bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic Labral Repair of Adolescent Athlete Shoulder Instability With Knotted Versus Knotless Suture Anchors
Authors: Michelin Richard M. , Gornick Bryn R. , Schlechter John A. 
Published: May 2022

Background: Shoulder instability is a common and complex problem seen in adolescent athletes. The use of bioabsorbable suture anchors with arthroscopically hand tied knots is widely accepted and has shown to provide reliable biomechanical and clinical results. Knotless suture anchor technology has become increasingly popular with proposed advantages of minimizing technical difficulty as well as mitigating knot migration and subsequent intraarticular cartilage irritation and damage. While there have been studies comparing knotted versus knotless suture anchors, studies comparing clinical outcomes solely focused on the adolescent athlete are limited. Purpose: To evaluate and compare outcomes of adolescent athletes treated with arthroscopic labral repair using knotted versus knotless bioabsorbable suture anchors. Methods: Adolescent athletes with shoulder instability treated arthroscopically with labral repair and a minimum of 2 year follow up were retrospectively reviewed. All patients had < 20% glenoid bone loss and a non-engaging Hill Sachs lesion at surgery. Patients were divided into three cohorts based on suture anchor knot management – knotted, knotless and combined. Data points examined included post-operative return to primary sport, recurrent instability, re-operation, and patient reported outcome measures (PROMs) utilizing the Pediatric/Adolescent Shoulder Survey (PASS). PASS was only collected on patients with no reported subsequent instability events. Results: 51 adolescent athletes (average age 16.3 ± 2.6 years) were identified. There were 20 athletes in the knotted fixation group, 17 in the knotless, and 14 in the combination group. Average follow up was 4.25 ± 1.2 years (Range 2.09-6.34 years). 46/51 athletes (90.2%) returned to sports post-operatively with only 34/51 athletes (66.7%) returning to their primary sport. Of the 17 athletes who did not return to their primary sport 14/17 athletes (82.4%) switched sports by choice, while the other 3/17 (17.6%) athletes stopped due to their shoulder. There were no significant differences between cohorts based on return to sport, re-operation, or post-operative PASS (average 90.2 ± 11.7). Recurrent instability episodes were reported in 12/51 athletes (23.5%), with significantly higher recurrence in the knotted group (7/20 athletes, 35%) and combination group (5/14 athletes, 35.7%), when compared to the knotless group (0/17 athletes, 0%). (p < 0.05). Conclusion: Arthroscopic labral repair for adolescent shoulder instability demonstrated high return to sport rates and equivalent PROMs with a significantly higher incidence of recurrent instability noted with knotted fixation when compared to knotless fixation. Favorable outcomes can be achieved in adolescent athletes undergoing shoulder stabilization with knotless suture anchors.
Low-Risk Foot and Ankle Stress Fractures in The Pediatric Population: A Case Series
Authors: Gremillion Matthew , Ghanta Ramesh , Borici Neritan , Kushare Indranil 
Published: May 2022

