bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 187: The Effect of Elbow Varus Torque on Medial Epicondyle in Little League Pitchers
Authors: Kida Yoshikazu , Kobayashi Yusuke , Sukenari Tsuyoshi , Minami Masataka , Kotoura Yoshihiro , Takahashi Kenji , Takatsuji Kenta 
Published: July 2022

Objectives: In baseball players, elbow varus torque is associated with the risk of medial elbow injuries. However, the effect of elbow varus torque on medial epicondyle deformity among youth baseball players has not yet been clarified. To clarify the relationship between elbow varus torque and medial epicondyle abnormality in little league pitchers. Methods: The participants consisted of 173 little league pitchers (mean age, 10.6±0.6 years; range, 10-12 years). The pitchers were instructed to throw a ball into a netting target at maximum effort three times. A sensor placed at the medial elbow reported elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. The medial epicondyle of each player was evaluated using ultrasound imaging (Figure 1). A questionnaire was used to investigate the background (age, height, weight) and the past or present elbow pain. The average of elbow varus torque was calculated. Players were divided into high-torque group and low-torque group depending on whether the torque is higher or lower than average elbow varus torque. The relationship between elbow varus torque and the presence of ultrasound abnormality and elbow symptom was statistically analyzed among two groups. Results: A medial epicondyle deformity was observed in 85 players (49%). The results of this study showed that height (146.8±6.6 cm vs. 138.9±5.9 cm), weight (39.5±7.1 kg vs. 32.4±4.8 kg), and ball velocity (72.7±7.5 km/h vs. 67.6±6.8 km/h) were significantly higher in the high torque group than in the lower torque group (P<.001), while arm slot (48.6±12.4 degrees vs. 54.9±14.4 degrees) was significantly lower in the high torque group (P<.05) (Table 1). The rate of players who experienced past elbow pain was significantly higher in the high-velocity group (P<.05), while there were no significant differences in the rate of present pain among the two groups (Table 2). The rate of medial epicondyle abnormality was significantly higher in the high-torque group than in the low-torque group (chi-square test; P<.05) (Figure 2). Conclusions: In this study, a medial epicondyle deformity and past elbow pain were significantly higher in the high torque group. High elbow varus torque would increase the risk of medial elbow disorder. [Table: see text][Table: see text][Figure: see text][Figure: see text]
Poster 236: There is No Difference in Early Functional Outcomes for Patients Undergoing Tele-Rehabilitation versus Standard in Office Rehab after Arthroscopic Meniscectomy: A Randomized Controlled Trial
Authors: Hurley Eoghan , Vasavada Kinjal , Lin Charles , Gonzalez-Lomas Guillem , Alaia Michael , Strauss Eric , Jazrawi Laith , Campbell Kirk , Mojica Edward 
Published: July 2022

Objectives: While a growing body of evidence has demonstrated that tele-rehabilitation is effective, the functional outcomes of patients undergoing tele-rehabilitation as compared to in-person rehabilitation after arthroscopic meniscectomy remains unclear. This is especially salient against the backdrop of COVID-19 and the Delta variant and the subsequent increased demand for remote care of these patients. Methods: A randomized-controlled trial was conducted including patients scheduled to undergo arthroscopic meniscectomy for meniscal injury by one of five fellowship trained sports medicine surgeons between August 2020 and May 2021. Patients were randomized to receive tele-rehabilitation, defined as exercises and stretches provided by trained physical therapists over a synchronous face-to-face video visit, or in-person rehabilitation for their post-operative course. International Knee Documentation Committee Subjective Knee Form (IKDC) score and Visual Analogue Scale (VAS) score were collected at timepoints of baseline, 3 months, 6 months, and 12 months post-operatively. Statistical analysis was conducted using Student T-test to assess for differences across the two groups. Results: An interim analysis was conducted on 60 patients with 6 month follow-up outcomes. There were no significant differences in VAS scores between groups at baseline (p =0.716) and 3 months postoperatively (p = 0.700). and 6 months postoperatively (p = 0.688). In addition, no significant differences in IKDC scores were seen between the groups at baseline (p = 0.146) and 3 months (p = 0.746). At 6 months, 24 patients were available with no significant differences observed across groups at this time point (IKDC; p = 0.633) (VAS; p = 0.688). Conclusions: Tele-rehabilitation is demonstrated to be as efficacious as traditional in-person rehabilitation following arthroscopic meniscectomy at up to 6 months post-op. This serves as a convenient and safe alternative for conventional patients during their post-operative course.
Poster 238: No Difference in Clinical Outcomes between Operative and Nonoperative Management of Minimally Retracted Proximal Hamstring Ruptures: A Matched Cohort Study
Authors: Kanakamedala Ajay , Rynecki Nicole , Markus Danielle , Song Melissa , Gonzalez-Lomas Guillem , Strauss Eric , Youm Thomas , Jazrawi Laith , Mojica Edward 
Published: July 2022

