bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toward a Better Understanding of Muscle Microvascular Perfusion During Exercise in Patients With Peripheral Artery Disease: The Effect of Lower-Limb Revascularization
Authors: Menêses Annelise , Krastins Digby , Nam Michael , Bailey Tom , Quah Jing , Sankhla Vaibhav , Lam Jeng , Jha Pankaj , Schulze Karl , O’Donnell Jill , Magee Rebecca , Golledge Jonathan , Greaves Kim , Askew Christopher D. 
Published: July 2022

Purpose: Leg muscle microvascular blood flow (perfusion) is impaired in response to maximal exercise in patients with peripheral artery disease (PAD); however, during submaximal exercise, microvascular perfusion is maintained due to a greater increase in microvascular blood volume compared with that seen in healthy adults. It is unclear whether this submaximal exercise response reflects a microvascular impairment, or whether it is a compensatory response for the limited conduit artery flow in PAD. Therefore, to clarify the role of conduit artery blood flow, we compared whole-limb blood flow and skeletal muscle microvascular perfusion responses with exercise in patients with PAD (n=9; 60±7 years) prior to, and following, lower-limb endovascular revascularization. Materials and Methods: Microvascular perfusion (microvascular volume × flow velocity) of the medial gastrocnemius muscle was measured before and immediately after a 5 minute bout of submaximal intermittent isometric plantar-flexion exercise using contrast-enhanced ultrasound imaging. Exercise contraction-by-contraction whole-leg blood flow and vascular conductance were measured using strain-gauge plethysmography. Results: With revascularization there was a significant increase in whole-leg blood flow and conductance during exercise (p<0.05). Exercise-induced muscle microvascular perfusion response did not change with revascularization (pre-revascularization: 3.19±2.32; post-revascularization: 3.89±1.67 aU.s−1; p=0.38). However, the parameters that determine microvascular perfusion changed, with a reduction in the microvascular volume response to exercise (pre-revascularization: 6.76±3.56; post-revascularization: 2.42±0.69 aU; p<0.01) and an increase in microvascular flow velocity (pre-revascularization: 0.25±0.13; post-revascularization: 0.59±0.25 s−1; p=0.02). Conclusion: These findings suggest that patients with PAD compensate for the conduit artery blood flow impairment with an increase in microvascular blood volume to maintain muscle perfusion during submaximal exercise. Clinical Impact The findings from this study support the notion that the impairment in conduit artery blood flow in patients with PAD leads to compensatory changes in microvascular blood volume and flow velocity to maintain muscle microvascular perfusion during submaximal leg exercise. Moreover, this study demonstrates that these microvascular changes are reversed and become normalized with successful lower-limb endovascular revascularization.
Revisiting the Role of Ultrasound Mapping in Arteriovenous Fistula Formation: A Single-Center Experience
Authors: Vo Anh Tuan , Nguyen Thanh Van , Kieu Son Minh , Kieu An Quang , Huynh Kha Tan , Nguyen Quynh Ngoc Hoa , Nguyen Truc T. T. , Nguyen Tien Cong 
Published: July 2022

Background: The global prevalence of chronic kidney disease (CKD) continues to increase, with the arteriovenous fistula (AVF) as the most preferred vascular access for hemodialysis. Whether routine preoperative ultrasound mapping improves the outcome of AVF formation compared with clinical examination alone remains controversial. Methods: This retrospective study included patients undergoing AVF surgery with and without preoperative ultrasound at our center between September 2017 and August 2020. Outcome measures included AVF early and mid-term outcome. Cox regression analysis was performed to identify independent predictors of favorable AVF outcome. Results: A total of 158 patients received an AVF during the study period. Both groups with (n = 79) and without (n = 79) ultrasound mapping were similar regarding baseline characteristics (age, sex, comorbidities). Patency rates were comparable between the 2 groups at 30 days, 3 months, and 6 months after AVF surgery, although there was a trend toward more favorable outcome for the mapping group ( P = .07). Kaplan-Meier analysis showed that at the end of study, the ultrasound mapping group had a higher mid-term patency rate; however, the improvement was not significant ( P = .07). Cox regression analysis did not reveal age, gender, comorbidities, and ultrasound as predictors of AVF survival. Conclusion: Our study did not find a significant benefit from routine preoperative ultrasound mapping in creating AVFs for hemodialysis. Further well-designed and adequately powered trials are needed to demonstrate the beneficial role of routine preoperative ultrasound mapping for vascular access in CKD coupled with clinical evaluation in short- and long-term AVF outcome.
A modified variant of HSS preconditioner for generalized saddle point problems
Authors: Zhang Li-Tao , Zhang Yi-Fan 
Published: July 2022

