bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technology supported rehabilitation for patients of critical illness caused by COVID-19: a protocol for a mixed-methods feasibility study
Authors: Gonçalves Ana-Carolina , Leckie Todd , Hunter Alexander , Fitzpatrick Daniel , Richardson Alan , Hardy Benjamin , Koulouglioti Christina , Venn Richard , Hodgson Luke 
Published: October 2020

Background/Aims The COVID-19 pandemic has created the need for research on how to effectively rehabilitate patients who have been discharged from an intensive care unit. This study is a protocol for a mixed methods feasibility study addressing the research questions: 1) what are the needs of patients who have survived COVID-19? 2) is the use of technology feasible to support their recovery? Methods A multicentre, technology supported, rehabilitation intervention for survivors of critical illness caused by COVID-19 will be assessed. Survivors in the study population will be offered a smartwatch to monitor their activity levels and will have biopsychosocial outcome measures monitored at three time points: discharge from hospital, 2–3 months post discharge and 1 year post discharge. Semi-structured interviews will be conducted across eight hospital sites with survivors, their relatives and professionals to understand their recovery experiences. Conclusions Designed by frontline clinicians, this protocol outlines a feasibility study that will provide new knowledge on the process of recovery of critical illness caused by COVID-19.
Effect of material selection on tibial post stresses in posterior-stabilized knee prosthesis
Authors: Huang Chang-Hung , Lu Yung-Chang , Hsu Lin-I , Liau Jiann-Jong , Chang Ting-Kuo , Huang Chun-Hsiung 
Published: October 2020

Aims The material and design of knee components can have a considerable effect on the contact characteristics of the tibial post. This study aimed to analyze the stress distribution on the tibial post when using different grades of polyethylene for the tibial inserts. In addition, the contact properties of fixed-bearing and mobile-bearing inserts were evaluated. Methods Three different grades of polyethylene were compared in this study; conventional ultra high molecular weight polyethylene (UHMWPE), highly cross-linked polyethylene (HXLPE), and vitamin E-stabilized polyethylene (VEPE). In addition, tibial baseplates with a fixed-bearing and a mobile-bearing insert were evaluated to understand differences in the contact properties. The inserts were implanted in neutral alignment and with a 10° internal malrotation. The contact stress, von Mises stress, and equivalent plastic strain (PEEQ) on the tibial posts were extracted for comparison. Results The stress and strain on the tibial post for the three polyethylenes greatly increased when the insert was placed in malrotation, showing a 38% to 56% increase in von Mises stress and a 335% to 434% increase in PEEQ. The VEPE insert had the lowest PEEQ among the three materials. The mobile-bearing design exhibited a lower increase in stress and strain around the tibial posts than the fixed-bearing design. Conclusion Using VEPE for the tibial component potentially eliminates the risk of material permanent deformation. The mobile-bearing insert can help to avoid a dramatic increase in plastic strain around the tibial post in cases of malrotation. The mobility allows the pressure to be distributed on the tibial post and demonstrated lower stresses with all three polyethylenes simulated. Cite this article: Bone Joint Res 2020;9(11):768–777.
Posterior tibial slope and anterior post-cam contact can change knee kinematics in extension in bi-cruciate stabilized total knee arthroplasty
Authors: Hada Masaru , Mizu-uchi Hideki , Okazaki Ken , Murakami Koji , Kaneko Takao , Higaki Hidehiko , Nakashima Yasuharu 
Published: October 2020

