bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suspensory Versus Interference Tibial Fixation of Hamstring Tendon Autografts in Anterior Cruciate Ligament Reconstruction: Results From the New Zealand ACL Registry
Authors: Rahardja Richard , Love Hamish , Clatworthy Mark G. , Monk Andrew P. , Young Simon W. 
Published: January 2022

Background: The hamstring tendon is frequently used to reconstruct the anterior cruciate ligament (ACL), but there is a lack of consensus on the optimal method of fixation. Registry studies have shown that the type of femoral fixation device can influence the risk of revision ACL reconstruction (ACLR), but it is unclear whether the type of tibial fixation has an effect. In New Zealand, over 95% of hamstring tendon grafts are fixed with an adjustable loop suspensory device on the femoral side, with variable usage between suspensory and interference devices, with or without a sheath, on the tibial side. Purpose: To investigate the association between the type of tibial fixation device and the risk of revision ACLR. Study Design: Cohort Study; Level of evidence, 2. Methods: Prospective data recorded in the New Zealand ACL Registry were analyzed. Only primary ACLRs performed with a hamstring tendon autograft fixed with a suspensory device on the femoral side were included. A Cox regression survival analysis with adjustment for patient factors was performed to analyze the effects of the type of tibial fixation device, the number of graft strands, and graft diameter on the risk of revision. Results: A total of 6145 primary ACLRs performed between 2014 and 2019 were analyzed. A total of 59.6% of hamstring tendon autografts were fixed with a suspensory device on the tibial side (n = 3662), 17.6% with an interference screw with a sheath (n = 1079), and 22.8% with an interference screw without a sheath (n = 1404). When compared with suspensory devices, a higher revision risk was observed when using an interference screw with a sheath (adjusted hazard ratio [HR], 2.05; P = .009) and without a sheath (adjusted HR, 1.81; P = .044). The number of graft strands and a graft diameter of ≥8 mm were associated with the rate of revision on the univariate analysis; however, after adjusting for confounding variables on the multivariate analysis, they did not significantly influence the risk of revision. Conclusion: In this study of hamstring tendon autografts fixed with an adjustable loop suspensory device on the femoral side during primary ACLR, the use of an interference screw, with or without a sheath, on the tibial side resulted in a higher revision rate when compared with a suspensory device.
Evolution of silicate bioglass particles as porous microspheres with a view towards orthobiologics
Authors: Islam Md Towhidul , Nuzulia Nur Aisyah , Macri-Pellizzeri Laura , Nigar Farah , Sari Yessie W. , Ahmed Ifty 
Published: January 2022

Although FDA approved and clinically utilised, research on 45S5 Bioglass® and S53P4 including other bioactive glasses continues in order to advance their applicability for a range of alternate applications. For example, rendering these particles porous would enable incorporation of varying biological payloads (i.e. cells, drugs and growth factors) and making them spherical would enhance their flow properties enabling delivery to target sites via minimally invasive injection procedures. This paper reports on the manufacture of solid (non-porous; SGMS) and highly porous microspheres (PGMS) with large external pores and fully interconnected porosity from bioactive silicate glass formulations (45S5 and S53P4) via a single stage flame spheroidisation process and their physicochemical properties including in vitro biological response. Morphological and physical characterisation of the SGMS and PGMS revealed interconnected porosity up to 65 ± 5%. Mass loss studies comparing between SGMS and PGMS revealed 1.5 times higher mass loss for the PGMS over 28 days. Also, in vitro bioactivity studies using simulated body fluid (SBF) revealed hydroxyapatite (HA) formation at earlier time point for PGMS compared to their SGMS counterparts (i.e day 1 for PGMS and day 3 for SGMS of 45S5). In addition, HA layers were also formed in cell culture media, with the exception of SGMS of 45S5, which revealed CaP formation with a ratio of 1.52–1.78. Direct cell seeding and indirect cell culture studies (via incubation with microsphere degradation products) revealed mouse 3T3 cells were able to grow and undergo osteogenic differentiation in vitro, confirming cytocompatibility of both 45S5 and S53P4 SGMS and PGMS. More importantly and especially for orthobiologic applications, cells were observed to have migrated within the pores of the PGMS. As such, the PGMS developed from these bioactive silicate glasses are highly promising candidate materials for orthobiologics and alternate applications requiring delivery of biologic payloads.
Effect of lanthanum cerium methionine on the properties of natural rubber
Authors: Li Shuai , Liu Zhaogang , Hao Wei , Zhang Wentao , Hu Yanhong , Wu Jinxiu 
Published: January 2022

