bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midterm Prospective Evaluation of Structural Allograft Transplantation for Osteochondral Lesions of the Talar Shoulder
Authors: Fletcher Amanda N. , Johnson Lindsey G. , Easley Mark E. , Nunley James A. , Adams Samuel B. 
Published: May 2022

Background: In cases of large osteochondral lesions of the talus (OLTs), fresh structural or bulk osteochondral allograft transplantation has yielded favorable outcomes in several retrospective and few prospective case series. The purpose of this study was to prospectively evaluate patients who received fresh structural allograft transplantation of the talar shoulder. Methods: A prospective evaluation of patients who received a fresh structural allograft of an OLT was performed. Preoperative imaging included magnetic resonance imaging (MRI) and/or computed tomography (CT) with plain radiographs. The following patient-reported outcomes questionnaires were administered preoperatively and yearly after surgery: 36-Item Short-Form Health Survey (SF-36), visual analog scale (VAS) for pain, and the Short Musculoskeletal Functional Assessment (SMFA). Preoperative and postoperative imaging were evaluated for allograft assimilation, evidence of arthritic changes, or functional range of motion abnormalities. Results: Thirty-one patients with a mean age of 41.4 years (±14.1, range 18-69) underwent structural fresh osteochondral allograft transplantation to the talar shoulder and were included in this study. The mean follow-up was 56.2 months (±36.1, range 24-142). The majority of patients were female (n=17, 54.8%), reported some history of prior ankle trauma (n=21, 67.7%), and underwent prior ankle surgery (n=23, 74.2%). The mean lesion size on CT scan was 1879 mm3 (n = 27) compared to the mean lesion size of 3877 mm3 (n = 21) on MRI. There was a significant improvement in the mean preoperative VAS score ( P < .0001), SF-36 score ( P < .0005), SMFA bother index ( P < .0015), and the SMFA function index ( P < .0001) at final follow-up. A total of 15 (48.4%) patients underwent an additional surgery following their osteochondral allograft transplant, most commonly arthroscopic debridement or removal of hardware, performed at an average of 25.2 (±13.0) from their index procedure. There was one failure that required a total ankle replacement. The overall graft survival rate was 96.8%. Conclusion: Fresh, structural allograft transplantation resulted in significant improvement in patient-reported postoperative pain and function in patients suffering from OLTs. The graft survival rate was 96.8% at a mean of 56.2 months follow-up, with half of patients requiring a second procedure. Level of Evidence: Level IV, prospective case series.
Coronal Plane Rotation of the Medial Column in Hallux Valgus: A Retrospective Case-Control Study
Authors: Lalevée Matthieu , Barbachan Mansur Nacime Salomao , Dibbern Kevin , Briggs Hunter , Maly Connor J. , Carvalho Kepler Alencar Mendes de , Lintz François , de Cesar Netto Cesar 
Published: May 2022

