bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Minimum 15-Year Follow Up After Lateral Discoid Meniscal Preservation Surgery in Children and Adolescents
Authors: Lins Laura A.B. , Feroe Aliya G. , Yang Brian , Williams Kathryn A. , Kocher Sophia D. , Sankarankutty Saritha , Micheli Lyle J. , Kocher Mininder S. 
Published: May 2022

Background: Discoid meniscus is a congenital variant typically affecting the lateral meniscus of the knee. Historically, surgical intervention when symptomatic consisted of total meniscectomy; however, after degenerative changes were observed, current treatments now focus on rim preservation with arthroscopic saucerization and meniscal repair for instability, when indicated. Purpose: The aim of this study was to examine long-term patient-reported outcomes of lateral discoid menisci (LDM) treated with meniscal-preserving techniques. Methods: Ninety-eight patients treated arthroscopically for LDM at a single institution at a minimum of 15 years ago were retrospectively identified and contacted by mailers and telephone to participate. Subjective functional outcomes and patient satisfaction data were collected using a questionnaire that included the validated IKDC Subjective Knee Evaluation Form, Lysholm Score, Marx Activity Rating Scale, Tegner Activity Score, and WOMAC Osteoarthritis Index. Patient and surgical characteristics and patient-reported outcomes were summarized by mean and standard deviation (SD), median and interquartile range (IQR), or frequency and percent, as appropriate. Results: Of the 46 patients contacted (response rate of 46/98 eligible), 25 (54%) completed the questionnaires. The mean (± SD) age at initial surgery was 10.8 (± 3.4) years and 30.3 (± 3.7) years at final follow-up. The mean (± SD) follow-up time from initial surgery was 19.5 (± 2.8) years (range, 16–27). Patient-reported outcomes included: IKDC 77.4 ± 17.2, Lysholm 78.6 ± 21, WOMAC 7.6 ± 11.3, Tegner Activity 7 (out of 10), and Marx Activity Rating Scale 8 (out of 10) (Table 1). Eleven (44%) cases underwent subsequent LDM-related surgery on the ipsilateral knee(s). There were no cases of total knee replacement (Table 2). Conclusions: Overall, patient-reported outcomes were favorable at a minimum of 15-year follow-up after rim-preserving saucerization of lateral discoid meniscus. While two-thirds of patients were satisfied with their surgical outcomes, nearly half of patients underwent revision saucerization with or without meniscal repair. Subsequent long-term follow-up studies with radiographs will be important to determine how meniscus-preserving procedures may curb the development of arthritis. [Table: see text][Table: see text]
Physician Preferences on Bone Age Determination for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with Acl Injuries
Authors: Nice Emily , Franklin Corinna C , Heidel Eric ,   Shriners Sports Medicine Consortium, Uquillas Carlos 
Published: May 2022

Introduction: The frequency of anterior cruciate ligament (ACL) injuries is increasing in pediatric and adolescent patients. Currently, there is no standardized skeletal maturity determination for pediatric and adolescent patients that present with an ACL tear. Hypothesis/Purpose: This study aims to evaluate physicians’ preferences for obtaining bone age studies for pediatric and adolescent patients with an ACL injury. Methods: A survey link was sent to the members of Pediatric Research in Sports Medicine (PRiSM). Participation in the survey was voluntary. Consent was obtained by the participants taking part in the survey. Results: Forty-five physician responses were included in this analysis. Seven were female, thirty-six male, and one preferred not to answer. Twenty physicians had completed a pediatric orthopaedic fellowship, six had completed a sports medicine fellowship, and nineteen had completed both. Thirty-five respondents reported that greater than 75% of their patients were 18 years old or younger. When asked about the number of ACL reconstructions performed each year on skeletally immature patients, 15.6% (n=7) report less than 5, 11.1% (n=5) said 5-9, 44.4% (n=20) said 10-34, 20.0% (n=9) report 35-49, and 8.9% (n=4) said they perform 50 or more. A majority of the participants (n=32) said that they routinely obtain a skeletal age study. Of the participants that routinely order a skeletal age study, 100% (n=32) get a bone age for patients 11 and 12 years old. Seventeen (n=17) obtain a bone age study for patients 8-14 years of age. When asked about bone age determination method, 100% (n=45) said one method they use is hand bone age and twenty-four (n=24) only use hand bone age. Thirty-four (n=34) report they sometimes see a significant difference (2 or more years) between bone age radiographs and chronological age while eleven (n=11) report they almost never see a significant difference. Thirty-one report that a patient’s skeletal age sometimes changes their technique or graft preference. Conclusion: Results of this survey suggest that bone age studies are used to treat pediatric and adolescent patients with ACL injuries. Hand bone age, in particular the Greulich-Pyle method, is the most widely used among the respondents. Obtaining bone age radiographs can help physicians to formulate a proper treatment plan for their patients. Further research is needed to identify the true impact of bone age studies on the treatment of ACL injuries in pediatric and adolescent patients. [Table: see text]
Knee Strength Outcomes in Adolescents by Age and Sex During Late-Stage Rehabilitation After Anterior Cruciate Ligament Reconstruction
Authors: Roman Dylan P. , Ness Brandon M. , Giampetruzzi Nicholas , Cleland Joshua A. , Weaver Adam 
Published: May 2022

