bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Mayo Periprosthetic Joint Infection Risk Score for Total Ankle Arthroplasty
Authors: Schon Lew C. , Chien Bonnie Y. , Noori Naudereh B. , Day Jonathan , Zhang Zijun 
Published: November 2022

Category: Ankle; Other Introduction/Purpose: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasty. The well known PJI risk factors are useful for identifying high-risk patients but would be even more helpful for clinical decision-making if they are converted to a risk assessment scores. The Mayo Prosthetic Joint Infection Risk Score was based on the data of total hip and knee arthroplasty and has not been validated for application for total ankle arthroplasty. Methods: A series of 398 consecutive cases of total ankle arthroplasty, with minimal follow-up of 6 months, was reviewed for Mayo Periprosthetic Joint Infection Risk Score (Mayo score) and PJI. The patients' Mayo scores and PJI was examined by logistic regression. T-test was performed to compare the Mayo score between the non-infected TAA cases and infected cases. Receiver Operating Characteristic (ROC) was used to identify the critical value of Mayo score for total ankle arthroplasty. Results: There were 12 cases of PJI or 3.0% in the series. Of the 398 patients, the Mayo scores were in the range from -4 to 13 (median 2; interquartile range (IQR) 0-4). Preliminary analysis showed that, by logistic regression, the probability of PJI was increased as increases of the Mayo scores (Fig A). The mean Mayo score of the PJI patients (8.6+-1.8) was significantly greater than the rest of the patients (mean Mayo score 1.9+-3.4; p < .0001). ROC analysis showed that, when a Mayo score was greater than 5, the patient has a high probability of PJI (sensitivity = 100%; specificity = 86.9%; Fig B). Conclusion: This study showed a high correlation between the Mayo score and PJI in total ankle arthroplasty, which is the same trend as in total knee and hip arthroplasty. The preliminary results suggest that strategically focusing on the patients, who have a Mayo score > 5, could be a more efficient approach to prevent PJI after total ankle arthroplasty.
Arthroscopic Articular Reduction for Posterior Malleolar Fracture using a “Handlebar”
Authors: Taki Masanori , Hio Naohiro 
Published: November 2022

Category: Trauma; Ankle; Arthroscopy Introduction/Purpose: Posterior malleolar fracture (PMF) of the ankle is one of the most challenging fractures to reconstruct. Recent studies suggest that the intra-articular step-off of PMFs should be <1 mm. However, very few surgical approaches for PMF repair allow direct visualization of the intra-articular fracture. The arthroscopic handlebar technique, our novel surgical method for the reduction and fixation of PMFs, involves the restoration of PMFs under arthroscopy and the use of Kirschner wire as a handlebar, which penetrates the fractured posterior malleolus. Methods: The arthroscopic handlebar technique was used in patients with a displaced AO/OTA type-44 ankle trimalleolar fracture (Haraguchi type 1 or 2 PMF). After fibular fracture reduction and internal fixation, the lateral side of the PMF was pierced with a Kirschner wire, such that it emerged from the medial edge of the PMF. The wire was guided through the medial incision to the outside, creating a bar that could be used to control the PMF, similar to the handlebar of a bicycle. Then, anterior ankle arthroscopy was performed. The PMF was reduced using the handlebar and a bone reduction forceps under arthroscopy. Subsequently, the PMF was fixed via the anterior incision using several screws. Eleven consecutive patients who had underwent this arthroscopic procedure and who were followed for at least one year and their postoperative AOFAS score, postoperative articular step-offs in CT sagittal section, and surgical complications were retrospectively evaluated. Results: The patients included four men and seven women (mean age 57.8 years [range 20-81 years]). The Haraguchi classification was type 1 in 4 cases and type 2 in 7 cases. The postoperative AOFAS score +- standard deviation was 93.1+-10.9 points. In one patient, CT revealed that a postoperative articular step-off of 1.5 mm remained at the PMF. In all other patients, the articular step-off of the PMF was <1 mm. Surgical complications revealed one case of dorsal foot neuropathy that healed spontaneously. Conclusion: This arthroscopic procedure provides an easier and less invasive approach to treat PMF. Articular PMF reduction can be performed under anterior ankle arthroscopic guidance. Surgeons can confirm the entire articular reduction status of the PMF. We believe that using this surgical procedure will change the standard of care for PMF cases.
Post-Operative Lucency Formation Amongst Stemmed vs Non-Stemmed Total Ankle Arthroplasty Constructs
Authors: Thompson John M. , Berlet Gregory C. , Togher Cody J. , Houng Brian E. , Vacketta Vincent G. 
Published: November 2022