Objectives: The optimal treatment protocol for proximal hamstring ruptures, particularly when involving less than 3 cm of retraction, is not known. The purpose of this study was to compare patient-reported outcomes (PROs) between patients who underwent operative or non-operative management of proximal hamstring ruptures. Methods: A retrospective review of the electronic medical record identified all patients who were treated operatively or non-operatively for a proximal hamstring rupture from 2013 to 2020. Patients were stratified into two groups which were matched based on demographics including age, gender, BMI, chronicity of the injury, tendon retraction, and injury grade (complete, or three tendons, versus partial, or one or two tendons). All patients completed a battery of PROs including the Perth Hamstring Assessment Tool (PHAT), Modified Harris Hip Score (MHHS), Visual Analogue Scale for pain (VAS), and the Tegner Activity Scale. Patients from the non-surgical group were then case-matched in 2:1 fashion to their surgical counterparts. Results: Overall, 113 patients met inclusion criteria and were available for follow-up. Of the 113, 59 (52.2%) underwent primary hamstring tendon repair and 54 (47.8%) patients underwent non-operative treatment consisting of physical therapy. These 54 patients were case-matched to 28 surgically managed patients. When controlling for patient demographics, there were no differences in patient reported outcomes between non-operative and operative treatment of proximal hamstring in any validated outcome indicator (p > 0.05). Chronicity of the injury and older age correlated significantly to worse outcomes in both groups (p < 0.05). Conclusions: In patients with proximal hamstring ruptures with <3 cm of retraction, there was no difference in PRO scores between matched cohorts of operatively and non-operatively treated proximal hamstring avulsions
Poster 253: Anterior Cruciate Ligament Reconstruction in 118 Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 5 years Mean Follow Up
Authors: Song Bryant , Wasserburger Jory , Till Sara , Camp Christopher , Levy Bruce , Stuart Michael , Okoroha Kelechi , Krych Aaron , Marigi Erick 
Published: July 2022

Objectives:Introduction: Wrestling is a physically demanding sport with young athletes prone to anterior cruciate ligament (ACL) injuries. However, there is a paucity of data evaluating the results of ACL reconstruction (ACLR) in this cohort. Purpose: To assess patient-reported outcomes, reoperation rates, graft survival, and return to play (RTP) following ACLR in a large cohort of competitive wrestlers Methods: All competitive wrestlers (high school, collegiate, or professional) with a history of an ACLR at a single institution between 2000 and 2019 were retrospectively identified. Graft failure was defined as a re-tear determined by clinical or advanced imaging evaluation, and/or revision ACL reconstruction. All patients were contacted for determination of reinjury rates, current sport status, visual analog scale (VAS), International Knee Documentation Committee (IKDC) and Tegner activity scores. Results: 118 knees in 114 wrestlers were included at a median follow-up time of 5.8 years (IQR: 3.6 – 10.3). The median age was 17 years (15 – 18) with 116 (98%) males. ACLR was most often performed with bone-patellar tendon-bone (BTB) autograft (n = 64; 54%) or hamstring tendon (HT) autograft (n = 43; 36%). At final follow-up, 80% of athletes were able to RTP at a median of 273 days (IQR: 203 – 379). Graft failure occurred in 17 (14%) patients at a median time of 1.4 years (IQR: 0.8 – 4.7) after the index ACLR. BTB autograft demonstrated a lower failure rate compared to HT autograft (8% vs. 21%; P = 0.044). Kaplan-Meier survivorship free from graft failure for the entire cohort was 95.3% at 1 year, 92.5% at 2 years, 89.8% at 5 years, 84.6 at 10 years, 77.6 at 20 years. BTB autograft was associated with better survival than HT autograft up to 15 years after the index ACLR (90.4% vs. 76.3%; P = 0.030). Conclusions: Return to competitive wrestling was observed in 80% of athletes after ACLR, with 14% of wrestlers experiencing graft failure. BTB autograft reconstruction may serve as a more durable graft for competitive wrestlers with lower rates of failure when compared to HT autograft even up to 15 years after surgery. [Table: see text][Figure: see text][Figure: see text][Figure: see text]
Immunomodulation and endothelial barrier protection mediate the association between oral imatinib and mortality in hospitalised COVID-19 patients
Authors: de Brabander Justin , Duijvelaar Erik , Schippers Job R. , Smeele Patrick J. , Peters-Sengers Hessel , Duitman Jan Willem , Aman Jurjan , Bogaard Harm Jan , van der Poll Tom , Bos Lieuwe D.J. 
Published: July 2022

