bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Aseptic Loosening After Total Knee Arthroplasty with a Rotating-Hinge Implant
Authors: Levent Ali , Suero Eduardo M. , Gehrke Thorsten , Citak Mustafa 
Published: December 2020

Background:
Successful results have been reported in association with the use of a rotating-hinge prosthesis for primary total knee arthroplasty (TKA). The objective of the present study was to identify risk factors for aseptic loosening in patients who underwent primary TKA with rotating-hinge knee prostheses.

Methods:
The records of 1,235 patients who underwent primary TKA with a rotating-hinge prosthesis at our center were evaluated. A total of 125 patients who underwent revision were further evaluated according to the inclusion and exclusion criteria, and 33 patients who underwent revision because of aseptic loosening were then compared with a group of 30 patients who did not require revision surgery. All data, including radiographic measurements, were obtained from records prior to the primary TKA.

Results:
On the basis of our review of demographic, anthropometric, clinical, surgical, and radiographic findings, we found that higher body mass index (BMI) was associated with revision. The majority of patients with aseptic loosening had loosening of the femoral component. Furthermore, the inner femoral diameter at 20 cm proximal to the knee joint (on both anteroposterior and lateral images) was found to be predictive of revision among those with aseptic loosening. Receiver operating characteristic curve analysis showed that an inner diameter of the femur of >19 mm on anteroposterior images had a sensitivity of 91% and specificity of 87% for predicting the need for revision surgery in patients with aseptic loosening.

Conclusions:
This is one of few studies that has focused on determining risk factors for the failure of rotating-hinge prostheses following TKA surgery. Our findings indicate that a novel variable, the inner (diaphyseal) diameter of the femur at the point 20 cm proximal to the knee joint, is an extremely reliable predictor of revision surgery in patients with aseptic loosening.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Bilateral Simultaneous Total Knee Arthroplasty May Not Be Safe Even in the Healthiest Patients
Authors: Warren Jared A. , Siddiqi Ahmed , Krebs Viktor E. , Molloy Robert , Higuera Carlos A. , Piuzzi Nicolas S. 
Published: December 2020

Background:
Bilateral total knee arthroplasty (TKA) has been shown to increase both mortality and complications, but has potential benefits including decreased length of stay, rehabilitation time, and costs. The purpose of this study was to use data from a nationally representative database to identify if there is a population of patients undergoing TKA in whom bilateral TKA can be safely performed, by comparing 30-day mortality and complication rates with those of patients undergoing unilateral TKA.

Methods:
The National Surgical Quality Improvement Program (NSQIP) was queried to compare 30-day rates of mortality and any complication between bilateral TKA and unilateral TKA. A total of 8,291 patients who underwent bilateral TKA were matched 1:1 with a unilateral TKA control cohort (n = 315,219) by morbidity probability, which is a cumulative variable encompassing demographic characteristics, comorbidities, and laboratory values. Patients were divided into quartiles based on morbidity probability. Binary logistic regression comparing bilateral TKA and unilateral TKA for the same quartiles was performed to establish if any population could safely have bilateral TKA performed.

Results:
Bilateral TKA had an increased risk for all complications (p < 0.001) and major complications (p < 0.001) when compared with unilateral TKA regardless of health status. For all complications, there was a greater than threefold increase for the first quartile (healthiest patients) (p < 0.001), a greater than fourfold increase for the second and third quartiles (p < 0.001), and a greater than threefold increase for the fourth quartile (least healthy patients) (p < 0.001). For major complications, there was a greater than twofold increase for the first quartile (p = 0.001) and the second quartile (p < 0.001), an almost threefold increase for the third quartile (p < 0.001), and a 57% increase for the fourth quartile (p = 0.005).

Conclusions:
This study will assist shared decision-making between orthopaedic surgeons and patients by suggesting that bilateral TKA may not be as safe an option for even healthy individuals compared with unilateral TKA.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Reconstructing Complex Open Back Wounds with a Modified Minimal-Access Keystone Flap
Authors: Anderson Spencer R. , Rako Kyle M. , Wimalawansa Sunishka M. 
Published: December 2020

Case:
A 61-year-old patient was referred 12 days postoperative with complex, infected, and dehisced paraspinal wound. After debridement and revision of hardware, deep dead space was eliminated through bilateral paraspinal muscle flap advancement. After hardware coverage, a large skin and tissue defect remained. The defect was reconstructed using a modified Keystone flap, eliminating the lateral cutaneous incision. Our patient healed without complication.

