bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Screw Length for Osteochondritis Dissecans Fixation of the Pediatric Distal Femur: A Magnetic Resonance Imaging Comparision Study of Pediatric Epiphyseal Thickness
Authors: Sampognaro Gabriel , Massey Patrick , Nelson Bradley , Ingraffia Patrick , Simoncini Alberto , Barton R. Shane 
Published: May 2022

Background: Magnetic Resonance Imaging (MRI) allows orthopaedic surgeons to assess Osteochondritis Dissecans (OCD) of the distal femur in children. When surgical fixation is indicated, headless compression screws can be used to stabilize the fragment and allow it to heal. During screw placement it is important to make sure the screw is not too long or it may cross the physis, leading to physeal growth arrest. Hypothesis/Purpose: The purpose of the study was to determine the optimal screw length for osteochondritis dissecans fixation of the pediatric distal femur. A secondary objective was to compare the thickness of the epiphysis of the pediatric distal femur at different locations and screw trajectories. Methods: This retrospective, IRB-approved, single-institution study identified 113 pediatric patients (ages 6-17 years old) with a knee MRI from January 1, 2008 to January 1, 2020. A total of 6 measurements were obtained on each pediatric MRI by two residents. The longitudinal axis of the femur was used as a reference trajectory. Three measurements were obtained from medial femoral condyle and lateral femoral condyle, respectively. The lengths measured were from the anteromedial (AM), posteromedial (PM), and distalmedial (DM) on the medial femoral condyle to the physis. On the lateral femoral condyle, the anterolateral (AL), posterolateral (PL), and distallateral (DL) were measured. 2 sample t-testing, chi-square analysis, and Pearson’s correlation coefficient were utilized to find significant associations. Results: Of the 113 pediatric knees identified, 32 did not meet inclusion criteria, yielding 81 patients for final analysis. The average epiphyseal thickness of the bone was 25.5 mm ± 4.2 (CI 24.5 – 26.4, range 14.1 – 33.1). There was a difference in epiphyseal thickness based on screw trajectory () with the average thickness being 23.0, 22.2, 30.5, 29.3, 25.5, and 22.3 mm for the AM, AL, PM, PL, DM and DL respectively. There was a negative correlation between increasing age and epiphyseal cartilage thickness (). There was a positive correlation between increasing age and bone only epiphyseal thickness (). Conclusion: Our study outlines important measurements that orthopedic surgeons must be aware of when operating on OCD lesions in pediatric patients. These results can aid in determining the appropriate screw length that can be implanted into the pediatric distal femur to avoid damaging the distal femur. Our study results show that the optimal screw length to use in pediatric OCD lesion is 18mm in order to avoid physeal disturbance in the majority of pediatric patients. [Figure: see text][Figure: see text]
Predictors of Professional Fulfillment and Burnout Among Otolaryngologists During the COVID‐19 Pandemic
Authors: Karras Rachel , Matos Sophia , Sharma Arun , Crosby Dana L. 
Published: May 2022

ObjectiveThe goal of this study is to assess burnout and professional fulfillment during the initial weeks of the COVID‐19 pandemic among otolaryngology practitioners.Study DesignCross‐sectional survey.SettingInternational survey of otolaryngologists during a pandemic.MethodsA cross‐sectional survey was performed from April 24 to May 8, 2020, via email and social media platforms to understand the impact of the COVID‐19 pandemic on otolaryngology practitioners in academic and private practice. The Professional Fulfillment Index was used to assess professional fulfillment and burnout. Burnout was divided into work exhaustion and interpersonal disengagement.ResultsOf 243 respondents, 202 completed the Professional Fulfillment Index portion of the survey. An average score ≥3 on the professional fulfillment section correlates with fulfillment, while an average score ≥1.33 on the burnout section correlates with burnout. The average score of professional fulfillment was 2.17, with 85.6% of respondents reporting lack of professional fulfillment. The average score on burnout was 1, with 40.1% of otolaryngologists reporting burnout. In multivariable analyses, females were found to have statistically lower professional fulfillment (beta = −2.28, P =. 010) with higher rates of work exhaustion (beta = 0.62, P <. 001), interpersonal disengagement (beta = 2.08, P =. 023), and burnout (beta = 4.49, P =. 002).ConclusionEarly in the COVID‐19 pandemic, most participants reported a lack of professional fulfillment while just under half experienced burnout. Female gender was associated with low professional fulfillment and high work exhaustion, interpersonal disengagement, and burnout. Attention to burnout and job satisfaction during a pandemic is critical for the appropriate well‐being of otolaryngology practitioners.
Exploring the underlying molecular mechanism of liver cancer cells under hypoxia based on RNA sequencing
Authors: Zhao Xin , Liu Wenpeng , Liu Baowang , Zeng Qiang , Cui Ziqiang , Wang Yang , Cao Jinglin , Gao Qingjun , Zhao Caiyan , Dou Jian 
Published: May 2022