BackgroundImatinib reduced 90-day mortality in hospitalised coronavirus disease 2019 (COVID-19) patients in a recent clinical trial, but the biological effects that cause improved clinical outcomes are unknown. We aimed to determine the biological changes elicited by imatinib in patients with COVID-19 and what baseline biological profile moderates the effect of imatinib.MethodsWe undertook a secondary analysis of a randomised, double-blind, placebo-controlled trial of oral imatinib in hospitalised, hypoxaemic COVID-19 patients. Mediating effects of changes in plasma concentration of 25 plasma host response biomarkers on the association between randomisation group and 90-day mortality were studied by combining linear mixed effect modelling and joint modelling. Moderation of baseline biomarker concentrations was evaluated by Cox regression modelling. We identified subphenotypes using Ward's method clustering and evaluated moderation of these subphenotypes using the aforementioned method.Results332 out of 385 participants had plasma samples available. Imatinib increased the concentration of surfactant protein D (SP-D), and decreased the concentration of interleukin-6, procalcitonin, angiopoietin (Ang)-2/Ang-1 ratio, E-selectin, tumour necrosis factor (TNF)-α, and TNF receptor I. The effect of imatinib on 90-day mortality was fully mediated by changes in these biomarkers. Cluster analysis revealed three host response subphenotypes. Mortality benefit of imatinib was only present in the subphenotype characterised by alveolar epithelial injury indicated by increased SP-D levels in the context of systemic inflammation and endothelial dysfunction (hazard ratio 0.30, 95% CI 0.10–0.92).ConclusionsThe effect of imatinib on mortality in hospitalised COVID-19 patients is mediated through modulation of innate immune responses and reversal of endothelial dysfunction, and possibly moderated by biological subphenotypes.
Detection of COPD in the SUMMIT Study lung cancer screening cohort using symptoms and spirometry
Authors: Tisi Sophie , Dickson Jennifer L. , Horst Carolyn , Quaife Samantha L. , Hall Helen , Verghese Priyam , Gyertson Kylie , Bowyer Vicky , Levermore Claire , Mullin Anne-Marie , Teague Jonathan , Farrelly Laura , Nair Arjun , Devaraj Anand , Hackshaw Allan ,   the SUMMIT Consortium, Hurst John R. , Janes Sam M. 
Published: July 2022

BackgroundCOPD is a major comorbidity in lung cancer screening (LCS) cohorts, with a high prevalence of undiagnosed COPD. Combining symptom assessment with spirometry in this setting may enable earlier diagnosis of clinically significant COPD and facilitate increased understanding of lung cancer risk in COPD. In this study, we wished to understand the prevalence, severity, clinical phenotype and lung cancer risk of individuals with symptomatic undiagnosed COPD in a LCS cohort.Methods16 010 current or former smokers aged 55–77 years attended a lung health check as part of the SUMMIT Study. A respiratory consultation and spirometry were performed alongside LCS eligibility assessment. Those with symptoms, no previous COPD diagnosis and airflow obstruction were labelled as undiagnosed COPD. Baseline low-dose computed tomography (LDCT) was performed in those at high risk of lung cancer (PLCOm2012score ≥1.3% and/or meeting USPSTF 2013 criteria).ResultsNearly one in five (19.7%) met criteria for undiagnosed COPD. Compared with those previously diagnosed, those undiagnosed were more likely to be male (59.1%versus53.2%; p<0.001), currently smoking (54.9%versus47.6%; p<0.001) and from an ethnic minority group (p<0.001). Undiagnosed COPD was associated with less forced expiratory volume in 1 s impairment (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1 and 2: 85.3%versus68.4%; p<0.001) and lower symptom/exacerbation burden (GOLD A and B groups: 95.6%versus77.9%; p<0.001) than those with known COPD. Multivariate analysis demonstrated that airflow obstruction was an independent risk factor for lung cancer risk on baseline LDCT (adjusted OR 2.74, 95% CI 1.73–4.34; p<0.001), with a high risk seen in those with undiagnosed COPD (adjusted OR 2.79, 95% CI 1.67–4.64; p<0.001).ConclusionsTargeted case-finding within LCS detects high rates of undiagnosed symptomatic COPD in those most at risk. Individuals with undiagnosed COPD are at high risk for lung cancer.
Obstructive sleep apnoea-related respiratory events and desaturation severity are associated with the cardiac response
Authors: Hietakoste Salla , Karhu Tuomas , Sillanmäki Saara , Bailón Raquel , Penzel Thomas , Töyräs Juha , Leppänen Timo , Myllymaa Sami , Kainulainen Samu 
Published: July 2022

