bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Radiological Evidence of Kaplan Fiber Injury on the Clinical and Functional Outcomes After Acute Anterior Cruciate Ligament Reconstruction
Authors: Devitt Brian M. , Klemm Haydn J. , Kirby Julia , Batty Lachlan M. , Webster Kate E. , Whitehead Timothy S. , Feller Julian A. 
Published: September 2022

Background: A paucity of information is available regarding the clinical outcomes of patients with radiological evidence of Kaplan fiber (KF) injury who undergo anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose/Hypothesis: The purpose was to compare clinical and functional outcomes in patients undergoing acute primary ACLR with and without magnetic resonance imaging (MRI) evidence of KF injury. The hypothesis was that there would be no difference in clinical or functional outcomes in patients with versus those without radiological evidence of KF injury. Study Design: Cohort study; Level of evidence, 3. Methods: MRI analysis was conducted on patients in a longitudinal prospective study of ACL injury. Only patients who had an MRI scan and had undergone isolated primary ACLR within 60 days of injury were included. MRI was performed using standard knee protocols, and diagnostic criteria were applied to identify KF injury. A total of 32 patients with KF injury (mean age, 24.2 years; 21 male, 11 female) were identified and matched for sex, age, graft type, and preinjury activity with 90 patients who had intact KF. Patients were followed up at 12 months with KT-1000 arthrometer measurements of side-to-side difference in anterior knee laxity, single- and triple-hop limb symmetry index (LSI), Marx activity and International Knee Documentation Committee (IKDC) scores, and return to sport (RTS) rates at 12 months and 24 months. Results: No differences were found in anterior knee laxity and single- and triple-hop LSI values between the KF-intact and KF-injured cohorts at 12 months. No differences in Marx and IKDC scores were found between the groups at 12 months and 2 years. The overall rate of RTS within 24 months was 75% (92/122), and 5 patients (2 KF-injured; 3 KF-intact) had a subsequent graft rupture. Conclusion: We found no difference in clinical or functional outcomes in patients with and without radiological evidence of KF injury who underwent acute primary ACLR. Based on these findings, the radiological presence of KF injury at the time of acute ACL injury should not be regarded as a risk factor for a negative prognosis after ACLR.
Early ACLR and Risk and Timing of Secondary Meniscal Injury Compared With Delayed ACLR or Nonoperative Treatment: A Time-to-Event Analysis Using Machine Learning
Authors: Lu Yining , Jurgensmeier Kevin , Till Sara E. , Reinholz Anna , Saris Daniel B.F. , Camp Christopher L. , Krych Aaron J. 
Published: September 2022

Background: Surgical and nonoperative management of anterior cruciate ligament (ACL) injuries seek to mitigate the risk of knee instability and secondary meniscal injury. However, the associated risk and timing of secondary meniscal tears have not been completely elucidated. Purpose: To compare risk and timing of secondary meniscal injury between patients receiving nonoperative management, delayed ACL reconstruction (ACLR), and early ACLR using a machine learning survival analysis. Study Design: Cohort study; Level of evidence, 3. Methods: A geographic database was used to identify and review records of patients with a diagnosis of ACL rupture between 1990 and 2016 with minimum 2-year follow-up. Patients undergoing ACLR were matched 1:1 with nonoperatively treated controls. Rate and time to secondary meniscal tear were compared using random survival forest algorithms; independent models were developed and internally validated for predicting injury-free duration in both cohorts. Performance was measured using out-of-bag c-statistic, calibration, and Brier score. Model interpretability was enhanced using global variable importance and partial dependence curves. Results: The study included 1369 patients who underwent ACLR and 294 patients who had nonoperative treatment. After matching, no significant differences in rates of secondary meniscal tear were found ( P = .09); subgroup analysis revealed the shortest periods of meniscal survival in patients undergoing delayed ACLR. The random survival forest algorithm achieved excellent predictive performance for the ACLR cohort, with an out-of-bag c-statistic of 0.80 and a Brier score of 0.11. Significant variables for risk of meniscal tear for the ACLR cohort included time to return to sports or activity ≤350 days, time to surgery ≥50 days, age at injury ≤40 years, and high-impact or rotational landing sports, whereas those in the nonoperative cohort model included time to RTS ≤200 days, visual analog scale pain score >3 at consultation, hypermobility, and noncontact sports. Conclusion: Delayed ACLR demonstrated the greatest long-term risk of meniscal injury compared with nonoperative treatment or early ACLR. Risk factors for decreased meniscal survival after ACLR included increased time to surgery, shorter time to return to sports or activity, older age at injury, and involvement in high-impact or rotational landing sports. Pending careful external validation, these models may be deployed in the clinical space to provide real-time insights and enhance decision making.
Using Narrative Inquiry to Understand Anti-Muslim Racism in Canadian Nursing
Authors: Saleh Nasrin , Clark Nancy , Bruce Anne , Moosa-Mitha Mehmoona 
Published: September 2022

