizes classified as fine, medium, and coarse (200, 500, and 1000 µm, respectively). Mechanical testing was used to evaluate the tensile, flexural, and impact properties, while optical microscopy was used to characterize particle dispersion within the composite matrix. The results revealed that a maximum tensile strength of 110.85 MPa at 10 wt %. medium n-HAp, decreasing at higher concentrations. The modulus peaked at 20% wt., measuring 1137.4 MPa, before entering a plastic region owing to defect-induced rupture. The flexural strength reached 103.9 MPa with 10% wt. Coarse particles, while energy absorption peaked at 48.57 J at 10% wt., indicating an effective fracture resistance. This demonstrated the potential of rHDPE and n-HAp composites to produce biodegradable materials contributing to waste valorization and sustainability.
Burnout of Physiotherapists in Primary Health Care and Hospitals of Thessaloniki During the COVID-19 Pandemic: A Combined Survey
Authors: Maria Klontira , Kyriaki Gkirni , Ioanna Fostiropoulou 
Published: January 2025

Burnout syndrome expresses the psychosomatic stress of the employee and the exhaustion of all mental reserves in an effort to adapt to the daily difficulties related to their professional activity. Due to the nature of their work, physiotherapists are a high-risk group for symptoms of burnout. The situation tends to be aggravated by the outbreak of the COVID-19 pandemic. The aim of this study was: (a) the assessment of the levels of burnout during the third wave of the COVID-19 pandemic of the active physiotherapists working in primary health care and general hospitals of the Prefecture of Thessaloniki, and (b) the identification, both quantitatively and qualitatively, of the existence of burnout among active physiotherapists. The validated questionnaire for the detection of burnout by Maslach and Jackson Burnout Inventory (MBI) and targeted open-ended questions were used to investigate the existence of work-related stress in active physiotherapists during the period March–July 2021 in the city of Thessaloniki. Participants were asked to sign informed consent. The analysis of the epidemiological questionnaire was carried out with the IBM/SPSS Statistics 25 statistical package. The analysis of the semi-structured open-ended questions was carried out with the Statistical Package ATLAS.ti 9 in the Cloud Version. Results Our study concluded that most of the participants had developed moderate to high level of burnout (45%–50%), both in the general hospitals and in primary health care. Conclusions The purpose of the research was to combine quantitative and qualitative data. Based on this correlation, an extremely strong link was found between burnout and depersonalisation.
Neurobehavioural Exploration of Breath-counting & Breath-awareness in Novice Indian Meditators: A Naturalised Ānāpānasati-based Paradigmatic Approach
Authors: Brahmi Mannu , Soni Dushyant , Kumar Jyoti 
Published: January 2025

Background Neural activity and subjective experiences indicate that breath-awareness practices, which focus on mindful observation of breath, promote tranquil calm and thoughtless awareness. Purpose This study explores the impact of tristage Ānāpānasati-based breath meditation on electroencephalography (EEG) oscillations and self-reported mindfulness states in novice meditators following a period of effortful cognition. Methods Eighty-nine novice meditators (82 males; Mean Age = 24.59 years) underwent a breath-based meditation intervention consisting of three stages: Resting State (RS), Breath Counting (BC), and Breath Focus (BF). EEG assessed neural oscillatory changes throughout the three stages while providing spectral indices for arousal and cognitive workload (CWL) stagewise. State mindfulness and breath awareness-related self-reported feedback were also collected using the Amsterdam Resting-State Questionnaire (ARSQ) post-BF stage and the curated Breath Count Feedback (BCF) post-BC stage, respectively. The internal reliability and construct validity of the standardised ARSQ and the designed BCF were satisfactorily computed within our sample. A within-subjects cross-sectional neurobehavioural examination of the breath self-regulatory novice experiences was thus conducted. Results The breath-based intervention significantly increased alpha power across all stages, indicating relaxation. Theta and delta powers increased during BC and BF in the prefrontal cortex (PFC), suggesting enhanced working memory and focused attention. Gamma power in meditation-associated brain regions and occipital beta oscillations showed significant positive correlations with breath counts, reflecting improved visual and attentional concentration. Lower pre-meditative arousal and smaller in-meditation CWL levels were associated with fewer distractions and increased confidence accuracy during BC. Conclusion The results suggest that BC may serve as a valuable tool for improving present-centric control and concentration, highlighting the importance of managing CWL and arousal levels to optimise meditation outcomes.
Research Status of Clustered Regulary Interspaced Short Palindromic Repeats Technology in the Treatment of Human Papillomavirus (HPV) Infection Related Diseases
Authors: Tang Minxue 
Published: January 2025

