bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acromioclavicular Joint Problem in Athletes
Authors: Prasetia Renaldi , Purwana Siti Zainab Bani , Rasyid Hermawan Nagar 
Published: February 2023

Introduction: Acromioclavicular (AC) joint separations account for 12% of all shoulder injuries. People doing high-energy physical activities such as athletes are at risk for AC joint separation. The mechanism of injury could be direct or indirect. Direct mechanism involves a direct blow to the AC and coracoclavicular (CC) ligaments. Indirect mechanism happens when the injury force hits the AC joint indirectly, involving axial compression, as seen in a fall with an extended arm, where caput humeri is pressed against the acromion. The purpose of this paper is to elaborate on AC joint problems in athletes by reviewing literatures. Review: Patients with AC joint injury will exert complaints of pain and be unwilling to lift the affected arm, implying mobility function impairment. Signs such as skin abrasions and bruises can be found during inspection. A prominent distal clavicle is a pathognomonic sign of dislocation of the AC joint. A well-known classification for AC joint separations, Rockwood classification, divides the separations into six types. The classification helps determine different managements and prognoses for each of the AC joint separation types. Athletes should be treated in consideration of their position in the sports season. For athletes in season, pain should be treated as the priority. Absolute indications for surgical management are then identified to help determine the athlete’s return-to-play capability. For out-of-season athletes with AC injury, look for absolute or relative indications for operative management. If there is no indication, plan for rehabilitation. But if there are some indications, either absolute or relative, plan for surgery immediately. Complaints of pain and functional disabilities such as motion should be carefully assessed and managed. To determine suitable management, the injury should be classified properly. Type I and II injuries are treated with nonsurgical management. For type IV and VI injuries, surgical intervention is needed. AC joint separation Rockwood type III and V both had complete AC and CC ligament tear but repair is adequate for acute type III AC injury while reconstruction is needed for type V AC injury. Conclusion: AC joint separations should be treated as joints, not as bones where compressions are applied therefore limiting movements. Repair and reconstruction indications should be properly assessed on patients to ensure functions returned to their pre-injury state which is important for athletes’ return to sports.
Lack of Rehabilitation of “High-Knee Demanding” Worker After Anterior Cruciate Ligament Reconstruction and Meniscus Repair: A Case Report
Authors: Yusman Arrio , Utoyo Ghuna Arioharjo 
Published: February 2023

Background: Anterior cruciate ligament reconstruction (ACLR) and meniscus repair (MR) procedures followed by adequate rehabilitation programs are necessary so the patients can perform daily activities adequately, especially on high-knee demanding workers. This case shows lack of rehabilitation of a worker after ACLR and MR. Case description: A 34 years old male worker, works in a squatting and kneeling position all the time. The patient underwent ACLR and MR procedures but did not follow rehabilitation afterwards. Twelve weeks later, the patient was still unable to squat fully and still had mild knee pain. The patient has returned to work but did not work in his original position. Conclusion: Rehabilitation protocols that are not implemented will result in unsatisfactory results even though the operating procedures have been carried out properly.
Characteristics of Patients with Neglected Fractures Who Seek Treatment at the Bone Setter before Going to the Hasan Sadikin General Hospital Bandung In 2021
Authors: Putra Dimas Harendra S , Ismiarto Yoyos Dias 
Published: February 2023

Introduction: Neglected fracture is a fracture that is not treated or treated improperly, resulting in a delay in treatment, or a worse condition and even disability. Until now, people still believe in the treatment of fractures by bone setter. More than 50% of complications occur in fracture treatment performed by bone setter. This study aims to determine the characteristics of patients with neglected fractures to a bone setter at the Hasan Sadikin General Hospital, Bandung in 2021. Method: This study is descriptive, the data were taken from the medical records of patients with neglected fractures who previously went to a bone setter before being treated at Hasan Sadikin Hospital in Bandung in 2021. Sampling used total sampling according to the inclusion and exclusion criteria. Results: The socioeconomic status of neglected fracture patients were obtained with high income (39.81%), very high (26.85%), low (18.52%), and moderate (14.81%). The confidence of neglected fracture patients in bone setter dominated the cases, that is 96.3%, and only 3.7% did not believe in the treatment carried out by a bone setter. The patient’s trust in medical treatment in cases of neglected fracture to a bone setter is quite high (71.3%). A total of 90.75% of neglected fracture patients who were brought to a bone setter previously had easy access to health facilities, while the other 9.25% experienced difficulties in accessing health facilities. Conclusion: This study concludes that trust in bone setters in the case of Neglected Fractures is not influenced by socioeconomic status.
Habitual Patellar Dislocation Treated By Anteromedial Tibial Tubercle Transfer (Fulkerson Osteotomy) with Medial Patellofemoral Ligament Reconstruction Using Superficial Layer of Quadriceps Tendon Autograft: A Case Report
Authors: Munthe Ronald Vinantius , Lubis Andri Maruli Tua 
Published: February 2023

