bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 139: Outcomes After Arthroscopic Assisted Lower Trapezius Transfer: A Retrospective Study
Authors: Wright Melissa , Murthi Anand , Chopra Aman 
Published: July 2022

Objectives: Massive irreparable rotator cuff tears lead to significant pain and disability. Tendon transfers have been described as one option to improve pain and function for patients, but clinical data are limited. The purpose of this study was to evaluate outcomes in patients after arthroscopically assisted lower trapezius tendon transfer (AALTT) for massive irreparable rotator cuff tears. Methods: Twenty-one patients with massive irreparable rotator cuff tears who underwent AALTT with a single surgeon from January 2017 to July 2021 were analyzed. Patient demographics such as age, sex, followup, worker’s compensation claims, and prior surgical history were recorded. Preoperative and one-year postoperative range of motion, external rotation strength, and pain visual analogue scale (VAS) were extracted from medical records. Patient reported outcomes measurements used for comparison included American Shoulder and Elbow Score (ASES), as well as Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function and Mental Function. Six-month postoperative MRIs were reviewed when available. Descriptive and univariate statistical analyses were performed. Results: The average patient age was 56.1 (range, 29-72) years and 19 patients (90.5%) were male. The average follow up was 13.2 (range, 4-45) months. Seven patients (33.3%) were involved in worker’s compensation claims and 17 patients (81%) had undergone prior rotator cuff repair. Out of 21 patients who were working at the time of surgery, eleven patients (52.4%) were able to return to their same occupation and 19 patients (86.4%) demonstrated complete tendon healing on postoperative MRI scans (Table 1). There was significant improvement in postoperative pain VAS (5.8±2 vs. 1.7±2) and ASES scores (44.3±18 vs. 71.6±23). No significant changes in PROMIS Physical (47.1±7 vs. 51.4±11) and PROMIS Mental (53.1±8 vs. 53.8±10) were observed. There were significant improvements in external rotation motion (11.0±17 degrees vs. 42.1±13 degrees) and strength (2.9/5 ±1 vs. 4.6/5 ±1) at final followup (Table 2). Conclusions: AALTT is a successful treatment option for the massive irreparable rotator cuff tear. Patients demonstrated significant improvements in pain, range of motion, and strength at one year, with complete tendon healing visualized on postoperative MRI scans. [Table: see text][Table: see text]
Poster 168: Is Workload Associated with Internal Impingement in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced
Authors: Chalmers Peter , Mcelheny Kathryn , Dangelo John , Ma Kevin , Rowe Dana , Erickson Brandon 
Published: July 2022

Objectives: The purpose of this study was to determine if number of days of rest between outings, number of innings pitched in each outing, number of batters faced in each outing, and being a starting pitcher are risk factors for internal impingement in professional baseball pitchers. Methods: All professional baseball pitchers who were diagnosed with internal impingement between 2011-2017 were identified using the Major League Baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared workload variables between pitcher-games 2, 6, 12, and >12 weeks prior to documented internal impingement to pitcher-games from a control group who were never diagnosed with internal impingement. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury to the injured pitcher’s workload >12 weeks prior to injury. Results: There were 624 professional baseball pitchers who were documented in the MLB HITS database as having had internal impingement between 2011-2017. Across all time points, players with more innings pitched per game and more batters faced per game were associated with a higher incidence of subsequent internal impingement compared to controls. However, there were not significantly more innings pitched, more batters faced, or fewer days rest in the acute period (12 weeks) prior to injury when compared to baseline workload. Being a starting pitcher was associated with a higher incidence of internal impingement. Conclusions: Greater pitcher workload and being a starting pitcher were associated with increased risk for internal impingement in professional baseball players. However, this injury was not associated with an acute increase in workload, suggesting that internal impingement may be due to the cumulative effects of workload over a career. [Table: see text]
Poster 175: Beach Chair Versus Lateral Decubitus Positioning for Primary Arthroscopic Posterior Shoulder Stabilization
Authors: Anderson Ashley , Mescher Patrick , Tennent David , LeClere Lance , Rue John Paul , Owens Brett , Cameron Kenneth , Posner Matthew , Dickens Jonathan , Donohue Michael , Yow Bobby 
Published: July 2022