BackgroundObstructive sleep apnoea (OSA) causes, among other things, intermittent blood oxygen desaturations, increasing the sympathetic tone. Yet the effect of desaturations on heart rate variability (HRV), a simple and noninvasive method for assessing sympathovagal balance, has not been comprehensively studied. We aimed to study whether desaturation severity affects the immediate HRV.MethodsWe retrospectively analysed the electrocardiography signals in 5-min segments (n=39 132) recorded during clinical polysomnographies of 642 patients with suspected OSA. HRV parameters were calculated for each segment. The segments were pooled into severity groups based on the desaturation severity (i.e.the integrated area under the blood oxygen saturation curve) and the respiratory event rate within the segment. Covariate-adjusted regression analyses were performed to investigate possible confounding effects.ResultsWith increasing respiratory event rate, the normalised high-frequency band power (HFNU) decreased from 0.517 to 0.364 (p<0.01), the normalised low-frequency band power (LFNU) increased from 0.483 to 0.636 (p<0.01) and the mean RR interval decreased from 915 to 869 ms (p<0.01). Similarly, with increasing desaturation severity, the HFNUdecreased from 0.499 to 0.364 (p<0.01), the LFNUincreased from 0.501 to 0.636 (p<0.01) and the mean RR interval decreased from 952 to 854 ms (p<0.01). Desaturation severity-related findings were confirmed by considering the confounding factors in the regression analyses.ConclusionThe short-term HRV response differs based on the desaturation severity and the respiratory event rate in patients with suspected OSA. Therefore, a more detailed analysis of HRV and desaturation characteristics could enhance OSA severity estimation.
Artemisinin relieves osteoarthritis by activating mitochondrial autophagy through reducing TNFSF11 expression and inhibiting PI3K/AKT/mTOR signaling in cartilage
Authors: Li Jin , Jiang Mengqing , Yu Zhentang , Xiong Chenwei , Pan Jieen , Cai Zhenhai , Xu Nanwei , Zhou Xindie , Huang Yong , Yang Zhicheng 
Published: July 2022

AbstractOsteoarthritis (OA) is a widespread chronic degenerative joint disease characterized by the degeneration of articular cartilage or inflamed joints. Our findings indicated that treatment with artemisinin (AT) downregulates the protein levels of MMP3, MMP13, and ADAMTS5, which are cartilage degradation-related proteins in OA, and inhibits the expression of inflammatory factors in interleukin-1β (IL-1β)-stimulated chondrocytes. However, the mechanism of the role of AT in OA remains unclear. Here, we performed gene sequencing and bioinformatics analysis in control, OA, and OA + AT groups to demonstrate that several mRNA candidates were enriched in the PI3K/AKT/mTOR signaling pathway, and TNFSF11 was significantly downregulated after AT treatment. TNFSF11 was downregulated in the OA + AT group, whereas it was upregulated in rat OA tissues and OA chondrocytes. Therefore, we confirmed that TNFSF11 was the target gene of AT. In addition, our study revealed that AT relieved cartilage degradation and defection by activating mitochondrial autophagy via inhibiting the PI3K/AKT/mTOR signaling pathway in IL-1β-induced chondrocytes. Furthermore, an OA model was established in rats with medial meniscus destabilization. Injecting AT into the knee joints of OA rat alleviated surgical resection-induced cartilage destruction. Thus, these findings revealed that AT relieves OA by activating mitochondrial autophagy by reducing TNFSF11 expression and inhibiting PI3K/AKT/mTOR signaling.
Homelessness and the use of Emergency Department as a source of healthcare: a systematic review
Authors: Vohra Neha , Paudyal Vibhu , Price Malcolm J. 
Published: July 2022

