bluuebunny/crossref_metadata_2025_split huggingface dataset:
Windswept deformities of the knee are challenging to manage
Authors: Babu Suresh , Vaish Abhishek , Vaishya Raju 
Published: August 2020

Abstract
Background
Little has been published about TKA in windswept deformities of the knees where combined varus and valgus deformities present in the same patient. Windswept deformities present with unique problems and must be addressed as two halves of a complex entity. Through this review we aim to understand the interrelation between the deformities, examine outcomes following simultaneous bilateral total knee arthroplasty in windswept deformities, and develop an algorithm for the management of windswept deformities by total knee arthroplasty.

Methods
An extensive online literature search for the keywords yielded 31 articles on which we based our review. Articles were analyzed in context to our research questions and are presented in a tabular format for quick reference and a better perspective.

Results
The abnormal biomechanics and force moment of the knee cause progressive arthritis of the knee. The valgus deformity usually precedes a varus deformity on the contralateral knee in windswept deformities. Correct restoration of mechanical tibiofemoral angles by individualizing valgus correction angles have better outcomes after TKA.

Conclusion
A well-planned and judiciously executed simultaneous bilateral total knee replacement can offer distinct advantages to the patient and surgeon and provides optimum utilization of time and resources in the management of windswept knees.
Demographics, clinical characteristics, and outcomes among hospitalized heart failure patients across different regions of Egypt
Authors: Hassanin Ahmed , Hassanein Mahmoud , Bendary Ahmed , Maksoud Madiha Abdel 
Published: August 2020

Abstract
Background
Regional level data on hospitalized heart failure (HHF) patients in Egypt is scarce. The aim of this study was to compare the demographics, clinical characteristics, and outcomes of HHF patients from four distinct geographical regions of Egypt.

Results
Study participants were part of the European Society of Cardiology Heart Failure Long Term (ESC-HF-LT) Registry, which enrolled patients from April 2011 to February 2014. A total of 1661 HHF patients from Egypt were enrolled, of whom 1645 were eligible for analysis: 914 from Alexandria, 249 from Cairo, 409 from the Delta region, and 73 from Upper Egypt.
The mean age ranged from 52.2 to 62.8 years and differed significantly between the 4 groups (P < 0.01). Females represented one-third of the cohort (P = 0.5 between groups). The prevalence of obesity, diabetes, and hypertension also varied significantly across the groups (P < 0.01). The most common etiology of heart failure (HF) was ischemic heart disease. HF with reduced systolic function was the leading type of HF in the 4 groups (P = 0.6). The most common valvular abnormality in all regions was mitral regurgitation. For patients with prior history of HF, community-acquired infection was the most common reason for a HF exacerbation in all 4 groups.
In-hospital mortality ranged from 2.9 to 7.7% in the 4 groups (P = 0.06). Only Alexandria and Delta groups provided reliable 1-year follow-up data, given low patient retention in Cairo and Upper Egypt groups. At one-year, 32% of patients from Alexandria compared to 22.6% from Delta were re-hospitalized for HF (P < 0.01). Mortality at 1 year was also significantly higher in Alexandria compared to Delta, 31.8 vs 13.2% respectively (P < 0.01).

Conclusions
HHF patients from different geographic regions of Egypt differed significantly in their demographics, clinical characteristics, and outcomes. Those differences underscore the importance of region-specific HF prevention and management strategies.
Prevalence and predictors of burnout syndrome, post-traumatic stress disorder, depression, and anxiety in nursing staff in various departments
Authors: Hamed Rania A. , Abd Elaziz Shaimaa Y. , Ahmed Amani S. 
Published: August 2020

Abstract
Background
Hospital settings are a highly challenging work environment because of the increased demands of most of the works assigned to do, changes in the everyday routine of work, unreasonable expectations of patients and their relatives, and serious legal and death problems. Nurses experience stress due to work exhaustion that makes them vulnerable to many psychiatric disorders. This study aimed to assess the prevalence of burnout syndrome, post-traumatic stress disorder, depression, and anxiety in nursing group and their possible risk factors. A cross-sectional study was conducted among 181 nurses working at Al Zahraa University Hospital, Cairo, Egypt; the sociodemographic characteristics and occupational data were collected and Hospital Anxiety Depression Scale, Davidson Trauma Scale, Maslach Burnout Inventory, and Proactive Coping Inventory were completed.

