bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of IVIg and TPE efficacy in the treatment of neurological disorders: a systematic literature review
Authors: Pinto Ashwin A. , De Seze Jerome , Jacob Anu , Reddel Stephen , Yudina Anna , Tan Kevin 
Published: March 2023

Background: Intravenous immunoglobulin (IVIg) and therapeutic plasma exchange (TPE) are among the main immunotherapies for neurological disorders. Their benefit is greatest in immune-mediated conditions, but their distinct efficacy cannot be simply explained. Objectives: This review aimed to systematically identify studies comparing the efficacy of TPE and IVIg treatments for selected autoimmune neurological disorders and identify optimal therapies for each condition. Data Sources and Methods: PubMed, MEDLINE and Embase databases were searched for original publications from 1990 to 2021. Additional publications were identified via expert recommendations. Conference abstracts older than 2017, review articles and articles without information on TPE and IVIg comparison in title and abstract were excluded. Risks of bias were descriptively addressed, without a meta-analysis. Results: Forty-four studies were included on Guillain–Barré syndrome (20 studies – 12 adult, 5 paediatric, 3 all ages), myasthenia gravis (11 studies –8 adult, 3 paediatric), chronic immune–mediated polyradiculoneuropathy (3 studies –1 adult, 2 paediatric), encephalitis (1 study in adults), neuromyelitis optica spectrum disorders (5 studies –2 adult, 3 all ages) and other conditions (4 studies – all ages). TPE and IVIg were mostly similarly efficacious, measured by clinical outcomes and disease severity scores. Some studies recommended IVIg as easy to administer. TPE procedures, however, have been simplified and the safety has been improved. TPE is currently recommended for management of neuromyelitis optica spectrum disorder relapses and some myasthenia gravis subtypes, in which rapid removal of autoantibodies is crucial. Conclusion: Despite some limitations (e.g. the low evidence levels), this review provides an extensive 30-year-long overview of treatments for various conditions. Both IVIg and TPE are usually comparably efficacious options for autoimmune neurological disorders, with few exceptions. Treatment choices should be patient-tailored and based on available clinical resources. Better designed studies are needed to provide higher-level quality of evidence regarding clinical efficacy of TPE and IVIg treatments.
Digital interactive app and students’ mathematics self-efficacy, anxiety, and achievement in the “new normal”
Authors: Mamolo Leo A , Sugano Shalom Grace C 
Published: March 2023

The pandemic brought changes in the educational setup leading all learning institutions to rely on online learning. In instruction, using the e-learning method has increased due to the pandemic. This study investigated the effects of the Digital Interactive Math Comics (DIMaC) mobile App on students’ self-efficacy, anxiety, and achievement in General Mathematics. The study employed quasi-experimental research, specifically a one-group pre-posttest design. Two adapted questionnaires were employed in the study. Results revealed that students’ self-efficacy remained the same as “Moderate,” anxiety significantly decreased, and their achievement improved from “Satisfactory” to “Very Satisfactory” when utilizing the DIMaC App for 6 weeks. A negative correlation was observed between students’ mathematics self-efficacy and anxiety, while no significant association was found in the combination of the other variables. Results revealed that interactive instructional materials like the DIMaC app help students decrease their learning anxiety in the “New Normal” setup and improve learning gain. Learning materials that students manipulate and interact with significantly affect Mathematics Performance. Therefore, school stakeholders, especially the subject teachers, may develop interactive materials to aid students in the new setup in education.
Effectiveness of precooling with ethyl chloride versus honey in alleviating intra-oral injection pain in adult patients: A randomized controlled trial
Authors: Abbasi Hira , Saqib Muhammad , Maqsood Afsheen , Jouhar Rizwan , Lal Abhishek , Ahmed Naseer , Heboyan Artak 
Published: March 2023