Lanthanum cerium methionine was synthesized using the metathesis method and its molecular formula was confirmed as La0.35Ce0.65Cl3(C5H10NO2S)3·2H2O via Inductively Coupled Plasma Optical Emission Spectrometer, FTIR, and thermogravimetry-differential scanning calorimetry characterization methods. Lanthanum cerium methionine can significantly reduce the activation energy of the vulcanization reaction. The vulcanization kinetics model is used to fit the vulcanization curve of the rubber, and the obtained vulcanization activation energy of lanthanum cerium methionine for rubber is E1 = 76.89 KJ/mol, E2 = 102.36 KJ/mol and E3 = 126.00 KJ/mol. The above value is lower than pristine rubber. The Kissinger method and Flynn–Wall–Ozawa method were used to analyze the activation energy of thermal-oxidative degradation of vulcanized rubber. It was found that the rubber added with lanthanum cerium methionine exhibited higher thermal-oxidative degradation activation energy compared to that of pristine rubber; in addition, it was more difficult to age under the same environment. These results indicated that lanthanum cerium methionine can be not only used as a vulcanization accelerator, but also plays a role in resisting thermal and oxygen aging.
Outcomes of First Metacarpal Extension Osteotomy for Base of Thumb Arthritis
Authors: Chiang Jenny , Graham David , Lawson Richard , Sivakumar Brahman 
Published: January 2022

Background: First metacarpal extension osteotomy (FMEO) aims to correct the adduction deformity associated with thumb arthritis, as well as improve the congruity at the first carpometacarpal (FCMC) joint. However, the benefits of this procedure are currently unclear. The purpose of this study is to investigate the outcomes of FMEO in the treatment of FCMC joint arthritis. Methods: Electronic databases were searched systematically for original data studies in the English language reporting outcomes following FMEO for base of thumb arthritis. Data were extracted from the text, tables, and figures of publications and meta-analyzed where possible. Results: Ten publications comprising 211 thumbs were included. FMEO was associated with an improvement in pain relief and patient-reported functional outcomes, however meta-analysis showed no significant long-term improvement in grip strength or lateral pinch grip. Although there was disease progression in one third of patients after FMEO, most did not require further procedures. Outcomes following secondary procedures was not analyzed in the literature. FMEO produced a range of minor complications, however, major complications were rare. Conclusions: The available evidence suggests FMEO does not improve grip or pinch strength. However, it may have a role in analgesia and improvement in functional outcomes. Further studies should compare outcomes of FMEO to continued nonoperative treatment, or other surgical options including arthroscopy or ligamentous reconstruction.
Rates, Barriers, and Facilitators of Outcome Collection on Hand Surgery Outreach to Low- and Middle-Income Countries
Authors: Welch Jessica M. , Kamal Robin N. , Chatterjee Maya , Shapiro Lauren M. 
Published: January 2022

