bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midterm Outcomes of Sliding Distal Metatarsal Minimally Invasive Osteotomy to Treat Bunionette Deformity
Authors: Del Vecchio Jorge Javier , Ghioldi Mauricio Esteban , Dealbera Eric Daniel , Chemes Lucas Nicolás , Abdelatif Nasef Mohamed N. , Dalmau-Pastor Miki 
Published: June 2022

Background: Bunionette deformity is described as a painful bony prominence on the lateral aspect of the fifth metatarsal head. The present study prospectively assessed the clinical, functional, and radiographic outcomes of sliding distal metatarsal minimally invasive osteotomy (S-DMMO) used in a large series of patients with a midterm follow-up period. Methods: From December 2015 to December 2018, we evaluated 74 feet (57 patients). Radiologic (4-to-5 intermetatarsal angle, fifth metatarsophalangeal angle, the fifth metatarsal head width, lateral deviation angle, fifth metatarsal length, medial displacement, and elevation), clinician-reported scores (AOFAS score, visual analog scale [VAS]) and patient-reported outcomes measure (Foot and Ankle Ability Measure [FAAM] activities of daily living [ADL], FAAM sports, Manchester-Oxford Foot Questionnaire [MOXFQ], and patient satisfaction survey) were included in the analysis. The time to bone union was also assessed. Results: The average 4-to-5 intermetatarsal angle improved from 11.1 degrees preoperatively to 4.5 degrees postoperatively ( P < .001), whereas the average fifth metatarsophalangeal angle improved from 15.7 degrees preoperatively to 4.8 degrees postoperatively ( P < .001). The lateral deviation angle was found to be 2.2 degrees. The fifth metatarsal length decreased from 66.6 to 64.3 mm postoperatively. The average initial medial displacement was 4.67 mm preoperatively and 4.54 mm at final follow-up. The elevation of the fifth metatarsal head was 1.08 mm. The American Orthopaedic Foot & Ankle Society score improved from 54.3 ± 20.86 points preoperatively to 93.4 ± 17.3 ( P < .001). VAS score decreased from 7.9 to 0.7 ( P < .001). Also, FAAM ALD, FAAM Sport, and MOXFQ showed statistically significant differences ( P < .001) between preoperative and postoperative periods. Patients found the procedure excellent in 89.1% of cases, very good in 5.4%, and good in 5.4%. Bone union was obtained at 8.1 weeks. Conclusion: The most important finding of the present study is that S-DMMO showed improvement in function and pain associated with a high satisfaction rate. Also, we found substantial capacity to correct deformities and a low incidence of complications. Level of Evidence: Level IV, case series.
Perioperative Impact of Early Limited Surgical Intervention to Treat Pilon Fractures
Authors: Hreha Jeremy , Metrione Michael D. , Reilly Mark C. , Sirkin Michael S. , Adams Mark R. 
Published: June 2022

Background: The operative treatment of pilon fractures is classically treated with a staged protocol with ankle spanning external fixator, followed by definitive open reduction and internal fixation in order to decrease risk of soft tissue complications and infection. However, treatment of pilon fractures with patrial tibial fixation in addition to ankle spanning external fixation at the time of index procedure may facilitate final fixation while avoiding complications that were associated with acute definitive fixation. Methods: Retrospective cohort series of 113 patients treated for pilon fractures from September 2012 to November 2018 at a single level 1 trauma center. Charts were reviewed to compare patients who underwent traditional management with a staged protocol and those who had a limited tibial reduction and fixation (LTRF) during the index procedure. The main outcome measurement was time to definitive fixation. Results: Twenty-six percent of patients (29 of 113) had limited tibial reduction and fixation (LTRF) during index surgery. Mean time between index procedure and definitive ORIF was 4.75 days less for LTRF cohort compared to standard stage cohort (10.86 ± 7.44 vs. 15.61 ± 8.59 days, P = .009). The index procedure took on average 51 minutes longer in the LTRF cohort ( P < .001), yet definitive procedure operative time was decreased by an average of 98 minutes ( P < .001), and overall (index plus definitive) operative duration was shortened by an average of 50 minutes ( P = .044). There was no difference in rate of infection between LTRF (3.1%) and traditional treatment (2.5%) ( P = .86) or reduction quality ( P = .270). There were no nonunions in either treatment group. Conclusion: Patients who had LTRF had quicker time to definitive ORIF and decreased operative time for definitive ORIF. There was no difference in infection rate, reduction quality, or nonunion rate between groups. Level of Evidence: Level IV, Retrospective Cohort Study.
Preoperative Risk Factors for Primary Metatarsophalangeal Arthroplasty Revision to MTP Arthrodesis for Hallux Rigidus
Authors: Althoff Alyssa D. , Ramamurti Pradip , Vennitti Corinne , Kamalapathy Pramod , Park Joseph S. , Werner Brian C. , Cooper Minton T. 
Published: June 2022