Introduction: Bony malalignment and soft tissue injury of Medial Patellofemoral Ligament (MPFL) in chronic patellar instability is considered as a surgical indication for distal realignment in the form of anteromedial tibial tubercle transfer (Fulkerson osteotomy) with MPFL reconstruction, are effectively unloads the lateral patella while making the patellofemoral joint more congruous, stable and pain free. Method: A 26 years old male with left habitual patellar dislocation and pain on his left knee. The patient underwent Fulkerson osteotomy (Tibial tuberosity elevation osteotomy and medial transfer) and medial patellofemoral ligament (MPFL) reconstruction using superficial layer of quadriceps tendon autograft. The patient underwent arthroscopic examination preoperatively and found cartilage lesion of patella (Outerbridge type III). Conclusion: Fulkerson osteotomy and MPFL reconstruction is a successful procedure to treat habitual patellar dislocation and patellofemoral pain. The Fulkerson osteotomy can improve the patella stability and knee function. MPFL reconstruction using superficial layer of quadriceps tendon was simple and has fewer complication than using other autografts, such as hamstring tendon, adductor tendon, and patellar tendon.
The Current Insight of Three Operative Approach for Lateral Epicondylitis: A Systematic Review & Meta-Analysis from 1944 Elbows
Authors: Singjie Leonard Christianto , Anastasia Maria , Felly  , Kholinne Erica 
Published: February 2023

Objective: Lateral epicondylitis (LE), also commonly known as tennis elbow, is one of the most common causes of lateral epicondyle pain. Most LE cases can resolve spontaneously or with conservative treatment. However, up to 10% of the patients still do not respond to the conservative treatment, making the operative treatment still needed. Yet, the best approach remains controversial, which leaves the option to the individual surgeon’s experience and ease of the procedure. Our study aims to objectively find the difference in the outcome of the operative modalities qualitatively and quantitatively. Methods: This study was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline where the protocol was registered PROSPERO [ID: CRD42022339650]. OCEBM level I-IV evidence studies were discovered using Boolean search strings that were created according to the patient, intervention, comparison, and outcomes of the study in three databases. Study quality was assessed with the Cochrane RoB tool and MINORS score. The success rate from operative modalities becomes the main outcome of the current study. Results: Forty-six studies were included in the study after a comprehensive literature search was done. From the analysis of 1944 elbows in three different groups, we found that arthroscopic surgery has the highest success rate (91.9%) compared to percutaneous (90.6%) and open (82.7%) lateral epicondylitis surgery with a change in mean pain score of 5.54, 4.90, and 3.63 respectively. The functional outcome improved according to DASH, in the arthroscopic group (51.51 to 15.47), the percutaneous group (44.90 to 10.47), and the open group (53.55 to 16.13). The overall improvement was also found in the MAYO score, in the arthroscopic group (55.12 to 64.70), in the percutaneous group (56.31 to 87.65), and the open group (64 to 93.37). Conclusion: Among the three different modalities of lateral epicondylitis surgery, arthroscopic surgery has the highest rate of success with the highest mean difference in pain score. Every surgical outcome also has an overall improvement in functional outcome scores.
Arthroscopic Bony Bankart Repair Technique: A Technical Note
Authors: Prasetia Renaldi , Purwana Siti Zainab Bani , Rasyid Hermawan Nagar 
Published: February 2023