Background: Global outreach to low- and middle-income countries (LMICs) continues to grow in an effort to improve global health. The practice of quality measurement is empirically lacking from surgical outreach trips to LMICs, which may limit the safety and quality of care provided. Using convergent mixed-methods, we aimed to: (1) identify and evaluate barriers and facilitators to outcome measure collection; and (2) report the sample rate of such collection on hand surgery outreach trips to LMICs. Methods: Surgeons and administrators involved in hand surgery outreach trips completed a survey regarding rates of outcome measure collection and a semi-structured interview to explore barriers and facilitators of outcome collection. Survey data were reported descriptively. Interviews were recorded and transcribed, and excerpts were categorized according to the Pettigrew framework for strategic change (content, process, and context). Results were combined through convergent mixed-methods analysis. Results: Thirty-three participants completed the survey, and 21 participated in interviews. Rates of collection were the most common for total case number (83%) and patient mortality (65%). Longitudinal outcomes (eg, patient follow-up or time away from work) were less frequently recorded (9% and 4%, respectively). Content analysis revealed barriers related to each domain of the Pettigrew framework. Conclusions: This analysis demonstrates low levels of outcome collection on outreach trips and identifies priority areas for improvement. Developing context-specific solutions aimed at addressing barriers (eg, resource/database availability) and promoting facilitators (eg, collaborative relationships) may encourage higher rates of collection, which stands to improve patient safety, quality of care, and accountability when conducting outreach trips to LMICs.
Acute phase reactant proteins in Buerger’s disease: Is it a systemic disease?
Authors: Keramat Shayan , Karahan Oguz , Patel Malay , Fazeli Bahare 
Published: January 2022

Aim: The aim of this study was evaluating acute phase reactant (APR) proteins including high sensitivity C-reactive protein (hsCRP), pentraxin 3 (PTX3), fibrinogen, complement C3, hepcidin, and albumin in patients suffering from Buerger’s disease (BD) compared to controls. Methods: The APRs were evaluated in 92 cases of BD patients and 90 healthy age and sex matched controls of blood from Iran and Turkey. The diagnosis was done according to Shionoya’s criteria. However, patients with age less than 40 were included, instead of those less than 50. The diagnosis was confirmed by angiography or CT angiography. The patients were categorized into active and quiescent phases of the disease according to clinical manifestation. Patients with rest pain, non-healing ulcer, and gangrene were categorized in the active phase of the disease and the patients with unchanged claudication for more than 6 months without trophic lesions or gangrene were categorized in the quiescent phase of the disease. Results: The serum level of PTX3, hsCRP, fibrinogen, C3, and hepcidin in BD was significantly higher than controls ( p < 0.004). Also, albumin in the BD group was significantly lower than controls ( p < 0.001). In patients that categorized in the active phase, fibrinogen, C3, and hsCRP were significantly higher and albumin was significantly lower compared to patients in the quiescent phase. No significant difference was found between the level of PTX3 and hepcidin in the patients in active and quiescent phases of the disease. Conclusion: The pattern of the level of APRs in BD seems more likely systemic inflammatory disorder than atherosclerosis obliterans. More clinical trials for evaluating the efficacy of anti-inflammatory medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids as a part of management of BD are required. Also, according to low level of albumin in TAO, a protein rich diet might be beneficial for BD patients in the active phase of their disease.
Clinical characteristics, long-term functional outcomes and relapse of anti-LGI1/Caspr2 encephalitis: a prospective cohort study in Western China
Authors: Guo Kundian , Liu Xu , Lin Jingfang , Gong Xue , Li Aiqing , Liu Yue , Zhou Dong , Hong Zhen 
Published: January 2022

Objective: To study the clinical characteristics of anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis and anti-contactin-associated protein-like 2 (Caspr2) encephalitis and to investigate factors associated with poor long-term neurological functional outcomes and relapse among patients in western China. Methods: In this single-center prospective cohort study, we consecutively enrolled patients with anti-LGI1 encephalitis and anti-Caspr2 encephalitis from April 2014 to February 2021. Patient outcomes were assessed using the modified Rankin scale. Predictors of long-term functional outcomes and relapse were analyzed. Results: Forty-four anti-LGI1 encephalitis patients [median age: 44 years, range: 18–82 years; females: 25 (56.8%)], 35 anti-Caspr2 encephalitis patients [median age: 43 years, range: 14–80 years; females: 19 (54.3%)], and 5 dual-positive patients [median age: 44 years, range: 36–58 years; females: 5 (100%)] were enrolled. Overall, 86.4% anti-LGI1 encephalitis patients and 80% anti-Caspr2 encephalitis had a favorable neurological functional outcome (mRS 0-2). Tumor occurrence and weight loss were associated with poor long-term functional outcomes in anti-LGI1 encephalitis, whereas in anti-Caspr2 encephalitis, predictors included behavioral disorder at acute phase, abnormalities in brain magnetic resonance imaging, higher modified Rankin scale scores at onset, poor response to the initial immunotherapy at 4 weeks, age at onset<30 years, and relapse ( p<0.05). Overall, 13.6% of anti-LGI1 encephalitis patients and 20% of anti-Caspr2 encephalitis patients had at least one relapse. Sleep disorder at the acute phase was the risk factor of relapse in anti-LGI1 encephalitis, while female, age at onset <30 years, and behavioral disorder at acute phase were the risk factors of relapse in anti-Caspr2 encephalitis (log rank p<0.05). Conclusion: The clinical characteristics such as age, gender, and tumor occurrence rates of anti-LGI1 encephalitis and anti-Caspr2 encephalitis in western China are different from those in the Western countries. Most patients in our study had favorable long-term functional outcomes. The relapse rates are still high in both types of encephalitis, which warrants caution.
Poor health and functioning in patients with axial spondyloarthritis during the COVID-19 pandemic and lockdown: REUMAVID study (phase 1)
Authors: Benavent Diego , Garrido-Cumbrera Marco , Plasencia-Rodríguez Chamaida , Marzo-Ortega Helena , Christen Laura , Correa-Fernández José , Plazuelo-Ramos Pedro , Webb Dale , Navarro-Compán Victoria 
Published: January 2022

