bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine and artificial intelligence to support self-isolation of COVID-19 patients: Recent updates and challenges
Authors: Huang Jessica A , Hartanti Intan R , Colin Michelle N , Pitaloka Dian AE 
Published: May 2022

Background Asymptomatic and high-risk COVID-19 patients are advised to self-isolate at home. However, patients may not realize that the condition is deteriorating until too late. Objective This study aims to review various artificial intelligence-based telemedicine research during the COVID-19 outbreak and proposes a framework for developing telemedicine powered by artificial intelligence to monitor progression in COVID-19 patients during isolation at home. It also aims to map challenges using artificial intelligence-based telemedicine in the community. Methods A systematic review was performed for the related articles published in 2019–2021 and conducted in the PubMed and ScienceDirect database using the keywords “telemedicine,” “artificial intelligence,” and “COVID-19”. The inclusion criteria were full-text articles and original research written in the English language. Results Thirteen articles were included in this review to describe the current application of artificial intelligence-based telemedicine during the COVID-19 pandemic. Various current applications have been implemented, such as for early diagnosis and tracing of contact for the users, to monitor symptoms and decision-making treatment, clinical management, and virtual and remote treatment. We also proposed the framework of telemedicine powered by artificial intelligence for support the self-isolation of COVID-19 patients based on the recent update in technology. However, we identified some challenges for using digital health technologies because of the ethical and practical use, the policy and regulation, and device use both for healthcare workers and patients. Conclusion Artificial intelligence promises to improve the practice of medicine in various ways. However, practical applications still need to be explored, and medical professionals also need to adapt to these advances for better healthcare delivery to the public.
Radiologic Analysis of Causes of Early Recurrence After Percutaneous Endoscopic Transforaminal Discectomy
Authors: Li Ze-Peng , Liu Lu-Lu , Liu Hao , Tan Jing-Hua , Li Xue-Lin , Xu Zhun , Ouyang Zhi-Hua , Wang Cheng , Yan Yi-Guo , Xue Jing-Bo 
Published: May 2022

Study Design Retrospective study. Objective To analyze the causes of and factors influencing early recurrence after TELD performed in the treatment of lumbar disc herniation. Methods We included 285 patients with single-segment lumbar disc herniation treated using transforaminal endoscopy lumbar discectomy TELD from January 2017 to December 2019 at the First Affiliated Hospital of the University of South China. Patients were classified into early recurrence and non-early recurrence groups based on clinical symptoms and MRI reexamination. Imaging data (eg, disc height index (DHI), Pfirrman grades, base width, postoperative annulus-fibrosus tear size, cross-sectional area of the foramen (CSAF), etc.)were analyzed, and multivariate, binomial logistic regression was utilized to determine which factors were associated with early recurrence after TELD. Results A total of 285 patients completed surgery and clinical follow-up, during which 19 patients relapsed within 6 months postsurgery, for an early recurrence rate of 6.7%. There were statistically significant differences between DHI, Pfirrman grades, base width, postoperative annulus-fibrosus tear size, herniation sites, CSAF and Modic changes between the early recurrence and non-early recurrence groups (P < .05). On multivariate logistic regression,the degree of disc degeneration (OR = .747, P = .037), CSAF (OR = 5.255, P = .006), degree of Modic change (OR = 1.831, P = .018) and base width of the herniation (OR = 4.942, P = .003) were significantly correlated with early recurrence after TELD. Conclusions Postoperative annulus-fibrosus tear size, DHI, and location of the disc herniation were associated with early recurrence after TELD. Increased base width of the herniation, severe disc degeneration, decreased CSAF and Modic change were risk factors for early recurrence after TELD.
The Effect of Different Abrasives on the Shear Bond Strength of Adhesive Resin Cements to Dentin
Authors: Yerliyurt Kaan , Hatırlı Hüseyin 
Published: May 2022

