bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variable Practice Patterns and Variation Among Orthopaedic Surgeons Specializing in Pediatric Sports Medicine
Authors: Block Andrew M , Ellis Henry B. , Schmitz Matthew R. , Crepeau Allison ,   PRiSM Hip RIG, Nepple Jeffrey J. 
Published: May 2022

Introduction: Pediatric sports medicine is a growing subspecialty within orthopedic surgery. However, there is very limited literature on the practice of pediatric sports medicine in North America. Purpose: To evaluate and describe the current practice patterns of orthopedic surgeons specializing in pediatric sports medicine via survey of PRiSM (Pediatric Research in Sports Medicine Society) members. Methods: An online survey was distributed to orthopaedic surgeons specializing in pediatric sports medicine through PRiSM in April 2021. The survey was designed to (1) characterize respondent demographics (practice focus on pediatric vs. adult, fellowship training, years in practice, location), (2) characterize the breakdown of different joint specialization, and (3) determine the most common procedures across different joints that the respondent specializes in. Specialization was defined as composing ≥ 25% of a respondent’s practice. Commonly operated joints were defined as composing ≥5% of their practice. Results: Responses from 55 orthopedic surgeons were collected and analyzed. The majority of respondents considered pediatric sports medicine as the primary focus of their practice (89.1%, n=49/55). The number of fellowships completed was almost evenly split between either a single fellowship (52.7%, 29/55) or two or more (47.3%, 26/55). The most common combination of fellowships was pediatric orthopaedics and adult sports medicine (32.7%, 18/55). The majority of survey respondents have been in practice for <10 years (69.0%, 38/55), were affiliated with an academic center (61.8%, 34/55), and utilized non-operative providers as a part of their practice (66.6%, 36/54). On average, 77.5% of patients treated were skeletally immature. Overall, 54.5% of respondents reported specializing in one joint and 41.8% specialized in two. Surgeons commonly operated on a mean of 3 joints. The knee was the most commonly specialized joint (composing a mean of 52.1% of an overall practice), followed by the shoulder (15.2%), hip (13.9%), ankle (7.5%), elbow (7.1%), and wrist (4.2%) (Table 1). Interestingly, 87.3% (48/55) commonly operate on the shoulder but only 21.8% (12/55) were specialists. Conversely, the hip had a similar amount of specialization (23.6%, 13/55) but 56.3% (31/55) reported that they rarely operated on the hip. Conclusions: Pediatric sports medicine practices in orthopaedic surgery are quite variable. The majority of surgeons are <10 years into practice, affiliated with academic centers and have typically completed either 1 or 2 fellowships after residency. The majority of patients are skeletally immature. Most surgeons specialize in one or two joints, most commonly the knee, followed by hip and then shoulder. [Table: see text][Figure: see text]
Wound Dillemmas: Investigating the Effect of Barbed Knotless Suture Versus Smooth Suture for Subcuticular Tissue Closure During Knee Surgery in Youth Athletes
Authors: Tsang Henry , Gornick Bryn , Schlechter John A. 
Published: May 2022