Objective: The objective of the study was to assess and compare the effectiveness of precooling with ethyl chloride versus honey in alleviating the pain of dental injection. Methods: About 90 patients were recruited for this randomized controlled trial. In each of the following three groups, 30 patients were allocated: Group 1, precooling with ethyl chloride; Group 2, honey; and Group 3, control. The pain score of patients in each group was measured after injecting the dental local anesthesia using a visual analog scale. Paired t-test and multiple linear regression tests were used for statistical analysis. A p value of ⩽0.05 was considered to be as significant. Results: The mean pain scores of participants residing in different groups were as follows: Group 1: 2.83 ± 1.46, Group 2: 4.33 ± 1.62, and Group 3: 7.80. After administrating ethyl chloride, the majority of the 18 (60%) patients reported to suffer from “mild pain.” Furthermore, in patients who were given honey in Group 2, most of the 21 (70%) patients reported suffering from “moderate pain.” In Group 3 (control) where no anesthetic modality was used, the majority of the 25 (83.33%) patients experienced “severe pain.” A significant difference was noted among the pain scores of three groups ( p = 0.001). Conclusion: The administration of local anesthetic is part of almost all dental procedures. Precooling with ethyl chloride resulted in a greater reduction in pain scores than honey upon administration of local anesthesia injection.
Surgical Experience With Nine Cases of Obstructed Right Aortic Arch
Authors: Gray W. Hampton , Sorabella Robert A. , Padilla Luz A. , Cleveland David C. , Maxwell Kathryn S. , Dabal Robert J. 
Published: March 2023

Background Right-sided aortic arch obstruction is an extremely rare congenital anomaly. A variety of surgical approaches have been described. This study reviews our institutional experience over the last 30 years. Methods Our surgical database at the University of Alabama at Birmingham and Children's Hospital of Alabama from 1992 to 2022 was reviewed to include all patients who underwent surgical repair for right-sided aortic arch obstruction. Results A total of nine patients underwent surgical repair for right-sided aortic arch obstruction. Surgical approach was via thoracotomy (n = 2, 22%), sternotomy (n = 5, 56%), or combined (n = 2, 22%). Primary extended end-to-end anastomosis was utilized for patients with discrete coarctation (n = 1, 11%), reverse subclavian flap for coarctation with associated distal arch hypoplasia (n = 2, 22%), GORE-TEX® tube graft for circumflex aorta (n = 1, 11%), and aortic arch advancement (n = 5, 56%) with or without patch augmentation for those with an interrupted or severely hypoplastic aortic arch. Reintervention was required in one patient (11%) for recoarctation. All patients were discharged in good condition. There was no hospital mortality and at 10.5 years (mean) follow-up there was one late death. Conclusion Right aortic arch obstruction is a rare entity. Surgical approach should be tailored to the anatomy and associated intracardiac defects. Preoperative imaging with a CT angiogram is useful for operative planning. Sternotomy with single-stage primary repair is safe, effective, and our preferred surgical approach for patients with right aortic arch obstruction and associated intracardiac pathology.
Paper 11: Clinical Outcomes and Return to Sport Following Patellofemoral Osteochondral Allograft with and Without Concomitant Tibial Tubercle Osteotomy: A Retrospective Cohort Study
Authors: Avila Amanda , Shankar Dhruv , Kamdar Parth , Strauss Eric , Alaia Michael , Jazrawi Laith , Campbell Kirk 
Published: March 2023

Objectives: This study aimed to evaluate the rate of graft failure, return to sport (RTS), and clinical outcomes in patients undergoing osteochondral allograft (OCA) transplantation in the patellofemoral (PF) joint with concomitant tibial tuberosity osteotomy (TTO) compared to those undergoing an isolated PF OCA transplantation. Methods: This is a retrospective review of patients who underwent PF OCA transplantation with or without TTO at a single institution. Patients with a primary patellar or trochlear lesion were included. Those undergoing revision OCA, medial patellofemoral ligament reconstruction (MPLFR), or who had a prior TTO were excluded. Graft failure was defined as cartilage procedure revision, chondroplasty, or conversion to joint replacement. Knee pain and functional outcomes were assessed with Visual Analog Scale (VAS), Knee Injury and Osteoarthritis Outcome Score Joint Restoration (KOOS JR), and Tegner Activity Scale. Additionally, patients were asked about preoperative and postoperative sports activity to determine rate of RTS. Results: A total of 40 patients met inclusion criteria for the study; 35 were available for follow-up at an average of 31.6 ± 7.8 months. The cohort had 20 female (64%) and 15 male (36%) patients; the average age was 34 ± 8 years. Graft failure rates were 7.7% and 22.7% in the PF OCA + TTO and isolated PF OCA groups, respectively (p= 0.254). There were no significant differences in RTS between groups (p=0.668). Among patients who returned to sport at a lower level, those in the OCA + TTO group unanimously cited pain as the primary reason (100%), while most in the isolated OCA group cited fear of re-injury instead (66.7%). Patients who underwent concomitant OCA + TTO experienced reported lower KOOS scores (p=0.009). However, after adjusting for covariates, there was no significant association between TTO (p=0.86) and KOOS. Conclusions: In this study population, patients undergoing OCA with concomitant TTO were found to have comparable return to sport rates compared to patients who underwent an isolated OCA. Both cohorts showed improvements in pain levels and functional outcomes from baseline. However, patients undergoing combined OCA and TTO exhibited higher pain levels with activity and cited pain as the primary reason for return at a lower level of performance. These findings highlight the need for additional well-powered studies to further investigate clinical and functional outcomes following OCA and concomitant TTO to offload the PF compartment.
Paper 12: Elite Female Athletes Demonstrate Comparable Improvement in Midterm Patient Reported Outcome Scores and Rate of Return to Sport Compared to Elite Male Athletes After Hip Arthroscopy: A Sex-Based Comparison in Professional and Collegiate Athletes
Authors: Owens Jade , Jimenez Andrew , Lee Michael , Maldonado David , Lall Ajay , Domb Benjamin 
Published: March 2023