Objectives: There are no studies that directly compare beach chair (BC) versus lateral decubitus (LD) position for arthroscopic treatment of posterior instability. In the few systematic reviews evaluating BC vs. LD, no difference had been demonstrated in regard to recurrence and revision rates. Additionally, bone loss was not accounted for in the recurrence rate. The purpose of this study is to identify predictors of shoulder instability recurrence and revision after posterior shoulder stabilization surgery in a young, high demand population and evaluate surgical position and glenoid bone loss as independent predictors of the outcomes of interest, recurrence and revision at short- and mid- term follow-up. Methods: A consecutive series of 147 arthroscopic posterior stabilization procedures were performed by sports medicine certified and fellowship trained orthopaedic surgeons from 2005-2019 in either the BC or LD position. Patients were included if they underwent an isolated primary arthroscopic posterior capsulolabral repair. Patients were excluded if concomitant anterior labral repair was performed at the time of surgery. Shoulders were additionally excluded if magnetic resonance imaging (MRI) was not available at the time of preoperative evaluation, or the patient was lost to follow up. All shoulders were evaluated for glenohumeral bone loss using the best-fit circle technique on the sagittal enface MRI. The primary outcomes of interest were recurrent instability and revision stabilization. Recurrent instability was defined as the presence of a recurrent pain limiting activities with physical exam consistent with recurrent posterior instability per clinical notes in the electronic medical record. Rates of recurrence and revision were calculated among the full cohort among patients with available 1-year or 5-year follow up. Patient and procedure characteristics were compared by BC or LD group using two sample t-tests or Chi-square tests. Results: A total of 147 shoulders with a mean age of 22.6 years (4.82 SD) underwent isolated arthroscopic repair and were followed for a mean 6.93 (3.29 SD) years. The overall recurrent instability and revisions rates were 16% (23/147) and 12% (18/147), respectively. With respect to surgical position, there was no significant difference in recurrence or revision (p-value >0.05). With respect to patient age, anchor number, and bone loss there was no significant difference in recurrence or revision with respect to patient age (p-value >0.05). Conclusions: Among fellowship-trained orthopaedic surgeons, there was no difference in rates of recurrent instability and revision surgery after performing arthroscopic stabilization for isolated posterior shoulder instability in a high demand population in either the BC or LD position.
Poster 193: Increased Hip Distractability in the Revision Hip Arthroscopy Setting: A Comparison Between Revision and Native Contralateral Hips with an Intra-Operative Axial Stress Exam Under Anesthesia
Authors: Tomasevich Kelly , Ohlsen Suzanna , O Dillon , Featherall Joseph , Aoki Stephen , Mortensen Alexander 
Published: July 2022

Objectives: Hip instability secondary to capsular insufficiency is a cause of persistent pain and/or functional disability following primary hip arthroscopy in a poorly defined subset of patients. Further, an easily distractible hip exam under anesthesia is a finding that has been described in the diagnosis of hip instability; however, the exam has relied on subjective findings of a perceived looseness and has lacked objective criteria. The purpose of this study was to compare intraoperative hip joint distractibility between hips that previously underwent arthroscopic surgery and the contralateral hip with no history of surgical manipulation. Methods: Patients undergoing revision hip arthroscopy between April 2019 and December 2020, who previously underwent arthroscopic hip surgery for femoroacetabular impingement syndrome, were prospectively enrolled. Exclusion criteria was any contralateral hip surgery. Prior to instrumentation, fluoroscopic images of both hips were obtained at 25 lb traction intervals up to 100 lbs. Total joint space and distraction were measured at each traction interval. (Figure 1) Distraction was calculated as the difference between the baseline joint space and the total joint space at each subsequent traction interval. (Figure 2) Wilcoxon signed ranks tests and McNemar tests were used to compare distraction between revision and native contralateral hips. Results: Forty-seven patients were included. Mean distraction of operative hips was significantly greater than mean distraction of non-operative hips at traction intervals of 50 lbs (2.13 vs. 1.04 mm, p = 0.002), 75 lbs (6.39 vs. 3.70 mm, p < 0.001), and 100 lbs (8.24 vs. 5.39, p < 0.001) (Figure 3). Mean total joint space of operative hips was significantly greater than mean total joint space of non-operative hips at traction intervals of 50 lbs (6.60 vs. 5.39 mm, p < 0.001), 75 lbs (10.86 vs. 8.05 mm, p < 0.001), and 100 lbs (12.73 vs. 9.73, p < 0.001). A higher percentage of operative hips achieved all distraction thresholds, in 2-mm intervals up to 10-mm, at each traction interval (Table 1). Conclusions: In the majority of patients undergoing revision hip arthroscopy, previous arthroscopic hip surgery increases axial distractibility of the hip joint compared to the native contralateral hip at axial traction forces of 50-100 lbs. Increased axial distractibility following hip arthroscopy may be suggestive of hip instability, and can be assessed on a stress exam under anesthesia. [Table: see text]
Poster 215: Application of Machine Learning for Predicting Opioid Use After Arthroscopic Meniscal Surgery
Authors: Jildeh Toufic , Chaudhry Farhan , Abbas Muhammad , Mahmoud Ossama , Turner Elizabeth , Hengy Meredith , Okoroha Kelechi , Castle Joshua 
Published: July 2022