Aim: The aim of this study was to evaluate the influence of dentin surface preparation with coarse diamond, extra-fine diamond, and polishing discs on the shear bond strength (SBS) of two resin cements (RCs) to dentin. Materials and Methods: Sixty-six recently extracted human mandibular third molar teeth that were free of cracks, caries, or restorations were collected. Sixty teeth were used for the SBS test. The occlusal part of the crowns was cut to expose mid-coronal dentin. The teeth were divided into three dentin preparation groups: coarse diamond (Meisinger, Germany), extra-fine diamond, and polishing discs (SofLex, 3MESPE, USA), and further conventional RC combined with a self-etch adhesive (Panavia F2.0/ED Primer II, Kuraray, Japan) or self-adhesive RC (Maxcem Elite, Kerr, USA) subgroups ( n = 10). Sixty composite resin blocks were prepared (diameter: 3 mm, height: 4 mm) and bonded to the teeth according to the groups. The SBS test was performed with a universal testing device. Six teeth were used for the observation of prepared dentin surfaces and the resin–cement dentin interfaces using field emission scanning electron microscopy (Mira 3 XMU, Tescan). Statistical analyses were performed using the Mann–Whitney U and Kruskal–Wallis tests ( P < .05). Results: Panavia F2.0/ED Primer II exhibited significantly higher SBS values for coarse and extra-fine diamond than for the polishing discs ( P <.05). Regarding Maxcem Elite, no significant difference was observed for the preparation methods ( P > .05). Panavia F2.0/ED Primer II had higher bond strength than Maxcem Elite for the dentin surface prepared with the coarse diamond ( P <.05). The differences were not significant for the extra-fine diamond and the polishing disc groups ( P > .05). Conclusion: The use of polishing discs did not increase the SBS of the RCs to the dentin.
Accuracy of the Arthroscopic Location of the Center of the Anterior Horn During Lateral Meniscal Allograft Transplantation
Authors: Choi Nam-Hong , Hwangbo Byung-Hun , Kang Hang-Ki , Yang Bong-Seok , Victoroff Brian N. 
Published: May 2022

Background: Anatomic placement of the meniscal allograft is imperative to achieve satisfactory outcomes after meniscal allograft transplantation (MAT). Few studies have reported on the accuracy of the provisional location of the center of the anterior horn of the lateral meniscus (AHLM). Hypothesis: The authors hypothesized that the provisional center would not coincide with the anatomic center of the AHLM. Study Design: Descriptive laboratory study. Methods: Tibial plateaus were retrieved from 93 consecutive patients who underwent total knee arthroplasty. A complete radial cut was made 2 cm lateral to the insertion of the AHLM on the retrieved tibial plateau. While moving the stump of the anterior horn with forceps, the center of the insertion was determined, and a Kirschner wire (provisional wire) was drilled into the location. The insertion area of the AHLM was dissected carefully, and the periphery of the insertion area of the anterior horn was marked. Another Kirschner wire (anatomic wire) was drilled into the center of the dissected anterior horn. The resected tibial plateau was positioned so that the longitudinal line of the tibial plateau was aligned on a plastic ruler. The distance between the provisional and anatomic wires was measured by a digital caliper along the longitudinal and vertical axes. Results: The mean distance between the provisional and anatomic wires was 2.5 ± 1.2 mm. The provisional wire in 14 patients (15%) was placed at the anatomic center. In 36 patients (39%), the provisional wire was drilled anterolateral to the anatomic center, and in 18 patients (19%), the wire was drilled anteromedial to the anatomic center. In 21 patients (23%), the provisional wire was located within 2 mm of the anatomic center, and in 62 patients (67%), the wire was located within 3 mm of the anatomic center. Conclusion: The provisional wire was located a mean of 2.5 mm from the anatomic center, and only 23% of patients had wires that were located within 2 mm of the anatomic center. In 39% of patients, the provisional wire was drilled anterolateral to the anatomic center. This finding needs to be considered during lateral MAT. Clinical Relevance: Without dissection of the AHLM, the determination of the anatomic center of the anterior horn is not accurate during lateral MAT.
Are Patient-Reported Outcome Scores a Reasonable Substitute for Clinical Follow-up After Surgically Managed Acromioclavicular Joint Injuries?
Authors: Dey Hazra Rony-Orijit , Blach Robert Maximillian , Ziert Yvonne , Ellwein Alexander , Warnhoff Mara , Hanhoff Marek , Lill Helmut , Jensen Gunnar 
Published: May 2022