Category: Ankle Arthritis; Ankle; Hindfoot Introduction/Purpose: Current available total ankle replacement constructs offer either proximal projecting pegs (non- stemmed) in various shapes or large stem (stemmed) designs to the superior aspect of the tibia component. Each design offers inherent stability and unique function. Periprosthetic radiolucency can develop post-operatively and lead to adverse effects. However, the incidence and clinical significance of lucency formation amongst stemmed and non-stemmed constructs is poorly understood. Methods: A retrospective radiographic and chart analysis was performed of 256 patients, under a single orthopedic practice, who underwent primary TAA between 2013-2019 with one of 3 total ankle systems. Pre-operative ankle characteristics, intraoperative procedures, as well as post-operative angles, lucency formation, region of lucency formation, and patient outcomes were analyzed. Results: Patients' mean age 65.5 yrs., male n=126 and female n=127, a mean follow-up of 24.3 months for our patient cohort. A total of 149 stemmed and 107 non-stemmed constructs were analyzed. Incidence of periprosthetic tibial lucency formation 33.2%, stemmed implants 10.0%, and 65.4% for non-stemmed implant (p value 0.00001). Conclusion: This paper describes the incidence of periprosthetic formation amongst a stemmed and non-stemmed total ankle arthroplasty cohort. Statistical significance was found when analyzing stemmed vs. non-stemmed incidence of radiolucency formation, this did not correlate with increased incidence of post-operative complications.
Stress Shielding and Aseptic Loosening in Fully Porous-Coated vs Smooth Stemmed Tibial Implants in Total Ankle Arthroplasty
Authors: Togher Cody J. , Perkins Jacob M. , Thompson John M. , Hyer Christopher F. , Berlet Gregory C. 
Published: November 2022

Category: Ankle Arthritis; Ankle Introduction/Purpose: Porous coating on the osseous interface of implants has gained increased popularity in total ankle replacement surgery. With the integration of porous coating into the newer generation of implants, this theoretically increases the chances of osseous ingrowth and survivorship in total ankle replacements. Alternatively, literature in hip replacement surgery has shown increased rates of stress shielding, aseptic loosening, thigh pain, and cystic formation around stemmed femoral implants extensively coated with porous surfaces. While some ankle prostheses have integrated porous coating technology with stemmed tibial implants, there is little to no research investigating the potential negative effects this may have on longevity or aseptic loosening secondary to a stress shielding effect. Methods: Our study identified 9 patients who underwent total ankle arthroplasty via a smooth-stemmed tibial prosthesis and matched these patients based on implant age with patients who received fully porous-coated tibial implants. We reviewed radiographs and compared postoperative rates of backside loosening and cystic formation secondary to stress shielding between the two groups. We also compared rates of heterotopic ossification between the two groups. A homoscedastic t-test was used to identify any statistical significance, which was defined as P < 0.05. Results: While the smooth-stem group showed no rates of backside cystic formation or stress shielding, the follow-up matched porous-coated group showed a rate of 55% of cystic formation and potential loosening secondary to stress shielding observed on final radiographic follow up (P < 0.01). There was no statistical difference between the two groups in their rates of heterotopic bone formation (P = 0.37). Conclusion: Despite having a relatively small sample size, this data shows that there is some consistency with the hip arthroplasty literature suggesting an increased risk for stress shielding in fully porous-coated stemmed tibial implants compared to smooth- stemmed tibial implants in total ankle arthroplasty.
Outcomes of Lisfranc Injuries in NCAA Football Players
Authors: Tortora Peter , Portnoff Brandon , Abdeen Ahmed , Koroneos Zachary , Aynardi Michael C. 
Published: November 2022

