Outcomes of bone-patellar tendon-bone autograft and quadriceps tendon autograft for ACL reconstruction in an all-female soccer player cohort with mean 4.8-year follow up.

OBJECTIVE: The purpose is to compare functional outcomes, return to soccer rates, and revision rates in an all-female soccer player cohort undergoing quadriceps tendon (QT) autograft ACLR versus bone-patellar tendon-bone (BPTB) autograft ACLR. METHODS: Female soccer players who sustained an ACL rupture and underwent primary anatomic, single-bundle ACLR with BPTB autograft or QT autograft were included. Demographic and surgical characteristics were collected. Outcomes of interest included Tegner score, International Knee Documentation Committee (IKDC) score, Marx score, return to soccer rates, and failure rates. RESULTS: Data on 23 patients undergoing BPTB autograft ACLR and 14 undergoing QT autograft ACLR was available. Average age was 18.7 years, and average follow up was 4.8 years. Overall, 76 â€‹% (28/37) returned to soccer and 5.4 â€‹% (2/37) underwent revision ACLR. No major significant differences were found in demographic or surgical characteristics. No differences were found in postoperative IKDC scores, preoperative, postoperative, or change from pre-to postoperative Marx activity scores, or pre-and postoperative Tegner scores between the groups. QT autograft ACLR patients had significantly less change in Tegner scores pre-to postoperatively compared to the BTPB autograft ACLR group (0.6 â€‹± â€‹1.2 versus 2.1 â€‹± â€‹1.8; p â€‹= â€‹0.02). Both groups had similar rates of return to soccer [78 â€‹% (18/23) BPTB autograft ACLR versus 71 â€‹% (10/14) QT autograft ACLR; p â€‹= â€‹0.64] and rates of revision (8.7 % (2/23) BPTB autograft ACLR; 0 % (0/14) QT autograft ACLR. CONCLUSION: Results of this study suggest that BPTB autograft ACLR and QT autograft ACLR produce comparable, successful functional and return to soccer outcomes in this all-female soccer player cohort study. Larger, prospective studies are needed to improve the strength of conclusions and provide more information on the optimal graft choice for female soccer players. Surgeons can use the results of this study to counsel female soccer players on expected outcomes after ACLR. LEVEL OF EVIDENCE: III.

Barriers to Bariatric Surgery: a Mixed Methods Study Investigating Obstacles Between Clinic Contact and Surgery.

PURPOSE: Populations most affected by obesity are not reflected in the patients who undergo bariatric surgery. Gaps in the referral system have been studied, but there is a lack of literature investigating obstacles patients encounter after first contact with bariatric surgery clinics. We aim to identify patient populations at risk for attrition during bariatric surgery evaluation and determine patient reported barriers to bariatric surgical care. MATERIALS AND METHODS: This study was a single institution, retrospective, mixed methods study from 2012 to 2021 comparing patients who underwent bariatric surgery to those that withdrew. Surveys were performed of patients who withdrew, collecting information on patient knowledge, expectations, and barriers. RESULTS: This study included 5982 patients evaluated in bariatric surgery clinic. Those who attained bariatric surgery (38.8%) were more likely to be White (81.2 vs. 75.6%, p<0.001), married (48.5 vs. 44.1%, p=0.004), and employed full time (48.2 vs. 43.8%, p=0.01). They were less likely to live in an area with low income (37.1 vs. 40.7%, p=0.01) or poverty (poverty rate 15.8 vs. 17.4, p<0.001). Of the 280 survey respondents, fear of complications, length of insurance approval process, and wait time between evaluation and surgery were the most reported barriers. CONCLUSION: Patients who undergo bariatric surgery were more likely to be White, married, employed full time, and reside in more resourced environments which is not reflective of communities most affected by obesity. The complexity of insurance coverage requirements was a major barrier to bariatric surgery and should be a focus of future healthcare reform.

Using Geopandas for locating virtual stations in a free-floating bike sharing system.

Free-floating bike-sharing systems can have a positive influence on the mobility of urban centers and developing efficient localization strategies is crucial to avoid crowding at peak times and increase service availability. Our study aims to efficiently resolve the location of virtual bike stations in a Latin American city through a geospatial data wrangling methodology that allows us to respond opportunely to the potential demand forecasted for the city. This approach is implemented in Python, and it uses the Geopandas and LocalSolver libraries to determine locations for the virtual bike stations that maximize the system coverage. The decision-making process is supported by a binary integer mathematical programming model, and the instances are built from intercity travel surveys that provide realistic data based on travel demand. The developed decision support system prototype provides a recommendation about where virtual bike stations should be located during peak hours and improve general availability by more than 37%. Moreover, when the system's users participate in the relocation of bicycles, the model can eliminate up to 80% of the CO2 emissions and nearly 50% of the operational costs associated with the relocation process.

Millennial research on fleek: Suggestions for improving generational research design.

This special issue will examine and embrace the uniqueness of millennials. We look at a number of issues related to this generational cohort, examining what makes them unique, challenging and even assets to those they come into contact with in their lives. In our opening article we discuss the unique attributes of millennials, provide researchers a framework for generational research best practices, and provide an overview of the articles featured in this special issue.

A comparison of coping factors in Western and non-Western cultures.

This study presents convergent support for the use of three empirically constructed factors, across four samples, from the Ways of Coping Questionnaire. Planning, Positive Reappraisal, and Distancing factors were congruent for comparisons made between U.S. healthcare workers, Chinese healthcare workers, Chinese teachers, and Taiwanese teachers. Additional evidence of congruency was provided on specific factors between specific pairs of groups. The results support the usage of common factors across languages, cultures, and occupational groups but also highlight the importance of not administering a test in a different cultural setting without assessing its dimensionality.