Background Islamophobia or, anti-Muslim racism, and more specifically, gendered islamophobia targeting Muslim women who wear a hijab is rising globally and is aggravated by the COVID-19 pandemic. However, anti-Muslim racism is not well understood in Canadian nursing. Purpose This study utilized narrative inquiry to understand anti-Muslim racism through the experiences of nurses who wear a hijab with the goal of putting forward their counter-narrative that disrupts anti-Muslim racism in Canadian nursing. Methods Narrative inquiry informed by Critical Race Feminism, care ethics, and intersectionality were used to analyze the factors shaping anti-Muslim racism and composite narratives were used to present the results. Results The three composite narratives are: ‘This is Who I Am: A Muslim Nurse with a Hijab and an Accent’; ‘I Know What is at Play: Unveiling Operating Power Structures and Power Relations’; and ‘Rewriting the Narrative: Navigating Power Structures and Power Relations’. These composite narratives constituted the nurses’ counter-narrative. They revealed intersections of gendered, racial divisions of labour and religious narratives that shape anti-Muslim racism, as operating power relations in nursing, and how Muslim nurses reclaimed control to resist their racialized stereotypes. Conclusion Findings suggest that anti-Muslim racism in nursing operates through multiple intersecting power relations. Using stories can mobilize transformational change so that anti-racist practices, policies, and pedagogy can be embraced.
The Results of Different Heating Temperatures on Activities of Bioactive Proteins in Human Milk
Authors: Zhang Jie , Duley John A. , Cowley David M. , Shaw Paul N. , Zhou Peng , Koorts Pieter , Bansal Nidhi 
Published: September 2022

Background: The most utilized pasteurization method in donor human milk banks is Holder pasteurization (heating 62.5 °C for 30 min). However, many bioactive proteins are heat sensitive and are inactivated. Research Aim: To determine the results of a range of heating regimes on the activities of xanthine oxidase, lactoperoxidase and lysozyme, the concentrations of immunoglobulin A and lactoferrin, as well as bacterial inactivation. Method: This prospective, cross-sectional, intervention study was designed to measure the influence of heating temperatures on bioactive components in donor human milk. Milk samples were processed at 40, 50, 55, 62.5, 75, 127 °C and the activities of the enzymes, and the concentration of immune proteins, were measured. Results: No bacterial colonies were detectable, using standard culture methods, after heating above 50 ºC. All proteins studied retained over 60% concentrations or activities when the pasteurization temperature was 50 ºC or lower, while their concentrations or activities were lost at higher temperatures. For lactoferrin, the residual concentration was above 80% when heating temperature was under 55 °C, while only 20% remained after Holder pasteurization. Both xanthine oxidase and lactoperoxidase had little residual activity when temperatures were above Holder pasteurization. Lysozyme retained a greater proportion of residual activity than other proteins, following heating at all temperatures. Conclusions: The concentrations or activities of immune proteins and bioactive enzymes decreased when heated above 50 °C. The results of this study can be used to design temperature control guidance during alternative methods of pasteurization.
Pilot study on accelerated aging in lupus using epigenetic biomarkers of age
Authors: Gensous Noémie , Blanco Patrick , Lazaro Estibaliz , Mercié Patrick , Pellegrin Isabelle , Richez Christophe , Duffau Pierre 
Published: September 2022