Background: Stress fractures are a common overuse injury in the pediatric population. Distal fibular and calcaneal stress fractures are considered low-risk stress fractures. Due to their rarity, they have not been studied as thoroughly as other stress fractures. Purpose: To present a descriptive case series of distal fibular and calcaneal stress fractures in the pediatric population and elaborate on demographics, mechanism of injury, management and outcomes. Methods: IRB-approved retrospective study included patients under 18 years at a tertiary children’s hospital who were diagnosed with a distal fibular or calcaneal stress fracture/reaction. Demographic data, mechanism of injury, physical exam, radiographic findings, treatment, and outcomes were collected. Descriptive statistical analysis was conducted. Results: 11 patients, 6 distal fibula (4 female, 2 male) and 5 calcaneus (2 female, 3 male) with stress injury on clinical exam and on X-ray or MRI were included. Mean age was 11 years (1-15) and average BMI of 23.5 (16-30.7). The common presenting complaint was pain aggravated by activity that began an average of 3 weeks prior. 7/11 (63.6%) participated in competitive sports: 4/6 with fibular stress fractures were runners (cross country, soccer and sprinting) compared to 0/5 patients with calcaneal involvement. Typical radiographic findings (periosteal reaction, cortical thickening) and a corresponding physical exam was sufficient to diagnose fibular stress fractures in 5/6 patients, with one requiring MRI for definitive diagnosis. 4/5 patients with calcaneal stress fractures required an MRI for a definitive diagnosis, delaying the diagnosis by an average of 3 weeks. 5/6 patients with fibular stress fractures had no other associated pathology, such as additional stress fractures, bone cysts, or osteoid osteomas, whereas 3/5 with calcaneal injuries had at least one of these associated pathologies. Patients with isolated fibular or calcaneal stress fractures (7/11) improved with conservative management, including a controlled ankle motion (CAM) boot, PT, and full activity rest over an average of 6.5 weeks. Out of the remaining 4 patients with associated pathologies, 3/4 improved with conservative management alone after an average of 20 weeks; however, one patient required surgical removal of a bone cyst before complete recovery. Conclusion: A history of pain with significant running, X-ray findings, and physical exam findings were sufficient for diagnosis of fibular stress fractures; however, calcaneal stress fractures were often occult, requiring MRI for definitive diagnosis, and were associated with other pathologies. Conservative management was sufficient for treatment of 91% of patients, regardless of additional fractures or pathology. [Figure: see text][Figure: see text]
What are the Causes and Consequences of Delayed Surgery for Pediatric Tibial Spine Fractures?
Authors: Patel Neeraj M. , Leska Tomasina M. , Ganley Theodore J. , Aoyama Julien T. , Cruz Aristides I. , Ellis Henry B. , Fabricant Peter D. , Green Daniel W. , Jagodzinski Jason E. , Johnson Benjamin , Kushare Indranil , Lee Rushyuan J. , McKay Scott D. , Rhodes Jason T. , Sachleben Brant C. , Sargent M. Catherine , Schmale Gregory A. , Yen Yi-Meng , Mistovich R. Justin 
Published: May 2022

Background: The uncommon nature of tibial spine fractures may result in delayed presentation, diagnosis, and treatment. Elucidation of the contributing factors to such delays may provide an opportunity to improve patient care. Additionally, the outcomes of delayed surgery are unknown. Hypothesis/Purpose: The purpose of this study is to evaluate risk factors for, and consequences of, delayed surgical treatment of pediatric tibial spine fractures. Methods: We performed a retrospective cohort study of tibial spine fractures treated surgically at 10 institutions between 2000 and 2019. Demographic and pre-operative data were collected, as was intra-operative information and post-operative complications. Attention was focused on delays in evaluation and treatment, which were treated as both continuous and categorical variables. Surgery ≥21 days after injury was considered “delayed”. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 368 subjects (mean age 11.7±2.9 years) were included, 21.2% of which underwent surgery ≥21 days after injury. Patients who experienced delayed surgery had 3.8 times higher odds of being diagnosed with a TSF 1 or more weeks after injury [95% confidence interval (CI) 1.1-14.3, p=0.04], 2.3 times higher odds of having seen multiple clinicians prior to the treating surgeon (95% CI 1.1-4.8, p=0.02), 5.8 times higher odds of having magnetic resonance imaging 1 or more weeks after injury (MRI; 95% CI 1.6-20.8, p<0.007), and were 2.4 times more likely to have public insurance (95% CI 1.3-4.2, p=0.003). Meniscal injuries were encountered intra-operatively in 42.3% of those that had delayed surgery compared to 16.6% of patients that did not (p<0.001), resulting in 2.8 times higher odds in multivariate analysis (95% CI 1.6-5.0, p<0.001). Delayed surgery was also a risk factor for procedure duration longer than 2.5 hours (odds ratio 3.3, 95% CI 1.4-7.9; p=0.006). Patients who experienced delayed surgical management and an operation longer than 2.5 hours had 3.7 times higher odds of developing arthrofibrosis (95% CI 1.1-12.5, p=0.03). Conclusion: When surgery for a TSF was performed ≥21 days after injury, patients were at increased risk for concomitant meniscal pathology, longer case duration, and possibly post-operative arthrofibrosis. Those who experienced delays in diagnosis or MRI, saw multiple clinicians, and had public insurance were more likely to have a delay to surgery. These results provide an opportunity to optimize care for children that are at highest risk for delayed treatment.
Meniscus Tear Types and Early Failures in Pediaric Patients: Descriptive EPIDemiologic Analysis from the Score Multi-Center Quality Imrovment Project.
Authors: Peddireddy Navya S. , Adsit Lizzie R. , Cooper Savannah , Milewski Matthew , Heyworth Benton , Edmonds Eric , Pacicca Donna , Bowen Richard , Clark Christian , Brey Jennifer , Niu Emily , Storer Stephanie , Shea Kevin , Ellis Henry B. ,   the SCORE group
Published: May 2022