Aims This study aims to investigate the effects of posterior tibial slope (PTS) on knee kinematics involved in the post-cam mechanism in bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) using computer simulation. Methods In total, 11 different PTS (0° to 10°) values were simulated to evaluate the effect of PTS on anterior post-cam contact conditions and knee kinematics in BCS TKA during weight-bearing stair climbing (from 86° to 6° of knee flexion). Knee kinematics were expressed as the lowest points of the medial and lateral femoral condyles on the surface of the tibial insert, and the anteroposterior translation of the femoral component relative to the tibial insert. Results Anterior post-cam contact in BCS TKA was observed with the knee near full extension if PTS was 6° or more. BCS TKA showed a bicondylar roll forward movement from 86° to mid-flexion, and two different patterns from mid-flexion to knee extension: screw home movement without anterior post-cam contact and bicondylar roll forward movement after anterior post-cam contact. Knee kinematics in the simulation showed similar trends to the clinical in vivo data and were almost within the range of inter-specimen variability. Conclusion Postoperative knee kinematics in BCS TKA differed according to PTS and anterior post-cam contact; in particular, anterior post-cam contact changed knee kinematics, which may affect the patient’s perception of the knee during activities. Cite this article: Bone Joint Res 2020;9(11):761–767.
A mutation in SLC20A2 (c.C1849T) promotes proliferation while inhibiting hypertrophic differentiation in ATDC5 chondrocytes
Authors: Li YiQiang , Lin XueMei , Zhu MingWei , Xun FuXing , Li JingChun , Yuan Zhe , Liu YanHan , Xu HongWen 
Published: October 2020

Aims This study aimed to investigate the effect of solute carrier family 20 member 2 ( SLC20A2) gene mutation (identified from a hereditary multiple exostoses family) on chondrocyte proliferation and differentiation. Methods ATDC5 chondrocytes were cultured in insulin-transferrin-selenium medium to induce differentiation. Cells were transfected with pcDNA3.0 plasmids with either a wild-type (WT) or mutated (MUT) SLC20A2 gene. The inorganic phosphate (Pi) concentration in the medium of cells was determined. The expression of markers of chondrocyte proliferation and differentiation, the Indian hedgehog (Ihh), and parathyroid hormone-related protein (PTHrP) pathway were evaluated by quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting. Results The expression of SLC20A2 in MUT group was similar to WT group. The Pi concentration in the medium of cells in MUT group was significantly higher than WT group, which meant the SLC20A2 mutation inhibited Pi uptake in ATDC5 chondrocytes. The proliferation rate of ATDC5 chondrocytes in MUT group was greater than WT group. The expression of aggrecan (Acan), α-1 chain of type II collagen (COL2A1), and SRY-box transcription factor 9 (SOX9) were higher in MUT group than WT group. However, the expression of Runt-related transcription factor 2 (Runx2), α-1 chain of type X collagen (COL10A1), and matrix metallopeptidase 13 (MMP13) was significantly decreased in the MUT group. Similar results were obtained by Alcian blue and Alizarin red staining. The expression of Ihh and PTHrP in MUT group was higher than WT group. An inhibitor (cyclopamine) of Ihh/PTHrP signalling pathway inhibited the proliferation and restored the differentiation of chondrocytes in MUT group. Conclusion A mutation in SLC20A2 (c.C1948T) decreases Pi uptake in ATDC5 chondrocytes. SLC20A2 mutation promotes chondrocyte proliferation while inhibiting chondrocyte differentiation. The Ihh/PTHrP signalling pathway may play an important role in this process. Cite this article: Bone Joint Res 2020;9(11):751–760.
Dead muscle tissue promotes dystrophic calcification by lowering circulating TGF-β1 level
Authors: Li La , Xiang Shiqi , Wang Bing , Lin Hang , Cao Guorui , Alexander Peter G. , Tuan Rocky S. 
Published: October 2020