Introduction: Labrum is a static stabilitator of the glenohumeral joint. Tear to this fibrocartilaginous structure could cause shoulder instability. Lately, anterior detachment of labrum is known as a contributor to recurrent anterior instability. Anterior labrum detachments are the classic Bankart lesion. Bankart lesion involving avulsion fracture is known as bony Bankart lesion. Management for this lesion is done operatively by doing antomical repair to return rigidity to its original state. Bankart repairs were originally done openly with coracoid osteotomy and subscapularis tenotomy. Currently, arthroscopic Bankart repair is often used as the preferred surgical management. Variations of portal placements, suture placements, suture technique and other components of Bankart repair can be found today, giving options for surgeons to achieve optimal results. Surgical Technique: In athletes, bony Bankart lesion, as an intraarticular lesion with displaced labrum and avulsion causing instability, is an absolute indication for surgical intervention to ensure function return. Nonoperative treatments have been reported on small bony Bankart lesions, but outcome on follow-up showed 25% recurrent instability. We performed arthroscopic bony Brankart repair by implementing labral repair, intraosesus tunneling and double-row suture bridge techniques. First, landmarks of incisions and portals were made. Incisions for visualisation were then done. Anterior portal and posterior portal were established before identifying bony Bankart lesion. A 5 o’ clock, trans subscapularis portal was then created. We released the bony Bankart and curatage the margin. A 6 o’clock stitch was anchored through rigid suture passage (drilled bone tunnel) in 5 o’clock direction. A 4.30 o’clock stitch was anchored in a 4 o’clock suture passage. The last stitch was a 3 o’clock stitch anchored through a 3 o’clock passage. Soft tissue release was conducted until subscapularis fibers were exposed. In the remodelling process, we performed overcorrection repair. Modifications done to the Bankart repair in this paper were done to achieve excellent post-op anterior stabilization.
Epidemiological Characteristics of Foot and Ankle Injuries in 2 Professional Ballet Companies: A 3-Season Cohort Study of 588 Medical Attention Injuries and 255 Time-Loss Injuries
Authors: Katakura Mai , Kedgley Angela E. , Shaw Joseph W. , Mattiussi Adam M. , Kelly Shane , Clark Richard , Allen Nick , Calder James D.F. 
Published: February 2023

Background: The foot and ankle are often reported as the most common sites of injury in professional ballet dancers; however, epidemiological research focusing on foot and ankle injuries in isolation and investigating specific diagnoses is limited. Purpose: To investigate the incidence rate, severity, burden, and mechanisms of foot and ankle injuries that (1) required visiting a medical team (medical attention foot and ankle injuries; MA-FAIs) and (2) prevented a dancer from fully participating in all dance-related activities for at least 24 hours after the injury (time-loss foot and ankle injuries; TL-FAIs) in 2 professional ballet companies. Study Design: Descriptive epidemiological study. Methods: Foot and ankle injury data across 3 seasons (2016-2017 to 2018-2019) were extracted from the medical databases of 2 professional ballet companies. Injury-incidence rate (per dancer-season), severity, and burden were calculated and reported with reference to the mechanism of injury. Results: A total of 588 MA-FAIs and 255 TL-FAIs were observed across 455 dancer-seasons. The incidence rates of MA-FAIs and TL-FAIs were significantly higher in women (1.20 MA-FAIs and 0.55 TL-FAIs per dancer-season) than in men (0.83 MA-FAIs and 0.35 TL-FAIs per dancer-season) (MA-FAIs, P = .002; TL-FAIs, P = .008). The highest incidence rates for any specific injury pathology were ankle impingement syndrome and synovitis for MA-FAIs (women 0.27 and men 0.25 MA-FAIs per dancer-season) and ankle sprain for TL-FAIs (women 0.15 and men 0.08 TL-FAIs per dancer-season). Pointe work and jumping actions in women and jumping actions in men were the most common mechanisms of injury. The primary mechanism of injury of ankle sprains was jumping activities, but the primary mechanisms of ankle synovitis and impingement in women were related to dancing en pointe. Conclusion: The results of this study highlight the importance of further investigation of injury prevention strategies targeting pointe work and jumping actions in ballet dancers. Further research for injury prevention and rehabilitation strategies targeting posterior ankle impingement syndromes and ankle sprains are warranted.
Muscle Edema of Retraction and Pseudo–Fatty Infiltration After Traumatic Rotator Cuff Tears: An Experimental Model in Sheep
Authors: Wang Sidi , Lädermann Alexandre , Chiu Joe , Nabergoj Marko , Ho Sean W.L. , Brigitte von Rechenberg , Bothorel Hugo , Lädermann Léo , Kolo Frank 
Published: February 2023