Background: The incidence of anterior cruciate ligament (ACL) injuries have been consistently increasing in adolescents, with those who return to competitive sport having up to a 32% risk of a secondary ACL injury. There is limited evidence regarding knee strength outcomes in young adolescents following ACL reconstruction during late-stage rehabilitation when compared to older patient groups. Purpose: The purpose of this study was to 1) establish normative knee strength values according to age group in adolescent female and male patients during late-stage rehabilitation following ACLR and 2) determine whether strength differences exist between age groups. Methods: A retrospective review of adolescent patients who underwent primary ACL reconstruction was performed. Patients completed a standardized isokinetic (60°/sec) knee extension and flexion strength assessment during late-stage rehabilitation. Peak torque was normalized to the patient’s body mass (Nm/kg) and used to calculate Limb Symmetry Index (LSI). Analyses were conducted separately for female and male cohorts and grouped by early (11-14 years) and middle (15-17 years) adolescence. An independent samples t-test examined strength differences between age groups. Results: 130 females (age=15.4 ± 1.4 years; days since surgery=239.0 ± 84.4) and 112 males (age=15.4 ± 1.5 years; days since surgery= 232.6 ± 91.2) were included. Normalized knee extension peak torque on the involved limb was reported for female (1.5 Nm/kg) and male (1.8 Nm/kg) cohorts. Differences between age groups in knee extension peak torque were found on the surgical and nonsurgical limbs in female (p = 0.02 – 0.05) and male (p<0.001 – 0.002) cohorts. No differences were found between age groups for either cohort when normalized to body mass (p = 0.30 – 0.89). Post hoc power analyses revealed 67% statistical power in the female cohort and 97% in the male cohort with an alpha level set to 0.05 based on the observed effect size for the differences in isokinetic knee extension/flexion peak torque between age groups. Conclusion: Early adolescents produced less knee extension and flexion peak torque compared to middle adolescents after ACLR, but no differences were found between age groups when normalized to body mass for female or male cohorts. Normalized knee extension strength in young adolescents may differ from older patients and should be considered in the rehabilitation process. [Table: see text][Table: see text][Table: see text][Table: see text]
Negative Predictive Value of Mri-Detected Medial Meniscus Tears is Reduced in Young Athletes with Chronic ACL Injury
Authors: Sliepka Joseph , Hagen Mia , Battan Shamele , Kweon Chris , Gee Albert , Schmale Gregory , Saper Michael 
Published: May 2022

Background: A delay in anterior cruciate ligament reconstruction (ACLR) is associated with an increase in the prevalence in medial meniscus tears identified at the time of surgery. However, the specific effect of time on the predictive value of magnetic resonance imaging (MRI) for detecting meniscus injury in the young athletic population with ACL tears is unclear. Purpose: To investigate the effect of time from MRI to ACLR on the predictive value of MRI to detect meniscus tears in adolescent and young adult athletes. Methods: A retrospective review was performed of patients aged 13-25 years who underwent primary ACLR at an academic institution from January 2017 to June 2020. Multi-ligament injuries were excluded. Primary data recorded included time from MRI to surgery and descriptions of medial and lateral meniscus tears on both MRI and operative reports. Time from MRI to surgery was divided into four intervals: 0 to 6 weeks, 6 weeks to 3 months, 3 months to 6 months, and beyond 6 months. Multivariable analysis was used to determine the positive (PPV) and negative predictive value (NPV) of MRI in detecting meniscus tears as compared to arthroscopic findings at each of the 4 time intervals. Results: 432 patients (54% female) were included with a mean age of 18 ± 3.4 years. The mean time from injury to MRI was 78 ± 187 days; the mean time from MRI to surgery was 71 ± 98 days. 252 patients had pre-operative MRIs without meniscus tears; 33 (13.1%) of those had a medial meniscus tear identified at the time of surgery (Table 1). New medial meniscus tears (100% vertical tears) were identified in 7/18 (38.9%) patients with surgery 6 months from MRI. There was a statistically significant decrease in the NPV of MRI to identify medial meniscus tears in patients who underwent ACLR greater than 6 months after imaging (odds ratio 0.16 [0.05–0.53], P < 0.005). Age, gender, body mass index, mechanism of injury, primary sport, and ethnicity did not affect the predictive value of MRI. Sensitivity and specificity of MRI to predict a medial meniscus tear in the entire cohort was 79% and 80%, respectively. Conclusion: Surgeons should counsel patients preoperatively about increased possibility of undiagnosed medial meniscus tears being found at the time of ACLR if greater than 6 months have passed from MRI to surgery. [Table: see text]
Does N‐acetylcysteine Improve Established Hearing Loss in Guinea Pigs?
Authors: Gill Gia , Blakley Brian W. 
Published: May 2022