Objectives: To identify predictive factors for continued opioid prescriptions after arthroscopic meniscal resection or repair and develop a predictive machine learning model. Methods: Patients undergoing arthroscopic meniscal surgery between August 2013 and February 2017 at a single institution were retrospectively identified. Patient demographic variables were recorded including age, sex, body mass index, and history of chronic opioid usage (> 1 month). Procedural details were recorded such as concomitant procedures, primary versus revision, and whether a partial debridement or a repair was performed. Intraoperative arthritis severity was measured using the Outerbridge Classification. Types of opioid medications prescribed and in which months were documented. For primary analysis, we used a multivariate Cox-Regression model. We then created a naïve Bayesian model, a machine learning classifier that utilizes Bayes’ theorem with an assumption of independence between the variables collected. The model randomly selected 70% of the sample to be trained on while 30% were tested. Results: A total of 735 patient were reviewed. Postoperative opioid refills occurred in 98 patients (16.9%). Using multivariate logistic modeling, independent risk factors for opioid refills included Male sex, larger BMI, chronic preoperative opioid use while meniscus resection demonstrated decreased likelihood of refills. Concomitant procedures, revisions, and presence of arthritis graded by the Outerbridge classification were not significant predictors of opioid refills. The Naïve Bayesian model for extended postoperative opioid use demonstrated good fit with our cohort with an area under the curve of 0.79, sensitivity of 94.5%, PPV of 83%, and a detection rate of 78.2%. Conclusions: After arthroscopic meniscus surgery, preoperative opioid consumption had the strongest association with sustained opioid use >1 month. Intraoperative arthritis was not an independent risk factor for continued refills. A novel machine learning algorithm performed with high accuracy and predictive ability to identify patients filling additional narcotic prescriptions after surgery. [Figure: see text][Table: see text]
Poster 267: The Impact of Posterior Malleolar Fixation on Syndesmotic Stability
Authors: Bryniarski Anna , Brady Alex , Miles Jon , Dornan Grant , Radsen Jan , Fossum Bradley , Haytmanek C. Thomas , Husebye Elisabeth , Clanton Thomas , Stake Ingrid 
Published: July 2022