Category: Sports; Midfoot/Forefoot Introduction/Purpose: While Lisfranc injuries are relatively infrequent, they are typically season-ending injuries for NCAA football players, and their impact on an athlete's future is poorly understood. In this study, we sought to define the rate of return to competition for NCAA Division I football players who sustained a Lisfranc injury, and analyze the effects on athletic performance and career outcomes. Methods: NCAA Division I football players who sustained Lisfranc injuries between 2012-2017 were identified and evaluated for their return to play in the season following their injury. Recorded demographic variables included position, class rank, and games played during the pre- and post-injury seasons. The underclassmen athletes who met performance criteria were then compared to matched, uninjured controls based on conference, position, age, and statistics. Career outcomes were evaluated for all athletes who sustained a Lisfranc injury based on whether they performed at the NFL Combine and/or played in at least 1 NFL game. Seniors were excluded from performance analysis because they did not have a post-injury NCAA season, but were included in career outcomes. Results: Sixty Lisfranc injuries were identified, 48 of which were sustained by underclassmen, who returned to play in the immediate post-injury season at a rate of 87.5%, and 95.8% returned at some point in their college careers. Of the players who met performance criteria, only quarterbacks showed statistically significant differences compared to controls for interceptions/game (p=0.0438), yet all positions experienced mild performance declines or stagnation across virtually all statistics, on average. However, 33.3% of athletes went on to perform at the NFL Combine, and 31.3% of athletes played in an NFL game, compared to 31.7% and 36.7%, respectively, for controls. Surprisingly, when evaluated separately, athletes who sustained a Lisfranc injury in their senior year had nearly identical career outcomes (Combine - 33.3%, NFL - 33.3%) compared to underclassmen. Conclusion: NCAA Division I football players return to play at a high rate following Lisfranc injuries, and largely maintain their athletic performance relative to uninjured controls. Moreover, Lisfranc injuries do not appear to have a significant impact on an athlete's ability to compete at an NFL-level.
Effect of Internal Bracing on Broström Operation Clinical Outcomes
Authors: Waggett Raines M. , Hoch Caroline P. , Ottofaro Trevor D. , Scott Daniel J. , Gross Christopher E. 
Published: November 2022

Category: Ankle; Other Introduction/Purpose: When patients fail conservative management for chronic lateral ankle instability, a Broström procedure is often recommended. The purpose of this study was to investigate the postoperative trends between Broström recipients who were and were not augmented with suture tape, while secondarily assessing the relationship between demographics and medical history with postoperative outcomes for those patients. Methods: We conducted a retrospective review of 125 patients treated with a modified Broström by a single fellowship-trained foot and ankle surgeon at an academic medical center between 2016 and 2020. Overall, 39 patients received suture tape augmentation, 95 underwent a primary Broström and 30 a revision, and 24 were operated on with a nanoscope. Various demographics, medical history, patient-reported outcome measures (PROMs) (e.g., Foot and Ankle Outcome Score [FAOS], Foot and Ankle Ability Measure [FAAM]), and postoperative outcomes were collected. Average follow-up was 1.0 years (0.25-4.58). Results: There were no differences in any postoperative PROMs (i.e., FAOS, FAAM) between suture tape augmentation cohorts. Similarly, no difference existed in follow-up duration or complication rate. The only significant difference between cohorts pertained to the proportion of patients who underwent a reoperation specifically for incision and debridement (suture tape=71.4%, no suture tape=0.0%; p=.013). Furthermore, when analyzing the primary and revision Broström operation cohorts, there were no differences in any postoperative PROM, follow-up duration, or complication. Finally, when analyzing cohorts whose procedures did and did not use a nanoscope, there was no difference in any PROMs, complications, or reoperation rate, but follow-up duration was significantly longer for those whose procedures did not use a nanoscope (nanoscope=0.71 years, no nanoscope=1.13 years; p=.003). (Table 1) Conclusion: Neither suture tape augmentation or revision status was found to affect postoperative outcomes or PROMs for the Broström operation. However, unlike the control group, no patients who did not received suture tape augmentation underwent reoperation for deep infection, and these patients had a lower complication rate. The only variable that showed a difference in postoperative outcomes was whether a patient was concomitantly operated on with a nanoscope, in which their follow-up duration was reduced. Based on their overall predictiveness, preoperative PROMs may provide insight into clinical success following a Broström operation.
Population genetic study of 17 Y-STR Loci of the Sorani Kurds in the Province of Sulaymaniyah, Iraq
Authors: Albarzinji Balnd M. , Abdulkarim Farhad M. , Hussein Shaho A. , Rashid Dlshad , Lazim Hayder 
Published: November 2022