ObjectiveTo assess whether multiple injections of a powerful antioxidant can improve established sensorineural hearing loss in guinea pigs.Study DesignAnimal study.SettingAnimal science laboratory, University of Manitoba.MethodsA total of 16 guinea pigs were used in our study: 8 underwent unilateral intracochlear neomycin injection, and 8 underwent unilateral saline to serve as controls. After a period of 3 weeks for hearing loss to stabilize, 4 guinea pigs from each group received weekly intraperitoneal injections of N‐acetylcysteine (NAC) for 4 weeks. Click auditory brainstem response (ABR) testing was conducted at baseline, weekly after the start of NAC injections, and after the last injection. Pure tone ABR tests were conducted prior to intracochlear injections and at completion of the study.ResultsClick ABR thresholds were significantly worse in ears treated with neomycin (P <. 001), as expected, but not significantly different when treated with NAC (P =. 664). Thresholds for pure tone ABR were also not statistically different in neomycin‐treated ears with or without NAC (P >. 99).ConclusionsThe aggressive antioxidant therapy performed in this study was not successful in improving established hearing loss via an antioxidant regimen that is known to change the oxidation‐reduction potential in the cochlea.
A Tailored Music-Motor Therapy and Real-Time Biofeedback Mobile Phone App (‘GotRhythm’) to Promote Rehabilitation Following Stroke: A Pilot Study
Authors: Hankinson Katherine , Shaykevich Alex , Vallence Ann-Maree , Rodger Jennifer , Rosenberg Michael , Etherton-Beer Christopher 
Published: May 2022

Background: Stroke persists as an important cause of long-term disability world-wide with the need for rehabilitation strategies to facilitate plasticity and improve motor function in stroke survivors. Rhythm-based interventions can improve motor function in clinical populations. This study tested a novel music-motor software application ‘GotRhythm’ on motor function after stroke. Methods: Participants were 22 stroke survivors undergoing inpatient rehabilitation in a subacute stroke ward. Participants were randomised to the GotRhythm intervention (combining individualised music and augmented auditory feedback along with wearable sensors to deliver a personalised rhythmic auditory stimulation training protocol) or usual care. Intervention group participants were offered 6-weeks of the GotRhythm intervention, consisting of a supervised 20-minute music-motor therapy session using GotRhythm conducted 3 times a week for 6 weeks. The primary feasibility outcomes were adherence to the intervention and physical function (change in the Fugl-Meyer Assessment of Motor Recovery score) measured at baseline, after 3-weeks and at end of the intervention period (6-weeks). Results: Three of 10 participants randomised to the intervention did not receive any of the GotRhythym music-motor therapy. Of the remaining 7 intervention group participants, only 5 completed the 3-week mid-intervention assessment and only 2 completed the 6-week post-intervention assessment. Participants who used the intervention completed 5 (IQR 4,7) sessions with total ‘dose’ of the intervention of 70 (40, 201) minutes. Conclusion: Overall, adherence to the intervention was poor, highlighting that application of technology assisted music-based interventions for stroke survivors in clinical environments is challenging along with usual care, recovery, and the additional clinical load.
Revisiting anemia in sickle cell disease and finding the balance with therapeutic approaches
Authors: Xu Julia Zhe , Thein Swee Lay 
Published: May 2022