Objectives: Trans-syndesmotic fixation with suture buttons, posterior malleolar fixation (PMF) with screws and anterior inferior tibiofibular ligament (AITFL) augmentation with suture tape have all been suggested as potential treatments in the setting of a malleolar fracture. However, there is no consensus on the optimal treatment for small vs. large malleolar fractures. The purpose of this study was to determine which combination of: 1) posterior malleolar screw fixation, 2) syndesmotic fixation with suture button (SB), and 3) AITFL augmentation with suture tape (ST) best restored native tibio-fibular and ankle joint kinematics following a small and large posterior malleolar fracture. Methods: Twenty fresh frozen cadaveric lower leg specimens were divided into two groups and underwent biomechanical testing using a 6-degrees-of-freedom robotic arm in 7 states: 1) Native, 2) Syndesmosis Injury + Malleolar Fracture (Group 1: small fracture, Group 2: large fracture) 3) Screw fixation, 4) Screw + Suture Tape Augmentation, 5) Screw + Suture Tape Augmentation + Suture Button, 6) Suture Button + Suture Tape Augmentation, 7) Suture Button. Four biomechanical tests were performed at neutral and at 30 degrees of plantarflexion: 1) Internal Rotation, 2) External Rotation, 3) Lateral Drawer, 4) Posterior Drawer. The position of the tibia, fibula and talus were continuously recorded using a 5-camera motion capture system. Results: No differences were found in the efficacy of treatments between the small fracture and large fracture groups. In the external rotation test, screws with ST augmentation resulted in best stability of the fibula and ankle joint. In the internal rotation test, all repairs that included posterior malleolar screws stabilized the fibula and ankle. Posterior and lateral drawer of the foot resulted in only small differences between the intact and malleolar fracture states. Conclusions: Posterior malleolar fixation resulted in higher syndesmotic stability compared to trans-syndesmotic fixation with SBs. AITFL augmentation with ST provided additional external rotation stability when combined with screw fixation. Posterior malleolar screw fixation with AITFL augmentation using ST may be the preferred surgical method when treating patients with acute ankle injury involving an unstable syndesmosis injury and a posterior malleolar fragment. [Figure: see text][Figure: see text]
Green and blue spaces and lung function in the Generation XXI cohort: a life-course approach
Authors: Queiroz Almeida Diogo , Paciência Inês , Moreira Carla , Cavaleiro Rufo João , Moreira André , Santos Ana Cristina , Barros Henrique , Ribeiro Ana Isabel 
Published: July 2022

BackgroundExposure to natural environments may affect respiratory health. This study examined the association of exposure to green and blue spaces with lung function in children, and assessed the mediation effect of air pollution and physical activity.MethodsThe study used data from the Generation XXI, a population-based birth cohort from the Porto Metropolitan Area (Portugal). Residential Normalised Difference Vegetation Index (NDVI) at different buffers (100, 250 and 500 m), the accessibility to urban green spaces (UGS) within 400 and 800 m and the minimum distance to the nearest UGS and to the nearest blue spaces were assessed at birth, 4, 7 and 10 years of age. Three life-course measures were calculated: averaged exposure, early-life exposure (birth) and exposure trend over time (change in exposure). Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and forced expiratory flow between 25% and 75% of FVC (FEF25–75%) at 10 years were used as outcomes. To assess associations, linear regression models and path analysis were used.ResultsThis study included 3278 children. The adjusted models showed that increasing the NDVI exposure over time within 100 m of the child's residence was associated with higher values of FEV1(L) and FEF25–75%(L·s−1) (β 0.01, 95% CI 0.0002–0.03 and β 0.02, 95% CI 0.001–0.05, respectively). No significant associations were observed for the remaining measures of exposure, and no mediation effect was found for pollution or physical activity.ConclusionIncreasing exposure to greenness at close proximity from residences was associated with improved lung function. While the mechanism remains unknown, this study brings evidence that city greening may improve children's respiratory health.
Lung cancer occurrence after an episode of tuberculosis: a systematic review and meta-analysis
Authors: Cabrera-Sanchez Javier , Cuba Vicente , Vega Victor , Van der Stuyft Patrick , Otero Larissa 
Published: July 2022

