bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior short segment fixation including the fractured vertebra combined with kyphoplasty for unstable thoracolumbar osteoporotic burst fracture
Authors: Hu Xudong , Ma Weihu , Chen Jianming , Wang Yang , Jiang Weiyu 
Published: August 2020

Abstract
Background
Various studies have described the efficacy and safety of the treatment for unstable thoracolumbar osteoporotic burst fracture, however, there is still no consensus on the optimal treatment regimen. The aim of this study was to evaluate the clinical and radiographic results of posterior short segment fixation including the fractured vertebra (PSFFV) combined with kyphoplasty (KP) for unstable thoracolumbar osteoporotic burst fracture.

Methods
Forty-three patients with unstable thoracolumbar osteoporotic burst fracture underwent PSFFV combined with KP from January 2015 to December 2017 were analyzed retrospectively. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) was used to evaluate the clinical outcome, radiological parametres including local kyphotic Cobb angle, percentage of the anterior, middle and posterior height of the fractured vertebra were measured and compared pre-operation, post-operation and at final follow-up.

Results
All patients underwent surgery successfully and with an average follow-up of 19.2 ± 6.7 months (rang 15–32). The VAS decreased from 7.1 ± 2.3 pre-operation to 1.6 ± 0.4 at the final follow-up (p < 0.05). The ODI decreased from 83.1 ± 10.5 pre-operation to 19.2 ± 7.3 (P < 0.05) at the final follow-up. The correction of local kyphotic angle was 16.9° ± 5.3° (p < 0.05), and the loss of correction was 3.3° ± 2.6° (p > 0.05), the correction of anterior vertebral height was 30.8% ± 8.6% (p < 0.05), and the loss of correction was 4.5% ± 3.9% (p > 0.05), the correction of middle vertebral height was 26.4% ± 5.8% (p < 0.05), and the loss of correction was 2.0% ± 1.6% (p > 0.05), the correction of posterior vertebral height was 9.4% ± 6.9% (p < 0.05), and the loss of correction was 1.6% ± 1.3% (p > 0.05). Two cases of screw pullout and 8 cases of cement leakage were observed, but without clinical consequence.

Conclusions
PSFFV combined with KP is a reliable and safe procedure with satisfactory clinical and radiological results for the treatment of unstable thoracolumbar osteoporotic burst fracture.
Traumatic brain injury neuroelectrochemical monitoring: behind-the-ear micro-instrument and cloud application
Authors: Tageldeen Momen K. , Gowers Sally A. N. , Leong Chi L. , Boutelle Martyn G. , Drakakis Emmanuel M. 
Published: August 2020

Abstract
Background
Traumatic Brain Injury (TBI) is a leading cause of fatality and disability worldwide, partly due to the occurrence of secondary injury and late interventions. Correct diagnosis and timely monitoring ensure effective medical intervention aimed at improving clinical outcome. However, due to the limitations in size and cost of current ambulatory bioinstruments, they cannot be used to monitor patients who may still be at risk of secondary injury outside the ICU.

Methods
We propose a complete system consisting of a wearable wireless bioinstrument and a cloud-based application for real-time TBI monitoring. The bioinstrument can simultaneously record up to ten channels including both ECoG biopotential and neurochemicals (e.g. potassium, glucose and lactate), and supports various electrochemical methods including potentiometry, amperometry and cyclic voltammetry. All channels support variable gain programming to automatically tune the input dynamic range and address biosensors’ falling sensitivity. The instrument is flexible and can be folded to occupy a small space behind the ear. A Bluetooth Low-Energy (BLE) receiver is used to wirelessly connect the instrument to a cloud application where the recorded data is stored, processed and visualised in real-time. Bench testing has been used to validate device performance.

Results
The instrument successfully monitored spreading depolarisations (SDs) - reproduced using a signal generator - with an SNR of 29.07 dB and NF of 0.26 dB. The potentiostat generates a wide voltage range from -1.65V to +1.65V with a resolution of 0.8mV and the sensitivity of the amperometric AFE was verified by recording 5 pA currents. Different potassium, glucose and lactate concentrations prepared in lab were accurately measured and their respective working curves were constructed. Finally,the instrument achieved a maximum sampling rate of 1.25 ksps/channel with a throughput of 105 kbps. All measurements were successfully received at the cloud.

Conclusion
The proposed instrument uniquely positions itself by presenting an aggressive optimisation of size and cost while maintaining high measurement accuracy. The system can effectively extend neuroelectrochemical monitoring to all TBI patients including those who are mobile and those who are outside the ICU. Finally, data recorded in the cloud application could be used to help diagnosis and guide rehabilitation.
Sternal reconstruction using locking compression plates (LCP): our experience in Egypt, a case series
Authors: Ahmed Kareem , Nady Mohamed Alaa 
Published: August 2020

Abstract
Background
Sternal fractures are rare accounting for about 3–8% of traumatic chest. There are many lines of treatments for sternal fractures which can be classified as conservative or surgical. Surgical techniques include wire fixation and sternal plating. There are no standardization of indications for each line of management.
We explore if sternal reconstruction using locking titanium plates and self-tapping screws provide the patient with the best chance of proper sternal healing avoiding chronic pain and its complications and allow the patient early mobilization and rapid restoring of his normal life at its maximum.

Methods
Our inclusion criteria are patients of both gender from 20 to 60 years of age presented with traumatic sternal fracture at any site or pathological fracture due to metastatic or primary tumors infiltrating the sternum. High Associated Injury Scale scores were excluded. Exclusion criteria also included patients younger than 20 years or older than 60 years. Primary outcome is post-operative pain score and is measured using numerical pain scale ranging from zero to 10 where zero means there is no pain at all and ten is the worst imaginable pain ever.