Abstract
Background
The Kurds as an ethnic group are believed to be a combination of earlier Indo-European tribes who migrated and inhabited a mountainous area thousands of years ago. However, as it is difficult to describe the precise history of their origin, it is necessary to investigate their population relationship with other geographical and ethnic groups.

Results
Seventeen Short Tandem Repeat markers on the Y chromosome (Y-STR) included in the AmpFLSTR™ Yfiler™ PCR Amplification Kit (Thermo Fisher Scientific, USA) were used to type DNA samples from the Sorani (Central) Kurdish population in Sulaymaniyah province. One hundred fifty-seven haplotypes were obtained from 162 unrelated male individuals. The highest and lowest gene diversities were DYS385a/b (GD = 0.848) and DYS392 (GD = 0.392), respectively. The haplotypes were used to predict the most likely haplogroups in the Sulaymaniyah population.

Conclusion
Haplogroup prediction indicated predominance (28%) of subclade J2 (44/157) in the Sorani Kurds, northeast of Iraq. The pairwise genetic distance results showed that the Kurdish group clustered along with Asian populations, whereas the furthest countries were Europeans and Africans.
Dual-modal in vivo assessment for electrophysical and hemodynamic characteristics of cerebral edema induced by lipopolysaccharide
Authors: Li Weitao , Zhang Yameng , Xie Qian , Qi Xinping , Yao Liuye , Ning Xue , Qian Zhiyu 
Published: November 2022

AbstractThe pathological features of cerebral edema are complicated. The intracranial pressure (ICP) is regarded as the most important indicator for monitoring cerebral edema. Recently, multi-parameter has been used to explore the types and pathogenesis of cerebral edema and design effective treatment strategies. This research focused on investigating the characteristic of the cerebral edema induced by lipopolysaccharide (LPS) in rats by using simultaneous electrophysical and hemodynamic parameters. The results showed that neurophysiologic parameters (firing rate (FR) and the power spectrum of local field potential (LFP power)) and hemodynamic parameters (relative concentration of oxygenated hemoglobin (ΔCHbO2), relative concentration of deoxyhemoglobin ΔCHbR) and relative cerebral blood flow (rCBF)) were linearly correlated, and the Pearson’s correlation coefficient was changed by pathological progression of cerebral edema induced by LPS. Furtherly, the treatment after two agents were observed successfully through these multi-parameters. Our findings revealed the relationship between neural activity and hemodynamic response during the progression of cerebral edema and provided a multi-parameter solution for cerebral edema functional monitoring and anti-edema drug efficacy evaluation.
Return of non-ACMG recommended incidental genetic findings to pediatric patients: considerations and opportunities from experiences in genomic sequencing
Authors: Bowling Kevin M. , Thompson Michelle L. , Kelly Melissa A. , Scollon Sarah , Slavotinek Anne M. , Powell Bradford C. , Kirmse Brian M. , Hendon Laura G. , Brothers Kyle B. , Korf Bruce R. , Cooper Gregory M. , Greally John M. , Hurst Anna C. E. 
Published: November 2022