Results
Psychiatric symptoms were prevalent among nurses, 79% were positive for depression and 64.6% were positive for anxiety. The prevalence of post-traumatic stress disorder was 19.9%, while 87.8% of nurses were positive for burnout syndrome and had symptoms for at least one of the 3 types of burnout syndrome: 73.5% for emotional exhaustion, 61.9% for depersonalization, and 68.5% for personal accomplishment. Eighty-six percent of nurses who had post-traumatic stress disorder were also positive for burnout syndrome. ICU nurses had 100% emotional exhaustion symptoms compared with other departments; lack of use of different coping approach towards stressors at work and work experience was risk factors of burnout syndrome.

Conclusion
Burnout syndrome, post-traumatic stress disorder, depression, and anxiety were common in a wide group of nurses; the development of health educational program for nurses about different coping strategies to face stressors and conflicts at work is mandatory.
Thyroid Hormone Induces DNA Demethylation in Xenopus Tadpole Brain
Authors: Raj Samhitha , Kyono Yasuhiro , Sifuentes Christopher J , Arellanes-Licea Elvira del Carmen , Subramani Arasakumar , Denver Robert J 
Published: August 2020

Abstract
Thyroid hormone (T3) plays pivotal roles in vertebrate development, acting via nuclear T3 receptors (TRs) that regulate gene transcription by promoting post-translational modifications to histones. Methylation of cytosine residues in deoxyribonucleic acid (DNA) also modulates gene transcription, and our recent finding of predominant DNA demethylation in the brain of Xenopus tadpoles at metamorphosis, a T3-dependent developmental process, caused us to hypothesize that T3 induces these changes in vivo. Treatment of premetamorphic tadpoles with T3 for 24 or 48 hours increased immunoreactivity in several brain regions for the DNA demethylation intermediates 5-hydroxymethylcytosine (5-hmC) and 5-carboxylcytosine, and the methylcytosine dioxygenase ten-eleven translocation 3 (TET3). Thyroid hormone treatment induced locus-specific DNA demethylation in proximity to known T3 response elements within the DNA methyltransferase 3a and Krüppel-like factor 9 genes, analyzed by 5-hmC immunoprecipitation and methylation sensitive restriction enzyme digest. Chromatin-immunoprecipitation (ChIP) assay showed that T3 induced TET3 recruitment to these loci. Furthermore, the messenger ribonucleic acid for several genes encoding DNA demethylation enzymes were induced by T3 in a time-dependent manner in tadpole brain. A TR ChIP-sequencing experiment identified putative TR binding sites at several of these genes, and we provide multiple lines of evidence to support that tet2 contains a bona fide T3 response element. Our findings show that T3 can promote DNA demethylation in developing tadpole brain, in part by promoting TET3 recruitment to discrete genomic regions, and by inducing genes that encode DNA demethylation enzymes.
Investigating the NPY/AgRP/GABA to GnRH Neuron Circuit in Prenatally Androgenized PCOS-Like Mice
Authors: Marshall Christopher J , Prescott Melanie , Campbell Rebecca E 
Published: August 2020

