bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Anteromedial Portal Versus Tibial Tunnel Drilling and Meniscal Reoperation Risk Following Anterior Cruciate Ligament Reconstruction: A Cohort Study
Authors: Davis Brent R. , Chang Richard N. , Prentice Heather A. , Tejwani Samir G. , Morris Andrew J. , Maletis Gregory B. 
Published: June 2022

Background: Anterior cruciate ligament reconstruction (ACLR) provides functional stability to an injured knee. While multiple techniques can be used to drill the femoral tunnel during ACLR, a single technique has yet to be proven as clinically superior. One marker of postoperative functional stability is subsequent meniscal tears; a lower risk of subsequent meniscal surgery could be expected with improved knee stability. Purpose: To determine if there is a meniscal protective effect when using an anteromedial portal (AMP) femoral tunnel drilling technique versus transtibial (TT) drilling. Study Design: Cohort study; Level of evidence, 2. Methods: Data from Kaiser Permanente’s ACLR registry were used to identify patients who had a primary isolated ACLR between 2009 and 2018; those with previous surgery in the index knee and meniscal pathology at the time of ACLR were excluded. The exposure of interest was TT (n = 2711) versus AMP (n = 5172) drilling. Multivariable Cox proportional hazard regression was used to evaluate the risk of a subsequent ipsilateral meniscal reoperation with adjustment for age, sex, femoral fixation, and graft choice. We observed a shift in surgeon practice from the TT to AMP over the study time frame; therefore, the relationship between technique and surgeon experience on meniscal reoperation was evaluated using an interaction term in the model. Results: At the 9-year follow-up, the crude cumulative meniscal reoperation probability for AMP procedures was 7.76%, while for TT it was 5.88%. After adjustment for covariates, we observed a higher risk for meniscal reoperation with AMP compared with TT (hazard ratio [HR], 1.53; 95% CI, 1.05-2.23). When stratifying by surgeon experience, this adverse association was observed for patients who had their procedure performed by surgeons with less AMP experience (no previous AMP ACLR: HR, 1.26; 95% CI, 0.84-1.91) while a protective association was observed for patients who had their procedure with more experienced surgeons (40 previous AMP ACLRs: HR, 0.34; 95% CI, 0.13-0.92). Conclusion: Drilling the femoral tunnel via the AMP was associated with a higher risk of subsequent meniscal surgery compared with TT drilling. However, when AMP drilling was used by surgeons experienced with the technique, a meniscal protective effect was observed.
Biomechanical Comparison of Ulnar Collateral Ligament Reconstruction With and Without Suture Augmentation
Authors: Narvaez Michael V. , Nelson Trevor J. , Youssefzadeh Keon , Limpisvasti Orr , Metzger Melodie F. 
Published: June 2022

Background: A common concern associated with elbow ulnar collateral ligament (UCL) reconstruction is the amount of time required for recovery and rehabilitation. For example, for Major League Baseball pitchers, the average time to return to competition ranges from 13.8 to 20.5 months. Suture tape augmentation has shown the ability to provide additional soft tissue stability across other joints in the body. By providing an additional checkrein to the UCL reconstruction while the graft is healing, it may be possible to accelerate the rehabilitation process in overhead athletes and thus effect a quicker return to sports. Purpose: To compare elbow valgus stability and load to failure between UCL reconstruction with and without suture tape augmentation. Study Design: Controlled laboratory study. Methods: Fresh-frozen cadaveric elbows (N = 24) were dissected to expose the UCL. Medial elbow stability was tested with the UCL intact, deficient, and reconstructed utilizing the 3-strand docking technique with or without suture augmentation. A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion-tracking cameras as the elbow was cycled through a full range of motion. After kinematic testing, reconstructed specimens were loaded to failure at 70° of elbow flexion. Results: UCL-deficient elbows demonstrated significantly greater valgus rotation when compared with intact and internally braced reconstructed elbows at every angle of flexion tested and when compared with unbraced UCL-reconstructed elbows at 50° to 120° of flexion ( P < .05). There were no significant differences between intact and UCL-reconstructed elbows with and without suture augmentation at any flexion angle tested. When loaded to failure, unbraced reconstructed elbows failed at a significantly lower torque as compared with elbows with UCL reconstruction with suture tape augmentation ( P < .01). Conclusion: In this cadaveric model, 3-strand UCL reconstruction with suture augmentation did not overconstrain the elbow throughout all flexion angles when compared with the native state and UCL reconstruction alone, while providing greater load to failure. Clinical Relevance: Suture tape augmentation may provide the additional strength necessary to accelerate rehabilitation after UCL reconstruction.
Effects of Male and Female Sex on the Development of Posttraumatic Osteoarthritis in the Porcine Knee After Anterior Cruciate Ligament Surgery
Authors: Pinette Megan P. , Molino Janine , Proffen Benedikt L. , Murray Martha M. , Fleming Braden C. 
Published: June 2022