Background: Revision or conversion to arthrodesis following metatarsophalangeal (MTP) joint arthroplasty are salvage procedures to manage complications of MTP joint arthroplasty. The purpose of this study is to use a national administrative database to characterize nationwide trends of patients undergoing hallux MTP arthrodesis vs arthroplasty for hallux rigidus. Additionally, the authors sought to evaluate demographic trends and evaluate influence of patient-related risk factors in those undergoing MTP arthroplasty revision to arthrodesis. Methods: Patients who underwent MTP arthroplasty for diagnosis of hallux rigidus from 2010 to 2019 were identified in the Mariner subset of the PearlDiver database. Patients were included if they had undergone MTP arthroplasty for the diagnosis of hallux rigidus. Notably, the database lacks resolution about critical features of the arthroplasty design and materials. The revision cohort encompassed patients who underwent subsequent ipsilateral MTP arthrodesis or arthroplasty within 2 years of index arthroplasty procedure. Demographic characteristics and medical comorbidities were examined as potential patient-related risk factors for arthroplasty revision or revision to fusion. Univariate analyses were performed to analyze differences in patient demographics, comorbidities, and risk factors. A multivariate regression analysis was subsequently conducted to control for confounding variables. Results: 2750 patients underwent primary MTP arthroplasty for diagnosis of hallux rigidus. Of these, 44 (1.6%) underwent revision arthroplasty and 188 patients (6.8%) were revised to arthrodesis within the first 2 years after the index procedure. Multivariate regression analysis indicates that obesity (odds ratio [OR] 1.48, 95% CI 1.05-2.09), depression (OR 1.59, 95% CI 1.15-2.20), and steroid use (OR 2.94, 95% CI 1.30-6.65) were associated with a statistically significant increase in revision to arthrodesis from primary arthroplasty. Conclusion: Revision arthrodesis following primary MTP arthroplasty for hallux rigidus within 2 years was found to be a relatively common occurrence in this national insurance database study. Risk factors for revision arthroplasty to arthrodesis within 2 years of primary arthroplasty include obesity, depression, and steroid use. Level of Evidence: Level III, case-control study.
Pentosan polysulfate for the treatment of hemorrhagic cystitis after allogeneic hematopoietic cell transplant
Authors: Hatch Rachel V , Freyer Craig W , Carulli Alison , Luger Selina M , Martin Mary E , McCurdy Shannon R , Porter David L , Loren Alison W 
Published: June 2022

Introduction Hemorrhagic cystitis can commonly occur following an allogeneic hematopoietic cell transplant and treatment options are currently limited. Pentosan polysulfate, a heparin-like, sulfated polysaccharide, is used to relieve bladder pain and discomfort associated with interstitial cystitis. Initial reports in patients with hemorrhagic cystitis demonstrate that pentosan polysulfate may hasten hemorrhagic cystitis resolution and control symptoms. Methods and results This report includes a retrospective case series of six patients who received pentosan polysulfate for the treatment of hemorrhagic cystitis following an allogeneic hematopoietic cell transplant. Pentosan polysulfate was initiated at a median of 4.5 days (range: 3–18) following hemorrhagic cystitis onset and continued for a median duration of 17.5 days (range: 7–64). Four patients were tested for BK virus and all were found to have BK viremia and viruria around the time of pentosan polysulfate initiation. The median number of red blood cell transfusions seemed to decrease in the patients initiated on pentosan polysulfate. All patients received a multi-agent treatment regimen, which included pentosan polysulfate, and half the patients had symptom resolution. The median time to symptom resolution from pentosan polysulfate initiation was 9 days (range: 7–10). Conclusion Pentosan polysulfate was well-tolerated and seemed to assist with symptom resolution. Future studies are needed to confirm the impact of pentosan polysulfate on the treatment of hemorrhagic cystitis.
Growth mindset in young people awaiting treatment in a paediatric mental health service: A mixed methods pilot of a digital single-session intervention
Authors: Ching Brian CF , Bennett Sophie D , Morant Nicola , Heyman Isobel , Schleider Jessica L , Fifield Kate , Allen Sophie , Shafran Roz 
Published: June 2022