Abstract
Background
The aim of our study was to use the differentially expressed mRNAs (DEmRNAs) and differentially expressed miRNAs (DEmiRNAs) to illustrate the underlying mechanism of hypoxia in liver cancer.

Methods
In this study, a cell model of hypoxia was established, and autophagy activity was measured with western blotting and transmission electron microscopy. The effect of hypoxia conditions on the invasion of liver cancer cell was evaluated. RNA sequencing was used to identify DEmRNAs and DEmiRNAs to explore the mechanism of hypoxia in liver cancer cells.

Results
We found that autophagy activation was triggered by hypoxia stress and hypoxia might promote liver cancer cell invasion. In addition, a total of 407 shared DEmRNAs and 57 shared DEmiRNAs were identified in both HCCLM3 hypoxia group and SMMC-7721 hypoxia group compared with control group. Furthermore, 278 DEmRNAs and 24 DEmiRNAs were identified as cancer hypoxia-specific DEmRNAs and DEmiRNAs. Finally, we obtained 19 DEmiRNAs with high degree based on the DEmiRNA-DEmRNA interaction network. Among them, hsa-miR-483-5p, hsa-miR-4739, hsa-miR-214-3p and hsa-miR-296-5p may be potential gene signatures related to liver cancer hypoxia.

Conclusions
Our study may help to understand the potential molecular mechanism of hypoxia in liver cancer.
Multiplex detection of five common respiratory pathogens from bronchoalveolar lavages using high resolution melting curve analysis
Authors: Ghorbani Jaber , Hashemi Farhad Bonakdar , Jabalameli Fereshteh , Emaneini Mohammad , Beigverdi Reza 
Published: May 2022

Abstract
Background
The study describes the application of the multiplex high-resolution melting curve (MHRM) assay for the simultaneous detection of five common bacterial pathogens (Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli) directly from bronchoalveolar lavage samples.

Results
Our MHRM assay successfully identified all five respiratory pathogens in less than 5 h, with five separate melting curves with specific melt peak temperatures (Tm). The different Tm were characterized by peaks of 78.1 ± 0.4 °C for S. aureus, 83.3 ± 0.1 °C for A. baumannii, 86.7 ± 0.2 °C for E. coli, 90.5 ± 0.1 °C for K. pneumoniae, 94.5 ± 0.2 °C for P. aeruginosa. The overall sensitivity and specificity of MHRM were 100% and 88.8–100%, respectively.

Conclusions
Our MHRM assay offers a simple and fast alternative to culture approach for simultaneous detection of five major bacterial lower respiratory tract infection pathogens. Utilization of this assay can help clinicians initiate prompt and appropriate antimicrobial treatment, towards reducing the morbidity and mortality of severe respiratory infections.
Perioperative outcomes of non-intubated versus intubated video-assisted thoracoscopic surgery in different thoracic procedures: a propensity score-matched analysis
Authors: Pathonsamit Chompunoot , Tantraworasin Apichat , Poopipatpab Sujaree , Laohathai Sira 
Published: May 2022

Abstract
Background
Non-intubated video-assisted thoracoscopic surgery (NIVATS) is increasingly performed in different types of thoracic procedures. Based on the anesthetic perspective, the outcomes of this method are limited. General anesthesia with intubation and controlled ventilation for video-assisted thoracoscopic surgery (IVATS) is a standard technique. The current study aimed to compare the pulmonary gas exchange between NIVATS and IVATS, with a focus on desaturation event.