Background: We previously reported an increase in pronation of the first metatarsal (M1) head relative to the ground in hallux valgus (HV) patients compared to controls. Still, the origin and location of this hyperpronation along the medial column is unknown. Recent studies showed that presence of progressive collapsing foot deformities (PCFDs), which is a condition frequently associated with HV, can strongly influence the medial column coronal plane alignment. The objective of this study was to assess the coronal rotation of the medial column bones in HV feet, HV feet with radiologic markers of PCFD, and controls. We hypothesized that hyperpronation in HV will originate from a combination of M1 intrinsic torsion and first tarsometatarsal joint malposition. Methods: The same cohort of 36 HV and 20 controls matched on age, gender, and body mass index was used. Previously, a validation of the measurements was carried out through a cadaveric study. Using these metrics, we assessed the coronal plane rotation of the navicular, medial cuneiform, and the M1 at its base and head with respect to the ground using weightbearing CT images. We measured the Meary angle and the calcaneal moment arm in our 36 HV subjects. We subdivided our cohort into an HV group and a potential PCFD HV group according to these measurements. Comparisons on medial column bones coronal rotation were performed between HV, PCFD HV, and control groups. Results: Twenty-two HV cases were included in the HV group and 14 in the PCFD HV group. Both groups presented an increase in pronation of the first metatarsal head relative to the ground when compared to the control group ( P < .001). Comparing HV and controls showed an 8.3 degrees increase in pronation of M1 intrinsic torsion ( P < .001) and a 4.7 degrees pronated malposition of the first tarsometatarsal joint ( P = .02) in HV. A 9.7 degrees supinated malposition of the first naviculocuneiform joint ( P < .001) was also observed in HV. Comparing PCFD HV and controls showed a significant increase in pronation of the navicular (respectively, 17.2 ± 5.4 and 12.3 ± 3.4 degrees, P = .007) and a 5.5 degrees increase in pronation of M1 intrinsic torsion ( P = .02) in PCFD HV, without malposition of the first tarsometatarsal and naviculocuneiform joints. Conclusion: Hyperpronation of the M1 head relative to the ground originated from both increases in pronation of M1 intrinsic torsion and first tarsometatarsal joint malposition in HV, although partially counterbalanced by a supinated malposition of the first naviculocuneiform joint. On the other hand, PCFD HV patients showed a generalized pronated position throughout the medial column from the navicular to the M1 head and may be related to the midfoot and hindfoot deformities frequently present in PCFD. Level of Evidence: Level III, retrospective comparative study.
Processes supporting effective skill-mix implementation in general practice: A qualitative study
Authors: Spooner Sharon , McDermott Imelda , Goff Mhorag , Hodgson Damian , McBride Anne , Checkland Katherine 
Published: May 2022

Objectives Health policy and funding initiatives have addressed increasing workloads in general practice through the deployment of clinicians from different disciplinary backgrounds. This study examines how general practices in England operate with increasingly diverse groups of practitioners. Methods Five general practices were selected for maximum variation of the duration and diversity of skill-mix in their workforce. Individual interviews were recorded with management and administrative staff and different types of practitioner. Patient surveys and focus groups gathered patients’ perspectives of consulting with different practitioners. Researchers collaborated during coding and thematic analysis of transcripts of audio recordings. Results The introduction of a wide range of practitioners required significant changes in how practices dealt with patients requesting treatment, and these changes were not necessarily straightforward. The matching of patients with practitioners required effective categorization of health care patients’ reported problem(s) and an understanding of practitioners’ capabilities. We identified individual and organizational responses that could minimize the impact on patients, practitioners and practices of imperfections in the matching process. Conclusions The processes underpinning the redistribution of tasks from GPs to non-GP practitioners are complex. As practitioner employment under the Primary Care Network contracts continues to increase, it is not clear how the necessarily fine-grained adjustments will be made for practitioners working across multiple practices.
Autistic children who create imaginary companions: Evidence of social benefits
Authors: Davis Paige E , Slater Jessica , Marshall David , Robins Diana L 
Published: May 2022

Past research shows that autistic children can and do create imaginary companions (ICs), and that these ICs resemble those that neurotypical children create. Neurotypical children creating ICs have been found to have significantly more developed theory of mind (ToM) and social understanding among other enhanced social cognitive skills. The study set out to determine if this finding applies to autistic children. Parents of 124 (38 female) autistic children, ages from 5 to –12 years old, completed questionnaires evaluating communication, social understanding, and social skills. Children with ICs had significantly higher ToM and social skills scores regardless of their communication abilities. Findings suggest that there is a variability in ToM and social skills in autistic children in reference to an IC play profile. Results are discussed in terms of direction of causality and lab-based investigations. Lay abstract Research on neurotypical children with imaginary friends has found that those with imaginary friends have better social skills and are more able to think about how other people’s minds work compared to children without imaginary friends. Research shows that some autistic children also create imaginary friends. This article is the first to look at whether or not autistic children with imaginary friends have stronger social skills and an improved ability to think about others’ minds than those without imaginary friends. We asked parents to report about their children aged 5 to 12. Finding almost half reported their child had an imaginary friend, a much larger number than previous research with younger children. Our findings also suggested that autistic children with imaginary friends were better able to understand others’ minds and had stronger social skills than their peers without imaginary friends. The children’s language ability did not influence this. The findings of this study add to the evidence that with respect to the creation imaginary friends and their potential benefits, the play profiles of autistic children are similar to the general population. It also provides more evidence that the understanding of others’ minds is not all or nothing in autism and gives reason for researchers to investigate whether the causes of these differences are the same or different for autistic children.
The Association of Cannabis Use Disorder with Acute Limb Ischemia and Critical Limb Ischemia
Authors: McGuinness Brandon , Goel Akash , Chen Jerry , Szalay David , Ladha Karim , Mittleman Murray A , Harlock John 
Published: May 2022