Background: Various clinical outcome scores have been described to evaluate postoperative shoulder function after operatively treated acromioclavicular joint (ACJ) instability. Clinical outcome scores can be divided between patient-reported outcome measures (PROMs) and examiner-dependent outcome measures (EDOMs) after a clinical examination by a physician. The correlation between PROMs and EDOMs, and thus their interchangeability with regard to operatively treated ACJ instability, has not yet been evaluated. Purpose: To investigate whether PROMs are a reasonable substitute for EDOMs. Correlations between global shoulder (GS) and ACJ-specific outcome measures were also investigated. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Included in this study were 131 consecutive patients with operatively treated ACJ instability between 2011 and 2017. Postoperative shoulder function was measured using PROMs, including the Subjective Shoulder Value (SSV), Subjective Shoulder Test, and Nottingham Clavicle Score (NCS), and EDOMs, including the Constant-Murley score (CMS), Taft score, ACJ instability (ACJI) score, and SICK Scapula Score (SSS). Associations between PROM and EDOM scores were calculated using the Pearson and Spearman correlation coefficients for linear and nonlinear variables, respectively, and were interpreted using the Cohen classification. The scores were further stratified into GS versus ACJ-specific measures. Results: A strong correlation was observed between several PROMs and EDOMs (CMS vs SSV [ r = 0.59; P = .02] and CMS vs NCS [ r = 0.79; P ≤ .001]) and between several GS and ACJ-specific scores (CMS vs NCS; CMS vs ACJI [ rs = 0.69; P < .001]; and CMS vs SSS [ r = –0.68; P < .001]). Conclusion: Based on the results of this study, PROMs such as the SSV (a GS measure) and the NCS (an ACJ-specific measure) can substitute for EDOMs. Clinical Relevance: PROMs that can be substituted for EDOMs can enable the conduct of clinical studies in circumstances in which in-person clinical follow-up of the patient by a physician is not possible.
Isolation and Characterization of Synovial Mesenchymal Stem Cells Derived From Patients With Chronic Lateral Ankle Instability: A Comparative Analysis of Synovial Fluid, Adipose Synovium, and Fibrous Synovium of the Ankle Joint
Authors: Nakashima Hirotaka , Uchida Soshi , Hatakeyama Akihisa , Murata Yoichi , Yamanaka Yoshiaki , Tsukamoto Manabu , Sekiya Ichiro , Sakai Akinori 
Published: May 2022

Background: Synovial mesenchymal stem cells (MSCs) have high proliferative potential and are considered an excellent source for stem cell therapy. Purposes: To isolate MSCs from the synovium of ankle joints in patients with chronic lateral ankle instability (CLAI) and to compare the characteristics of MSCs derived from the synovium anterior to the talus with those from the surrounding anterior talofibular ligament (ATFL) synovium. Study Design: Controlled laboratory study. Methods: The synovium was harvested from 2 locations in the ankle, the synovium anterior to the talus and the surrounding ATFL synovium, of 14 patients who underwent arthroscopic ATFL repair for CLAI without osteochondral lesions of the talus (OLTs). Synovial fluid was also harvested. MSCs were isolated from both types of synovial tissue, as well as synovial fluid. The number of MSCs in the synovium and their viability, proliferation, colony-forming units, and potential to differentiate into adipose, bone, and cartilage tissues were determined and compared between groups. Additionally, real-time polymerase chain reaction was used to assess the differentiation capacity of adipose, bone, and cartilage tissues from both samples. The Wilcoxon signed rank test was used to compare the sample weight, number of colonies, number of nucleated cells per colony, yield obtained, and phenotypic characteristics of MSCs derived from different locations of the synovium. Results: No significant differences were observed in the sample weight ( P = .051), number of nucleated cells per milligram ( P = .272), number of colonies ( P = .722), and yield obtained ( P = .099) between the 2 groups. MSCs could not be isolated from synovial fluid. The frequency of oil red O–positive adipogenic colonies ( P = .028) and the expression of the adipsin gene ( P < .05) were significantly increased in the cells from the synovium anterior to the talus compared to those in the cells from the surrounding ATFL synovium. However, chondrogenic and osteogenic potentials were not significantly different between the 2 groups. Conclusion: Synovial MSCs obtained from the ankle joint had self-renewal and multilineage differentiation potential, although the adipogenesis potential of MSCs from the synovium anterior to the talus was superior to that from the surrounding ATFL synovium. Clinical Relevance: Both the adipose synovium and fibrous synovium in the ankle joints of patients with CLAI may be a good source of MSCs for stem cell therapy applications, whereas synovial fluid appeared unsuitable.
Association of Insurance Status With Treatment Delays for Pediatric and Adolescent Patients Undergoing Surgery for Patellar Instability
Authors: Allahabadi Sachin , Halvorson Ryan T. , Pandya Nirav K. 
Published: May 2022