Conclusion:
The modified Keystone flap is an option for reconstructing spinal wound defects, yielding excellent tissue coverage and advancement, grants additional flap advancement if necessary because of elimination of the lateral cutaneous incision, and an overall pleasing aesthetic result.
neue Hibiskus-Beet
Authors: Steinecke Hilke 
Published: December 2020

Hibiscus moscheutos (Sumpf-Eibisch) ist ein Vertreter der Malvaceae. Im Frühling 2015 wurde im Palmengarten ein neues Beet mit Sumpf-Eibisch angelegt. Vorgestellt werden Blütenbau und verschiedene Kultivare. Es gibt verschiedene Sorten und Hybriden mit unterschiedlichen Blütenfarben und vor allem außergewöhnlich großen Blüten.
Assuring water quality along multi-barrier treatment systems for agricultural water reuse
Authors: Mohr Marius , Dockhorn Thomas , Drewes Jörg E. , Karwat Sybille , Lackner Susanne , Lotz Bryan , Nahrstedt Andreas , Nocker Andreas , Schramm Engelbert , Zimmermann Martin 
Published: December 2020

Abstract
Based on three pilot- and demonstration-scale projects investigating agricultural irrigation practices with reclaimed water, risks associated with these water reuse practices are highlighted and processes and strategies to minimize associated microbial risks were evaluated. A number of treatment processes and combinations were tested regarding their efficacy for pathogen removal, representing the biggest threat to the quality of products from reuse irrigation practices. In addition, the importance of regrowth potential and different methods for monitoring risks associated with pathogens were discussed. One method for online monitoring is flow cytometry. The results of an exemplary quantitative microbial risk assessment (QMRA) were discussed to determine the significance of microbial risks. Multi-barrier approaches comprised of technical and administrative barriers can reduce the risks of water reuse significantly. Quality management also needs to address all stakeholders involved in a reuse project, starting from source control in the sewershed to marketing of the final products. In addition, environmental risks of water reuse need to be addressed by quality management as well.
Facile Synthesis of Boc-Protected Selenocystine and its Compatibility with Late-Stage Farnesylation at Cysteine Site
Authors: Zhu Peng-Cheng , Chen Yong-Xiang 
Published: December 2020

Background:
The unique hypervariable C-terminal region (HVR) of K-Ras4B, one of
the most frequently mutated proteins in many powerful cancers, contains a C-terminal farnesylated
and methylated Cys and a poly-lysine motif, which decides the association of K-Ras4B to the inner
leaflet of plasma membrane for activating the downstream signaling activity. In our previous work,
we inserted an additional Cys in K-Ras4B HVR peptide synthesis for NCL in the semi-synthesis of
K-Ras4b protein, but it is not suitable for application in protein dimerization research. The recently
developed selenocysteine (Sec, U) mediated native chemical ligation reaction followed by selective
deselenization, which can help to broaden the scope of protein synthesis, requires the generation of
the peptide fragment with an N-terminal Sec.

Objective:
To synthesize K-Ras4B HVR peptide containing both N-terminal Sec and C-terminal farnesylated and
methylated Cys to achieve traceless protein semi-synthesis.

Methods and Results:
We have developed a facile synthesis approach for producing Boc-Sec)2-OH
using economic Se powder, which can facilitate scaling up preparation of peptides containing Sec
at the N-terminus. Furthermore, we synthesized K-Ras4B HVR peptide containing selenocystine
by utilization of Boc-Sec)2-OH. Finally, we took K-Ras4B HVR peptide as an example to test the
compatibility of farnesylation reaction at Cys with the N-terminal Sec)2, and the farnesyl group
was successfully added to the thiol group of Cys.
Clinical Relevance and Immunohistochemical Patterns of Silent Pituitary Adenomas: 10 Years of Single-centre Experience
Authors: Akkus Gamze , Karagun Barış , Çetinalp Nuri E. , Açıkalın Arbil , Evran Mehtap , Sengöz Sinem , Sert Murat , Zorludemir Suzan , Tetiker Tamer 
Published: December 2020