Background Wait times are significant in child mental health services but may offer opportunity to promote growth mindsets in young people with physical and mental health needs. A digital growth mindset single-session intervention is effective in young people, but its use in paediatric settings has not been examined. This mixed methods pilot aimed to assess the intervention’s feasibility, acceptability, and impact in this population. Method Patients aged 8–18 on waiting lists in a paediatric hospital’s specialist mental health service were offered the intervention remotely. Treatment completion and retention rates, symptoms of depression and anxiety, perceived control, and personality mindset were assessed at baseline, post-treatment, and follow-ups. Semi-structured interviews to explore the intervention’s acceptability were conducted post-treatment. Results Twenty-five patients completed the intervention and 17 patients and three carers/parents were interviewed. Outcomes showed small to large improvements across time-points. Most patients reported finding the intervention enjoyable, accessible, and instilled a hope for change. They valued elements of the intervention but made suggestions for improvement. Conclusions The digital growth mindset single-session intervention is feasible, acceptable, and potentially beneficial for young people with physical and mental health needs on waiting lists. Further research is warranted to examine its effectiveness and mechanism of change.
The effects of age and experience with input in the acquisition of clitic climbing in heritage and L2 Spanish
Authors: Martín Gómez Antonio 
Published: June 2022

Aims and objectives: This study examines the role of age of first exposure and experience with input in the syntax of English–Spanish bilinguals. More specifically, I examine the production of clitic climbing constructions in Spanish (e.g., lo quiero ver “[I] want to see it” [Kayne; Rizzi]). Design/methodology: I compare two experimental groups of heritage speakers of Spanish ( n = 16) and L2 Spanish learners ( n = 17) from the United States (matched in proficiency) against a group of native Spanish speakers from Mexico ( n = 20). A sentence completion task was employed to elicit proclitic sentences across four verbal conditions: two in which clitic climbing is possible but with a higher or lower probability of occurrence, and two in which proclitic placement is agrammatical. Data and analysis: Results show a strong tendency to avoid clitic climbing constructions across all testing conditions. Two logistic regression analyses report no differences across all groups, who only favored the proclisis in highly grammaticalized verbs; proficiency among the experimental groups was a predictor in the production of these sentences. Findings/conclusions: A different time of onset of first exposure to the second language and a different experience with linguistic input (heritage language acquisition vs L2 acquisition) do not appear to affect the production of complex proclitic sentences in Spanish. Originality: Previous studies have employed a few selected periphrastic conditions to elicit clitic climbing constructions among English–Spanish bilinguals. This study further expands the range of verbal matrices employed in the four testing conditions and uses a more controlled testing environment. Significance: This study adds adult bilingual data to the ongoing debate on whether an early exposure to the second language results in advantages in the morphosyntactic domain.
Modified stress field model for critical tearing strength of architectural coated fabrics
Authors: Zhang Xubo , Wu Minger 
Published: June 2022