Background: CRISPR/Cas9 technology has rapidly advanced as a pivotal tool in cancer research, particularly in the precision targeting required for both detecting and treating malignancies. Its high specificity and low off-target effects make it exceptionally effective in applications involving Human Papillomavirus (HPV) related diseases, most notably cervical cancer. This approach offers a refined methodology for the rapid detection of viral infections and provides a robust platform for the safe and effective treatment of diseases associated with viral infections through gene therapy. Purpose: Gene therapy, within this context, involves the strategic delivery of genetic material into target cells via a vector. This is followed by the meticulous modulation of gene expression, whether through correction, addition, or suppression, specifically honed to target tumor cells while sparing healthy cells. This dual capacity to diagnose and treat at such a precise level underscores the transformative potential of CRISPR/Cas9 in contemporary medical science, particularly in oncology and virology. Research Design: This article provides an overview of the advancements made in utilizing the CRISPR-Cas9 system as a research tool for HPV-related treatments while summarizing its application status in basic research, diagnosis, and treatment of HPV. Data Collection: Furthermore, it discusses the future prospects for this technology within emerging areas of HPV research and precision medicine in clinical practice, while highlighting technical challenges and potential directions for future development.
Associations between dementia and exposure to topical glaucoma medications
Authors: Davidson Oliver , Lee Michael L , Kam Jason P , Brush Michael , Rajesh Anand , Blazes Marian , Arterburn David E , Duerr Eric , Gibbons Laura E , Crane Paul K , Lee Cecilia S ,   on behalf of the Eye ACT study group
Published: January 2025

Background Some studies have suggested that glaucoma may be associated with neurodegeneration and a higher risk of dementia. Objective To evaluate whether exposure to different categories of topical glaucoma medications is associated with differential dementia risks in people with glaucoma. Methods We used data from Adult Changes in Thought, a population-based, prospective cohort study that follows cognitively normal older adults from Kaiser Permanente Washington (KPWA) until Alzheimer's disease (AD) and related dementia development. We included participants with a diagnosis of glaucoma, KPWA pharmacy records of filling topical glaucoma medication (alpha-adrenergic agonists [AAA], beta-adrenergic antagonists, miotics, carbonic anhydrase inhibitors [CAI], and prostaglandins) and at least 10 years of pharmacy records. Eight-year sliding windows were derived for each medication class by computing days on each medication starting 10 years earlier and excluding the most recent 2 years. Cox regression used all 5 classes of medication simultaneously to predict AD and all-cause dementia. Results We included 521 participants (mean age 78 [range 65–96], 62% female) with APOE genotype data. Beta-adrenergic antagonists were the most frequently prescribed (n = 431) followed by prostaglandins (351), AAA (239), CAI (162), and miotics (142). Adjusting for time-varying exposure to other glaucoma medications, APOE, demographics, and smoking, each year of use of alpha-adrenergic agonists in an 8-year window was associated with a higher risk of developing dementia (HR = 1.33, 95% CI = 1.03–1.72). Conclusions Among older adults with treated glaucoma, exposure to alpha-adrenergic agonists appears to be associated with risk for developing all-cause dementia.
Combined technique versus stent-retriever alone: Interaction analysis of angioarchitectural and technical features
Authors: Tarek Mohamed A. , Monteiro Mateus Damiani , Martins Pedro N. , Mohammaden Mahmoud H , Grossberg Jonathan A. , Dolia Jay , Pabaney Aqueel , Al-Bayati Alhamza , Nogueira Raul G. , Haussen Diogo C. 
Published: January 2025

Introduction We aimed to explore if anatomical and technical features could interact and favor the chances of reperfusion according to the treatment strategy: combined technique (CoT) of mechanical thrombectomy (MT) with contact aspiration and stent-retriever (SR) versus SR alone. Methods Retrospective analysis of a prospective MT database for carotid terminus or MCA-M1 occlusion, first-line SR alone or CoT, and angiographic run with SR deployed on the first pass. The primary analysis involved the interaction between clinical and angiographic characteristics and first-line MT modality on first-pass effect (FPE; first pass eTICI2c-3). Results A total of 300 consecutive patients were included (SR alone, n = 210 vs CoT, n = 90). Baseline characteristics as well as baseline ASPECTS, CTA collateral score, clot burden score, FPE were similar amongst groups. Anatomical and technical variables (presence of reperfusion channel, frequency of SR position in dominant MCA division, angle of device-clot interaction, and clot length) were comparable between groups, with exception of SR opening (diameter across the occlusion) and length of SR purchase beyond the clot being more pronounced in the SR group. None of the clinical, anatomical, and technical factors were found to have an interaction with the MT strategy on the chances of FPE ( P-interaction ≥ 0.001). Multivariable logistic regression showed that clot burden score ≥8 (aOR 3.02, P = 0.003), angle of interaction (aOR 1.01, P = 0.015) but not the MT modality were associated with FPE. Conclusion No specific anatomical or technical features were observed to predispose to benefit when combining contact aspiration and SR thrombectomy. Clot burden score ≥ 8 and angle of interaction were independent factors associated with FPE. Additional studies are warranted.
Safety and outcomes of intravenous thrombolysis in acute ischemic stroke with intracranial artery dissection
Authors: Egashira Shuhei , Kunisawa Susumu , Koga Masatoshi , Ihara Masafumi , Tsuruta Wataro , Uesaka Yoshikazu , Fushimi Kiyohide , Toda Tatsushi , Imanaka Yuichi 
Published: January 2025