Background: Meniscal tears have been reported at higher rates in the pediatric patient in recent years. Meniscus repair to restore meniscus function may be invaluable to the long-term health of the knee. Hypothesis/Purpose: To describe demographic characteristics, tear types, and surgical techniques for meniscus repair in pediatric patients, including risk factors for early repair failure. Methods: A multi-center quality improvement registry (16 institutions, 26 surgeons) monitoring the safety of meniscus repairs was reviewed. Audit processes using CPT codes were designed to ensure that all consecutive cases were prospectively entered on patients <19 years old into a HIPAA-compliant electronic platform. Each meniscus repair case with a complication form was secondarily reviewed to ensure consistency of identification and grading. Demographics, tear type, repair technique, and implant type, when applicable, were included, and a common cause analysis was performed to evaluate risk factors for early repair failures. Results: 1230 meniscus repair cases (mean age 15.2, 5-19; Female 43.8%) were identified, consisting of 49.0% lateral meniscus repair (LMR), 36.0% medial meniscus repair (MMR), and 15.0% LMR+MMR. The majority (69.7%) were performed in conjunction with either ACL reconstruction (ACLr) or tibial spine repair (TSr). In both LMR and MMR, the most common tear type, technique, and implant were longitudinal/vertical tear (50.3%, 80.0%, respectively), all-inside repair (69.3%, 68.9%, respectively), and Smith & Nephew Fast-Fix 360 (37.8%, 36.8%, respectively). An inside-out repair was performed twice as often in both LMR and MMR when performed in isolation without an ACLr or TSr. For both LMR and MMR, surgeons used an average of 2 sutures/devices (38.0%) with 6.5% involving 10+ sutures/implants. Variation in meniscus repair techniques was seen between tear types, displacement, and location (Tables 1, 2). Radial tears were uncommon in the MM (2.7%), but were commonly treated in the LM (12.32%) using all-inside (42.1%), inside-out (30.2%), and outside-in (19.7%) techniques. Meniscus tears with displacement were seen in 35.2% of MM tears and 25.3% of LM tears, with anterior displacement being the most common direction. For both LMR and MMR, the most common technique for tears with displacement was all-inside (58.4%). There were 15 early (<8 months) repair failures (1.2%), most common type and technique of which were MMR (73.3%) and all-inside (73.3%). Conclusion: The techniques utilized for pediatric meniscus tears depend upon tear type, displacement, and whether performed in conjunction with an ACLr or TSr. MMR performed with all-inside technique may be at risk for early failure. [Table: see text][Table: see text]
Progression to Surgery in Adolescent Osteochondritis Dissecans of the ELBOW
Authors: Sandridge Brionna M. , Howell David R. , Albright Jay C. 
Published: May 2022