This report presents a new critical tearing strength prediction model, the modified stress field model. Firstly, the critical tearing strength of six coated fabrics is obtained using the single-edge notched tests. The results show that the warp and weft strength utilization of different coated fabrics is similar. Based on the test data, the prediction effects, parameter meanings, and basic properties of three models, namely Thiele’s empirical formula, the stress field model, and the modified stress field model, are discussed and compared. Then, the predicted results and properties of the three models in different crack ranges, specifically the small crack range, are compared, and their application scopes are verified. The two commonly used models lack the improved prediction effects in the small crack range that is provided by the modified stress field model. Finally, to reduce the workload while maintaining a certain accuracy, a crack combination of 3 mm + 15 mm is recommended, which is further confirmed using the root-mean-square error index. The prediction results of Thiele’s empirical formula and the modified stress field model under this crack combination are compared. The new model can still maintain good prediction effects even when extrapolating for small cracks using limited test data. Because of its precision and convenience, the proposed model may relatively facilitate the application of single-edge notched or uniaxial central tearing tests.
Analysis of Presentation and Outcomes in Acute Limb Ischemia Patients During COVID-19 State of Emergency
Authors: Siu Margaret , Lin Alex M. , Narvaez Vincent F. , Perez-Coulter Aixa , Norris Marc A. , Kronick Matthew D. , Hadro Neal C. , Kravetz Amanda J. , Ching Yiming A. , Morris Marvin E. 
Published: June 2022

Background During the COVID-19 pandemic, cardiovascular patients were found to be presenting to hospitals with myocardial infarctions and cerebrovascular accidents at progressed disease states. We noticed a parallel in acute limb ischemia (ALI) patients presenting during Massachusetts’ COVID-19 State of Emergency declaration. We question whether patients developed a hesitancy to seek medical attention at hospitals due to fear of COVID-19. Our objective was to compare acuity of ALI, interventions, and limb survival in patients presenting before, during, and after a state of emergency. Methods Four timeframes were set to compare patients presenting peri-2020 COVID-19 State of Emergency and patients presenting during a pre-pandemic era at a tertiary, academic institution. A reference period from 2019, Pre-State of Emergency period, State of Emergency period, and Post-State of Emergency period were designated. Patient characteristics, interventions, and outcomes data were collected. Unpaired t-test, ANOVA, and Chi-square statistical analyses were used. Results A total of 95 patients presenting with ALI were identified. Compared to Reference group, state of emergency group had more patients presenting with Rutherford Class III, 12.9% vs 35%, and less patient presenting with Class I, 45.1% vs 0%, P = .02. State of emergency group had more delayed presentations with ≥6 hours after symptom onset, 45% vs 85%, P = .01. Above-knee amputations were performed in 20% of patients during state of emergency and 31.6% for Post-State of Emergency, vs 6.5% in the Reference group; P = .03. There was no difference in intensive care unit admission, length of stay, or mortality between patients from different groups. Conclusion During a state of emergency, ALI patients were noted to present later from symptom onset, have greater disease severity, and more likely to undergo amputations. We suspect delay in presentation and limb lost to be attributed to reluctance to seek immediate medical attention.
Characterization of Trapezial Pommel in Relation to Radiographic and Wear Patterns in Carpometacarpal Osteoarthritis
Authors: Bourdillon Alexandra T. , Shapiro Lauren , Kerkhof Faes D. , Segovia Nicole A. , Weiss Arnold-Peter , Ladd Amy L. 
Published: June 2022

Background: Trapezial pommel, or ulnar osteophyte positioned at the vertex of the saddle-shaped facet, is a consistent structural appearance in osteoarthritis (OA) of the first carpometacarpal. This study investigates its relation to radiographic measures (modified Eaton staging and thumb OA [ThOA] index) and wear patterns (trapezial surface morphology and cartilaginous eburnation). Methods: In all, 137 whole trapezia were explanted from 116 patients and evaluated for Eaton staging, morphology (saddle, cirque, or dish), and eburnation (degree of cartilaginous effacement) of the articular surface of the trapezium. In total, 131 Robert’s views and 126 stress views were reviewed by 2 blinded senior surgeons for ThOA index and pommel size. Statistical analyses included Spearman correlation and linear regression. Results: Standardized pommel size achieved good intrarater reliability (correlation coefficient: 0.80-0.98) and moderate interrater reliability (correlation coefficient: 0.60-0.67). The ThOA index and pommel size were significantly correlated across Robert’s ( rs = 0.51) and stress views ( rs = 0.64). The ThOA index better distinguished between stages compared with pommel size. All the radiographic measures inversely correlated with preserved cartilage and varied across morphologies. Pommel size differed significantly between dish and saddle, and the ThOA index was significantly different between all morphologies when using stress views. Conclusions: We reliably quantified the pommel feature and demonstrated significant correlations with other radiographic and topologic measures of arthritic disease. If future studies can demonstrate that the pommel is a pathogenic process in ThOA and its correction can curb disease progression, the identification of the pommel feature may help guide targeted intervention.
Utility of the novel guide catheter in mechanical thrombectomy for emergent large vessel occlusion stroke
Authors: Zakeri Amanda , Schreiber Craig , Shah Varun , VonEnde Elizabeth , Granger Jessica , Minnema Amy J , Constable Mark , Shujaat Taimur , Youssef Patrick , Powers Ciarán , Jankowitz Brian , Nimjee Shahid M. 
Published: June 2022