Objective Despite an important increase in lifespan over the last decades, patients with systemic lupus erythematosus (SLE) still have to face a high morbi-mortality, particularly related to cardiovascular diseases, infections and cancers. Such events are more commonly found during old age in the general population, raising the hypothesis of an acceleration of the aging process in SLE patients. In this pilot study, we wanted to test the hypothesis that SLE would be associated with an accelerated biological aging measured by the epigenetic clocks models. Methods We applied DNA methylation-based biomarkers of age in publicly available datasets of SLE patients. For every SLE patient and control included in the dataset, we calculated their epigenetic age and a measure of epigenetic age acceleration, according to Horvath’s epigenetic clock model. Results We included in our analysis two distinct DNA methylation datasets of 30 subjects (among which 15 with SLE) and 55 subjects (among which 30 with SLE), respectively. In both datasets, there was a statistically significant correlation between chronological age and epigenetic age. We did not observe any statistically significant difference in the measure of epigenetic age acceleration between SLE patients and controls. Conclusion We did not observe any evidence of an accelerated biological aging in SLE patients, according to Horvath’s epigenetic clock model.
Cognitive Development in Lambdoid Craniosynostosis: A Systematic Review and Meta-Analysis
Authors: Chiang Sarah N. , Fotouhi Annahita R. , Doering Michelle M. , Skolnick Gary B. , Naidoo Sybill D. , Strahle Jennifer M. , McEvoy Sean D. , Patel Kamlesh B. 
Published: September 2022

Objective Lambdoid craniosynostosis affects approximately 1 in 33 000 live births per year, and surgical correction is often sought in order to achieve normocephaly and allow for adequate brain growth. However, the effects of lambdoid synostosis and its treatment on cognitive development are unknown. Design Systematic review and meta-analysis. Patients, Participants A systematic review of Ovid Medline, Embase, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov was conducted in January 2022. Included studies assessed cognitive development of patients with nonsyndromic unilateral lambdoid craniosynostosis. Main Outcome Measures Results of developmental tests were compared to normative data or controls to generate Hedges’ g for meta-analysis. Results Nine studies met the inclusion criteria. Meta-analysis of 3 studies describing general cognition showed that cases scored significantly lower than their peers, but within 1 standard deviation ( g = 0.37, 95% CI [−0.64, −0.10], P = .01). Meta-analysis of verbal and psychomotor development showed no significant differences in children with lambdoid synostosis. Studies were of fair quality and had moderate-to-high heterogeneity. Conclusions Patients with lambdoid craniosynostosis may score slightly below average on tests of general cognition in comparison to normal controls, but results in other domains are variable. Analyses were limited by small sample sizes. Multidisciplinary care and involvement of a child psychologist may be helpful in identifying areas of concern and providing adequate scholastic support. Further research recruiting larger cohorts will be necessary to confirm these findings and extend them to other developmental domains such as attention and executive function.
Effect of Number of Retrieved Lymph Nodes on Prognosis in FIGO Stage IA1-IIA2 Cervical Cancer Patients Treated With Primary Radical Surgery
Authors: Jiang Shan , Jiang Peng , Jiang Tingting , Tu Yuan , Zhang Jingni , Li Ning , Kong Wei , Huang Yuzhen , Yuan Rui 
Published: September 2022