AbstractBackgroundPersons experiencing homelessness (PEH) often use hospital Emergency Department (ED) as the only source of healthcare. The aim of this study was to undertake a systematic review to identify the prevalence, clinical reasons and outcomes in relation to ED visits by PEH.MethodsA protocol-led (CRD42020189263) systematic review was conducted using search of MEDLINE, EMBASE, CINAHL and Google Scholar databases. Studies that reported either the prevalence of homelessness in the ED or clinical reasons for presentation to ED by PEH and published in English language were included. Definitions of homelessness used by study authors were accepted.ResultsFrom the screening of 1349 unique titles, a total of 36 studies were included. Wide variations in the prevalence and key cause of presentations were identified across the studies often linked to differences in country, study setting, disease classification and data collection methods. The proportion of ED visits contributed by PEH ranged from 0.41 to 19.6%. PEH made an average of 0.72 visits to 5.8 visits per person per year in the ED [rate ratio compared to non-homeless 1.63 to 18.75]. Up to a third and quarter of the visits were contributed by alcohol-related diagnoses and substance poisoning respectively. The percentage of PEH who died in the ED ranged from 0.1 to 0.5%.ConclusionsDrug-, alcohol- and injury-related presentations dominate the ED visits by PEH. Wide variations in the data were observed in regard to attendance and treatment outcomes. There is a need for prevention actions in the community, integrated discharge and referral pathways between health, housing and social care to minimise frequent usage and improve attendance outcomes.
Duplex sequencing identifies genomic features that determine susceptibility to benzo(a)pyrene-induced in vivo mutations
Authors: LeBlanc Danielle P. M. , Meier Matthew , Lo Fang Yin , Schmidt Elizabeth , Valentine Charles , Williams Andrew , Salk Jesse J. , Yauk Carole L. , Marchetti Francesco 
Published: July 2022

AbstractExposure to environmental mutagens increases the risk of cancer and genetic disorders. We used Duplex Sequencing (DS), a high-accuracy error-corrected sequencing technology, to analyze mutation induction across twenty 2.4 kb intergenic and genic targets in the bone marrow of MutaMouse males exposed to benzo(a)pyrene (BaP), a widespread environmental pollutant. DS revealed a linear dose-related induction of mutations across all targets with low intra-group variability. Heterochromatic and intergenic regions exhibited the highest mutation frequencies (MF). C:G > A:T transversions at CCA, CCC and GCC trinucleotides were enriched in BaP-exposed mice consistent with the known etiology of BaP mutagenesis. However, GC-content had no effect on mutation susceptibility. A positive correlation was observed between DS and the “gold-standard” transgenic rodent gene mutation assay. Overall, we demonstrate that DS is a promising approach to study in vivo mutagenesis and yields critical insight into the genomic features governing mutation susceptibility, spectrum, and variability across the genome.
Characterization of a novel recombinant halophilic β-glucosidase of Trichoderma harzianum derived from Hainan mangrove
Authors: Sun Nan , Liu Xiaoxuan , Zhang Bingxi , Wang Xuemei , Na Wei , Tan Zhen , Li Xiaochun , Guan Qingfeng 
Published: July 2022

Abstract
Background
β-glucosidase is an important biomass-degrading enzyme and plays a vital role in generating renewable biofuels through enzymatic saccharification. In this study, we analyzed the transcriptome of Trichoderma harzianum HTASA derived from Hainan mangrove and identified a new gene encoding β-glucosidase Bgl3HB. And the biochemically characterization of β-glucosidase activity was performed.

Results
Bgl3HB showed substantial catalytic activity in the pH range of 3.0–5.0 and at temperatures of 40 ℃-60 ℃. The enzyme was found quite stable at 50 ℃ with a loss of only 33.4% relative activity after 240 min of heat exposure. In addition, all tested metal ions were found to promote the enzyme activity. The β-glucosidase activity of Bgl3HB was enhanced by 2.12-fold of its original activity in the presence of 5 M NaCl. Surprisingly, Bgl3HB also showed a remarkable ability to hydrolyze laminarin compared to other measured substrates. Enzyme efficiency was examined in the sugarcane bagasse saccharification processes, in which Bgl3HB with 5 M NaCl worked better supplementing Celluclast 1.5L than the commercial Novozyme 188 ascertained it as an admirably suited biocatalyst for the utilization of agricultural waste. In this work, this is the first report of a halophilic β-glucosidase from Trichoderma harzianum, and represents the β-glucosidase with the highest known NaCl activation concentration. And adding 5 M NaCl could enhance saccharification performance even better than commercial cellulase.

Conclusions
These results show that Bgl3HB has great promise as a highly stable and highly efficient cellulase with important future applications in the industrial production of biofuels.