Background: Osteochondritis dissecans (OCD) is a disorder characterized by the separation of subchondral bone and articular cartilage from underlying bone due to lack of blood supply. Effective treatment and knowing whether a patient will need to have surgery is still debated. Purpose: The purpose of this study is to compare the characteristics and clinical outcomes of adolescent patients with OCD of the elbow whose treatment either progressed to surgery or did not. Methods: We performed a retrospective chart review of patients 7-17 years of age who were diagnosed with OCD of the elbow at a regional children’s hospital sports medicine surgery practice. Demographic and radiographic variables such as age, sex, skeletal maturity, range of motion, and lesion size were obtained. Clinical outcomes collected included time to return to sport and need for second surgery. Results: We identified 41 patients to meet inclusion criteria; 34 progressed to surgery and 7 did not. Of the 34 that eventually required surgery, 11 (32%) initially presented with stable lesions. There were no significant differences between groups regarding sex, age, skeletal maturity, or insurance type (Table 1). Loss of range of motion in the elbow was seen in 79% of patients who progressed to surgery and in 29% of those who did not (Table 1). Patients who progressed to surgery had significantly greater average lesion sizes on x-ray than those who did not (Table 2). Those who progressed to surgery also had significantly higher grade lesions on MRI compared to those who did not (Table 2). After adjusting for the independent effect of loss of range of motion, each increase in MRI lesion grade resulted in a 4.8X greater odds of eventually progressing to surgery (adjusted odds ratio=4.8, 95% CI=1.21, 19.17, p=0.026). We did not observe any significant differences between groups in time to return to sport. Conclusions: Overall, we observed that patients who progressed to surgery had initially worse OCD lesion grades compared to those who did not. This may be clinically useful when considering initial conservative treatment versus surgical intervention in these patients. Long term outcomes, including need for second surgery and return of symptoms, should be further investigated. [Table: see text][Table: see text]
Minimally Invasive Distal Chevron Osteotomy for Symptomatic Bunionette: Clinical and Radiologic Results of a 31-Case Retrospective Study
Authors: Benavente Valdivia Juan Carlos , Thull Daniel M. 
Published: May 2022

Background: Bunionette is a common forefoot deformity that usually leads to significant discomfort. Multiple surgical techniques have been described for correcting bunionette. The purpose of this study is to analyze the clinical and radiologic outcomes of a new surgical technique via minimally invasive distal Chevron osteotomy of the fifth metatarsal without fixation, trying to find an effective technique with fewer complications. Methods: We retrospectively analyzed the data of 28 patients (31 feet) who presented with symptomatic bunionette that was resistant to conservative treatment and who underwent surgery at our center from February 2018 to February 2020. A minimum follow-up of 20 months was obtained (mean follow-up 26 months, range 20–37). Clinical results were evaluated using the visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society (AOFAS) score; 5 different radiologic parameters were analyzed. Results: After surgery, the mean AOFAS score increased by 29 points ( P < .001) and the mean VAS scores decreased by 6 points ( P < .001). An adequate radiologic correction was observed with a decrease in the M4–M5 intermetatarsal angle from 10.3 to 4.8 degrees ( P < .001), metatarsophalangeal angle by a mean of 16.05 degrees ( P < .001), and lateral deviation angle of the fifth metatarsal from 8.5 to 0.97 degrees ( P < .001). Moreover, the length of the fifth metatarsal and the forefoot width was reduced ( P < .001). The only complication was an asymptomatic delay in bone healing, but a complete bone consolidation was achieved after therapy. Conclusion: The proposed surgical technique shows a good correction capacity with excellent clinical and radiologic results and low complication rates. Level of Evidence: Level IV, retrospective case series.
Patients with CLL have a lower risk of death from COVID-19 in the Omicron era
Authors: Niemann Carsten U. , da Cunha-Bang Caspar , Helleberg Marie , Ostrowski Sisse R. , Brieghel Christian 
Published: May 2022