AbstractChronic hemolytic anemia and intermittent acute pain episodes are the 2 hallmark characteristics of sickle cell disease (SCD). Anemia in SCD not only signals a reduction of red cell mass and oxygen delivery, but also ongoing red cell breakdown and release of cell-free hemoglobin, which together contribute to a number of pathophysiological responses and play a key role in the pathogenesis of cumulative multiorgan damage. However, although anemia is clearly associated with many detrimental outcomes, it may also have an advantage in SCD in lowering risks of potential viscosity-related complications. Until recently, clinical drug development for SCD has predominantly targeted a reduction in the frequency of vaso-occlusive crises as an endpoint, but increasingly, more attention is being directed toward addressing the contribution of chronic anemia to poor outcomes in SCD. This article aims to explore the complex pathophysiology and mechanisms of anemia in SCD, as well as the need to balance the benefits of raising hemoglobin levels with the potential risks of increasing blood viscosity, in the context of the current therapeutic landscape for anemia in SCD.
Airway fibrin formation cascade in allergic asthma exacerbation: implications for inflammation and remodeling
Authors: Zhu Yanlong , Esnault Stephane , Ge Ying , Jarjour Nizar N. , Brasier Allan R. 
Published: May 2022

Abstract
Background
Airway remodeling in patients with asthma, which leads to a decline in pulmonary function, is likely the result of repeated exacerbations often provoked by aeroallergen exposures. Aeroallegen exposure triggers a stereotypic response orchestrated by growth factor cytokines and other protein mediators. This results in a late-phase allergic reaction characterized by vascular permeability, recruitment of activated leukocytes, and activation of structural cells of the airway. The spectrum of protein mediators and their functions are incompletely understood.

Methods
Bronchoalveolar lavage fluid (BALF) samples were obtained from 12 volunteers who exhibited robust eosinophilic recruitment following segmental bronchial provocation with allergen (SBP-Ag). We systematically identified and quantified proteins in BALF using high-performance liquid chromatography–high-resolution mass spectrometry (LC–MS/MS) followed by pathway analysis and correlations with airway physiology.

Results
Pairwise analysis of protein abundance in BALF pre- vs post-SBP-Ag revealed that 55 proteins were upregulated and 103 proteins were downregulated. We observed enrichment of groups of proteins mapping to hemostasis/fibrin clot, platelet activation, lipoprotein assembly, neutrophil degranulation proteins, and acute-phase inflammation-airway remodeling pathways. The abundances of F2 and Fibrinogen γ (FGG) correlated with eosinophil numbers, whereas SERPINA3 negatively correlated with change in FeNO. The coagulation proteins F2 and KNG negatively correlated with FN1 an index of airway remodeling. Interestingly, patients with lower FEV1 showed distinct allergen-induced patterns of 8 BALF proteins, including MUC1, alarmins (HSPB1), and actin polymerization factors.

Conclusions
Protein abundance of the fibrin formation cascade, platelet activation and remodeling are associated with late-phase leukocyte numbers and markers of remodeling. Patients with lower FEV1 have distinct dynamic responses to allergen.
Localization of EccA3 at the growing pole in Mycobacterium smegmatis
Authors: Kriel Nastassja L. , Newton-Foot Mae , Bennion Owen T. , Aldridge Bree B. , Mehaffy Carolina , Belisle John T. , Walzl Gerhard , Warren Robin M. , Sampson Samantha L. , Gey van Pittius Nico C. 
Published: May 2022

Abstract
Background
Bacteria require specialized secretion systems for the export of molecules into the extracellular space to modify their environment and scavenge for nutrients. The ESX-3 secretion system is required by mycobacteria for iron homeostasis. The ESX-3 operon encodes for one cytoplasmic component (EccA3) and five membrane components (EccB3 – EccE3 and MycP3). In this study we sought to identify the sub-cellular location of EccA3 of the ESX-3 secretion system in mycobacteria.

Results
Fluorescently tagged EccA3 localized to a single pole in the majority of Mycobacterium smegmatis cells and time-lapse fluorescent microscopy identified this pole as the growing pole. Deletion of ESX-3 did not prevent polar localization of fluorescently tagged EccA3, suggesting that EccA3 unipolar localization is independent of other ESX-3 components. Affinity purification - mass spectrometry was used to identify EccA3 associated proteins which may contribute to the localization of EccA3 at the growing pole. EccA3 co-purified with fatty acid metabolism proteins (FAS, FadA3, KasA and KasB), mycolic acid synthesis proteins (UmaA, CmaA1), cell division proteins (FtsE and FtsZ), and cell shape and cell cycle proteins (MurS, CwsA and Wag31). Secretion system related proteins Ffh, SecA1, EccA1, and EspI were also identified.