Background: Traumatic rotator cuff tears can result in retraction of the tendon and may be associated with muscle edema, which may be confused with fatty infiltration as seen on magnetic resonance imaging (MRI). Purpose: To describe the characteristics of a type of edema associated with acute retraction of the rotator cuff tendon (termed “edema of retraction”) and to highlight the risk of mistaking it with pseudo–fatty infiltration of the rotator cuff muscle. Study Design: Descriptive laboratory study. Methods: A total of 12 alpine sheep were used for analysis. On the right shoulder, osteotomy of the greater tuberosity was performed to release the infraspinatus tendon; the contralateral limb acted as the control. MRI was performed immediately after surgery (time zero) and at 2 and 4 weeks postoperatively. T1-weighted, T2-weighted, and Dixon pure-fat sequences were reviewed for hyperintense signals. Results: Edema of retraction resulted in hyperintense signals around or within the retracted rotator cuff muscle on both T1- and T2-weighted imaging, but there was an absence of hyperintense signals on Dixon pure-fat imaging. This represented pseudo–fatty infiltration. Edema of retraction created a characteristic “ground glass” appearance of the muscle on T1-weighted sequences and was often found in either the perimuscular or intramuscular location of the rotator cuff muscle. Compared to time zero values, a decrease in the percentage of fatty infiltration was observed at 4 weeks postoperatively (16.5% ± 4.0% vs 13.8% ± 2.9%, respectively; P < .005). Conclusion: The location of edema of retraction was often peri- or intramuscular. Edema of retraction presented as a characteristic “ground glass” appearance of the muscle on T1-weighted sequences and led to a decrease in the fat percentage because of a dilution effect. Clinical Relevance: Physicians should be aware that this edema can result in a form of pseudo–fatty infiltration, as it is associated with hyperintense signals on both T1- and T2-weighted sequences, and it can be mistaken for fatty infiltration.
Factors associated with clinically apparent congenital urethra anomalies among pediatric patients attending Muhimbili National Hospital, Dar Es Salaam, Tanzania
Authors: Kahuruta Joshua Jackson , Yongolo Sydney , Kimu Njiku , Aboud Muhsin 
Published: February 2023

Abstract
Background
Despite the clinically apparent congenital urethra anomalies being one of the common causes of admission in pediatric urology, yet little is known about its associated factors, especially in third world countries. Understanding associated factors of clinically apparent congenital urethra anomalies is important in prevention and in genetic counseling that may help in reducing the incidence of their occurrence.

Methods

Hospital-based cross-sectional prospective study conducted among pediatric patients admitted to pediatric surgery unit at Muhimbili National Hospital from July 2021 to March 2022. Socio-demographic and clinical characteristics were collected from participant’s parent or guardian. Patients were examined thoroughly for clinically apparent congenital urethra anomalies and associated genital-urinary tract anomalies. Analysis was done using SPPS version 23 with descriptive statistics for categorical variables and univariate and multivariate logistic regression for association between presence of clinically apparent urethra anomaly and associated factors at 95% CI. A p-value of < 5 was considered statistically significant.

Results
Overall proportion of clinically apparent urethra anomaly was 24.4% (94 out of 386) with hypospadias being the commonest anomaly (23.6%); others were epispadias in 2 patients (0.5%) and bladder exstrophy in one patient (0.3%). Among hypospadias cases, sub-coronal (37.4%) and mid-shaft (29.6%) were the most prevalent. About 9.6% had associated anomalies cryptorchidism being the commonest in 8 (8.5%) patients. There was no any factor that was independently associated with development of clinically apparent congenital urethra anomalies. However, folic acid supplementation, maternal hypertension, environmental exposure to pesticides and familial history of congenital urethra anomalies were related to higher proportion of the anomalies despite no any significant relationship detected.

Conclusion
Hypospadias is the commonest clinically apparent congenital urethra anomalies with cryptorchidism being the most prevalent associated genital-urinary tract anomaly. No associated factor has shown significant relationship with clinically apparent congenital urethra anomalies; however, attention is called to maternal hypertension, environmental exposure, especially pesticides and familial history of congenital urethra anomalies for detailed study. Proper examination of newborns is encouraged for early detection of such anomalies and hence planning for early intervention.
Complete chloroplast genome sequences of the medicinal plant Aconitum transsectum (Ranunculaceae): comparative analysis and phylogenetic relationships
Authors: Yanfei Niu , Tai Su , Chunhua Wu , Jia Deng , Fazhong Yang 
Published: February 2023

Abstract
Background
Aconitum transsectum Diels. (Ranunculaceae) is an important medicinal plant that is widely used in traditional Chinese medicine, but its morphological traits make it difficult to recognize from other Aconitum species. No research has sequenced the chloroplast genome of A.transsectum, despite the fact that phylogenetic analysis based on chloroplast genome sequences provides essential evidence for plant classification.