Background: Health care disparities have been highlighted in pediatric sports medicine, but the association between insurance status and delayed care for patients undergoing surgery for patellar instability has not been defined. Purpose: To determine whether there is an association between insurance status and delays in care in pediatric and adolescent patients undergoing surgery for patellar instability. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective case series at a safety-net tertiary referral center of pediatric and adolescent patients undergoing surgical treatment for patellar instability. Insurance status was classified as public or private. We calculated the times from injury to clinical evaluation, injury to magnetic resonance imaging (MRI), injury to surgery, clinical evaluation to MRI, and clinical evaluation to surgery. Comparisons were made between insurance groups. Results: Included were 78 patients (38 public, 40 private insurance) who underwent surgery for patellar instability. The public insurance group was older ( P = .019), with a lower proportion of White patients (15.8% vs 52.5%; P = .0005), higher proportion with Hispanic ethnicity (55.3% vs 15.0%; P = .0001), and higher proportion of Spanish-speaking patients (21.1% vs 2.5%; P = .007). Publicly insured patients had longer times from initial injury to clinical evaluation (466 vs 77 days; P = .002), MRI (466 vs 82 days; P = .003), and surgery (695 vs 153 days; P = .0003), as well as a longer time from clinical evaluation to surgery (226 vs 73 days; P = .002). Multivariable models confirmed insurance status as an independent predictor in each of the identified delays. Conclusion: Significant delays were seen for pediatric and adolescent patients with patellar instability and public insurance (approximately 6 times longer to clinical evaluation, more than 5.5 times longer to obtain MRI, and 4.5 times longer to surgery) relative to injured patients with private insurance. Even after adjusting for delays to clinical evaluation, publicly insured patients had a delay from clinic to surgery that was triple that of privately insured patients.
Use of a Nanofiber Resorbable Scaffold During Rotator Cuff Repair: Surgical Technique and Results After Repair of Small- to Medium-Sized Tears
Authors: Seetharam Abhijit , Abad Joel , Baessler Aaron , Badman Brian L. 
Published: May 2022

Background: The rate of retear after primary rotator cuff failure remains unacceptably high (up to 36% for small- to medium-sized tears). Augmentation of cuff repair with scaffold devices has been reported to improve healing after cuff repair. Purpose/Hypothesis: To describe the surgical technique of using an interpositional nanofiber scaffold during rotator cuff repair and report on a retrospective series of patients regarding functional outcomes and postoperative healing on magnetic resonance imaging (MRI). We hypothesized that augmentation of cuff repair with an interpositional scaffold would result in a high rate of tendon healing and excellent functional outcomes. Study Design: Case series; Level of evidence, 4. Methods: A total of 33 patients underwent arthroscopic rotator cuff repair augmented with a nanofiber, bioresorbable polymer patch secured as an inlay between the tendon and underlying bone. Patients were evaluated preoperatively and postoperatively with the Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) shoulder score, and active range of motion (ROM) measurements. Postoperative MRI was used to evaluate repair status. Results: At a minimum follow-up of 6 months, the patients showed significant improvement on SST and ASES scores ( P < .0001 for both). ROM in forward flexion, abduction, internal rotation, and external rotation significantly improved at 6 months postoperatively ( P < .05 for all). MRI at an average of 11 months postoperatively showed healing in 91% of patients; one patient had a recurrent tear with transtendon failure, and another patient had retear at the insertional site. The patch was not visible on postoperative imaging, suggesting complete resorption in all patients. No adverse events were associated with the patch. Conclusion: Our results demonstrate the preliminary safety and efficacy of a novel, bioresorbable synthetic scaffold for rotator cuff repair. The use of the scaffold resulted in a 91% tendon healing rate and significant improvements in functional and patient-reported outcome measures. The results are promising for improving the current unacceptably high rate of rotator cuff repair failure.
Sex-Based Differences in Femoroacetabular Impingement Syndrome and the Effect of Cam Deformity Location on the Extent of Labral Tearing: A 3-Dimensional Computed Tomography Study
Authors: Alter Thomas D. , Knapik Derrick M. , Lambers Floor , Guidetti Martina , Chahla Jorge , Malloy Philip , Nho Shane J. 
Published: May 2022