Background A number of large bore guide catheters are currently available for use in neuroendovascular surgery. This study represents a multi-institutional retrospective series of patients undergoing mechanical thrombectomy with the use of a TracStar Large Distal Platform (LDP) guide catheter and assessed its performance in vivo in 107 patients. Objective To review a multi-institutional initial experience with the TracStar LDP guide catheter during mechanical thrombectomy for emergent large vessel occlusion (ELVO). Methods A retrospective review was performed at two level one stroke centres to include all patients who underwent mechanical thrombectomy and had the TracStar LDP guide catheter used during the intervention. Results The TracStar LDP guide catheter was successfully used in 107 mechanical thrombectomies. In anterior circulation ELVO, the guide catheter advanced into the cavernous segment of the internal carotid artery in 62.6% (62/99) of cases. In posterior circulation cases, the guide catheter advanced to the basilar artery in 87.5% (7/8) of cases. A thrombolysis in cerebral infarction 2b or greater reperfusion was obtained in 90.7% (97/107). No complications occurred related to the TracStar LDP guide catheter. Three complications occurred with aspiration catheters including a small dissection that did not require further intervention and fracturing of the AXS Catalyst 6 catheter tip in two cases. No thromboembolic events occurred. Conclusions The TracStar LDP large bore guide catheter is safe and effective at navigating the tortuous vascular anatomy often encountered during mechanical thrombectomy for stroke. The flexible distal and stiffer proximal components provide a good combination of navigability and support for use in neuroendovascular interventions.
Developing a fast-track discharge protocol for patients with cerebral aneurysms treated via neuroendovascular techniques
Authors: Entezami Pouya , Rock Andrew K. , Topp Gregory P. , Heydari Ehsaun S. , Field Nicholas C. , Boulos Alan S. , Dalfino John C. , Yamamoto Junichi , Pilitsis Julie G. , Cherukupalli Divya , McCallum Sarah E. , Paul Alexandra R. 
Published: June 2022

Introduction As we emerge from the current pandemic, hospitals, staff, and resources will need to continue to adjust to meet ongoing healthcare demands. Lessons learned during past shortages can be used to optimize peri-procedural protocols to safely improve the utilization of hospital resources. Methods Retrospective review of patients who underwent elective endovascular intracranial aneurysm treatment was performed. Multivariable logistic regression was used to identify factors associated with patients who were able to be discharged within 24 h of elective procedures. Rates of complications (particularly readmission) were determined. Results 330 patients underwent elective endovascular aneurysm treatment with 86 (26.1%) discharged within 24 h. Factors associated with earlier discharge included procedure years (2019–2021) and male sex. Patients were more likely to be discharged later (after 24 h) if they underwent stent-coil embolization or flow-diversion. There was no association between discharge timing and likelihood of readmission. Discussion Our review highlights the safety of earlier discharge and allowed us to prepare a fast-track protocol for same-day discharge in these patients. This protocol will be studied prospectively in the next phase of this study. As we gain more comfort with emerging, minimally invasive endovascular therapies, we hope to safely achieve same-day discharge on a protocolized and routine basis, reducing the demand of elective aneurysm treatments on our healthcare system. Conclusion We retrospectively demonstrate that early discharge following elective aneurysm treatment is safe in our cohort and provide a fast-track pathway based on these findings for other centers developing similar protocols.