Recently, Zhang [Numerical Linear Algebra with Applications, 2018: e2166] constructed an efficient variant of Hermitian and skew-Hermitian splitting (HSS) preconditioner for generalized saddle point problems, and gave the corresponding theoretical analysis and numerical experiment. In this paper, based on the efficient variant of the HSS (EVHSS) preconditioner, we relax the strong condition on the iterative parameter [Formula: see text], generalize the algorithms and further present the modified variant of Hermitian and skew-Hermitian splitting (HSS) (MVHSS) preconditioner for solving the generalized saddle point problem. Moreover, by similar theoretical analysis, we obtain that the MVHSS iterative method is convergent under weaker conditions. Finally, an example is given to verify the effectiveness of the proposed method. MSC: 65F10; 65F15; 65F50
Early antiplatelet for minor stroke following thrombolysis (EAST): Rationale and design
Authors: Li Xiao-Qiu , Cui Yu , Wang Xin-Hong , Chen Hui-Sheng 
Published: July 2022

Background: Early neurological deterioration (END) occurs in about 10% of patients after intravenous thrombolysis (IVT) and is related to poor outcome. In theory, early antiplatelet following IVT could reduce END by preventing re-occlusion and stroke progression, but current guidelines recommend starting antiplatelet treatment at 24 h after IVT due to concerns about hemorrhagic transformation. Given higher risk of hemorrhagic transformation in severe stroke, we hypothesized that minor stroke patients following IVT can safely benefit from early antiplatelet treatment. Aims: To explore the efficacy and safety of early antiplatelet in minor stroke patients after IVT. Sample size estimates: A maximum of 1022 patients are required to test the superiority hypothesis with 80% power according to a two-side 0.05 level of significance, stratified by age, gender, history of stroke or transient ischemic attack, history of hypertension, history of diabetes mellitus, systolic blood pressure at admission, time from IVT to treatment, thrombolysis drug, stroke territory, and stroke etiology. Design: Early antiplatelet for minor stroke following thrombolysis is a prospective, double-blinded, multicenter, randomized and placebo-controlled trial. Minor stroke patients within 6 h following IVT are randomly assigned into experimental group and control group with the ratio of 1:1. The experimental group is orally administered with 300 mg clopidogrel and 100 mg aspirin, and control group with placebo. Subsequently, both groups received guideline-based antithrombotic treatment from 24 h after IVT to 90 days. Outcome: The primary efficacy endpoint is excellent functional outcome, defined as the modified Rankin Scale 0–1 at 90 days after randomization, while primary safety endpoint is symptomatic intracerebral hemorrhage, defined as National Institutes of Health Stroke Scale score increase ⩾ 4 caused by intracranial hemorrhage within 36 h after randomization. Conclusions: The results of EAST will provide us powerful early antiplatelet evidence for minor stroke population following intravenous thrombolysis in clinical practice.
Prospective cohort study of same-day discharge shoulder arthroplasty in patients of 85 years and younger
Authors: van Kampen Derk A , de Vries Lieke , Jan Hillen Robert , La Guardia Paulo , van Beek Rienk 
Published: July 2022

Introduction Shoulder arthroplasty is mostly performed as an inpatient procedure. Same-day discharge arthroplasty has shown positive results in hip and knee surgery. Primary objective of this study was to investigate whether a safe and satisfactory same-day discharge (SDD) can be predicted with a set of easy to use predefined criteria, without increasing complications and re-admissions. Methods This study was a prospective cohort study. Patient selection criteria were: <85 years old, ASA 1, 2, and mild ASA 3. Primary outcome variables were successful SDD, complications, re-admissions and patient satisfaction. Secondary outcomes were patient-reported outcome scores. The results are compared with the inpatient cohort. Results In total, 163 patients were treated for elective shoulder arthroplasty. Of which 51 patients were selected for same-day discharge arthroplasty. 94% of pre-planned same-day discharge arthroplasty patients were discharged on the day of surgery. In the same-day discharge group, there were no complications related to the early discharge and a 2% readmission rate as opposed to a 3% readmission rate in the inpatient group. Surgery related as well as medical complications did not differ between the same-day discharge and inpatient cohort. Discussion Same-day discharge shoulder arthroplasty is a safe and satisfying treatment option in selected patient groups.
Efficacy and safety of selpercatinib in Chinese patients with advanced RET fusion-positive non-small-cell lung cancer: a phase II clinical trial (LIBRETTO-321)
Authors: Lu Shun , Cheng Ying , Huang Dingzhi , Sun Yuping , Wu Lin , Zhou Chengzhi , Guo Ye , Shao Jingxin , Zhang Wanli , Zhou Jianying 
Published: July 2022