Background: Surgical procedures of the knee are commonly performed on youth athletes for a myriad of conditions. Restoration of motion is paramount following surgery and wound healing issues may arise. Studies have investigated wound closure technique and its’ effect on wound healing in arthroplasty, but there is a paucity of information in youth sports medicine. Purpose: To investigate wound healing following knee surgery as affected by smooth running monofilament versus barbed running knotless suture for subcuticular closure. Methods: A retrospective investigation was conducted of a single surgeon’s knee procedures between January 2013 to December 2020. Suture type for closure of the operative wound as well as any wound healing dilemmas (i.e., wound dehiscence and formal operative debridement) encountered during the post-operative period were recorded. The surgical procedure, perioperative antibiotics, wound lavage, dressing type and patient demographics were also recorded. Group 1 underwent subcuticular wound closure performed with a running smooth non-barbed monofilament suture and was compared to Group 2 where closure was performed with barbed monofilament suture. Exclusion criteria was a history of ipsilateral knee surgery and congenital syndromes. Statistical analysis was performed. Results: 486 patients were identified of which 21 were excluded leaving 202 patients in Group 1 and 263 in Group 2. Average age was 15.8 years (range 10 to 25 years). 277 were female. Wound dehiscence occurred in 17 patients in Group 1 (8.42%) and 25 in Group 2 (9.51%) (p=0.684). Formal debridement was performed in 8 patients in Group 1 (3.96%) and 4 (1.52%) in Group 2 (p=0.100). There was a significantly higher tourniquet time (p<0.001), number of meniscus repairs (p<0.001) and trochleoplasties (P=0.011) in Group 2. There was no difference between groups regarding comorbidities, body mass index, and age. A power analysis yielded to reach 80% power (p<0.05) 12,405 patients per group would be needed for investigating the rate of dehiscence and 868 patients per group for formal debridement. Conclusion: Subcuticular suture type did not significantly affect the rate of wound healing dilemmas encountered following knee surgery in this young cohort. Formal debridement was required at a diminished rate in the barbed suture group but not significant enough to recommend routine use. Larger cohort studies are needed to further investigate this trend. [Table: see text]
Radiologic Predictors of Failure of Patellofemoral Instability Surgery in Adolescents
Authors: Wilson Benjamin R. , Zheng Evan T. , Cook Danielle L. , Hussain Zaamin B. , Nunally Kianna D. , Heyworth Benton E. , Micheli Lyle J. , Yen Yi-Meng , Kramer Dennis E. , Kocher Mininder S. 
Published: May 2022

Background: Adolescents often benefit from surgical management of recurrent patellofemoral instability (PFI). However, the precise radiologic risk factors for failure of PFI surgery remains incompletely investigated. Hypothesis/Purpose: The purpose of this study was to determine the rate of failure, defined as recurrence of instability, in a large cohort of adolescent athletes undergoing primary surgery for PFI, and to identify preoperative radiologic risk factors for recurrence. Methods: A retrospective review was performed on patients aged ≤19 years who underwent primary surgery for PFI at a single tertiary care center between 2008 and 2017. Patients underwent procedures including medial retinacular plication/reefing/advancement (MRP), medial patellofemoral ligament reconstruction (MPFLR), tibial tubercle osteotomy with or without MRP (TTO), or combined TTO/MPFLR. Exclusion criteria were BMI >30kg/m2, surgery for fixation of chondral fractures >1cm, and diagnosis of a syndromic disorder. Preoperative magnetic resonance imaging (MRI) studies were reviewed, and radiologic parameters were recorded. Demographic and radiologic variables were compared between patients with and without subsequent PFI. Logistic regression was utilized to determine which imaging variables were associated with post-operative PFI. Results: 303 patients (mean age 15.1 years, 71% female) underwent surgery for PFI with median follow up time of 3.0 years. At final follow-up, 76/303 (25%) of patients experienced post-operative PFI, with 41 of these patients (54%; 14% overall) undergoing revision PFI surgery. Post-operative PFI patients were younger (14.3 vs 15.4 years; p<0.001) and more likely to have undergone isolated MRP surgery (66% vs 35%; p<0.001) (Table 1). Pertinent radiologic findings in recurrent PFI patients vs non-recurrence patients included open physes (62% vs 49%; p<0.001), larger sulcus angle (163.9 vs 159.2; p<0.001), larger patellar tilt angle (26.3 vs 23.6; p=0.04), and larger Caton-Deschamps Index (CDI) (1.3 vs 1.2; p=0.03) (Table 2). Each additional degree of sulcus angle increased the odds of recurrent instability by 5% (OR=1.05; p=0.002), while each additional year of age decreased the odds of failure by 23% (OR=0.77; p<0.001). Conclusion: In conclusion, 25% of adolescents experienced post-operative PFI after primary patellofemoral stabilization surgery. However, such patients were more likely to be younger—a known risk factor for recurrence—and were more likely to undergo MRP, a procedure now largely replaced by MPFLR. Radiologic risk factors for failure included open physes, flatter trochlea, greater patellar tilt, and greater patella alta. Such data should guide treatment decisions and inform the risk of failure of surgical stabilization procedures in adolescents with PFI. [Table: see text][Table: see text]
Trochleoplasty in the Pediatric Population - A Systematic Review of Patient Characteristics, Treatment Strategies and Outcomes
Authors: Amato Chad , Williams Brendan A. 
Published: May 2022