Abstract
Background
The uptake of exome/genome sequencing has introduced unexpected testing results (incidental findings) that have become a major challenge for both testing laboratories and providers. While the American College of Medical Genetics and Genomics has outlined guidelines for laboratory management of clinically actionable secondary findings, debate remains as to whether incidental findings should be returned to patients, especially those representing pediatric populations.

Methods
The Sequencing Analysis and Diagnostic Yield working group in the Clinical Sequencing Evidence-Generating Research Consortium has collected a cohort of pediatric patients found to harbor a genomic sequencing-identified non-ACMG-recommended incidental finding. The incidental variants were not thought to be associated with the indication for testing and were disclosed to patients and families.

Results
In total, 23 "non-ACMG-recommended incidental findings were identified in 21 pediatric patients included in the study. These findings span four different research studies/laboratories and demonstrate differences in incidental finding return rate across study sites. We summarize specific cases to highlight core considerations that surround identification and return of incidental findings (uncertainty of disease onset, disease severity, age of onset, clinical actionability, and personal utility), and suggest that interpretation of incidental findings in pediatric patients can be difficult given evolving phenotypes. Furthermore, return of incidental findings can benefit patients and providers, but do present challenges.

Conclusions
While there may be considerable benefit to return of incidental genetic findings, these findings can be burdensome to providers and present risk to patients. It is important that laboratories conducting genomic testing establish internal guidelines in anticipation of detection. Moreover, cross-laboratory guidelines may aid in reducing the potential for policy heterogeneity across laboratories as it relates to incidental finding detection and return. However, future discussion is required to determine whether cohesive guidelines or policy statements are warranted.
Sequentially mediated effects of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction among Taiwanese university students: A cross-sectional study
Authors: Huang Po-Ching , Lee Chiu-Hsiang , Griffiths Mark D. , O’Brien Kerry S. , Lin Yi-Ching , Gan Wan Ying , Poon Wai Chuen , Hung Ching-Hsia , Lee Kuo-Hsin , Lin Chung-Ying 
Published: November 2022

Abstract
Background
Weight-related stigma has negative physiological and psychological impacts on individuals’ quality of life. Stigmatized individuals may experience higher psychological distress and therefore increase the potential risk to develop obesity and/or food addiction. The present study examined the associations and mediated effect between perceived weight stigma, weight-related self-stigma, and psychological distress in explaining food addiction among Taiwanese university students.

Methods
All participants (n = 968) completed an online survey which included the Perceived Weight Stigma Questionnaire, Weight Self-Stigma Questionnaire, Depression, Anxiety, Stress Scale-21, and Yale Food Addiction Scale Version 2.

Results
After controlling for demographic variables, significant associations were found in the paths from (1) perceived weight stigma to weight-related self-stigma ($$\beta$$
β
= 0.23), psychological distress ($$\beta$$
β
= 0.35), and food addiction ($$\beta$$
β
= 0.23); (2) weight-related self-stigma to psychological distress ($$\beta$$
β
= 0.52) and food addiction ($$\beta$$
β
= 0.59); and (3) psychological distress to food addiction ($$\beta$$
β
= 0.59) (all p-values < 0.001). The mediation model showed the sequential mediated effect of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction.

Conclusions
The results provide novel insights that weight-related self-stigma and psychological distress sequentially mediated the relationship between perceived weight stigma and food addiction among Taiwanese university students. The findings of the present study could be implemented into interventions that aim to reduce food addiction derived from weight-related stigma. Future studies should consider group analysis to consider confounding factors or other populations to provide more evidence regarding the mechanism of weight-related stigma.