Objectives: (1) To report minimum 5-year patient reported outcome scores (PROs) and continuation of sport for elite female athletes undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and (2) to compare clinical results with a matched control group of elite male athletes. Methods: Data on all consecutive elite female athletes who underwent primary hip arthroscopy performed by the senior author (X.X.X.) between March 2009 and March 2016 were collected. Patients were eligible if underwent hip arthroscopy for labral tears or FAI and participated at a collegiate or professional level within 1 year of surgery. Minimum 5-year PROs were collected for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain. The rates of patients achieving minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were also recorded. These athletes were propensity-matched to elite male athletes for comparison. Results: Sixty-five elite female athlete hips were included in the study. Elite female athletes had an average follow-up time of 67.6 ± 6.5 and age of 24.3 ± 6.8. When propensity-matched to a control group of elite male athletes, female athletes demonstrated lower preoperative PRO scores and comparable minimum 5-year post-op scores, improvement between preoperative and minimum 5-year scores, and continuation of sport rate. Conclusions: Elite female athletes undergoing primary hip arthroscopy for FAI demonstrated significant improvement in PROs and high rates of CTS which were similar to a propensity-matched group of elite male athletes. [Figure: see text][Table: see text] [Table: see text]
Paper 15: Is Asymmetry of the Medial and Lateral Posterior Femoral Condyles Associated with ACL Rupture: A Case Control Study of Pediatric Patients
Authors: Pascual-Leone Nicolas , Chipman Danielle , Gorelick Danielle , Fabricant Peter , Warren Russell , Mintz Douglas , Green Daniel 
Published: March 2023

Objectives: Rates of anterior cruciate ligament (ACL) injury in the pediatric population have increased in the last 20 years. While many risk factors have been investigated, to the authors knowledge no study has analyzed the difference in the posterior femoral condyles in patients who have sustained ACL rupture. Therefore, this case control study sought to understand the relationship between the medial and lateral posterior condyles, as well as examining distal femoral version. The authors hypothesized that pediatric patients who suffered ACL rupture will have a relatively larger medial posterior femoral condyle leading to increase structural valgus in flexion. Methods: Pediatric patients with a pre-operative knee MRI who underwent ACL reconstruction between February 2016 and June 2020 at a tertiary orthopedic hospital were collected. Cases were matched to controls based on sex, laterality of injury, and age at imaging within 1.5 years. Medial and lateral posterior condylar height was measured for each participant. Condylar difference was calculated as medial posterior condylar height minus lateral posterior condylar height. The distal femoral version was calculated as the angle between the femoral posterior cortical axis and the posterior condylar axis. Mann-Whitney U tests were used to compare continuous variables. Significance was set as a p≤0.05. Results: A total of 72 participants were included in this analysis - 36 cases and 36 controls. Median age was 13.5 ± 3.3 years for all participants. Condylar difference was noted to be 1.8 mm greater in cases than controls (p=0.038), while distal femoral version was noted to be 2.0° greater in cases than controls (p=0.025). Conclusions: This study demonstrated a significantly greater posterior condylar height difference and distal femoral version among pediatric patients who suffered ACL rupture compared to a matched control group. We speculate that this morphology leads to a relative increase in knee valgus in flexion. [Figure: see text][Table: see text][Figure: see text]
Paper 19: Evidence-Based Machine Learning Algorithm to Predict Failure Following Cartilage Preservation Procedures in the Knee
Authors: Gilat Ron , Gilat Ben , Patel Sumit , Wagner Kyle , Haunschild Eric , Tauro Tracy , Kaiser Joshua , Chahla Jorge , Yanke Adam , Cole Brian 
Published: March 2023