Abstract
Polycystic ovary syndrome (PCOS), the most common form of anovulatory infertility, is associated with altered signaling within the hormone-sensitive neuronal network that regulates gonadotropin-releasing hormone (GnRH) neurons, leading to a pathological increase in GnRH secretion. Circuit remodeling is evident between GABAergic neurons in the arcuate nucleus (ARN) and GnRH neurons in a murine model of PCOS. One-third of ARN GABA neurons co-express neuropeptide Y (NPY), which has a known yet complex role in regulating GnRH neurons and reproductive function. Here, we investigated whether the NPY-expressing subpopulation (NPYARN) of ARN GABA neurons (GABAARN) is also affected in prenatally androgenized (PNA) PCOS-like NPYARN reporter mice [Agouti-related protein (AgRP)-Cre;τGFP]. PCOS-like mice and controls were generated by exposure to di-hydrotestosterone or vehicle (VEH) in late gestation. τGFP-expressing NPYARN neuron fiber appositions with GnRH neurons and gonadal steroid hormone receptor expression in τGFP-expressing NPYARN neurons were assessed using confocal microscopy. Although GnRH neurons received abundant close contacts from τGFP-expressing NPYARN neuron fibers, the number and density of putative inputs was not affected by prenatal androgen excess. NPYARN neurons did not co-express progesterone receptor or estrogen receptor α in either PNA or VEH mice. However, the proportion of NPYARN neurons co-expressing the androgen receptor was significantly elevated in PNA mice. Therefore, NPYARN neurons are not remodeled by prenatal androgen excess like the wider GABAARN population, indicating GABA-to-GnRH neuron circuit remodeling occurs in a presently unidentified non-NPY/AgRP population of GABAARN neurons. NPYARN neurons do, however, show independent changes in the form of elevated androgen sensitivity.
Sudden Cardiac Arrest in a Patient With Myxedema Coma and COVID-19
Authors: Dixit Neal M , Truong Katie P , Rabadia Soniya V , Li David , Srivastava Pratyaksh K , Mosaferi Tina , Calfon Press Marcella A , Donangelo Ines , Kelesidis Theodoros 
Published: August 2020

Abstract
SARS-CoV-2 infection is associated with significant lung and cardiac morbidity but there is a limited understanding of the endocrine manifestations of coronavirus disease 2019 (COVID-19). Although thyrotoxicosis due to subacute thyroiditis has been reported in COVID-19, it is unknown whether SARS-CoV-2 infection can also lead to decompensated hypothyroidism. We present the first case of myxedema coma (MC) in COVID-19 and we discuss how SARS-CoV-2 may have precipitated multiorgan damage and sudden cardiac arrest in our patient.
A 69-year-old woman with a history of small cell lung cancer presented with hypothermia, hypotension, decreased respiratory rate, and a Glasgow Coma Scale score of 5. The patient was intubated and administered vasopressors. Laboratory investigation showed elevated thyrotropin, very low free thyroxine, elevated thyroid peroxidase antibody, and markedly elevated inflammatory markers. SARS-CoV-2 test was positive. Computed tomography showed pulmonary embolism and peripheral ground-glass opacities in the lungs. The patient was diagnosed with myxedema coma with concomitant COVID-19. While treatment with intravenous hydrocortisone and levothyroxine were begun the patient developed a junctional escape rhythm. Eight minutes later, the patient became pulseless and was eventually resuscitated. Echocardiogram following the arrest showed evidence of right heart dysfunction. She died 2 days later of multiorgan failure. This is the first report of SARS-CoV-2 infection with MC. Sudden cardiac arrest likely resulted from the presence of viral pneumonia, cardiac arrhythmia, pulmonary emboli, and MC—all of which were associated with the patient’s SARS-CoV-2 infection.
A cost-effectiveness assessment of dual-mobility bearings in revision hip arthroplasty
Authors: Khoshbin Amir , Haddad Fares S. , Ward Sarah , O hEireamhoin S. , Wu James , Nherera Leo , Atrey Amit 
Published: August 2020