Methods
This was a retrospective study conducted at Vajira Hospital. Data were collected from the hospital medical record database between January 9, 2019, and May 15, 2020. A propensity score-matched analysis was used to adjust the confounders by indications and contraindication between NIVATS and IVATS. The perioperative outcomes of VATS and NIVATS were compared by the regression analysis method.

Results
In total, 180 patients were included in the analysis. There were 98 and 82 patients in the NIVATS and IVATS groups, respectively. After a propensity score matching, the number of patients with similar characteristics decreased to 52 per group. None of the patients in both groups experienced desaturation. The lowest oxygen saturation of the NIVATS and IVATS groups did not significantly differ (96.5% vs. 99%, respectively; p = 0.185). The NIVATS group had a significantly higher ETCO2 peak than the IVATS group (43 vs. 36 mmHg, respectively; p < 0.001). According to the regression analysis, the NIVATS group had a significantly shorter anesthetic induction time (Mean difference (MD) = -5.135 min (95% CI = (- 8.878)- (-1.391)) and lower volume of blood loss (MD = -75.565 ml (95%CI = (- 131.08)—(- 20.65) but a higher intraoperative ETCO2 than the IVATS group (MD = 4.561 mmHg (95%CI = 1.852—7.269). Four patients in the NIVATS group required conversion to intubation due to difficulties encountered when using the surgical technique (7.7%, p = 0.041). Seven patients in the IVATS group, but none in the NIVATS group, presented with sore throat (13.5% vs. 0%, respectively; p = 0.006). Moreover, none of the patients in both groups experienced postoperative pneumonia, underwent reoperation, or died.

Conclusions
The anesthetic and surgical outcomes of NIVATS were comparable to those of IVATS.
Hypertension modifies the associations of body mass index and waist circumference with all-cause mortality among older Chinese: a retrospective cohort study
Authors: Bai Kaizhi , Chen Xuejiao , Shi Zhan , He Kun , Hu Xueqi , Song Rui , Shi Wenlong , Tian Qingfeng , Shi Songhe 
Published: May 2022

Abstract
Background
The effect of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to explore the relationships of body mass index (BMI) and waist circumference (WC) with all-cause mortality among older hypertensive and normotensive Chinese individuals.

Methods
This retrospective cohort study was conducted in Xinzheng, Henan Province, Central China. The data came from the residents’ electronic health records of the Xinzheng Hospital Information System. A total of 77,295 participants (41,357 hypertensive participants and 35,938 normotensive participants) aged ≥ 60 years were included from January 2011 to November 2019. Cox proportional hazard regression model was used to examine the relationships.

Results
During a mean follow-up of 5.3 years, 10,755 deaths were identified (6,377 in hypertensive participants and 4,378 in normotensive participants). In adjusted models, compared with a BMI of 18.5–24 kg/m2, the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of BMI < 18.5, 24–28 and ≥ 28 kg/m2 for mortality in hypertensive participants were 1.074 (0.927–1.244), 0.881 (0.834–0.931) and 0.856 (0.790–0.929), respectively, and 1.444 (1.267–1.646), 0.884 (0.822–0.949) and 0.912 (0.792–1.051), respectively, in normotensive participants. Compared with normal waist circumference, the adjusted HRs and 95% CIs of central obesity for mortality were 0.880 (0.832–0.931) in hypertensive participants and 0.918 (0.846–0.996) in normotensive participants. A sensitivity analysis showed similar associations for both hypertensive and normotensive participants.

Conclusion
Low BMI and WC were associated with a higher risk of all-cause mortality regardless of hypertension status in older Chinese individuals. The lowest risk of death associated with BMI was in the overweight group in normotensive participants and in the obesity group in hypertensive participants.
Efficacy and safety of sugammadex for neuromuscular blockade reversal in pediatric patients: an updated meta-analysis of randomized controlled trials with trial sequential analysis
Authors: Lang Bingchen , Han Lu , Zeng Linan , Zhang Qianqian , Chen Shouming , Huang Liang , Jia Zhijun , Yu Qin , Zhang Lingli 
Published: May 2022

Abstract
Background
A recent survey revealed that extensive off-label use of sugammadex in pediatric anesthesia deserved particular attention. The present study with trial sequential analysis (TSA) aimed to evaluate the effects of sugammadex for antagonizing neuromuscular blockade (NMB) in pediatric patients, and to investigate whether the findings achieved the required information size to draw conclusions.