Introduction: Oncogenic alterations in RET occur in 1–2% of non-small-cell lung cancers (NSCLCs). The efficacy and safety of the first-in-class, highly selective, and potent RET inhibitor selpercatinib in Chinese patients with RET fusion-positive NSCLC remains unknown. Methods: In this open-label, multicenter, phase II study (NCT04280081), patients with advanced RET-altered solid tumors received selpercatinib (160 mg orally twice daily) in a 28-day cycle. The primary endpoint was independent review committee (IRC)-assessed objective response rate (ORR; Response Evaluation Criteria in Solid Tumors v1.1). Secondary endpoints included duration of response, central nervous system (CNS) response, and safety. Efficacy against NSCLC was assessed in the primary analysis set (PAS; centrally confirmed RET status) and in all enrolled patients with NSCLC. Results: Of 77 enrolled patients, 47 had RET fusion-positive NSCLC. After 9.7 months of median follow-up, IRC-assessed ORR in the PAS ( n = 26) was 69.2% [95% confidence interval (CI), 48.2–85.7] and 94.4% of responses were ongoing; the ORR was 87.5% and 61.1% in treatment-naïve and pre-treated patients, respectively. IRC-assessed ORR in all patients with NSCLC ( n = 47) was 66.0% (95% CI, 50.7–79.1). Among five patients with measurable CNS metastases at baseline, four (80%) achieved an IRC-assessed intracranial response. In the safety population ( n = 77), most treatment-emergent adverse events (TEAEs) were grade 1 or 2. The most common grade ⩾3 TEAE was hypertension (19.5%). Three (3.9%) patients discontinued therapy due to treatment-related AEs; no deaths occurred due to treatment-related AEs. Conclusion: Selpercatinib, with potent and durable antitumor activity including intracranial activity, was well tolerated in Chinese patients with RET fusion-positive NSCLC, consistent with LIBRETTO-001 (ClinicalTrials.gov: NCT04280081).
Paper 16: Effectiveness of hematoma aspiration and platelet-rich plasma muscle injections for the treatment of hamstring strains in athletes
Authors: Trunz Lukas , Dodson Christopher , Zoga Adam , Cohen Steven , Roedl Johannes 
Published: July 2022

Objectives: The effect of platelet-rich plasma (PRP) treatment on recovery in acute hamstring injuries is controversial. Previous study results are inconsistent, and a standardized therapeutic approach has not been established yet. The objective of the study was to assess the treatment effect using a combination of hematoma aspiration and muscle strain PRP injection in partial hamstring muscle tears (grade 2 strains) in athletes. Methods: MRIs of athletes with grade 2 hamstring strains were reviewed from 2013 to 2018. From 2013 to 2015 athletes were treated conservatively and from 2016 to 2018 with a combination of ultrasound-guided hematoma aspiration and PRP muscle strain injection. The outcome, including return-to-play (in days) and recurrence rate, was compared retrospectively between both groups (conservative vs. aspiration/PRP) using ANOVA and Fisher’s Exact test. There was no significant difference in age, type of sport, and muscle involvement (including injury grade/location, hamstring muscle type, and length/cross-sectional area of the strain). Results: Fifty-five athletes (28 treated conservatively, 27 with hematoma aspiration/PRP injection) were included. Average return-to-play time (mean) was 32.4 days in the conservative group and 23.5 days in the aspiration/PRP group (p<0.001). Recurrence rate of the hamstring strain was 28.6% (8/28) in the conservative treatment group and less than 4% (1/27) in the aspiration/PRP group (p=0.025). Conclusions: Athletes with grade 2 hamstring strains treated with a combination of hematoma aspiration and PRP injection had a significantly shorter return-to-play and a lower recurrence rate compared to athletes receiving conservative treatment. [Figure: see text][Figure: see text][Figure: see text][Figure: see text]
Paper 18: Effect of Bone Marrow Aspirate Concentrate on Osteochondral Allograft Transplantation Incorporation: A Prospective, Randomized, Single Blind Investigation
Authors: Yanke Adam , Dandu Navya , Bodendorfer Blake , Darwish Reem , Zavras Athan , Forsythe Brian , Cole Brian , Trasolini Nicholas 
Published: July 2022