Background: Sex-specific quantification of cam morphology in patients with femoroacetabular impingement syndrome may improve diagnostics, surgical planning, and outcomes. Purpose: To (1) examine differences between men and women with symptomatic cam deformities based on deformity location, magnitude, and extent; (2) assess the association between cam deformity and labral pathology; and (3) evaluate the relationship between cam deformity and patient-reported outcome measures after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Computed tomography (CT) scans were acquired in 98 consecutive patients before hip arthroscopy for femoroacetabular impingement syndrome. Custom software was used to generate 3-dimensional bone models and align them to a standard coordinate system. The alpha angle was measured at the 12-, 1-, 2-, and 3-o’clock positions, with 12 and 3 o’clock corresponding to the superior and anterior aspects of the femur, respectively. These alpha angle measurements were used to define the cam midpoint and extent. The labral tear midpoint and extent were evaluated intraoperatively. Bivariate correlation analysis was used to evaluate the association between the cam and labral tear midpoints and between the extent of the cam morphology and labral tearing. Results: The 3-dimensional models were analyzed in a cohort of 69 female and 29 male patients. Male patients were older (mean ± SD, 38.9 ± 12.6 vs 30.7 ± 12.2 years, P = .006) and had a greater body mass index (27.8 ± 4.4 vs 25.3 ± 5.6 kg/m2, P = .005). Male patients had greater alpha angle measures at 12, 1, and 3 o’clock ( P < .05) and a greater maximum alpha angle (69.0° ± 18.8° vs 62.1° ± 21.0°, P = .031); the location of their maximum cam impingement was also significantly different ( P < .05) when compared with female patients. Cam impingement (2:06 ± 1:09 vs 1:33 ± 1:16 clockfaces, P = .032) and labral tearing (3:02 ± 0:35 vs 2:34 ± 0:53 clockfaces, P = .003) in men extended over a greater region of the femoral clockface when compared with women. Significant correlations were demonstrated between the cam and labral tear midpoint locations ( r = 0.190, P = .032) and the extent of the cam deformity and labral tearing ( r = 0.203, P = .024). There were no sex-based differences in patient-reported outcome measures at baseline or 2-year follow-up. Conclusion: Male patients possessed greater cam deformity magnitude and extent when compared with female patients. Cam pathomorphology was associated with the location and extent of labral tearing.
Midterm Outcomes After Arthroscopic Repair of Type VIII SLAP Lesions in Active Duty Military Patients Younger Than 35 Years
Authors: Green Clare K. , Scanaliato John P. , Fares Austin B. , Czajkowski Hunter , Dunn John C. , Parnes Nata 
Published: May 2022

Background: Superior labrum from anterior to posterior (SLAP) lesions represent a significant cause of shoulder pain and disability among active duty members of the US military. However, few data exist regarding the surgical management of type VIII SLAP lesions. Hypothesis: We hypothesized that arthroscopic repair would decrease pain and increase function at the midterm follow-up and allow for a high rate of maintenance of active duty status. Study Design: Case series; Level of evidence, 4. Methods: Consecutive active duty military patients were identified from January 2011 through June 2015 who underwent arthroscopic repair of type VIII SLAP lesions performed by a single surgeon. Patients were excluded if they underwent glenoid microfracture, other capsulolabral repair, or rotator cuff repair. Outcome measures were completed by patients within 1 week before surgery and at latest follow-up: pain visual analog scale, Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons shoulder score, and Rowe instability score. Results: A total of 30 patients met the inclusion criteria for the study. The mean ± SD follow-up was 96.60 ± 10.91 months. At final follow-up, the mean visual analog scale score improved from 8.17 ± 1.6 to 1.63 ± 1.90 ( P < .0001), the Single Assessment Numeric Evaluation score from 41.65 ± 16.78 to 87.63 ± 13.02 ( P < .0001), the American Shoulder and Elbow Surgeons score from 36.47 ± 10.26 to 88.07 ± 13.94 ( P < .0001), and the Rowe score from 35.33 ± 6.56 to 90.00 ± 14.68 ( P < .0001). Three patients reported postoperative complications, and 1 progressed to further surgery. Overall, 90% of patients remained on active duty military service and were able to return to preinjury levels of work and recreational activity. The failure rate, defined as persistent instability or activity-limiting pain, was 10%. Conclusion: The results of this study demonstrated favorable outcomes for the majority of patients after arthroscopic repair of type VIII SLAP lesions at midterm follow-up, supporting repair as a viable treatment option for type VIII SLAP tears in this patient population.