Background: The influence of the number of removed lymph nodes (RLNs) on patients with early-stage cervical cancer (ESCC) is still questionable. The objective of this study was to explore the prognostic value of RLNs on ESCC patients. Methods: A retrospective study was performed including all ESCC patients who underwent radical surgery from January 2016 to December 2018. Cox regression analysis was performed to verify the correlation between the number of RLNs and the prognosis (recurrence-free survival [RFS], disease-specific survival [DSS]) of ESCC. According to the guidelines, all the patients were divided into high-risk and non-high-risk groups. The optimal cut-off values of RLNs were determined by receiver operating characteristic curve analysis and Youden index and further the prognostic value of them was explored. Results: A total 1101 patients were enrolled. The number of RLNs was an independent prognostic influence factor of the prognosis of ESCC ( P < .001 for RFS, P < .001 for DSS). The optimal cut-off values of RLNs (40 in the high-risk group and 23 in the non-high-risk group) were significantly associated with the prognosis of ESCC, in the high-risk group ( P < .001 for RFS, P = .002 for DSS) and non-high-risk group ( P < .001 for RFS, P < .001 for DSS), respectively. Conclusions: More extensive lymph node dissection (RLNs ⩾ 40) could benefit the high-risk ESCC patients. However, in the non-high-risk group, moderate lymph node dissection (RLNs ≈23) could also benefit them and may reduce the incidence of related complications. Those findings may help to determine the scope of lymph node dissection in ESCC patients before operation.
Sensorimotor network dynamics predict decline in upper and lower limb function in people with multiple sclerosis
Authors: Strik Myrte , Eijlers Anand JC , Dekker Iris , Broeders Tommy AA , Douw Linda , Killestein Joep , Kolbe Scott C , Geurts Jeroen JG , Schoonheim Menno M 
Published: September 2022

Background: Upper and lower limb disabilities are hypothesized to have partially independent underlying (network) disturbances in multiple sclerosis (MS). Objective: This study investigated functional network predictors and longitudinal network changes related to upper and lower limb progression in MS. Methods: Two-hundred fourteen MS patients and 58 controls underwent functional magnetic resonance imaging (fMRI), dexterity (9-Hole Peg Test) and mobility (Timed 25-Foot Walk) measurements (baseline and 5 years). Patients were stratified into progressors (>20% decline) or non-progressors. Functional network efficiency was calculated using static (over entire scan) and dynamic (fluctuations during scan) approaches. Baseline measurements were used to predict progression; significant predictors were explored over time. Results: In both limbs, progression was related to supplementary motor area and caudate efficiency (dynamic and static, respectively). Upper limb progression showed additional specific predictors; cortical grey matter volume, putamen static efficiency and posterior associative sensory (PAS) cortex, putamen, primary somatosensory cortex and thalamus dynamic efficiency. Additional lower limb predictors included motor network grey matter volume, caudate (dynamic) and PAS (static). Only the caudate showed a decline in efficiency over time in one group (non-progressors). Conclusion: Disability progression can be predicted using sensorimotor network measures. Upper and lower limb progression showed unique predictors, possibly indicating different network disturbances underlying these types of progression in MS.
The effect of an mHealth intervention for adolescents with Type 1 diabetes and their parents
Authors: Holtz Bree E , Mitchell Katharine M , Holmstrom Amanda J , Hershey Denise S , Cotten Shelia R , Dunneback Julie K , Ellis Deborah A , Wood Michael A 
Published: September 2022

Background Past research has demonstrated that adolescents with Type 1 diabetes (T1D) typically have a decline in health outcomes as they begin to assume more self-management activities. Mobile app interventions have been suggested as one possible way to improve this behavior. Purpose The primary aim of this study was to address declines in health outcomes by pilot testing the satisfaction, use and feasibility of an app-based family communication intervention aimed to assist in adolescent self-management of T1D. Methods Thirty-three adolescent–parent pairs were enrolled in and completed the 12-week pilot study. Participants were randomized 2:1 to intervention (app use) or control group. Pre/post quantitative and qualitative data were collected, including HbA1c and surveys. Paired-sample t-tests and ANOVA statistics were conducted. Results The parents and adolescents reported high satisfaction with the app, and that it was easy to use. Results showed HbA1c stability in the intervention group and significant worsening in the control group. There were also significant improvements in adherence to diabetes management and quality of life for the parents in the intervention group. The adolescents did not show any improvement in quality-of-life measures. Conclusion This study suggests that the app intervention is acceptable, shows promise for improving health outcomes for adolescents with T1D, and may improve family communication. The public health implications of this work are that app interventions have a potential role in positively influencing chronic disease outcomes. Additional research with a more extensive and diverse sample is needed to determine generalizability.
Is External Carotid Artery Hemodynamics Helpful in Detecting Internal Carotid Artery Stenosis?
Authors: Zakko Jason , Shah Kejal , Best Cameron , Baetz Laureen , Haurani Mounir J. , Satiani Bhagwan 
Published: September 2022