Introduction:People with tuberculosis experience long-term health effects beyond cure, including chronic respiratory diseases. We investigated whether tuberculosis is a risk factor for subsequent lung cancer.Methods:We searched PubMed, Scopus, Cochrane, Latin American and Caribbean Health Sciences Literature and the Scientific Electronic Library Online for cohort and case–control studies providing effect estimates for the association between tuberculosis and subsequent lung cancer. We pooled estimates through random-effects meta-analysis. The study was registered in PROSPERO (CDR42020178362).Results:Out of 6240 records, we included 29 cohort and 44 case–control studies. Pooled estimates adjusted for age and smoking (assessed quantitatively) were hazard ratio (HR) 1.51 (95% CI 1.30–1.76, I2=81%; five studies) and OR 1.74 (95% CI 1.42–2.13, I2=59%; 19 studies). The occurrence of lung cancer was increased for 2 years after tuberculosis diagnosis (HR 5.01, 95% CI 3.64–6.89; two studies), but decreased thereafter. Most studies were retrospective, had moderate to high risk of bias, and did not control for passive smoking, environmental exposure and socioeconomic status. Heterogeneity was high.Conclusion:We document an association between tuberculosis and lung cancer occurrence, particularly in, but not limited to, the first 2 years after tuberculosis diagnosis. Some cancer cases may have been present at the time of tuberculosis diagnosis and therefore causality cannot be ascertained. Prospective studies controlling for key confounding factors are needed to identify which tuberculosis patients are at the highest risk, as well as cost-effective approaches to mitigate such risk.
A practice test and selection of a core set of outcome-based quality indicators in Dutch primary care physical therapy for patients with COPD: a cohort study
Authors: Verburg Arie C. , van Dulmen Simone A. , Kiers Henri , Nijhuis-van der Sanden Maria W.G. , van der Wees Philip J. 
Published: July 2022

AimTo estimate the comparability and discriminability of outcome-based quality indicators by performing a practice test in Dutch physical therapy primary care, and to select a core set of outcome-based quality indicators that are well accepted by physical therapists based on their perceived added value as a quality improvement tool.MethodsFirst, a list of potential quality indicators was defined, followed by determination of the comparability (case-mix adjusted multilevel analysis) and discriminability (intraclass correlation coefficient (ICC)). Second, focus group meetings were conducted with stakeholders (physical therapists and senior researchers) to select a core set of quality indicators.ResultsOverall, 229 physical therapists from 137 practices provided 2651 treatment episodes. Comparability: in 10 of the 11 case-mix adjusted models, the ICC increased compared with the intercept-only model. Discriminability: the ICC ranged between 0.01 and 0.34, with five of the 11 ICCs being >0.10. The majority of physical therapists in each focus group preferred the inclusion of seven quality indicators in the core set, including three process and four outcome indicators based upon the 6-min walk test (6MWT), the Clinical COPD Questionnaire (CCQ), and the determination of quadriceps strength using a hand-held dynamometer.ConclusionThis is the first study to describe the comparability and discriminability of the outcome-based quality indicators selected for patients with COPD treated in primary care physical therapy practices. Future research should focus on increasing data collection in daily practice and on the development of tangible methods to use as the core set of a quality improvement tool.
Infant tidal flow–volume parameters and arousal state
Authors: Bains Karen Eline Stensby , Färdig Martin , Gudmundsdóttir Hrefna Katrín , Almqvist Catarina , Hedlin Gunilla , Nordhagen Live S. , Rehbinder Eva M. , Skjerven Håvard O. , Söderhäll Cilla , Vettukattil Riyas , Nordlund Björn , Lødrup Carlsen Karin C. 
Published: July 2022

BackgroundInfant lung function can be assessed with tidal flow–volume (TFV) loops. While TFV loops can be measured in both awake and sleeping infants, the influence of arousal state in early infancy is not established. The aim of the present study was to determine whether TFV loop parameters in healthy infants differed while awake compared to the sleeping state at 3 months of age.MethodsFrom the population-based Scandinavian Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) birth cohort, 91 infants had reproducible TFV loops measured with Exhalyzer®D in both the awake and sleeping state at 3 months of age. The TFV loops were manually selected according to a standardised procedure. The ratio of time to peak tidal expiratory flow (tPTEF) to expiratory time (tE) and the corresponding volume ratio (VPTEF/VE), as well as tidal volume (VT) and respiratory rate were compared using nonparametric tests.ResultsThe mean (95% CI)tPTEF/tEwas significantly higher while awake compared to the sleeping state: 0.39 (0.37–0.41)versus0.28 (0.27–0.29); with the correspondingVPTEF/VEof 0.38 (0.36–0.40)versus0.29 (0.28–0.30). TheVTwas similar, while the respiratory rate was higher while awake compared to the sleeping state: 53 (51–56) breaths·min−1versus38 (36–40) breaths·min−1.ConclusionHighertPTEF/tE,VPTEF/VEand respiratory rate, but similarVTwhile awake compared to the sleeping state suggests that separate normative TFV loop values according to arousal state may be required in early infancy.