Background: Trochleoplasty is a treatment considered for patellofemoral instability patients with high grade dysplasia and those who have failed other surgical intervention. However, the indications for and the safety profile of this procedure remain unclear, particularly in the pediatric population where concerns exist regarding physeal arrest and the development of premature patellofemoral arthritis. Purpose: To systematically review the literature to evaluate trochleoplasty use, outcomes and complications observed among pediatric patients. Methods: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines reviewing Pubmed and SCOPUS databases. Inclusion criteria were studies including pediatric (<18yo) patients undergoing trochleoplasty with either a mean age <18 or those in which individualized patient characteristics and resultant outcomes were reported. Patient demographics, dysplasia type, procedure type and patient outcomes were abstracted when available and summarized with descriptive statistics. Results: Our search strategy identified 4 studies published from 2016-2020 that included 86 patients (mean age=14.5yo) with a mean follow up of 31.6 months (range 12-60 months). All were classified as Level IV evidence. The majority (65%) of patients were Dejour B (56/86). A thin-flap technique was used in three studies while a lateral wedge augmentation procedure was utilized in the fourth. Kujala and Lysholm scores were collected in two studies with demonstrable patient improvement. The most common early complication noted was arthrofibrosis requiring arthroscopic lysis of adhesions (5 total patients). Only a single recurrent instability event was reported. In a single study, 4 of 23 patients had radiographic trochlear osteoarthritic changes at 5 years postoperatively. There were no reports of premature physeal arrest in two studies that monitored for this outcome. Conclusion: There remains a limited evidence base regarding trochleoplasty use in pediatric patients. Overall, favorable outcomes have been observed with infrequent recurrent instability. There are no reports of growth disturbance from physeal arrest as a result of this procedure identified, but reporting among patients with confirmed skeletal immaturity is scarce. Patellofemoral arthritic changes were observed radiographically in a small subgroup of patients, but further work is necessary to determine if this is a result of the procedure itself or the underlying pathology being treated. As interest grows in implementing trochleoplasty in the pediatric population and potentially skeletally immature individuals, improved evidence is necessary to determine the incidence of major complications in order to better define the safety profile and indications for use in children and adolescents.
Type VII Tibial Tubercle Fractures are Different from Osgood Schlatter Syndrome and Tibial Tubercle Physeal Fractures
Authors: Gamble James G. , Shirodkar Rati , Gamble Jamison G. , Chan Charles M. 
Published: May 2022

Introduction: Children and adolescents are prone to both overuse and acute injuries at the tibial tubercle. The most common overuse injury is Osgood Schlatter Syndrome (OSS,) and the most common acute severe injury is tibial tubercle avulsion fracture (TTF). Here we present evidence for a Type VII, all-epiphyseal, tibial tubercle fracture (VIITF) that is different from OSS and TTF. Methods: This IRB–approved study involved patients that were treated and registered at a tertiary care pediatric hospital from 2014 to 2020. We compared the clinical information, the radiographs, the treatments, and the outcomes of 15 patients with VIITF to 19 patients with OSS and to 14 patients with TTF. Results: All VIITF patients had a sudden onset of pain associated with a specific sports-related injury, and all had lateral radiographs showing a chip-like ossific fragment displaced from the secondary center but with no involvement of the physis. All of the OSS patients had an insidious onset of symptoms with no specific injury, and none had radiographs showing a chip-like fragment. All the TTF patients had a sudden onset of pain after an acute injury. Eleven of the 15 VIITF patients (73%) have formed retro-patellar tendon ossicles, and 7 of those patients (46%) have undergone surgery. All but one of the OSS patients have resolved, and all with non-operative management. All the TTF patients have resolved, and all except those with Ogden type IA fractures, had undergone urgent surgery. Conclusions: We accepted our hypothesis. VIITF is different from OSS and TTF and can be differentiated on the basis of clinical and radiographic data. Clinical Relevance: Most patients with OSS resolve with non-operative management, and TTF patients usually require urgent surgery. Children with VIITF do not need urgent surgery but do need to be followed because some can form painful retro-patellar tendon ossicles, have focal anterior knee pain, and may need surgery to resolve their symptoms. Level of Evidence: Level III: Case Control Study.
Pediatric Research in Sports Medicine Research Interest Group Spine/Spondylolysis Clinical Practice SurveY
Authors: Riederer Mark F. , Achar Suraj , McHorse Kevin , MacDonald James P. 
Published: May 2022