AimsDystrophic calcification (DC) is the abnormal appearance of calcified deposits in degenerating tissue, often associated with injury. Extensive DC can lead to heterotopic ossification (HO), a pathological condition of ectopic bone formation. The highest rate of HO was found in combat-related blast injuries, a polytrauma condition with severe muscle injury. It has been noted that the incidence of HO significantly increased in the residual limbs of combat-injured patients if the final amputation was performed within the zone of injury compared to that which was proximal to the zone of injury. While aggressive limb salvage strategies may maximize the function of the residual limb, they may increase the possibility of retaining non-viable muscle tissue inside the body. In this study, we hypothesized that residual dead muscle tissue at the zone of injury could promote HO formation.MethodsWe tested the hypothesis by investigating the cellular and molecular consequences of implanting devitalized muscle tissue into mouse muscle pouch in the presence of muscle injury induced by cardiotoxin.ResultsOur findings showed that the presence of devitalized muscle tissue could cause a systemic decrease in circulating transforming growth factor-beta 1 (TGF-β1), which promoted DC formation following muscle injury. We further demonstrated that suppression of TGF-β signalling promoted DC in vivo, and potentiated osteogenic differentiation of muscle-derived stromal cells in vitro.ConclusionTaken together, these findings suggest that TGF-β1 may play a protective role in dead muscle tissue-induced DC, which is relevant to understanding the pathogenesis of post-traumatic HO. Cite this article: Bone Joint Res 2020;9(11):742–750.
Efficacy and safety of intrawound vancomycin in primary hip and knee arthroplasty
Authors: Xu Hong , Yang Jingli , Xie Jinwei , Huang Zeyu , Huang Qiang , Cao Guorui , Pei Fuxing 
Published: October 2020

Aims The efficacy and safety of intrawound vancomycin for preventing surgical site infection in primary hip and knee arthroplasty is uncertain. Methods A systematic review of the literature was conducted, indexed from inception to March 2020 in PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar databases. All studies evaluating the efficacy and/or safety of intrawound vancomycin in patients who underwent primary hip and knee arthroplasty were included. Incidence of periprosthetic joint infection (PJI), superficial infection, aseptic wound complications, acute kidney injury, anaphylactic reaction, and ototoxicity were meta-analyzed. Results were reported as odds ratios (ORs) and 95% confidence intervals (CIs). The quality of included studies was assessed using the risk of bias in non-randomized studies of interventions (ROBINS-I) assessment tool. Results Nine studies involving 4,607 patients were included. Intrawound vancomycin was associated with lower incidence of PJI (30 patients (1.20%) vs 58 control patients (2.75%); OR 0.44, 95% CI 0.28 to 0.69) and simultaneous acute kidney injury (four patients (0.28%) vs four control patients (0.35%), OR 0.71, 95% CI 0.19 to 2.55). However, it did not reduce risk of superficial infection (four patients (0.67%) vs six control patients (1.60%), OR 0.60, 95% CI 0.17 to 2.12) and was associated with higher incidence of aseptic wound complications (23 patients (2.15%) vs eight in control patients (0.96%), OR 2.39, 95% CI 1.09 to 5.23). Four studies reported no anaphylactic reactions and three studies reported no ototoxicity in any patient group. Conclusion The current literature suggests that intrawound vancomycin used in primary hip and knee arthroplasty may reduce incidence of PJI, but it may also increase risk of aseptic wound complications. Cite this article: Bone Joint Res 2020;9(11):778–788.
Yes, she can! Why medtech needs female innovators now more than ever
Authors: Karim JS 
Published: October 2020

The medtech sector is innovative, influential and thriving. Yet, to its detriment, the industry consistently fails to attract female talent. The following article explores the impact that gender inequality has on the development of new medical technologies and highlights why diversity must no longer be considered an aspiration but a necessity in order for the industry to reach its full potential. As the medtech sector enters a new phase of rapid growth, it has never been more vital to encourage women to participate in shaping the future of healthcare technology. Now is the time for meaningful and enduring change. Forging new paths for enduring change.
How well are women represented at orthopaedic conferences?
Authors: Krahelski O , Gallivan S , Hing CB 
Published: October 2020

Women comprise over 55% of all UK medical students, yet only 11% of orthopaedic consultants, associate specialists and higher surgical trainees are women. Gender imbalance at congresses has been noted in other specialties such as emergency medicine and intensive care. The BOA annual congress was therefore analysed to determine if similar gender disparities existed in the UK in orthopaedics. To increase the number of female role models in surgery, we need to amplify the visibility of female surgeons.
The incompetent expert: a cautionary case
Authors: Todd NV 
Published: October 2020