Methods
PubMed, Embase, Cochrane Library and China National Knowledge Infrastructure (CNKI) were searched from inception to April 2021. All randomized controlled trials used sugammadex as reversal agent in pediatric patients were enrolled. Time from NMB reversal to recovery of the train-of-four ratio (TOFr) to 0.9 and extubation time were considered as co-primary outcomes, and incidences of adverse events were considered as secondary outcomes. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to rate the quality of evidences.

Results
Data from 18 studies involving 1,065 pediatric patients were acquired. The results revealed that use of sugammadex was associated with shorter duration from administration of reversal agents to TOFr > 0.9 (MD = -14.42, with 95% CI [-17.08, -11.75]) and shorter interval from reversal from NMB to extubation (MD = -13.98, with 95% CI [-16.70, -11.26]) compared to control groups. TSA also indicated that the current sample sizes were sufficient with unnecessary further trials. Analysis of secondary outcomes indicated that administration of sugammadex was associated with less incidence of postoperative nausea and vomiting (PONV), bradycardia, and dry mouth compared to control groups.

Conclusion
Considering of satisfactory and rapid neuromuscular blockade reversal with low incidences of adverse events, sugammadex might be considered as the preferred option for children in clinical anesthesia practice compared to acetylcholinesterase inhibitors. However, overall low-quality evidences in present study rated by GRADE system indicated that superiority of sugammadex employed in pediatric patients needs to be confirmed by more studies with high quality and large sample size in future.
Parents’ awareness and perceptions of the Change4Life 100 cal snack campaign, and perceived impact on snack consumption by children under 11 years
Authors: Day Rhiannon E. , Bridge Gemma , Austin Kate , Ensaff Hannah , Christian Meaghan S. 
Published: May 2022

Abstract
Background
Childhood obesity is a pertinent public health problem in the UK. Consumption of free sugars has been associated with the development of obesity. In 2018, the Change 4Life (C4L) 100 cal snack campaign was launched with the slogan ‘100 calorie snacks, two a day max’, aiming to encourage parents to choose lower sugar, fat and calorie snacks for their children. This study aimed to examine how the campaign has been perceived by parents.

Methods
An online survey was developed to explore parent awareness, perceptions and understanding of the C4L 100 cal snack campaign. Respondents were recruited via Leeds City Council, posters displayed at primary schools and children’s centres across Leeds and via social media. Paper surveys were also shared with voluntarily led playgroups. Survey data was analysed using descriptive statistics. Thematic analysis was performed on open text responses.

Results
Three hundred forty-two 342 respondents completed the survey. Just over half of the respondents had come across the campaign, most seeing the leaflet or a television advert. Over two-thirds of respondents ‘agreed’ or ‘strongly agreed’ that the campaign caught their attention. A similar proportion ‘agreed’ or ‘strongly agreed’ that the campaign informed them about 100 cal snacks and just over a half thought it was memorable. Most respondents used positive language to describe the campaign, but there was no clear consensus of a perceived positive impact on healthier snack purchasing, nor preparing more 100 cal snacks at home. Respondents provided examples of how the campaign could be improved to positively impact eating behaviours: better publicity and information delivery; healthier snack examples made more visible; improved nutritional labelling and access to healthier products in supermarkets (availability, promotion, display, choice).

Conclusions
The C4L 100 cal snack campaign was perceived positively by parents and carers, with many agreeing that the campaign was informative and memorable. However, there was no agreement in terms of the parents reporting an impact of the campaign on behaviour change and healthier snack habits. Future social marketing campaigns could be improved through more formal pilot testing to assess the understanding and acceptance of the campaign amongst the target audience.
Adductor canal block combined with local infiltration analgesia with morphine and betamethasone show superior analgesic effect than local infiltration analgesia alone for total knee arthroplasty: a prospective randomized controlled trial
Authors: Luo Zhen-Yu , Yu Qiu-Ping , Zeng Wei-Nan , Xiao Qiang , Chen Xi , Wang Hao-Yang , Zhou Zongke 
Published: May 2022

Abstract
Background
Local infiltration analgesia (LIA) and adductor canal block (ACB) provide postoperative analgesia for total knee arthroplasty (TKA). ACB blocks the saphenous nerve and has smaller impacts on quadriceps muscle weakness. ACB theoretically does not have enough analgesic effects on posterior sensory nerves. LIA may increase its analgesic effects on the posterolateral knee. The purpose of this study was to evaluate whether ACB combined with a LIA cocktail of ropivacaine, morphine, and betamethasone has superior analgesic effect than LIA for TKA.