Background: Posttraumatic osteoarthritis (PTOA) is a common sequela of anterior cruciate ligament (ACL) injury, even when surgical treatment is selected. The effect of patient sex on cartilage health after ACL injury and surgical treatment has been less studied. Purpose/Hypothesis: The study objective was to compare the macroscopic cartilage damage that develops after ACL surgery in male and female Yucatan minipigs. It was hypothesized that after ACL surgery, the macroscopic cartilage damage of the tibiofemoral joints from female animals would be greater than that from male animals. Additionally, it was hypothesized that the effect of sex on the macroscopic cartilage damage would depend on surgical treatment. Study Design: Controlled laboratory study Methods: Twelve-month follow-up data were obtained for 55 adolescent Yucatan minipigs (22 female/33 male) that were randomized to 1 of 3 experimental groups: no treatment (ACL transection [ACLT]), ACL reconstruction, and bridge-enhanced ACL restoration. The Osteoarthritis Research Society International guidelines were used to determine a standardized macroscopic cartilage damage score on 5 surfaces of the knee joint. Results: Females had significantly worse mean total macroscopic cartilage damage scores on the surgical side (adjusted P value [ P adj] = .04) and significantly better scores on the contralateral side ( P adj = .01) when compared with males. The trochlear damage scores were also significantly worse in females for surgical limbs ( P adj = .009) and significantly better for the contralateral limbs ( P adj < .001) when compared with males. Although there were no significant differences in total macroscopic cartilage damage scores between sexes within treatment groups on the surgical limbs (ACLT, P adj = 0.45; ACL reconstruction, P adj = .56; bridge-enhanced ACL restoration, P adj = .23), the mean trochlear scores on the surgical limb of females were significantly worse than those of the males in the ACLT group ( P adj = .003). Conclusion: Mean total macroscopic cartilage damage scores of Yucatan minipigs were significantly worse in females than males, regardless of treatment. These differences were predominantly found in the trochlear scores across all treatment groups. Clinical Relevance: These data suggest that patient sex could be more influential in the progression of PTOA than surgical treatment after ACL injury. Identifying factors responsible for this discrepancy may prove valuable to identify targets to slow PTOA progression in male and female ACL-injured populations.
Avoiding Overcorrection to Increase Patient Satisfaction After Open Wedge High Tibial Osteotomy
Authors: Lee Sung-Sahn , Kim Joo Hwan , Kim Su , Jung Eui Yub , Ryu Dong Jin , Lee Do Kyung , Wang Joon Ho 
Published: June 2022