Objectives: To develop machine learning algorithms to predict failure of surgical procedures that address cartilage defects of the knee and detect the most valuable variables associated with failure. Methods: A single institution prospectively collected database of cartilage procedures was queried for procedures performed between 2000 and 2018. Failure was defined as revision cartilage surgery and/or knee arthroplasty. One hundred and one preoperative and intraoperative features were evaluated as potential predictors. The dataset was randomly divided into training (70%) and independent testing (30%) sets. Four machine learning algorithms were trained and internally validated. Algorithm performance was assessed using area under curve (AUC) and the Brier score. Local Interpretable Model-agnostic Explanations (LIME) was utilized to assess the optimized algorithm fidelity. Results: A total of 1091 patients who underwent surgical procedures addressing cartilage defects in the knee with a minimum of 2-years of follow-up were included. The mean follow-up was 3.5 ± 2.8 years. The mean age was 40.5 ± 15 years. There were 205 (18.8%) patients who failed at final follow-up. The Random Forest algorithm was found to be the best performing algorithm, with an AUC of 0.765 and a Brier score of 0.135. The 10 most important features for predicting failure following surgical procedures addressing cartilage defects of the knee were: symptom duration, age, body mass index (BMI), lesion grade, total lesion area (sum of all lesion areas), number of previous surgeries, number of lesions in the knee, gender, athletic level, and traumatic etiology. LIME analysis allowed for assessment of the optimized algorithm fidelity, as well as provided a patient-specific comparison for the risk of failure of an individual patient being assigned various types of cartilage procedures. Conclusions: Machine learning algorithms were accurate in predicting the risk of failure following cartilage procedures of the knee, with the most important features being symptom duration, age, BMI, lesion grade, and total lesion area. Machine learning algorithms may be used to compare the risk of failure of specific patient-procedure combinations in the treatment of cartilage defects of the knee. Integrated human and machine learning decision-making may improve patient selection and bring about the new era of patient-tailored evidence-based clinical care. [Table: see text][Table: see text][Figure: see text][Figure: see text]
Paper 21: All-Inside Soft Suture Anchor Meniscus Repair Devices vs. PEEK Anchor Devices: A Biomechanical Analysis
Authors: Scalisi Wayne , Solitro Giovanni , Massey Patrick , Barton Shane , Robinson James , Daily Drayton 
Published: March 2023

Objectives: To evaluate the load to failure and meniscus gapping of longitudinal meniscus repairs with Soft Suture Based all-inside devices and compare them to a polyether ether ketone (PEEK) anchored device and inside-out repair. Methods: After IRB review 12 human cadaver knees were dissected leaving only the tibia, the posterior capsule and the medial and lateral menisci with roots still attached to the tibia. This yielded 24 menisci total (12 medial, 12 lateral). Posterior horn longitudinal full thickness meniscus tears were simulated with a scapel and 5mm Mersiline tapes were used to load the repair site. Each knee was randomized to one of 4 meniscus repair groups: Fiberstitch, Juggerstitch, FAST-FIX 360(PEEK), and inside-out with Broadband tape meniscus needles. For each meniscus, 2 longitudinal repairs were performed. The specimens were tested with an Instron imposing 20 cycles between 10N and 30N then the tear gap was measured, followed by a distraction to failure phase after imposing a displacement at a rate of 0.5mm/sec. Results: There There were 6 menisci tested in each of the 4 groups. After low-load cyclical loading, the gaps measured were .63mm, 1.1mm, 1.7mm, and 1.2mm for the Juggerstitch, Fiberstitch, FAST-FIX 360, and Inside-out Groups respectively (see figure 2). The failure load was 352N, 301N, 167N, and 189N for the Juggerstitch, Fiberstitch, FAST-FIX 360, and Inside-out (see figure 3). There was less gap formation and higher load to failure for the Juggerstitch over the FAST-FIX 360 (p=.014 and p=.03, respectively). When comparing all other groups there was no significant difference between groups with respect to gapping or failure load. Conclusions: The Juggerstitch had less gapping at the repair site and a higher failure load than the FAST-FIX 360. The soft suture based All-Inside meniscus repair devices have gapping and failure load comparable or better than traditional repair devices.
Nutritional Assessment in Chronic Kidney Disease Patients in the Bundelkhand Region (Uttar Pradesh), India
Authors: Yadav Sanjay Kumar , Verma Rajeev , Kumar Kanishka , Mishra Praveen Raman , Srivastavsa Deepak Chandra , Budhwani Priyanka 
Published: March 2023