Background:Silent pituitary adenomas are clinically non-functional (i.e., without clinically evident pituitary hormone production).Introduction:The aim of this study was to investigate subjects with silent pituitary adenomas for possible variations in their clinical status.Methods:A total of 102 patients who had undergone surgery for pituitary adenoma and had been diagnosed with silent pituitary adenoma was included in the study. The patients’ preoperative and postoperative hormonal parameters and magnetic resonance imaging (MRI) features were collected, and pathological specimens were re-evaluated.Results:Immunohistochemistry results of the 102 patients were as follows: hormone-negative adenomas (n=35) 35.5%; FSH+LH-positivity (n=32) 31.3%; ACTH-positivity (n=11) 10.7%; α-subunit- positivity (n= 9) 8.8%; prolactin-positivity (n=8) 7.8%; GH-positivity (n=6) 5.4%; and plurihormonal adenoma (n=1). The mean sizes of SGA, SGHA, and SCA were 28.0±12.7, 30.0±16.0, and 27.7±8.9mm (p>0.05), respectively. With the exception of silent gonadotroph adenomas (SGAs), female gender dominance was shown in patients with silent growth hormone adenoma (SGHA) and silent corticotroph adenoma (SCA). Although no clinical relevance was observed in relation to hormonal excess, preoperative GH (4.21±4.6, vs. 0.27±0.36 p=0.00) was slightly more elevated in SGHA than in GH-negative adenomas. Additionally, preoperative basal ACTH values (47.3±28.7 vs. 23.9±14.4, p=0.003) were also higher in SCA compared to the other types. Our findings revealed SCAs to be of more aggressive behaviour than SGHAs and SGAs due to invasiveness in radiological imaging, their elevated re-operation, and postoperative ACTH values.Conclusion:Silent pituitary adenomas represent a challenging diagnostic tumour group. Careful initial evaluation of patients with pituitary adenomas should consider any mild signs and symptoms of functionality, particularly in cases of GH- and ACTH-secreting adenomas.
Significance of MRI Guided Focused Ultrasound Thalamotomy for Parkinson’s Disease: A Review
Authors: Pooja N.A. , Pahuja S.K. , Veer K. 
Published: December 2020

Background:
Magnetic-Resonance guided Focused Ultrasound (FUS) thalamotomy is a
new and less invasive surgical technique for treating Parkinson’s disease (PD). During therapy, the
required part of the cerebral (as STN, Internal Globus Pallidus, and Ventral Intermediate Nucleus)
is ablated with less possibility of infection and brain hemorrhage as it normally happens in invasive
procedures.

Introduction:
New advancement in the technique enable it for transcranial transportation of US. Now a days, US coupling
with MRI confirms the accurate energy transferring and monitoring. So, MRI guided FUS lesioning is discovered for
various psychiatrics and brain disorders.

Methods:
A technical overview of non-invasive MRI-FUS thalamotomy to treat various tremors is described here.
Research, review articles, and book chapters are extracted from online resources using related search strings from year
1994-2020.

Results:
MRgFUS is concluded a non-invasive, satisfactory, and safe technique to reduce the tremor.

Conclusion:
MRgFUS is comparatively a new method that is being explored as a non-invasive cerebral
ablation to solve the problems of movement disorder.
Zinc Supplementation in Preterm Neonates with Jaundice: Is it Beneficial?
Authors: Elfarargy Mohamed S. , Al-Ashmawy Ghada M. , Abu-Risha Sally E. , Khattab Haidy 
Published: December 2020

Background:
Neonatal jaundice is a common neonatal disease that has adverse effects
on neonates, especially preterm neonates, when indirect bilirubin level is adequately high to pass
the blood-brain barrier, causing bilirubin encephalopathy or kernicterus.

Aim:
This study aimed to investigate the value of zinc (Zn) supplementation in preterm neonates
with jaundice and whether it will be beneficial.