Objectives Heavy cannabis use has been associated with the development of acute myocardial infarction and stroke. The objective of this study was to determine if heavy, chronic cannabis use is associated with the development of acute limb ischemia (ALI) or critical limb ischemia (CLI). Methods We conducted a retrospective cohort study within the National Inpatient Sample (2006–2015). Patients without cannabis use disorder (CUD) were matched to patients with CUD in a 2:1 ratio using propensity scores. Our primary outcomes were incidence of ALI and CLI. Secondary outcomes included incidence of acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), frequency of open or endovascular interventions, length of stay, and total costs. Sensitivity analyses were performed with alternative models, including in the entire unmatched cohort with regression models utilizing survey weights to account for sampling methodology. Results We identified a cohort of 46,297 857 unmatched patients. Patients with CUD in the unmatched cohort were younger, with less cardiovascular risk factors, but higher rates of smoking and substance abuse. The matched cohort included 824,856 patients with CUD and 1,610,497 controls. Those with CUD had a higher incidence of ALI (OR 1.20 95% CI: 1.04-1.38 P=.016). Following multiple sensitivity analyses, there was no robust association between CLI and CUD. We observed no robust association of CUD with AMI, CMI, procedures performed, frequency of amputation, costs, or total length of stay. Conclusions Cannabis use disorder was associated with a significantly higher incidence of admission for acute limb ischemia. CUD was not associated with an increased risk of critical limb ischemia following sensitivity analysis. Given CUD is often seen in younger, less co-morbid patients it provides an important target for intervention in this population.
Bone Marrow Edema Injury Patterns in the Pediatric Knee: An MRI Study
Authors: Green Daniel W. , Hidalgo Perea Sofia , Kelly Anne M. , Potter Hollis G. 
Published: May 2022

Background: Symptomatic pediatric patients referred for magnetic resonance imaging (MRI) commonly present with traumatic bone marrow edema (BME) patterns. Purpose: We sought to associate discrete MRI patterns of BME with specific injury mechanisms in pediatric knee injuries to classify injury patterns by anatomical location of the BME. We aimed to group these into 6 patterns: patellar dislocation, extensor mechanism overload, hyperextension, single compartment impaction, ligament avulsion/translation, and direct contusion. Methods: We retrospectively reviewed 314 MRIs performed with a standard protocol on symptomatic patients aged 3 to 18 years at 1 institution. Our analysis included images, reports, and traumatic BME patterns. A musculoskeletal radiologist and orthopedic surgeon independently assigned 1 of the 6 injury patterns to each scan. Results: After exclusion criteria were applied to the 314 MRIs, 62 (19.7%) remained, 40 boys and 22 girls. The average age was of 12.2 years. The most frequent injury patterns were patellar dislocation (n = 22, 35%) and extensor mechanism overload (n = 14, 22%). κ value associated with pattern determination was .766, indicating substantial concordance. Bone marrow edema signal intensity on fat-suppressed sequences was classified as severe in 92% of cases. Conclusions: The strength of pediatric knee ligaments and tendons relative to epiphyseal bone may contribute to a high rate of BME injury patterns seen on MRI in symptomatic pediatric patients. We found that pediatric BME could be classified into 6 specific injury patterns, which might be useful to clinicians in recognizing mechanisms of injury. Further clinical studies are needed to assess the clinical differences in both short-term and long-term outcomes of the BME patterns described.
Ultrasound Assisted Extraction and Characterization of Bioactives From Verbascum thapsus Roots to Evaluate Their Antioxidant and Medicinal Potential
Authors: Shahbaz Fatima , Akhter Naheed , Shahid* Muhammad , Riaz Muhammad , Anjum Fozia , Hussain Fatma 
Published: May 2022