Background: The Pediatric Research in Sports Medicine (PRiSM) society is a multi-disciplinary group of healthcare providers who provide clinical care to young athletes with a variety of conditions, including isthmic spondylolysis. It is thought that significant practice differences exist in the way providers diagnose, image, and treat this condition. Hypothesis/Purpose: The purpose of this study is to survey the members of PRiSM on clinical practice patterns in the diagnosis, imaging, and management of isthmic spondylolysis in young athletes. Methods: An electronic, thirty-three question REDCaps survey was distributed to the PRISM membership via email during the 2021 virtual annual meeting and one reminder was sent after the meeting. Responses were collected during a 6-week period. The survey collected information based upon the following: demographics, diagnosis, imaging, and management. Results: Ninety-eight surveys were completed. Most of the respondents were divided between orthopaedic surgeons, non-operative sports medicine physicians and physical therapists, approximately half of which are fellowship trained. Approximately 42% of respondents make the diagnosis based upon MRI results in addition to history, physical examination, and plain radiographs. Approximately 24% obtain oblique radiographs as part of their assessment. MRI is the most frequently used advanced imaging modality with nearly 90% of respondents using this. The use of rigid bracing varies widely among respondents, with 20.6% bracing regularly, 35.3% sometimes bracing, and 44.1% not using rigid braces at all. The use of non-rigid bracing is similarly varied with 17.6% prescribing this regularly, 44.1% sometimes, and 38.2% not using non-rigid bracing at all. There is variance as well with regards to initiation of physical therapy (PT): prescribing immediately (42.6%) versus prescribing a period to rest prior to PT (57.4%). When young athletes are returned to sport, 52.9% of respondents indicated that they would impose restrictions to activity and 47.1% would not. Conclusion: Although there are similarities in how the diagnosis of isthmic spondylolysis in young athletes is made by PRISM members, there is variability in management, especially the use of bracing, the timing of physical therapy, and return to sport restrictions. MRI is the most common advanced imaging modality being used to help with the diagnosis.
Enhancement of atomic oxygen resistance for heat-sealable isomeric co-polyimide films by combining ether linkage with diphenylphosphine oxide
Authors: Ni Hongjiang , Yang Xiaoke , Li Jun , Zhang Daijun , Liu Jingang , Yang Shiyong , Chen Xiangbao 
Published: May 2022

Heat-sealable isomeric co-polyimide (CPI) films with enhanced atomic oxygen (AO) resistance and mechanical strength were synthesized from 2,3,3′,4′-oxydiphthalic anhydride (aODPA), 4,4′-oxydianiline (ODA), and 2,5-bis [(4-aminophenoxy)phenyl]diphenylphosphine oxide (BADPO). We investigated how the molecular structure and diamine ratio affected the thermal properties, solubility, mechanical properties, AO resistance and heat-sealability. The diphenylphosphine oxide (DPO) side group decreased the CPI film mechanical strength and its higher ODA reactivity increased the molecular weight. At 10 mol% ODA in the aODPA-BADPO system, the CPI film exhibited increased tensile strength with no detriment to the AO resistance. Meanwhile, the CPI films demonstrated good heat-sealability indicated by a completely merged interface after heat sealing.
Allelic complexity of KMT2A partial tandem duplications in acute myeloid leukemia and myelodysplastic syndromes
Authors: Tsai Harrison K. , Gibson Christopher J. , Murdock H. Moses , Davineni Phani , Harris Marian H. , Wang Eunice S. , Gondek Lukasz P. , Kim Annette S. , Nardi Valentina , Lindsley R. Coleman 
Published: May 2022