Background: Intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) related to underlying intracranial artery dissection (IAD) poses potential risks, including the exacerbation of intramural hematoma and the rupture of the dissected arterial wall. However, the safety of IVT in this specific population remains uncertain. Aims: This study aimed to assess whether IAD is associated with an increased risk of intracranial hemorrhage (ICH) following IVT and to evaluate its impact on functional outcomes. Methods: This retrospective matched-pair cohort study used a nationwide inpatient database that includes discharge abstracts and administrative claims data in Japan. We included adult patients with AIS treated with IVT between July 2010 and July 2024. We excluded patients with carotid or vertebral artery dissections due to difficulties distinguishing between intracranial and extracranial involvement, those lacking premorbid/discharge modified Rankin Scale (mRS) data, and those who received intra-arterial thrombolysis. Patients with IAD were matched 1:4 with non-IAD controls based on age, sex, premorbid mRS, endovascular treatment (EVT), and teaching hospital status. We assessed ICH, functional independence at discharge (mRS = 0–2), and in-hospital mortality using multivariable logistic regression with generalized estimating equations to account for clustering within matched pairs, adjusting for age, sex, premorbid mRS, body mass index, smoking history, hypertension, diabetes mellitus, atrial fibrillation, coagulopathy, Japan Coma Scale, EVT, and teaching hospital status. Results: Of 83,139 patients with AIS treated with IVT, 242 (0.3%) had underlying IAD (median age = 54 (46–67) years; 34% women). These patients were matched with 968 non-IAD controls. IAD was associated with a higher risk of ICH (odds ratio (OR) = 3.18; 95% confidence interval (CI) = 1.26–8.06) and a lower likelihood of functional independence at discharge (OR = 0.51; 95% CI = 0.37–0.72), but not with increased in-hospital mortality (OR = 1.09; 95% CI = 0.50–2.38). Conclusion: Patients with underlying IAD may face an increased risk of ICH and a reduced chance of functional recovery following IVT compared to those without.
Patient and public involvement in the co-design and assessment of unobtrusive sensing technologies for care at home: a user-centric design approach
Authors: Sharma Jenny , Gillani Nazia , Saied Imran , Alzaabi Aaesha , Arslan Tughrul 
Published: January 2025

Abstract

Background
There is growing interest in developing sensing solutions for remote health monitoring to support the safety and independence of older adults. To ensure these technologies are practical and relevant, people-centred design is essential. This study aims to explore the involvement of various stakeholders across different developmental stages to inform the design and assess the capabilities of unobtrusive sensing solutions being developed as part of the Advanced Care Research Centre (ACRC), Edinburgh, UK.

Methods
This study was conducted in two phases. In Phase I (Ideation), discussions were held with stakeholders (n = 19), including senior geriatricians (n = 2), healthcare and care home professionals (n = 4), PPI experts (n = 2), researchers (n = 4) and public members aged 65 and above from the ACRC Patient and Public Involvement (PPI) Network (n = 7). The goal was to identify clinically significant health parameters and design preferences. Based on this, prototypes of unobtrusive sensors for monitoring movement, hydration, and respiration were developed. In Phase II (Development and Co-Design), an in-person PPI workshop was conducted with PPI experts (n = 2), researchers (n = 4) and PPI members (n = 8). The developed prototypes were demonstrated, and qualitative feedback was collected through focus group discussions on themes such as acceptability, usability, privacy, data sharing, and functionality enhancement.

Results
Stakeholder input from Phase I emphasized the importance of non-contact sensing technologies that maintain privacy. Movement, hydration, and respiration were identified as critical health parameters. In Phase II, PPI members were optimistic about the prototypes, valuing their unobtrusive design and privacy-preserving features. Key themes identified included (1) the need for user-customized alarms, (2) clear data-sharing protocols, and (3) the importance of embedding sensors into familiar household objects. Suggestions for refining the prototypes included adding functionality for detecting deviations in daily routines and integrating feedback mechanisms for caregivers.

Conclusions
Involving diverse stakeholders from the early stages of technology development enhanced the relevance and acceptability of unobtrusive sensing solutions. This study highlights the importance of integrating public perspectives into the design process. For successful implementation, developers of healthcare technologies should prioritize privacy, usability, and clear communication with end-users and caregivers.