Background: Achieving the postoperative mechanical axis passing through 62.5% of the tibial plateau is considered successful osteotomy surgery. Despite precise preoperative planning and surgical techniques, some procedures result in under- or overcorrection. Few studies have investigated the relationship between clinical outcomes and unintentional under- or overcorrection after open wedge high tibial osteotomy (OWHTO) using whole-leg standing radiographs. Purpose: To investigate the relationship between postoperative alignment using whole-leg standing radiographs and clinical outcomes after OWHTO. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 89 knees (72 patients) that underwent OWHTO between October 2013 and September 2018 were included. Patients with postoperative weightbearing line (WBL) ratios within 57% to 67% were classified as appropriate correction (group A; 45 cases), whereas ratios <57% and >67% were classified as undercorrection (group U; 20 cases) and overcorrection (group O; 24 cases), respectively. The following patient-reported outcomes (PROs) were investigated: International Knee Documentation Committee (IKDC) subjective score, Kujala score, and Knee injury and Osteoarthritis Outcome Score (KOOS). The correlation between postoperative WBL and PROs was analyzed. PROs were compared among the 3 groups. Results: Regarding the correlation between postoperative WBL ratio and PROs, a larger postoperative WBL ratio was significantly correlated with a poor IKDC subjective score ( P = .002), Kujala score ( P = .009), and KOOS. Group O showed inferior postoperative PRO scores when compared with group A or U, whereas group U showed a similar result to group A (mean IKDC subjective scores: group U, 62.0; group A, 61.2; group O, 47.6; P = .004). Conclusion: Overcorrection after OWHTO surgery correlated with inferior PROs; therefore, overcorrected alignment should be avoided for patient satisfaction. Knees with an undercorrected alignment showed clinical results similar to those with appropriate correction.
Curcumin and resveratrol inhibit chemoresistance in cisplatin-resistant epithelial ovarian cancer cells via targeting P13K pathway
Authors: Muhanmode Yalikun , Wen Meng Ke , Maitinuri Amina , Shen Guqun 
Published: June 2022

Background: The activation of the PI3K/AKT/mTOR pathway has been proved to be associated with survival as well as proliferation of various tumour cells in multiple cancer types, including epithelial ovarian cancer (EOC). Purpose: Moreover, the activation of the PI3K/AKT/mTOR pathway is the key mechanism responsible for higher invasiveness and migratory capacities of ovarian cancer cells. Furthermore, PI3K is crucial for activation of the PI3K/AKT/mTOR pathway; therefore, its inhibition might be an effective strategy against cancer. Research Design: The combination approach is now an established strategy against cancer. So, the present study evaluated molecular mechanics behind the synergistic effects of curcumin and resveratrol along with cisplatin treatment on inhibition of the PI3K pathway in ovarian cancer cells. Results: The present study confirmed significant inhibition of the PI3K/AKT/mTOR pathway as observed by Matrigel invasion assay, Western blot expression of important molecular markers and apoptotic markers. Conclusion: The present study concludes that the combination of curcumin and resveratrol significantly sensitized the EOC cells to cisplatin treatment, thereby inhibiting chemoresistance in ovarian cancer cells by significant inhibition of the PI3K/AKT/mTOR pathway.
Older adults` sense of dignity in digitally led healthcare
Authors: Raja Moonika , Uhrenfeldt Lisbeth , Galvin Kathleen T , Kymre Ingjerd G 
Published: June 2022

Background Health ministries in Europe are investing increasingly in innovative digital technologies. Older adults, who have not grown up with digital innovation, are expected to keep up with technological shifts as much as other age groups. This is ethically challenging, as it may threaten a sense of dignity and well-being in older adults. Research objective To clarify the phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met within the context of digitally led healthcare in Norway. Research design A Reflective Lifeworld Research design was chosen, and purposive, in-depth interviews were conducted. Participants and research context The participants were 13 adults 75 years and older from Northern Norway, living at home and not receiving consistent assistance. Ethical considerations Followed the principles of the Helsinki Declaration. This study was approved by the Social Science Data Services in Norway (project number 916119). Interviews were conducted carefully within a safe environment chosen by the participants. Findings Older adults experience that using new digital systems in healthcare makes them become dependent with experiences of helplessness. They feel an increased sense of dependency on other people, and that recognition can assail their experience of personal dignity. Older adults not only expect digitally led healthcare to give them a feeling of safety but also experience feeling insecure concerning privacy and loss of possibilities for dialogue with healthcare providers. They are met by demands from society, which they often struggle to achieve. Conclusion The phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met within digitally led healthcare, indicates a sense of feeling lost in the digital world. Further, innovative healthcare lacks focus on ethical performance. This impacts their perception of dignity, as loss of dignity is noticed especially in its rupture.
Informed consent prior to nursing care: Nurses’ use of information
Authors: Aveyard Helen , Kolawole Abimola , Gurung Pratima , Cridland Emma , Kozlowska Olga 
Published: June 2022