Conclusions
Time-lapse microscopy demonstrated that EccA3 is located at the growing pole in M. smegmatis. The co-purification of EccA3 with proteins known to be required for polar growth, mycolic acid synthesis, the Sec secretion system (SecA1), and the signal recognition particle pathway (Ffh) also suggests that EccA3 is located at the site of active cell growth.
Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
Authors: Chen Chuyun , Yang Ying , Ma Wei , Qi Litong , Zhang Baowei , Zhang Yan 
Published: May 2022

Abstract
Background
Left atrial (LA) size is often used as a surrogate marker of LA function in clinical practice, with larger atrial thought to represent a “dysfunctioning” atrium, since there is no accepted ‘gold’ standard to evaluate LA function. The exact relationship between LA size and phasic function, and whether LA dysfunction occur before LA enlargement (LAE) may be of clinical interest while have not been fully studied. Two-dimensional speckle-tracking echocardiography (2D STE) was showed a promising method in measuring LA physical deformation.

Materials and methods
A community cohort of 715 subjects at cardiovascular disease high risk accepted comprehensive echocardiography. LA longitudinal phasic strain Sa (absolute peak strain during atrial contraction), Se (peak strain at early diastole) and Stot (total atrial strain = Sa + Se), representing contractile, conduit, and reservoir function respectively, were measured using off-line 2D STE software in apical 4 chamber view, and data were compared among groups at different LA size and between subgroups in normal LA size with and without hypertension (HT).

Results
With LAE (from normal size, mild, moderate to severe LAE), the Stot (21.74 ± 5.97, 20.75 ± 4.99, 20.49 ± 5.27, 17.75 ± 4.71, respectively, ANOVA P = 0.003) and Sa (11.84 ± 3.92, 11.00 ± 3.29, 10.11 ± 2.57, 8.55 ± 2.88, respectively, ANOVA P < 0.001) reduced while Se had no change. Stot of Severe LAE group was significantly lower than that of Normal LA size group (P = 0.002). Sa of the three LAE groups were all significantly lower than that of Normal LA size group (P = 0.024, P = 0.002, P < 0.001, respectively). In normal sized LA subgroups, Stot (21.35 ± 5.91 vs. 23.01 ± 6.02, P = 0.008) and Se (9.51 ± 4.41 vs. 11.17 ± 4.89, P < 0.001) reduced in subjects with HT comparing with those without.

Conclusion
LA phasic function remodeling occurs before LAE and continues with LAE, with reservoir, conduit and contractile function being affected unparalleled.
Association between prehospital shock index variation and 28-day mortality among patients with septic shock
Authors: Jouffroy Romain , Gilbert Basile , Thomas Léa , Bloch-Laine Emmanuel , Ecollan Patrick , Boularan Josiane , Bounes Vincent , Vivien Benoit , Gueye Papa-Ngalgou 
Published: May 2022

Abstract
Purpose
Septic shock (SS) hyperdynamic phase is characterized by tachycardia and low-blood pressure reflecting the relative hypovolemia. Shock index (SI), the ratio between heart rate and systolic blood pressure, is a simple objective tool, usable for SS prognosis assessment.
This study aims to evaluate the relationship between prehospital SI variation and 28-day mortality of SS patients initially cared for in prehospital setting by a mobile intensive care unit (mICU).

Methods
From April 6th, 2016 to December 31st, 2020, 406 patients with SS requiring prehospital mICU were retrospectively analyzed. Initial SI, i.e. first measurement after mICU arrival to the scene, and final SI, i.e. last measurement of the prehospital stage, were used to calculate delta SI (initial SI—final SI) and to define positive and negative delta SI. A survival analysis after propensity score matching compared the 28-day mortality of SS patients with positive/negative delta SI.

Results
The main suspected origins of infection were pulmonary (42%), digestive (25%) and urinary (17%). The 28-day overall mortality reached 29%.
Cox regression analysis revealed a significant association between 28-day mortality and delta SI. A negative delta SI was associated with an increase in mortality (adjusted hazard ratio (HRa) of 1.88 [1.07–3.31] (p = 0.03)), whereas a positive delta SI was associated with a mortality decrease (HRa = 0.53 [0.30–0.94] (p < 10–3)).

Conclusion
Prehospital hemodynamic delta SI among SS patients cared for by a mICU is associated with 28-day mortality. A negative prehospital delta SI could help physicians to identify SS with higher risk of 28-day mortality.