AimsThe rate of dislocation when traditional single bearing implants are used in revision total hip arthroplasty (THA) has been reported to be between 8% and 10%. The use of dual mobility bearings can reduce this risk to between 0.5% and 2%. Dual mobility bearings are more expensive, and it is not clear if the additional clinical benefits constitute value for money for the payers. We aimed to estimate the cost-effectiveness of dual mobility compared with single bearings for patients undergoing revision THA.MethodsWe developed a Markov model to estimate the expected cost and benefits of dual mobility compared with single bearing implants in patients undergoing revision THA. The rates of revision and further revision were calculated from the National Joint Registry of England and Wales, while rates of transition from one health state to another were estimated from the literature, and the data were stratified by sex and age. Implant and healthcare costs were estimated from local procurement prices and national tariffs. Quality-adjusted life-years (QALYs) were calculated using published utility estimates for patients undergoing THA.ResultsAt a minimum five-year follow-up, the use of dual mobility was cost-effective with an estimated incremental cost-effectiveness ratio (ICER) of between £3,006 and £18,745/QALY for patients aged < 55 years and between 64 and 75 years, respectively. For those aged > 75 years dual mobility was only cost-effective if the timeline was beyond seven years. The use of dual mobility bearings was cost-saving for patients aged < 75 years and cost-effective for those aged > 75 years if the time horizon was beyond ten years.ConclusionThe use of dual mobility bearings is cost-effective compared with single bearings in patients undergoing revision THA. The younger the patient is, the more likely it is that a dual mobility bearing can be more cost-effective and even cost-saving. The results are affected by the time horizon and cost of bearings for those aged > 75 years. For patients aged > 75 years, the surgeon must decide whether the use of a dual mobility bearing is a viable economic and clinical option. Cite this article: Bone Joint J 2020;102-B(9):1128–1135.
La boca de Pantagruel: una imatge de Rabelais heretada de la ficció llucianesca
Authors: Solé Gimeno David 
Published: August 2020

Llucià de Samòsata influí destacablement en diversos autors del Renaixement com François Rabelais. El metge francès sabé extreure del polèmic escriptor de la Segona Sofística tota la seva essència més satírica i mordaç així com també l’afició (sempre amb un rerefons crític) a les narracions de viatges. Una de les analogies que, en aquest darrer aspecte, evidencien estudiosos de l’obra del francès i del de Samòsata és la que existeix entre la descripció de l’interior de la boca del gegant Pantagruel en el seu Gargantua i Pantagruel i la de la balena que habiten els protagonistes dels Relats Verídics. El propòsit d’aquest article consisteix a analitzar els paral·lels entre ambdós episodis, tot justificant com Rabelais fa efectiva una vívida ficció amb l’ús de diversos procediments heretats de Llucià.
Complementary photonic crystal integrated logic devices
Authors: Pedraza Caballero Luis , Povinelli Michelle L. , Ramirez Jhonattan C. , Guimarães Paulo S. S. , Vilela Neto Omar P. 
Published: August 2020

We theoretically propose and demonstrate through numerous simulations complementary photonic crystal integrated logic (CPCL) devices. Simulation results provide demonstration of a highly efficient clock rate, higher than 20 GHz, guaranteeing operation at both input and output with the same wavelength (around

λ
=
1550

n
m

). The proposed devices show well-defined output power values representing the two logic states 1 and 0, with a contrast ratio as high as 6 dB. The results presented here provide countless possibilities for future research, targeting the development of photonic crystal logic and communications systems with CPCLs acting as the core hardware devices.
Perfect Laguerre–Gauss beams
Authors: Mendoza-Hernández Job , Hidalgo-Aguirre Maribel , Inclán Ladino Adriana , Lopez-Mago Dorilian 
Published: August 2020

Perfect vortex beams (PVBs) have intensity distributions independent of their topological charges. We propose an alternative formulation to generate PVBs through Laguerre–Gauss beams (LGBs). Using the connection between Bessel and LGBs, we formulate a modified LGB that mimics the features of a PVB, the perfect LGB (PLGB). The PLGB is closer to the ideal PVB, maintaining a quasi-constant ring radius and width. Furthermore, its number of rings can be augmented with the order of the Laguerre polynomial, showing an outer ring independent of the topological charge. Since the PLGB comprises a paraxial solution, it is closely related to an experimental realization, e.g., using spatial light modulators [Phys. Rev. A 100, 053847 (2019)PLRAAN1050-294710.1103/PhysRevA.100.053847].
Fast Brillouin optical time-domain reflectometry using the optical chirp chain reference wave
Authors: Ba Dexin , Wang Benzhang , Li Tianfu , Li Yijia , Zhou Dengwang , Dong Yongkang 
Published: August 2020