Introduction: There is a paucity of validated external carotid artery (ECA) velocity criteria and data on the association between ECA velocities and internal carotid artery (ICA) stenosis by carotid duplex ultrasound (CDU) scanning. Our objectives were to determine the relationships between ECA peak systolic velocity (PSV) and percent stenosis seen on confirmatory imaging, as well as to correlate ECA hemodynamics with known ICA disease by CDU. Methods: A retrospective chart review was performed for patients who had CDU, as well as confirmatory testing such as angiography, at a single academic medical center. ICA stenosis was grouped into 4 categories (0 = <50%, 1 = 50%-69%, 2 = 70%-99%, 3 = 100%) based on validated CDU criteria. ECA PSVs were analyzed, in addition to degree of both ECA and ICA stenosis from the same CDU study. Results: Of 247 carotid arteries reviewed, 136 vessels were included in the final analysis. The mean PSV of the normal ECA cohort (<50% ECA stenosis per the NASCET measurement method) was 135.3 ± 82.1 cm/s, and the mean PSV of the diseased ECA cohort was 279.7 ± 112.2 cm/s. Mean ECA PSV for each category of ICA stenosis was: ICA category 0 = 119.9 cm/s; category 1 = 200.4 cm/s; category 2 = 167.7 cm/s; and category 3 = 155.5 cm/s. There was a statistically significant but non-linear difference in ECA velocities between ICA stenosis categories 0 vs 1 (mean rank diff. −49.91 cm/s; P = .0007); and 0 vs 2 (mean rank diff. −32.61 cm/s; P = .0047). Conclusion: We have demonstrated a possible separation of <50% vs ≥50% stenosis of the ICA using ECA PSV. Although the data suggest a weak but statistically significant correlation between ECA PSV and degree of ICA stenosis, further data with a larger sample size and confirmatory studies are needed to utilize ECA hemodynamics to indicate ICA disease.
YouTube videos on ulnar collateral ligament reconstruction are highly variable in terms of reliability and quality: A quantitative analysis
Authors: Megalla Martinus , Imam Nareena , Almadani Hamzah , Klein Sydney , Kohan Eitan M , Alberta Frank G 
Published: September 2022

Background Ulnar collateral ligament reconstruction (UCLR) is commonly performed on adolescent athletes, who often turn to online sources such as YouTube for health information. The purpose of this study was to retrospectively review the accuracy, reliability, and quality of UCLR videos using validated scoring instruments. Methods YouTube was queried for “Tommy John surgery,” “UCL reconstruction,” and “ulnar collateral ligament reconstruction.” After categorization by physician, nonphysician/trainer, patient or commercial source, videos were assessed for reliability and quality using the Journal of the American Medical Association (JAMA) benchmark criteria (0–4) and DISCERN tool (16–80). Results 104 videos were included in the final analysis. 74% of videos (77/104) were made by physicians. The mean JAMA and DISCERN scores for all videos were 3.1 ± 0.8 and 46.1 ± 8.5, respectively. The majority of videos were rated as “fair” based on DISCERN score (56/104, 53.8%). JAMA scores were significantly higher for physician videos compared to nonphysician videos (3.3 ± 0.8 vs 2.6 ± 0.7, p < 0.0001), but no such difference was found for DISCERN scores (46.3 ± 7.7 vs 45.3 ± 10.57, p = 0.43). Conclusion Physicians should be cognizant of the quality and reliability of YouTube videos when instructing patients on information sources related to UCLR.