Patients and Methods:
A prospective randomized clinical trial, with the identification number TCTR20200504007,
was conducted at Tanta University Hospital from July 2016 to March 2018 on
200 preterm neonates with jaundice. The studied neonates were divided into two groups: group 1,
which received Zn and phototherapy, and group 2, which received phototherapy only and did not
receive Zn. In group 1, 100 preterm neonates with jaundice received Zn as 0.6 mL (cm3) of zinc
origin/kg/day orally through the oro-nasogastric tube divided into two doses (every 12 h), which
was equal to 1.2 mg elemental zinc/kg/day orally for 10 days.

Results:
There was no significant difference in serum bilirubin level between the two groups on
the 2nd, 4th, and 6th days of admission, while the serum bilirubin level was significantly decreased
in group 1 compared with that in group 2 only on the 8th, 9th, and 10th days of admission. The p--
values were 0.045*, 0.027*, and 0.004*, respectively.

Conclusions::
Zn administration to preterm neonates with jaundice was found to be beneficial in decreasing
serum bilirubin level.

Recommendation:
Zn supplementation should be provided to preterm neonates with jaundice.
Comparison of Biomechanical Parameters between Medial and Lateral Compartments of Human Knee Joints
Authors: Devaraj Ashwin Kumar , Acharya Kiran Kumar V , Adhikari Raviraja 
Published: December 2020

Background:
The knowledge of biomechanics helps in predicting stresses in different parts of the knee joint during daily activities.

Objective:
The objective of this study is to evaluate the biomechanical parameters of the knee joint, such as contact pressure, contact area, and maximum compressive stress, at full extension position during the gait cycle.

Methods:
The three-dimensional finite element models of human knee joints are developed from magnetic resonance images (MRI) of multiple healthy subjects. The knee joints are subjected to an axial compressive force of 1150 N at full extension position.

Results:
The maximum compressive stresses on the medial and lateral tibial cartilages were 2.98±0.51 MPa and 2.57±0.53 MPa, respectively. The maximum compressive stresses on the medial and lateral menisci were 2.81±0.92 MPa and 2.52±0.97 MPa, respectively. The contact area estimated on medial and lateral tibial cartilages were 701±89 mm2 and 617±63 mm2, respectively.

Conclusion:
The results were validated using experimental and numerical results from literature and were found to be in good agreement. The magnitude of maximum compressive stress and the contact pressure was found to be higher at the medial portion of the cartilages as compared to that in the lateral portion of the cartilages. This study shows that the medial meniscus is more prone to tear under severe loading conditions, as the stresses in the medial meniscus are higher than that in the lateral meniscus. The total contact area in the medial tibial cartilage is larger than that in the lateral tibial cartilage.
Water Pipe Tobacco Smoking and Risk of Coronary Artery Disease: A Systematic Review and Meta-Analysis
Authors: Morovatdar Negar , Poorzand Hoorak , Bondarsahebi Yones , Hozhabrossadati Seyyed A. , Montazeri Sanaollah , Sahebkar Amirhossein 
Published: December 2020

Background:
Water pipe smoking has become a vitally important public health issue in the world with
untruthful assumed less harmful effect.

Objective:
The aim of this study was to systematically review the association of water pipe tobacco smoking and risk of
coronary artery disease (CAD).

Methods:
Up to September 25, 2018, we electronically searched the PubMed, Embase, and ISI Web of Science with no
time restriction. We included observational studies and excluded conference abstracts, editorials, case-reports, case series,
and reviews. With fixed model effect, we conducted Meta-analysis to evaluate the association between Water pipe
smoking and coronary artery disease. Heterogeneity among studies was assessed by I2 square test. Publication bias was
assessed by Egger test. P<0.05 set as significant level.

Results:
Among 248 paper records identified through database search, 52 full texts were eligible for full text assessment
whereas 49 papers were excluded. Additionally, three studies were eligible for meta-analysis, which involved 58,960
adults with 1334 in the water pipe smoker group. Risk of CAD was increased in water pipe smokers compared to
individuals who had never smoked water pipe but the result did not reach statistical significance (OR=1.18, 95% CI: 0.98-
1.38, p=0.06). We found that heavy water pipe smoking (40 to 50 sessions of water-pipe smoking/year) was associated
with CAD compared to lower smokers defined as less than 40 to 50 water pipe/year (OR=2.001, 95% CI: 1.13-2.87).