Worldwide, Verbascum thapsus is used for the treatment of various ailments owing to the presence of bioactives of therapeutic potential. Current study was planned to extract bioactives from V thapsus roots using methanol and water as solvents under stimulated effect of ultrasonic waves and characterize them to evaluate their potential benefits. Proximate analysis explored the presence of significant contents of protein, fats, fiber, organic and inorganic minerals. Fourier transform infrared spectra and high-performance liquid chromatography chromatogram indicated the presence of different phytochemicals having antioxidant potential as evidenced by total phenolic contents, total flavonoids content and 2,2-diphenyl-1-picrylhydrazyl activity of both extracts. Both extracts displayed excellent antimicrobial potential against Staphylococcus aureus (S aureus) and Fusarium Solani (F solani). Aqueous and methanolic extracts exhibited higher inhibition of biofilm made by Bacillus subtilis (B subtilis) as 55.09 and 61.58%, respectively in comparison to biofilm of Escherichia coli ( E coli) as 48.11 and 36.51%, respectively. Methanol extract exhibited anti-amylase activity (IC50 5.26 ± .31 μg/mL) with an inhibition rate of 68.11% whereas IC50 of aqueous extract was 6.59 ± .53 μg/mL with an inhibition rate of 63.53%. Inhibitory potential against α-glucosidase (IC50 3.70 ± .94 ppm) was demonstrated by methanol extract in comparison to aqueous extract (IC50 7.58 ± .15). The study concluded that V thapsus roots have significant medicinal potential due to the presence of variety of bioactive molecules and can be used in pharmaceutical preparations.
Sex differences in long-term outcomes of patients with deep vein thrombosis
Authors: Chan Shin Mei , Brahmandam Anand , Valcarce-Aspegren Marcus , Zhuo Haoran , Zhang Yawei , Tonnessen Britt H , Lee Alfred I , Ochoa Chaar Cassius Iyad 
Published: May 2022

Objective Sex differences in short-term outcomes of patients with deep vein thrombosis (DVT) have been reported, but differences in long-term outcomes remain poorly characterized. This study aimed to evaluate sex differences in long-term mortality, venous thromboembolism (VTE)-related mortality, and bleeding-related mortality in patients with DVT at a tertiary care center. Methods A retrospective chart review from 2012 to 2018 of all consecutive patients diagnosed with DVT was performed. Patients were grouped by sex, and baseline characteristics and treatment modalities were compared. Long-term outcomes of recurrent VTE, bleeding, and related mortalities were analyzed. Multivariable regression analysis was performed to determine factors associated with overall mortality. Results A total of 1043 (female = 521 and male = 522) patients with DVT were captured in this study period. Female patients were older (64.7 vs 61.6 years old, p = 0.01) and less likely to be obese (68.2% vs. 71.1% , p = 0.04 ),but had a higher average Caprini score (6.73 vs 6.35, p = 0.04). There was no difference in anatomic extent of DVT, association with PE, and severity of PE between sexes. Most patients (80.5%) were treated with anticoagulation, with no differences in choice of anticoagulant or duration of anticoagulation between females and males. Male patients were more likely to undergo catheter-directed thrombolysis (CDT) for DVT (4.2% vs 1.7%, p = 0.02) and PE (2.7% vs 0.9%, p = 0.04). Female patients were more likely to receive systemic thrombolysis for PE (2.9% vs 1.1%, p = 0.05). After an average 2.3 years follow-up, there was significantly higher bleeding complications among females (22.2% vs 16.7%, p = 0.027). The overall mortality rate was 33.5% and not different between males and females. Females were more likely to experience VTE-related mortality compared to males (3.3% vs 0.6%, p = 0.002). On regression analysis, older age (OR = 1.04 [1.03–1.06]), cancer (OR = 7.64 [5.45–10.7]), and congestive heart failure (OR = 3.84 [2.15–6.86]) were independently associated with overall mortality. Conclusions In this study, there was no difference in overall long-term mortality between sexes for patients presenting with DVT. However, females had increased risk of long-term bleeding and VTE-related mortality compared to males.
Feeling the music: The feel and sound of songs attenuate pain
Authors: Lad Dhillon , Wilkins Alex , Johnstone Emma , Vuong Quoc C 
Published: May 2022