Aim: To evaluate the overall health and functioning in patients with axial spondyloarthritis (axSpA) and related factors affecting these during the COVID-19 pandemic and lockdown measures. Methods: Data from 587 axSpA patients participating in the first phase (April–July 2020) of the REUMAVID study who completed the ASAS Health Index (ASAS-HI) were analysed. REUMAVID is a cross-sectional study that collects data through an online survey to assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases across seven European countries. Poor health was defined as ASAS-HI ⩾ 12. The World Health Organization Five well-being index, self-perceived health status and change in health status during COVID-19 pandemic were evaluated as secondary outcomes. Logistic regression models were used to identify the factors associated with poor health. Results: According to the ASAS-HI, 147 (25.0%) patients reported poor health. Pain and moving around were the main affected categories. In addition, 14.0% reported their self-perceived health status as ‘bad’ or ‘very bad’ and 46.8% as worse than before the pandemic. In the multivariate analysis, smoking (OR = 1.98), diabetes (OR = 4.89) and taking painkillers (OR = 2.82) or corticosteroids use (OR = 2.20) were significantly associated with poor health, while engaging in physical activity (OR = 0.54) and being actively employed (OR = 0.48) were inversely associated with this. Conclusions: During the first wave of the COVID-19 pandemic, one in four axSpA patients reported poor health and functioning, while the self-perceived health status of almost half of these patients worsened. Nonsmoking, physical activity and being employed were associated with better outcomes.
An oleuropein-based dietary supplement may improve joint functional capacity in older people with high knee joint pain: findings from a multicentre-RCT and post hoc analysis
Authors: Horcajada Marie-Noëlle , Beaumont Maurice , Sauvageot Nicolas , Poquet Laure , Saboundjian Madleen , Costes Berenice , Verdonk Peter , Brands Geoffrey , Brasseur Jean , Urbin-Choffray Didier , Vandenberghe Marc , Brabants Karl , De Vlam Kurt , Fache Werner , Jandrain Bernard , Grek Vincent , Malaise Michel , Henrotin Yves 
Published: January 2022