Conclusions:
Heavy Water pipe smoking was associated to coronary artery disease on a clinical level. It seems very
crucial to increase public awareness on adverse effects of water pipe smoking and its cessation in clinical setting.
Perceptions of Physical Activity among Students Living on and off Campus in a University in the Western Cape
Authors: Nyangiwe Simamkele , Mgwambane Tshegofatso , Malema Makhaya J. 
Published: December 2020

Background:
Universities are said to have a responsibility to offer holistic education and should, therefore, include ways to prevent risky behaviour such as sedentary living. University students are expected to make informed decisions about their future endeavours. About 23% of adults and 8% of adolescents globally do not meet the global recommendations on minimum Physical Activity (PA) for general health promotion of the World Health Organisation.

Objective:
The objectives of the current study were to explore factors that lead to participation and non-participation in PA among university students, as well as their preferred PA participation activities.

Methods:
The study used a qualitative ethnographic design to purposefully collect data from nine (9) participants by means of semi-structured one-on-one interviews. Open coding was applied when analysing the transcribed data through the ATLAS.ti software programme.

Results:
The findings reveal six themes: Factors that lead to Physical Activity (PA) participation; factors that lead to non-participation in PA; environmental convenience for PA participation; a definition of PA; PA participation preference and benefits of PA. Despite the known benefits of regular physical activity, research shows a significant decline in physical activity participation and an increase in sedentary behaviour in university students.

Conclusion:
Further studies are needed to interrogate PA and its related concepts to raise awareness of each concept. In conclusion, the study recognises that since lifestyle changes during the university period are sustained into adulthood, students tend to engage in risky behaviour such as alcohol and tobacco use, and physical inactivity, which may have long-term negative implications for their health and lead to poor perceptions about their body structure.
In-silico Discovery of Fungal Metabolites Bergenin, Quercitrin and Dihydroartemisinin as Potential Inhibitors against Main Protease of SARSCoV- 2
Authors: Patel Ravi S , Vanzara Akash G , Patel Nimisha R , Vasava Ajit M , Patil Sachin M , Rajput Kishore S 
Published: December 2020

Background:
Emergence of severe acute respiratory syndrome coronavirus 2 (SARSCoV-
2) infection has given rise to COVID-19 pandemic, which has become a wreaking havoc
worldwide. Therefore, there is an urgent need to find out novel drugs to combat SARS-CoV-2 infection.
In this backdrop, the present study aimed to assess potent bioactive compounds from different
fungi as potential inhibitors of SARS-CoV-2 main protease (Mpro) using an in-silico analysis.

Methods:
High-Resolution Liquid Chromatography Mass Spectrometry analysis (HR-LCMS) was
used for the bioactive profiling of ethanolic crude extract of Dictyophora indusiata, Geastrum triplex
and Cyathus stercoreus. Of which, only bergenin (D. indusiata), quercitrin (G. triplex) and dihydroartemisinin
(C. stercoreus) were selected based on their medicinal uses, binding score and
the active site covered. The 6LU7, a protein crystallographic structure of SARS-CoV-2 Mpro, was
docked with bergenin, quercitrin and dihydroartemisinin using Autodock 4.2.

Results:
A total of 118 bioactive compounds were analyzed from the crude extract of used fungi
and identified using HR LC/MS analysis. The binding energies obtained were -7.86, -10.29 and
-7.20 kcal/mol, respectively, after docking analysis. Bergenin, quercitrin and dihydroartemisinin
formed hydrogen bond, electrostatic interactions and hydrophobic interactions with foremost active
site amino acids THR190, GLU166, GLN189, GLY143, HIS163, HIS164, CYS145 and PHE140.

Conclusion:
Present investigation suggests that these three compounds may be used as alternative
inhibitors against SARS-CoV-2 Mpro. However, further research is necessary to assess in vitro potential
of these compounds. To the best of our knowledge, the present investigation reported these
three bioactive compounds of fungal origin for the first time.