Objectives: Osteochondral allograft transplantation for cartilage defects of the knee has demonstrated excellent long-term clinical outcomes and survival, which largely depends on successful graft osseointegration. Biologics have been suggested as a viable adjunct to enhance successful healing in several musculoskeletal applications. In the context of OCA, early results have suggested that BMAC may improve cellular repopulation and viability within the osseus portion of an implanted graft. However, few clinical studies to date have investigated the impact of BMAC on patient outcomes following OCA. The purpose of this study was to investigate the effect of bone marrow aspirate concentrate (BMAC) on osseointegration and patient-reported outcome metrics (PROMs) after osteochondral allograft transplantation in a prospective, randomized controlled single-blinded trial. Methods: Patients undergoing osteochondral allograft transplantation of the knee were consented and enrolled. Prior to surgery, patients were randomized into either the BMAC or sham incision groups. In the BMAC group, the osteochondral allograft plug was soaked in BMAC for a minimum of 2 minutes prior to implantation. All patients underwent postoperative computed tomography (CT) scanning at 6 months postoperatively and completed PROMs preoperatively, 6 months, and 1 year postoperatively. Two board-eligible orthopaedic surgeons blinded to treatment allocation independently assessed and graded each CT according to the ACTOCA system proposed by Gelber et al. Results: Thirty-six patients enrolled between April 2018 to December 2020 (17 female, 19 male) were included for analysis. There were no significant differences between the BMAC and non-BMAC groups in graft signal density (Grader 1: p=0.283, Grader 2: p=0.467), osseous integration (both graders: p=0.489), surface percentage with discernible cleft (Grader 1: 0.287, Grader 2: 0.469), or intra-articular fragments (Grader 1: p=0.617, Grader 2: p=0.810) (Table 1). A significantly greater number of patients receiving BMAC demonstrating cystic changes <3 mm (Grader 1: p=0.015, Grader 2: p=0.05) (Figure 1). At 1 year, BMAC patients reported significantly better WOMAC Pain (87.82±14.26 vs 75.80±15.56, p=0.043) and trended towards improved PROMIS Pain (54.14±8.31 vs 61.79±5.24, p=0.09). Conclusions: Patients receiving BMAC soaked OCA grafts demonstrated no difference from controls with respect to graft signal intensity, osseous integration, intra-articular fragments, or discernible graft-host clefts at 6-months postoperatively. BMAC patients had a significantly greater occurrence of small (<3 mm) cystic changes. At 1 year, BMAC patients reported significantly less pain than controls on WOMAC Pain, with similar trends on PROMIS Pain Interference. [Table: see text][Figure: see text]
Paper 22: PREDICTORS OF RE-OPERATION IN ADOLESENTS UNDERGOING HIP PRESERVATION SURGERY FOR FEMOROACETABULAR IMPINGEMENT
Authors: Cooper Savannah , Johnson Benjamin , Youngman Tyler , Wilson Philip , Sucato Daniel , Podeszwa David , Ellis Henry , Serbin Philip 
Published: July 2022