Abstract
Previous studies have shown that patients with chronic lymphocytic leukemia (CLL) and coronavirus disease 2019 (COVID-19) have high mortality rates. Infection with the Omicron variant has been described as a milder disease course in the general population. However, the outcome for immunocompromised patients has not previously been reported. In a cohort of patients with CLL tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at hospital test sites in the time periods before and after dominance of the Omicron variant, rates of hospitalizations and intensive care unit admissions declined significantly, whereas 30-day mortality remained as high as 23% in the period with dominance of the Omicron sublineage BA.2 variant. However, for a larger population-based cohort of patients with CLL (including the hospital cohort), 30-day mortality was 2%. Thus, patients with CLL with close hospital contacts and, in particular, those &gt;70 years of age with 1 or more comorbidities should be considered for closer monitoring and preemptive antiviral therapy upon a positive SARS-CoV-2 test.
Genome mining reveals polysaccharide-degrading potential and new antimicrobial gene clusters of novel intestinal bacterium Paenibacillus jilinensis sp. nov.
Authors: Ma Ke , Chen Wei , Yan Shi-Qing , Lin Xiao-Qi , Liu Zhen-Zhen , Zhang Jia-Bao , Gao Yu , Yang Yong-Jun 
Published: May 2022

Abstract
Background
Drug-resistant bacteria have posed a great threat to animal breeding and human health. It is obviously urgent to develop new antibiotics that can effectively combat drug-resistant bacteria. The commensal flora inhabited in the intestines become potential candidates owing to the production of a wide range of antimicrobial substances. In addition, host genomes do not encode most of the enzymes needed to degrade dietary structural polysaccharides. The decomposition of these polysaccharides mainly depends on gut commensal-derived CAZymes.

Results
We report a novel species isolated from the chicken intestine, designated as Paenibacillus jilinensis sp. nov. and with YPG26T (= CCTCC M2020899T) as the type strain. The complete genome of P. jilinensis YPG26T is made up of a single circular chromosome measuring 3.97 Mb in length and containing 49.34% (mol%) G + C. It carries 33 rRNA genes, 89 tRNA genes, and 3871 protein-coding genes, among which abundant carbohydrate-degrading enzymes (CAZymes) are encoded. Moreover, this strain has the capability to antagonize multiple pathogens in vitro. We identified putative 6 BGCs encoding bacteriocin, NRPs, PKs, terpenes, and protcusin by genome mining. In addition, antibiotic susceptibility testing showed sensitivity to all antibiotics tested.

Conclusions
This study highlights the varieties of CAZymes genes and BGCs in the genome of Paenibacillus jilinensis. These findings confirm the beneficial function of the gut microbiota and also provide a promising candidate for the development of new carbohydrate degrading enzymes and antibacterial agents.
Brassinosteroid-lipid membrane interaction under low and high temperature stress in model systems
Authors: Rudolphi-Szydło Elżbieta , Dyba Barbara , Janeczko Anna , Latowski Dariusz , Sadura Iwona , Filek Maria 
Published: May 2022

Abstract
Background
In earlier studies [1], we indicated that applying brassinosteroids (BRs) to lipids that had been isolated from plants altered the physicochemical properties of the monolayers. A continuation of these dependencies using the defined model lipid systems is presented in this paper. The influence of homocastasterone (HCS) and castasterone (CS) (BRs for which the increase in concentration were characteristic of plants grown at low temperatures) on the membrane properties of their polar and the hydrophobic parts were studied.

Results
Changes in the electrokinetic potential indicate that both BRs decreased the negative charge of the surface, which is an important factor in modifying the contacts with the polar substances. This property of BRs has not yet been described. The studies of the interactions that occur in the hydrophobic part of the membrane were investigated using the EPR methods and Langmuir techniques. The physicochemical parameters of the lipid structure were determined, and the excess of Gibbs free energy was calculated.

Conclusion
We conclude that examined BRs modify both the hydrophilic and hydrophobic properties of the membranes, but to a greater extent HCS. The consequence of these changes may be the attempt to maintain the stability of the membranes in stressful temperature conditions and / or to the possibility of adsorption of other substances on membranes surfaces. The change of plant metabolism towards increasing the amount of BR, mainly HCS (under cooling) may by an important factor for maintaining optimal structural properties of membranes and their functionality despite temperature changes.