Methods
A total of 86 patients were assessed for eligibility from February 2019 to May 2019. 26 of those were excluded, and 60 patients were divided into 2 groups by computer-generated random number. Group A (LIA group) received LIA cocktail of ropivacaine, morphine and betamethasone. Group B (LIA+ ACB group) received ultrasound-guided ACB and LIA cocktail of ropivacaine, morphine and betamethasone. Postoperative visual analogue scale (VAS) resting or active pain scores, opioid consumption, range of motion (ROM), functional tests, complications and satisfaction rates were measured. The longest follow-up was 2 years.

Results
Two groups have no differences in terms of characteristics, preoperative pain or function (P > 0.05). ACB combined with LIA had significantly lower resting and active VAS pain scores, better ROM, better sleeping quality and higher satisfaction rates than LIA alone within 72 h postoperatively (P < 0.05). Complications, or adverse events and HSS score, SF-12 score were observed no significant differences within 2 years postoperatively.

Conclusions
Adductor canal block combined with Local infiltration analgesia provide better early pain control. Although the small statistical benefit may not result in minimal clinically important difference, Adductor canal block combined with Local infiltration analgesia also reduce opioid requirements, improve sleeping quality, and do not increase the complication rate. Therefore, Adductor canal block combined with Local infiltration analgesia still have good application prospects as an effective pain management for total knee arthroplasty.

Trial registration
Chinese Clinical Trial Registry, ChiCTR1900021385, 18/02/2019.
Comparative retrieval analysis of a novel anatomic tibial tray backside: alterations in tibial component design and surface coating can increase cement adhesions and surface roughness
Authors: Mathis Dominic T. , Schmidli Joshua , Amsler Felix , Henckel Johann , Hothi Harry , Hart Alister , Hirschmann Michael T. 
Published: May 2022

Abstract
Background
With the Persona® knee system a novel anatomic total knee design was developed, which has no pre-coating, whereas the predecessor knee system is pre-coated with polymethylmethacrylate (PMMA). Joint registry data have shown no decrease in risk of aseptic revision of PMMA pre-coated tibial components compared with non-pre-coated implants. The aim of this retrieval study was to compare the amount of cement adhesions, geometry and surface features between the two knee designs and to correlate them with the underlying reason for revision surgery.

Methods
Retrieval analysis was performed of 15 NexGen® and 8 Persona® fixed-bearing knee implants from the same manufacturer retrieved from two knee revision centres. A photogrammetric method was used to grade the amount of cement attached to the tibial tray backside. The geometry and dimensions of the tibial trays, tray projections and peripheral lips were measured using digital callipers and compared between the two different designs. To measure the surface roughness on the backside of the tibial tray, a contact profilometer was used. To investigate differences between the two designs statistical analyses (t-test) were performed.

Results
All Persona® trays showed evidence of cement adhesion with a % area of 75.4%; half of the NexGen® trays had cement adhesions, with a mean value of 20%. There was a significant difference in the percentage of area covered by cement between the two designs (p < 0.001). Results from the contact profilometer revealed that Persona® and NexGen® tray backsides showed a similar lateral (1.36 μm and 1.10 μm) and medial (1.39 μm and 1.12 μm) mean surface roughness with significant differentiation (p < 0.05) of the lateral and medial roughness values between the two designs. Persona® stems showed a significantly higher mean surface roughness (1.26) compared to NexGen® stems (0.89; p < 0.05).

Conclusion
The novel anatomic knee system showed significantly more cements adhesions and a higher surface roughness which was most likely attributed to the most obvious design and coating alteration of the tibial tray. This study provides first retrieval findings of a novel TKA design recently introduced to the market.