Objectives: To investigate a 6-month intervention with an olive leaf extract (OLE) on knee functionality and biomarkers of bone/cartilage metabolism and inflammation. Design: This randomized, double-blind, placebo-controlled, multi-centric trial included 124 subjects with knee pain or mobility issues. Subjects received twice a day one capsule of placebo or 125 mg OLE (Bonolive™, an OLE containing 50 mg of oleuropein) for 6 months. The co-primary endpoints were Knee injury and Osteoarthritis Outcome Score (KOOS) and serum Coll2-1NO2. The secondary endpoints were the subscales of the KOOS, knee pain VAS at rest and at walking, OARSI core set of performance-based tests and multiple inflammatory and bone or cartilage remodeling serum biomarkers and concentration of oleuropein’s metabolites in urine. Results: At 6 months, OLE group was not efficient on global KOOS score, changes of inflammatory and cartilage remodeling biomarkers compared to placebo. Post hoc analyses demonstrated a large and significant treatment effect of OLE in a sub-group of subjects with high walking pain at baseline ( p = 0.03). This was observed at 6 months for the global KOOS score, and each different subscale and for pain at walking ( p = 0.02). OLE treatment was well tolerated. Conclusion: OLE was not effective on joint discomfort excepted in a sub-group of subjects with high pain at treatment initiation. As oleuropein is well tolerated, OLE can be used to relieve knee joint pain and enhance mobility in subjects with articular pain.
Smart Offloading Boot System for Remote Patient Monitoring: Toward Adherence Reinforcement and Proper Physical Activity Prescription for Diabetic Foot Ulcer Patients
Authors: Park Catherine , Mishra Ramkinker , Vigano Davide , Macagno Maurizio , Rossotti Stefano , D’Huyvetter Karen , Garcia Jason , Armstrong David G. , Najafi Bijan 
Published: January 2022

Background: A critical factor in healing diabetic foot ulcers is patient adherence to offloading devices. We tested a smart offloading boot (SmartBoot) combined with a smartwatch app and cloud dashboard to remotely monitor patient adherence and activity. In addition, the impact of SmartBoot on balance, gait, and user experience was investigated. Methods: Fourteen volunteers (31.6±8.7 years; 64% female) performed natural activities (eg, sitting, standing, walking) with and without the SmartBoot for approximately 30 minutes. All participants completed balance tests, 10-meter walking tests at slow, normal, and fast pace while wearing the SmartBoot, and a user experience questionnaire. The accuracy of real-time adherence reporting was assessed by comparing the SmartBoot and staff observation. Center of mass (COM) sway and step counts were measured using a validated wearable system. Results: Average sensitivity, specificity, and accuracy for adherence and non-adherence were 90.6%, 88.0%, and 89.3%, respectively. The COM sway area was significantly smaller with the SmartBoot than without the SmartBoot regardless of test condition. Step count error was 4.4% for slow waking, 36.2% for normal walking, 16.0% for fast walking. Most participants agreed that the SmartBoot is easy to use, relatively comfortable, nonintrusive, and innovative. Conclusions: To our knowledge, this is the first smart offloading system that enables remote patient monitoring and real-time adherence and activity reporting. The SmartBoot enhanced balance performance, likely due to somatosensory feedback. Questionnaire results highlight SmartBoot’s technical and clinical potential. Future studies warrant clinical validation of real-time non-adherence alerting to improve wound healing outcomes in people with diabetic foot ulcers.
Syndesmosis Injury Contributes a Large Negative Effect on Clinical Outcomes: A Systematic Review
Authors: Heifner John J. , Kilgore Jack E. , Nichols Jennifer A. , Reb Christopher W. 
Published: January 2022

Introduction: The literature largely addresses questions of diagnostic accuracy and therapeutic accuracy. However, the magnitude of the clinical impact of syndesmosis injury is commonly described in intuitive yet qualitative terms. This systematic review aimed to quantify the impact of syndesmosis injury. Methods: Published clinical outcomes data were used to compute an effect size reflecting the impact of syndesmosis injury. This was done within the clinical contexts of isolated syndesmosis injury and syndesmosis injury with concomitant ankle fracture. Clinical outcomes data included Olerud-Molander (OM) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale for pain, and days missed from sport competition. Parametric data were compared with Student t tests. Effect size was computed using Cohen’s d. Results: In ankle fracture patients, syndesmosis injury demonstrated a large effect size for OM (d = 0.96) and AOFAS (d = 0.83) scores. In athletic populations without concomitant ankle fracture, syndesmosis injury demonstrated a large effect size on days missed from competition (d = 2.32). Discussion: These findings confirm the magnitude of the negative impact of syndesmosis injury in athletic populations with isolated injury and in ankle fracture patients. In ankle fracture patients, this large negative effect remains despite surgery. Thus, syndesmosis repair may not fully mitigate the impact of the injury. Levels of Evidence: Level III: Systematic review