A new technique for the fast implementation of Brillouin optical time-domain reflectometry has been proposed and demonstrated with the optical chirp chain (OCC) reference wave. By using the fixed bandpass filter and envelope detection, the spontaneous Brillouin spectrum can be online demodulated in the time domain for truly distributed, one-end access and fast measurement. The measurement time is only limited by the pulse repetition rate and averaging times. For a 400 m single-mode fiber, a

31.58

H
z

strain vibration on a 2 m fiber segment is measured for a wide dynamic range (

∼

3200

µ
ε

) with an equivalent sampling rate of

200

H
z

when 200 times of averaging is performed. Furthermore, the performance on the measurement accuracy is investigated with different OCC frequency spans and durations.
Anomalous bi-directional scanning electro-optic KTN devices with UV-assisted electron and hole injections
Authors: Chen Chang-Jiang , Shang Annan , Lee Yun Goo , Chao Ju-Hung , Liu Ruijia , Yin Shizhuo , Hoffman Robert C. 
Published: August 2020

In this Letter, we reported anomalous electro-optic potassium tantalate niobate (KTN) devices, in which both electrons and holes were injected into the KTN crystal via ultraviolet (UV) illumination-assisted charge injection. This could not only significantly enhance the performance of electro-optic devices (e.g., a 270% increase in the deflection angle in terms of the KTN deflector) but also enable the new bi-directional scanning capability. The results in this work would be very useful for a variety of devices and applications, such as electro-optic based vari-focal lenses.
KIBRIS MESELESİ, “DAVA”DAN “SORUN”A: BİR DIŞ POLİTİKA SORUNUNUN SÖYLEMSEL VE ANLATIBİLİMSEL ÇÖZÜMLEMESİ
Authors: ŞENCAN GÜRTUNCA Evrim 
Published: August 2020

Bu çalışma, anlatıbilim yönteminden yararlanılarak, Kıbrıs meselesinin doğuşunu, davadan soruna dönüşüm sürecini ve durumun kamuoyuna yansımasını çözümlemektedir. Çalışma, Ada yönetiminin İngiltere’ye geçici devri (1878) ve Kıbrıs Barış Harekâtı (1974) arası dönemi kapsamaktadır. Bir yeniden yapılandırma olan bu çalışmanın özgün tarafı, Kıbrıs konusunun, söylemlerin analiziyle değerlendirilmesidir.
Anlatıbilim, belli bir mekân ve zamanda geçen bir olay örgüsünün, dönemin aktörlerinin söylemleri üzerinden analiz edilmesidir. Yönteme uygun olarak, dönemin Kıbrıs gazeteleri, basın bültenleri ve raporları, Girne Millî Arşivi ve Lefkoşa Millî Kütüphanesi arşivinden taranmış ve kendi dönemlerine damga vuran siyasî aktörlerinin söylemleri tespit edilmiştir. Bu verilerle, Ada’da yaşayan iki halk (Türkler ve Rumlar) arasında cereyan eden olaylar ve Türkiye, Yunanistan ve İngiltere’nin duruma müdahale süreçleri değerlendirmeye alınmıştır.
Sonuçta, ülkelerin Kıbrıs meselesini farklı değerlendirdiği; konunun, Kıbrıs Türkleri için bir mücadele olduğu, Yunanistan ve Rumlar için bir mesele olduğu, Türkiye için millî bir dava olduğu, uluslararası platformda ise sorun olarak görüldüğü tespit edilmiştir.
Strategic Assumptions for The Success of Coal Mining Reclamation to be A Tourism Site; A Case Study in Rantau Pandan Village of Bungo Regency
Authors: Daulay Asnelly Ridha 
Published: August 2020