In court, a medical expert was asked to describe the tests by which medical experts assess duty of care for the actions or inactions of other doctors. Despite repeated questions from cross-examining counsel and the judge, the expert concluded that he did not know the test(s) to be applied. The judge rejected his evidence and the claimant lost her case. The defendant's solicitors applied for, and were granted, a wasted costs order (of £88,801.68) against the medical expert. The art of preparation for cross-examination.
Potential History: Unlearning Imperialism, Ariella Aïsha Azoulay (2019)
Authors: Fletcher Alex 
Published: October 2020

Review of: Potential History: Unlearning Imperialism, Ariella Aïsha Azoulay (2019)
London and New York: Verso, 656 pp.,
ISBN 978-1-78873-571-1, p/bk, £30.00
Evaluation of Calibration Procedures of British Pendulum Tester
Authors: Guo W. , Chu L. , Fwa T. F. 
Published: October 2020

Abstract
Like all test devices, a British pendulum tester has to be calibrated to ensure that its measurements are correct and accurate within acceptable limits. The ASTM E303 and BS EN 13036-4 standards present two established and widely followed calibration procedures for the British pendulum tester. Though similar in most aspects, there are some differences in the two calibration procedures. This study examines the impacts on British pendulum test (BPT) results of the calibration requirements of the two standards by means of a finite element BPT simulation model developed based on theories of mechanics. The simulation model is applied to analyze the range of variations in the test values of BPT devices with different operating parameter values within the allowable limits of the two standard procedures. It is found that two BPT devices both satisfying the ASTM E303 calibration requirements could produce measurements with a difference of more than 60 % of their mean test value, and for BS EN 13036-4 it is more than 25 %. It means that different BPT devices, all meeting necessary calibration and precision requirements of either of the two standards, could give different test values that might lead to different skid resistance assessments of the pavement tested. This is unsatisfactory for practical applications in skid resistance evaluation of pavements. Based on analyses of the simulation model, this study proposed revised calibration limits to achieve more acceptable magnitudes of differences between the measurements made by different BPT devices.
Modeling the Yield Strength of an A356 Aluminum Alloy during the Aging Process
Authors: Guo Guannan , Wang Qigui , Rong Yiming , Sisson Richard D. 
Published: October 2020

Abstract
The wide applications and continuously developing manufacturing methods of heat-treatable aluminum alloys require accurate and efficient precipitate hardening models to predict the microstructure behaviors response to the aging process. The current article proposed a modified precipitate hardening model of A356 aluminum alloy used for engine block. In terms of the microstructure parameters of β” as the primary strengthening phase, the relative volume fraction is studied and modified because of the phase transformation in aging process. The proposed model successfully predicts the yield strength at underaged aging process in the temperature range of 150°C∼170°C after considering the impact of coexist precipitate phases such as β’ phase. After the modification, the deviation between the yield strengths at low temperature and high temperature was greatly eliminated. This successful modification draws attention to the precipitate phase volume fraction in the research of the precipitate hardening model. The composition of the precipitate phase and interactive transformation when altering the aging process parameters has a significant impact on the yield strength behaviors in the aging process.
CREB Coactivator CRTC2 Plays a Crucial Role in Endothelial Function
Authors: Kanki Hideaki , Sasaki Tsutomu , Matsumura Shigenobu , Kawano Tomohiro , Todo Kenichi , Okazaki Shuhei , Nishiyama Kumiko , Takemori Hiroshi , Mochizuki Hideki 
Published: October 2020