Results
In this study, the chloroplast (cp) genome of A. transsectum was sequenced, assembled, and annotated. A. transsectum cp genome is a 155,872 bp tetrameric structure including a large single copy (LSC, 87,671 bp) and a small single copy (SSC, 18,891 bp) section, as well as a pair of inverted repeat sequences (IRa and IRb, 25,894 bp each). 131 genes are encoded by the complete cp genome, comprising 86 protein-coding genes, 37 tRNAs, and 8 rRNAs. The most favored codon in the A. transsectum cp genome is AUG, and 46 repeats and 241 SSRs were also identified. The A. transsectum cp genome is similar in size, gene composition, and IR expansion and contraction to the cp genomes of seven Ranunculaceae species. Phylogenetic analysis of cp genomes of 28 plants from the Ranunculaceae family shows that A. transsectum is most closely related to A. vilmorinianum, A. episcopale, and A. forrestii of Subgen. Aconitum.

Conclusions
Overall, this study provides complete cp genome resources for A. transsectum that will be beneficial for identifying potential.
Brain fatty acid and transcriptome profiles of pig fed diets with different levels of soybean oil
Authors: da Silva Bruna Pereira , Fanalli Simara Larissa , Gomes Julia Dezen , de Almeida Vivian Vezzoni , Fukumasu Heidge , Freitas Felipe André Oliveira , Moreira Gabriel Costa Monteiro , Silva-Vignato Bárbara , Reecy James Mark , Koltes James Eugene , Koltes Dawn , de Carvalho Balieiro Júlio Cesar , de Alencar Severino Matias , da Silva Julia Pereira Martins , Coutinho Luiz Lehmann , Afonso Juliana , Regitano Luciana Correia de Almeida , Mourão Gerson Barreto , Luchiari Filho Albino , Cesar Aline Silva Mello 
Published: February 2023

AbstractBackgroundThe high similarity in anatomical and neurophysiological processes between pigs and humans make pigs an excellent model for metabolic diseases and neurological disorders. Lipids are essential for brain structure and function, and the polyunsaturated fatty acids (PUFA) have anti-inflammatory and positive effects against cognitive dysfunction in neurodegenerative diseases. Nutrigenomics studies involving pigs and fatty acids (FA) may help us in better understanding important biological processes. In this study, the main goal was to evaluate the effect of different levels of dietary soybean oil on the lipid profile and transcriptome in pigs’ brain tissue.ResultsThirty-six male Large White pigs were used in a 98-day study using two experimental diets corn-soybean meal diet containing 1.5% soybean oil (SOY1.5) and corn-soybean meal diet containing 3.0% soybean oil (SOY3.0). No differences were found for the brain total lipid content and FA profile between the different levels of soybean oil. For differential expression analysis, using the DESeq2 statistical package, a total of 34 differentially expressed genes (DEG, FDR-corrected p-value < 0.05) were identified. Of these 34 DEG, 25 are known-genes, of which 11 were up-regulated (log2 fold change ranging from + 0.25 to + 2.93) and 14 were down-regulated (log2 fold change ranging from − 3.43 to -0.36) for the SOY1.5 group compared to SOY3.0. For the functional enrichment analysis performed using MetaCore with the 34 DEG, four pathway maps were identified (p-value < 0.05), related to theALOX15B(log2 fold change − 1.489),CALB1(log2 fold change − 3.431) andCAST(log2 fold change + 0.421) genes. A “calcium transport” network (p-value = 2.303e-2), related to theCASTandCALB1genes, was also identified.ConclusionThe results found in this study contribute to understanding the pathways and networks associated with processes involved in intracellular calcium, lipid metabolism, and oxidative processes in the brain tissue. Moreover, these results may help a better comprehension of the modulating effects of soybean oil and its FA composition on processes and diseases affecting the brain tissue.