Background Informed consent prior to nursing care procedures is an established principle which acknowledges the right of the patient to authorise what is done to him or her; consent prior to nursing care should not be assumed. Nursing care procedures have the potential to be unwanted by the patient and hence require an appropriate form of authorisation that takes into consideration the relationship between the nurse and patient and the ongoing nature of care delivery. Research question How do nurses obtain consent from patients prior to nursing care?. Design Critical incident technique and the collection of critical happenings. Participants 17 participants who were all qualified nurses took part in in-depth interviews Ethical considerations Ethical approval was obtained from the university ethics committee. Findings Information giving is a key component prior to nursing care procedures. Nurses provide information to patients as a routine aspect of care delivery, and do so even when the patient is unable to communicate themselves. Whilst some participants described how information giving might be rushed or overlooked at times, it is clearly an established part of nursing care and is provided to ensure the patient knows what to expect when care is delivered. What is less clear is the extent to which information is given in order to seek the consent – rather than merely inform the patient – about nursing care. Conclusion Implied consent is often an appropriate way in which consent is obtained prior to nursing care procedures. It takes into account the ongoing care provision and the relationship that exists between the nurse and patient. However implied consent should not be assumed. Nurses need to ensure that information is given not only to inform the patient about a procedure but to enable the patient to give his or her consent and to find an alternative way forward if the patient withholds their consent.
Behavior and adoptability of hoarded cats admitted to an animal shelter
Authors: Jacobson Linda S , Ellis Jacklyn J , Janke Kyrsten J , Giacinti Jolene A , Robertson Jyothi V 
Published: June 2022

Objectives The aim of this study was to analyze the behavioral characteristics and success of adoption for previously hoarded cats. Methods Shelter records and post-adoption surveys were analyzed for hoarded cats ⩾6 months old at intake. A non-standard scoring system was used. Intake scores were allocated contemporaneously and socialization scores were applied retrospectively for three time points (TPs): 5–10 days post-intake (shelter TP), ⩽1 week post-adoption (home TP1) and >1 week post-adoption (home TP2). Adoption returns were compared between hoarded and non-hoarded cats. Results The study included 195 hoarded cats, of which 174 were adopted. Of 164 cats with intake scores, 86 (52%) were scored as ‘friendly’ at intake. Forty-five cats had socialization scores for all of the TPs, and of these, the percentages of ‘supersocial’ or ‘social’ decreased from 87% at the shelter TP to 47% at home TP1, then increased to 84% at home TP2. Most cats that scored as ‘tense’ at intake had supersocial or social scores at home TP2. Nine of the 88 cats with survey results had out-of-box (OOB) elimination in either the shelter or home but only 1/88 in both. Adopters expressed positive feelings for 42/43 cats for which feelings-based language was used in their survey responses. Notable behaviors, such as neediness, were recorded for 48/88 cats. Relationships with other household pets were typically positive. Eighteen of 174 hoarded (10%) and 188/2662 non-hoarded (7.1%) cats were returned post-adoption. Of these, six hoarded and 87 non-hoarded returns included behavioral reasons. There were no significant differences between hoarded and non-hoarded cats for total or behavioral returns. Conclusions and relevance Hoarded cats had high adoption rates, high adopter satisfaction and the potential for good emotional well-being in adoptive homes. Behavior at intake and OOB elimination in the shelter may not reflect post-adoption behavior. Behavior-based outcome decisions for these vulnerable animals should be deferred to allow time for habituation.
Glycerophosphoinositol is Elevated in Blood Samples From CLN3Δex7-8 pigs, Cln3Δex7-8 Mice, and CLN3-Affected Individuals
Authors: Brudvig Jon J , Swier Vicki J , Johnson Tyler B , Cain Jacob C , Pratt Melissa , Rechtzigel Mitch , Leppert Hannah , Dang Do An N , Porter Forbes D , Weimer Jill M 
Published: June 2022