Objectives: Femoroacetabular Impingement(FAI) is a condition caused by repetitive motion of abnormal hip osseous anatomy that contributes to labral and chondral injury. An understanding of radiographic parameters associated with successful primary surgery has not been well established. The primary objective was to determine pre-operative radiographic parameters that predict reoperation for FAI and, secondarily, correlate radiographic measures and outcomes in these patients. Methods: A prospectively-collected institutional registry of adolescent patients (age <19 y.o.) who underwent surgery for FAI (arthroscopic/open) was reviewed. Standing AP pelvis X-rays were analyzed for alpha, lateral center edge(LCEA), Tönnis, and Sharp’s angles, and femoro-epiphyseal acetabular(FEAR) index. Patient-reported outcomes(PROs) [modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score(HOOS)] were analyzed. Mann-Whitney-U test was used to compare the radiographic measures of re-operation to non-reoperation patients and those who achieved MCID to those who did not. Radiographic indication of risk for re-operation was evaluated with receiver operating characteristic(ROC) analysis. Spearman’s correlation was calculated between radiographic measurements and PROs at 2-years post-op. Results: Eighty-seven patients underwent primary surgery (56 surgical dislocations vs 31 scopes) for FAI. The average age at time of primary operation was 16.27 years(73.6%Female). 10 underwent re-operation (11.5%) at an average of 20.6 months from primary surgery. No differences were found in demographics, activity, surgery type, labral disease, or alpha angle for re-operation vs. non-reoperation. The LCEA, FEAR Index, Sharps, and Tönnis angle were significantly different (p<0.05) (Table 1). ROC analysis indicated that LCEA<21 and FEAR index>-8.8 were predictors for increased risk of reoperation. Patients with LCEA<21°, 46% underwent a reoperation compared to those with LCEA>21° (6%). Patients with FEAR index<-8.8, 32% underwent a reoperation compared to patients>-8.8 (5%). Patients who achieved MCID (61.9%) had lower BMI, worse pre-operative PROs, and better post-operative PROs at 2-years. Alpha, Tönnis, and Sharp’s angles were positively correlated with 2+ year PROs, while LCEA was negatively correlated(p<0.05). Conclusions: In patients undergoing treatment for FAI, a reoperation was associated with radiographic signs of hip dysplasia, indicating that patients with a shallower acetabulum are at risk for a repeat operation. Surgeons can utilize these parameters to help in surgical decision making, better predict outcomes and to counsel patients the need for potential subsequent surgery. UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/10177e80-b6a8-458e-b216-840ad950f2a6/1/Tables.docx
Paper 24: The Power of Information: Influence of Interim Function Assessments on Patient Outcomes at the time of Return to Sport Progression Following Anterior Cruciate Ligament Reconstruction
Authors: Bruce Amelia , Diduch David , Miller Mark , Brockmeier Stephen , Gwathmey F. Winston , Werner Brian , Hart Joseph , Bodkin Stephan 
Published: July 2022

Objectives: The administration of return to sport assessments have become common in patients following Anterior Cruciate Ligament Reconstruction (ACLR). However, they are often administered after the time of clinical supervision which may leave patients without access to clinical personnel to appropriately address the functional deficits identified. It is currently unknown if patient outcomes would benefit from interim functional assessments while under clinical supervision. The purpose of this study is to compare patient outcomes at the time of return to sport (RTS) progression between those with a prior interim assessment and those without. We hypothesize that patients with prior interim assessments will demonstrate stronger and more symmetric quadriceps strength, greater hopping performance, and higher subjective function. Methods: Patients following ACLR were retrospectively identified through an ongoing RTS assessment program where patients were referred from a sports medicine subspecialist orthopedic clinic to complete a battery of functional assessments This program assessed knee extensor and flexor strength (Nm/kg) and symmetry (%) and patient reported outcomes. Patients were stratified into “Single Test”: first assessment between 6- and 9-months post-ACLR and “Repeat Test”: prior assessment performed at least 2-months before RTS assessment between 6- and 9-months post-ACLR (Figure 1). Patients were matched based on time post-surgery, age, pre-injury activity level, and graft type. Results: A total of 392 patients were included (Single Test n=303, Repeat Test n=89.) Once matched, 169 patients (21.1±7.0 years, 7.3±.9 mo. post-ACLR) were analyzed (n=69 per group, Figure 2.) Controlling for age, activity level, graft type, and time of the assessment, Repeat Test patients demonstrated higher measures of subjective function ( P=.028) and greater knee flexion symmetry ( P=.006) compared to Single Test patients. There were no differences in quadriceps strength ( P=.82) and symmetry ( P=.18) between groups. Conclusions: Patients that received interim functional assessments reported better subjective function and higher hamstring symmetry at the time of return to sport progression compared to patients that completed their first and only assessment at this time-point. Interim referral for functional assessments may identify limitations which medical provides can address prior to the time of RT progression.