Introduction This research aimed to assess the nutritional intake and anthropometry of patients presenting with CKD in a hospital clinic. Methods The study was carried out on 100 CKD patients who were on maintenance hemodialysis at Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India. The patient’s file was inspected to get the relevant anthropometric and biochemical data. The information was gathered using a pre-designed proforma. Results The study included 100 CKD patients with a mean age of 45.74 ± 14.93 years. Males outnumber females, with a male-to-female ratio of 6.69:1. The mean calorie and protein given to the CKD patients (according to body weight) are 1657.60 ± 240.179 and 71.75 ± 77.165, respectively. The mean weight, BMI, and MUAC of the CKD patient were 57.371±6.22, 21.56 ± 1.705, and 23.86 ± 1.709, respectively. After 3 months of nutritional assessment, the patient’s mean weight, BMI, and MUAC were increased. The mean cholesterol, Triglyceride, HDL, VLDL, and RBS levels of the CKD patient were 163.90 ± 29.75, 139.76 ± 35.72, 49.46 ± 6.29, 28.488 ± 7.114, and 117.65 ± 21.46, respectively. After three months of the nutritional assessment, the patient’s mean cholesterol, Triglyceride, HDL, and VLDL levels increased while RBS level decreased. The CKD patient’s mean S. creatinine and S. albumin levels were 9.97 ± 3.453 and 3.285 ± 0.531, respectively. After 3 months of nutritional assessment, the patient’s mean S. creatinine and S. albumin levels increased to 10.4231 ± 3.420 and 4.056 ± 5.6389, respectively. Conclusion The nutritional diet influences body weight, BMI, and biochemical indicators. Low energy and protein intake was reported; hence, educating patients, co-patients, and families about the essential foods that fulfill the recommended intake for CKD patients is required. Follow-up patients showed better nutritional knowledge as compared with baseline patients.
Advancing Diabetes Quality Measurement in the Era of Continuous Glucose Monitoring
Authors: Khan Maliha , Wahid Naila , Musser Taylor , Bergenstal Richard M. , Ebekozien Osagie , Snow Kenneth , Thomas Kate , Aprigliano Christel 
Published: March 2023

Purpose The purpose of this research is to develop a set of continuous glucose monitoring (CGM)-related measure concepts to be tested in a health care system. Existing measures assessing the quality of diabetes care do not include modern approaches to diabetes management, such as CGM. Continuous glucose monitors rival traditional methods of measuring diabetes management by providing real-time, longitudinal data and demonstrating glucose variability over time. The Improving Diabetes Quality Initiative seeks to address this gap in diabetes quality measurement. Methods A Technical Expert Panel (TEP) was convened to curate a diabetes quality measures portfolio and conceptualize three new CGM-related quality measures within the portfolio. From the additional measure concepts identified in the portfolio, the TEP prioritized three for conceptualization. High-level measure concept specifications were made available during a public comment period. Results The measure concepts prioritized by the TEP included a shared decision-making measure to assess the value of initiating CGM for disease management, a utilization measure to address disparities in access and use of CGM, and a patient-provider review of CGM data to promote routine consideration of these assessments in treatment and ongoing management. Clinical literature, public comments, and TEP feedback informed full measure specifications. Conclusions The evolution of diabetes technology reflects the need to shift diabetes quality of care. The measure concepts will be tested in a flexible pilot setting to understand the future of diabetes care and communicate the value of CGM to people with diabetes, providers, and payers.