BackgroundExtensive research has demonstrated that music and touch can separately attenuate perceived pain intensity. However, little research has investigated how auditory and tactile stimulation can synergistically enhance pain attenuation by music. In the current study, we investigated whether tactile stimulation can enhance music-induced analgesia for noxious force stimulation on the fingertip.MethodsWe systematically applied force to 34 listeners’ fingertips to induce pain. We then compared the force measurement (in Newton) that gave rise to the same perceived moderate pain intensity when listeners were presented their self-selected liked or disliked song with auditory-only, tactile-only and auditory-tactile stimulation. Higher force indicated less perceived pain. The tactile stimulation were low-frequency modulations extracted from the songs and presented as vibrations on the wrist.ResultsThe results showed a significant interaction between song preference and stimulation condition. Listeners had higher force measurements at the same moderate pain for their liked compared to disliked song only in the auditory-tactile condition. They also had higher force measurements for their liked song with auditory-tactile stimulation compared to the other remaining conditions except for the liked song with auditory-only stimulation.ConclusionsThe addition of tactile stimulation enhanced music-induced analgesia which reduced subjective pain intensity. The findings suggest that combined auditory and tactile stimulation may increase the affective content of self-selected preferred music, which may stimulate affective and motivation mechanisms which inhibit pain transmission.
Strategies for improving recruitment of pregnant women to clinical research: An evaluation of social media versus traditional offline methods
Authors: Cochrane Kelsey M , Hutcheon Jennifer A , Karakochuk Crystal D 
Published: May 2022

Objectives To evaluate the recruitment of pregnant women for a clinical trial in Vancouver, Canada, via social media versus offline methods and to explore optimization of social media campaigns. Methods Facebook was used to run nine social media campaigns (15 weeks total, CA$675). Offline methods were used concurrently over 64 weeks (printing costs: CA$300). The cost, rate of recruitment and conversion rate in each group was calculated. Performance metrics of social media campaigns (reach, impressions, clicks, inquiries, enrolments) were recorded. Linear regression was used to explore the association between metrics and dollars spent per campaign. Results In total, n = 481 inquiries were received: n = 51 (11%) via offline methods and n = 430 (89%) via social media. Enrolees (n = 60 total) included n = 24 (40%) and n = 36 (60%) via offline and social media methods, respectively. Gestational weeks upon inquiry (n = 251; mean ± SD) were not different among groups (offline: 13.3 ± 4.7; social media: 13.2 ± 5.6). Direct cost per enrolee was CA$13 and CA$19 via offline and social media methods, respectively (however, this does not include cost of labour). The rate of recruitment was approximately six times faster via social media. However, the conversion rate was higher via offline methods than social media (47% vs. 8%). The amount spent per campaign was significantly associated with improved clicks and inquiries, but not enrolments. Conclusions Social media was more efficient and effective than offline methods. We gained numerous insights for optimization of social media campaigns (dollars spent, attribution setting, photo testing, automatic optimization) to increase clicks and inquiries, however, this does not necessarily increase enrolments, which was more dependent on study-specific factors (e.g. time of year, study design).