The cAMP pathway is known to stabilize endothelial barrier function and maintain vascular physiology. The family of cAMP-response element binding (CREB)-regulated transcription coactivators (CRTC)1–3 activate transcription by targeting the basic leucine zipper domain of CREB. CRTC2 is a master regulator of glucose metabolism in liver and adipose tissue. However, the role of CRTC2 in endothelium remains unknown. The aim of this study was to evaluate the effect of CRTC2 on endothelial function. We focused the effect of CRTC2 in endothelial cells and its relationship with p190RhoGAP-A. We examined the effect of CRTC2 on endothelial function using a mouse aorta ring assayex vivoand with photothrombotic stroke in endothelial cell-specific CRTC2-knock-out male micein vivo. CRTC2 was highly expressed in endothelial cells and related to angiogenesis. Among CRTC1–3, only CRTC2 was activated under ischemic conditions at endothelial cells, and CRTC2 maintained endothelial barrier function through p190RhoGAP-A expression. Ser171was a pivotal regulatory site for CRTC2 intracellular localization, and Ser307functioned as a crucial phosphorylation site. Endothelial cell-specific CRTC2-knock-out mice showed reduced angiogenesisex vivo, exacerbated stroke via endothelial dysfunction, and impaired neurologic recovery via reduced vascular bedsin vivo. These findings suggest that CRTC2 plays a crucial protective role in vascular integrity of the endothelium via p190RhoGAP-A under ischemic conditions.SIGNIFICANCE STATEMENTPreviously, the role of CRTC2 in endothelial cells was unknown. In this study, we firstly clarified that CRTC2 was expressed in endothelial cells and among CRTC1–3, only CRTC2 was related to endothelial function. Most importantly, only CRTC2 was activated under ischemic conditions at endothelial cells and maintained endothelial barrier function through p190RhoGAP-A expression. Ser307in CRTC2 functioned as a crucial phosphorylation site. Endothelial cell-specific CRTC2-knock-out mice showed reduced angiogenesisex vivo, exacerbated stroke via endothelial dysfunction, and impaired neurologic recovery via reduced vascular bedsin vivo. These results suggested that CRTC2 maybe a potential therapeutic target for reducing blood–brain barrier (BBB) damage and improving recovery.
The Notch Ligand Jagged1 Is Required for the Formation, Maintenance, and Survival of Hensen's Cells in the Mouse Cochlea
Authors: Chrysostomou Elena , Zhou Luyi , Darcy Yuanzhao L. , Graves Kaley A. , Doetzlhofer Angelika , Cox Brandon C. 
Published: October 2020

During cochlear development, the Notch ligand JAGGED 1 (JAG1) plays an important role in the specification of the prosensory region, which gives rise to sound-sensing hair cells and neighboring supporting cells (SCs). While JAG1's expression is maintained in SCs through adulthood, the function of JAG1 in SC development is unknown. Here, we demonstrate that JAG1 is essential for the formation and maintenance of Hensen's cells, a highly specialized SC subtype located at the edge of the auditory epithelium. UsingSox2CreERT2/+::Jag1loxP/loxPmice of both genders, we show thatJag1deletion at the onset of differentiation, at embryonic day 14.5, disrupted Hensen's cell formation. Similar loss of Hensen's cells was observed whenJag1was deleted after Hensen's cell formation at postnatal day (P) 0/P1 and fate-mapping analysis revealed that in the absence ofJag1, some Hensen's cells die, but others convert into neighboring Claudius cells. In support of a role for JAG1 in cell survival, genes involved in mitochondrial function and protein synthesis were downregulated in the sensory epithelium of P0 cochlea lackingJag1. Finally, usingFgfr3-iCreERT2::Jag1loxP/loxPmice to deleteJag1at P0, we observed a similar loss of Hensen's cells and found that adultJag1mutant mice have hearing deficits at the low-frequency range.SIGNIFICANCE STATEMENTHensen's cells play an essential role in the development and homeostasis of the cochlea. Defects in the biophysical or functional properties of Hensen's cells have been linked to auditory dysfunction and hearing loss. Despite their importance, surprisingly little is known about the molecular mechanisms that guide their development. Morphologic and fate-mapping analyses in our study revealed that, in the absence of the Notch ligand JAGGED1, Hensen's cells died or converted into Claudius cells, which are specialized epithelium-like cells outside the sensory epithelium. Confirming a link between JAGGED1 and cell survival, transcriptional profiling showed that JAGGED1 maintains genes critical for mitochondrial function and tissue homeostasis. Finally, auditory phenotyping revealed that JAGGED1's function in supporting cells is necessary for low-frequency hearing.