Abstract
KMT2A partial tandem duplication (KMT2A-PTD) is an adverse risk factor in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), a potential therapeutic target, and an attractive marker of measurable residual disease. High initial KMT2A-PTD RNA levels have been linked to poor prognosis, but mechanisms regulating KMT2A-PTD expression are not well understood. Although KMT2A-PTD has been reported to affect only a single allele, it has been theorized but not proven that genomic gains of a monoallelic KMT2A-PTD may occur, thereby potentially driving high expression and disease progression. In this study, we identified 94 patients with KMT2A-PTDs using targeted DNA next-generation sequencing (NGS) and found that 16% (15/94) had complex secondary events, including copy-neutral loss of heterozygosity and selective gain involving the KMT2A-PTD allele. High copy numbers indicating complexity were significantly enriched in AML vs MDS and correlated with higher RNA expression. Moreover, in serial samples, complexity was associated with relapse and secondary transformation. Taken together, we provide approaches to integrate quantitative and allelic assessment of KMT2A-PTDs into targeted DNA NGS and demonstrate that secondary genetic events occur in KMT2A-PTD by multiple mechanisms that may be linked to myeloid disease progression by driving increased expression from the affected allele.
Preparation of carbon nanoparticles from activated carbon by aqueous counter collision
Authors: Yu Liwei , Tatsumi Daisuke , Kondo Tetsuo 
Published: May 2022

AbstractIn the present study, crystalline cellulose biomass material was converted into carbon nanoparticles via carbonization to activated carbon with micropores of various sizes. This was subsequently subjected to aqueous counter collision (ACC) to produce hydrophobic porous functional particles. Initially, raw crystalline cellulose material was carbonized into activated carbon materials with various pore distributions prior to ACC. Pore distribution depended on the activation time, and was confirmed by nitrogen (N2) adsorption isotherms. The surface areas and pore volumes of carbon activated for 8 h were larger than those of carbon activated for 2 h. When they were subjected to ACC, the width and length of the carbon particles decreased as the number of pulverizing cycles during the ACC treatment increased. Eventually, carbon nanoparticles of 70 nm width that had improved dispersibility and stability were produced. The diameters of the carbon nanoparticles and their dispersibility were dependent on the pore distribution and surface areas of the activated carbon subjected to the ACC treatment. The ACC process facilitated the preparation of carbon nanoparticles from activated carbon derived from biomass, and is, therefore, an important strategy for the sustainable production of a sought-after and valuable resource.
13C15N: glucagon-based novel isotope dilution mass spectrometry method for measurement of glucagon metabolism in humans
Authors: Renuse Santosh , Benson Linda M. , Vanderboom Patrick M. , Ruchi F. N. U. , Yadav Yogesh R. , Johnson Kenneth L. , Brown Benjamin C. , Peterson Jane A. , Basu Rita , McCormick Daniel J. , Pandey Akhilesh , Basu Ananda 
Published: May 2022

Abstract
Background
Glucagon serves as an important regulatory hormone for regulating blood glucose concentration with tight feedback control exerted by insulin and glucose. There are critical gaps in our understanding of glucagon kinetics, pancreatic α cell function and intra-islet feedback network that are disrupted in type 1 diabetes. This is important for translational research applications of evolving dual-hormone (insulin + glucagon) closed-loop artificial pancreas algorithms and their usage in type 1 diabetes. Thus, it is important to accurately measure glucagon kinetics in vivo and to develop robust models of glucose-insulin-glucagon interplay that could inform next generation of artificial pancreas algorithms.

Methods
Here, we describe the administration of novel 13C15N heavy isotope-containing glucagon tracers—FF glucagon [(Phe 6 13C9,15N; Phe 22 13C9,15N)] and FFLA glucagon [(Phe 6 13C9,15N; Phe 22 13C9,15N; Leu 14 13C6,15N; Ala 19 13C3)] followed by anti-glucagon antibody-based enrichment and LC–MS/MS based-targeted assays using high-resolution mass spectrometry to determine levels of infused glucagon in plasma samples. The optimized assay results were applied for measurement of glucagon turnover in subjects with and without type 1 diabetes infused with isotopically labeled glucagon tracers.

Results
The limit of quantitation was found to be 1.56 pg/ml using stable isotope-labeled glucagon as an internal standard. Intra and inter-assay variability was < 6% and < 16%, respectively, for FF glucagon while it was < 5% and < 23%, respectively, for FFLA glucagon. Further, we carried out a novel isotope dilution technique using glucagon tracers for studying glucagon kinetics in type 1 diabetes.

Conclusions
The methods described in this study for simultaneous detection and quantitation of glucagon tracers have clinical utility for investigating glucagon kinetics in vivo in humans.