Bad practice of open coal mining in Bungo Regency leaves many abandoned ponds. One pond in Rantau Pandan Village has been neglected for 5 years. Its environmental and social impacts pushed people to sue the government to revoke the permit of XXX Company that manages the mining. The low price of coal as well as the deep and large area to be piled make more difficult to do reclamation. This study aims at exploring the prospect of doing reclamation for tourism purposes with the concept of Community Based Tourism (CBT) and analyzing some strategic assumptions for the success that of reclamation. Primary data were collected through observation, interview and focus group discussion. Data were analyzed descriptively and qualitatively using Strategic Assumption Surfacing and Testing (SAST) method. Research finding shows that the people are eager to welcome the idea of CBT however the compensation from the mining company should be paid first. Of 22 assumptions for the development of tourism village, 18 assumptions can be grouped into quadrant II or Certain Planning Region, while 4 assumptions are in quadrant IV or Problematic Planning Region. To support this plan, it’s suggested five things i.e. resolving the social conflict among parties, strengthening the local institution, giving a mandate to villagers to manage the pond as a tourism site, then followed by supervising and enhance infrastructure to ease access.
Analisis Sebaran Parameter Kualitas Air dan Indeks Pencemaran di Perairan Teluk Parepare-Sulawesi Selatan
Authors: Handiani Dian Noor , Heriati Aida 
Published: August 2020

Teluk Parepare di Sulawesi Selatan merupakan kawasan dengan aktivitas pelabuhan penumpang dan kargo, serta perikanan yang produktif. Aktifitas ini berdampak terhadap ekologi di perairan tersebut. Pesisir dan laut secara ekologi memiliki fungsi penting bagi kehidupan manusia. Salah satunya fungsi siklus biogeokimia dari buangan limbah yang masuk ke perairan tersebut. Akan tetapi, kebermanfaatan ini hendaknya tidak melebihi kapasitas ekologinya dalam menerima suatu jumlah limbah. Jika berlebih, maka akan terjadi kerusakan lingkungan dan kesehatan yang sulit ditoleransi. Kondisi ini mempersulit perairan tersebut untuk mewujudkan pembangunan berkelanjutan dan berkesesuaian dengan lingkungan. Penelitian ini bertujuan menganalisis sebaran spasial parameter kualitas air laut dan indeks pencemaran di perairan Teluk Parepare, serta sebagai upaya membantu pemerintah setempat melakukan pengawasan dan pengendalian pencemaran di perairan tersebut. Penelitian ini memanfaatkan hasil pengukuran in situ enam parameter (suhu, salinitas, pH, ammonia, timbal dan tembaga) di 28 stasiun pengamatan. Parameter tersebut mencakup baku mutu peruntukkan wilayah pelabuhan dan mengingat di kawasan tersebut terdapat juga aktivitas kilang minyak. Sebaran spasial parameter kualitas perairan merupakan hasil interpolasi dengan metode Inverse Distance Weighted (IDW) dari hasil pengukuran lapangan dan dihitung indeks pencemarannya. Hasil menunjukkan sebaran suhu, salinitas, ammonia, dan pH terlarut berkesesuaian dengan baku mutu, sedangkan konsentrasi timbal dan tembaga (logam berat) berada di atas baku mutu. Indeks pencemaran (IP) menghasilkan nilai antara 1,69–38,66. Nilai IP diklasifikasikan menjadi indeks cemar ringan di 14 stasiun pengamatan dan sebaran cemar ringan dominan di Teluk Parepare bagian dalam. Indeks cemar sedang terdapat di 12 stasiun pengamatan dan sebarannya di Teluk Parepare bagian luar, sedangkan cemar berat terdapat di 2 stasiun dan sebarannya di sekitar pesisir Kota Parepare. Kondisi ini menunjukkan bahwa parameter logam berat (seperti timbal dan tembaga) telah melebihi baku mutu dan berkaitan dengan berbagai kegiatan pelabuhan, serta perkapalan di sekitar perairan Teluk Parepare.