Introduction: CLN3 Batten disease is a rare pediatric neurodegenerative lysosomal disorder caused by biallelic disease-associated variants in CLN3. Despite decades of intense research, specific biofluid biomarkers of disease status have not been reported, hindering clinical development of therapies. Thus, we sought to determine whether individuals with CLN3 Batten disease have elevated levels of specific metabolites in blood. Methods: We performed an exhaustive metabolomic screen using serum samples from a novel minipig model of CLN3 Batten disease and validated findings in CLN3 pig serum and CSF and Cln3 mouse serum. We further validate biomarker candidates with a retrospective analysis of plasma and CSF samples collected from participants in a natural history study. Plasma samples were evaluated from 22 phenotyped individuals with CLN3 disease, 15 heterozygous carriers, and 6 non-affected non-carriers (NANC). Results: CLN3 pig serum samples from 4 ages exhibited large elevations in 4 glycerophosphodiester species: glycerophosphoinositol (GPI), glycerophosphoethanolamine (GPE), glycerophosphocholine (GPC), and glycerophosphoserine (GPS). GPI and GPE exhibited the largest elevations, with similar elevations found in CLN3 pig CSF and Cln3 mouse serum. In plasma samples from individuals with CLN3 disease, glycerophosphoethanolamine and glycerophosphoinositol were significantly elevated with glycerophosphoinositol exhibiting the clearest separation (mean 0.1338 vs 0.04401 nmol/mL for non-affected non-carriers). Glycerophosphoinositol demonstrated excellent sensitivity and specificity as a biomarker, with a receiver operating characteristic area under the curve of 0.9848 ( P = .0003). Conclusions: GPE and GPI could have utility as biomarkers of CLN3 disease status. GPI, in particular, shows consistent elevations across a diverse cohort of individuals with CLN3. This raises the potential to use these biomarkers as a blood-based diagnostic test or as an efficacy measure for disease-modifying therapies.
Prevalence of the Clinical Symptoms and PCR Test Results on Patients With COVID-19 in South of Tehran
Authors: Monireh Rahimkhani , Kiana Kazemian 
Published: June 2022

Background: The first human case of COVID-19 was reported on 19 February 2020 in Iran, since then the number of infected cases has dramatically increased to about 1.800 million and about 62 000 deaths, also elderly people have accounted for the largest frequency of mortality. Objective: This study aims to evaluate the prevalence of Covid-19 RT-PCR positive among Iranian patients and to evaluate the most important clinical symptoms of identified patients based on age, gender, and their background diseases to be used as an aid for early diagnosis. Methods: During 9 months, swab samples of 11 034 patients’ nasopharynx and oropharynx secretions were obtained and were referred to the laboratory for Covid-19 RT-PCR test. In addition, the history of signs and symptoms from patients was recorded. Results: In total, 11 034 Covid-19 RT-PCR tests that performed, 3358 samples had positive results (30.4%). Headache was the most commonly reported, which was found in 42.5% of our cases. Fever was the second most common symptom among the patients studied, with a prevalence rate of 36.2%. Conclusion: In this study, almost 30% of symptomatic patients had positive Covid-19 RT-PCR test results. Headache was the most common symptom; also diarrhea and nausea were the least common symptoms among patients under this study.