Results
Sternal reconstruction using titanium plates has proven to be an efficient method of stabilization with tremendous immediate relief of pain showed by the differences between pre-operative and post-operative pain scale scores in our patients (n = 5) with Median scores being 7 and 1.5 with range being from 7 to 9 and 1 to 3 respectively (p-value = .039). Operative time range between 150 min and 90 min with median of 120 min. Extubation of patients was smooth with no events with median time of extubation being 120 min. From our experience, there were no observed wound complications except at the third patient who suffered a small wound hematoma that was resolved by gentle compressing only and needed no further intervention.

Conclusion
We recommend adopting sternal reconstruction using titanium plating systems more readily encouraging even larger clinical trials on the way to a clear guidelines. Plating systems show promising results with least pain, better stability, less complications and rapid, smooth recovery.

Trial registration
NCT04092374
MILO/ENGOT-ov11: Binimetinib Versus Physician’s Choice Chemotherapy in Recurrent or Persistent Low-Grade Serous Carcinomas of the Ovary, Fallopian Tube, or Primary Peritoneum
Authors: Monk Bradley J. , Grisham Rachel N. , Banerjee Susana , Kalbacher Elsa , Mirza Mansoor Raza , Romero Ignacio , Vuylsteke Peter , Coleman Robert L. , Hilpert Felix , Oza Amit M. , Westermann Anneke , Oehler Martin K. , Pignata Sandro , Aghajanian Carol , Colombo Nicoletta , Drill Esther , Cibula David , Moore Kathleen N. , Christy-Bittel Janna , del Campo Josep M. , Berger Regina , Marth Christian , Sehouli Jalid , O’Malley David M. , Churruca Cristina , Boyd Adam P. , Kristensen Gunnar , Clamp Andrew , Ray-Coquard Isabelle , Vergote Ignace 
Published: August 2020

PURPOSE Low-grade serous ovarian carcinomas (LGSOCs) have historically low chemotherapy responses. Alterations affecting the MAPK pathway, most commonly KRAS/BRAF, are present in 30%-60% of LGSOCs. The purpose of this study was to evaluate binimetinib, a potent MEK1/2 inhibitor with demonstrated activity across multiple cancers, in LGSOC. METHODS This was a 2:1 randomized study of binimetinib (45 mg twice daily) versus physician’s choice chemotherapy (PCC). Eligible patients had recurrent measurable LGSOC after ≥ 1 prior platinum-based chemotherapy but ≤ 3 prior chemotherapy lines. The primary end point was progression-free survival (PFS) by blinded independent central review (BICR); additional assessments included overall survival (OS), overall response rate (ORR), duration of response (DOR), clinical-benefit rate, biomarkers, and safety. RESULTS A total of 303 patients were randomly assigned to an arm of the study at the time of interim analysis (January 20, 2016). Median PFS by BICR was 9.1 months (95% CI, 7.3 to 11.3) for binimetinib and 10.6 months (95% CI, 9.2 to 14.5) for PCC (hazard ratio,1.21; 95%CI, 0.79 to 1.86), resulting in early study closure according to a prespecified futility boundary after 341 patients had enrolled. Secondary efficacy end points were similar in the two groups: ORR 16% (complete response [CR]/partial responses[PRs], 32) versus 13% (CR/PRs, 13); median DOR, 8.1 months (range, 0.03 to ≥ 12.0 months) versus 6.7 months (0.03 to ≥ 9.7 months); and median OS, 25.3 versus 20.8 months for binimetinib and PCC, respectively. Safety results were consistent with the known safety profile of binimetinib; the most common grade ≥ 3 event was increased blood creatine kinase level (26%). Post hoc analysis suggests a possible association between KRAS mutation and response to binimetinib. Results from an updated analysis (n = 341; January 2019) were consistent. CONCLUSION Although the MEK Inhibitor in Low-Grade Serous Ovarian Cancer Study did not meet its primary end point, binimetinib showed activity in LGSOC across the efficacy end points evaluated. A higher response to chemotherapy than expected was observed and KRAS mutation might predict response to binimetinib.
LONG-TERM ATHLETIC DEVELOPMENT AS A FRAMEWORK TO INFLUENCE WELLNESS DURING CHILDHOOD AND ADOLESCENCE
Authors: Eisenmann Joey C. , Howard Rick , Moreno Tony 
Published: August 2020

Apply It!
• Health and fitness professionals working with children and adolescents should first understand normal growth, maturation, and development (the “business of growing up”) when considering the implementation and effect of lifestyle behaviors.
• Fundamental movement skills provide the foundation or building blocks for developing confidence and competency in sports, games, play, and physical activity and, along with developing muscular fitness, should be the focus of youth physical development.
• Along with physical activity, sleep and nutrition also serve as a polypill for optimal growth, maturation, and development. Youth programs should provide education and intervention on these key behaviors as well.
• Quality instruction and supervision of youth programs should include assessment and monitoring of growth and maturation, fundamental movement skill acquisition, physical performance, injury prevention, nutrition, sleep, and psychosocial well-being.
Effect of 6-Month Exercise Training on Neurovascular Function in Spinal Cord Injury
Authors: OZTURK ERIN D. , LAPOINTE MATTHEW S. , KIM DONG-IL , HAMNER J. W. , TAN CAN OZAN 
Published: August 2020

ABSTRACT

Introduction
Although previous data show exacerbated incidence of cognitive impairment after spinal cord injury (SCI), the physiology that underlies this postinjury cognitive decline is unknown. One potential culprit is impairment in the ability of cerebral vasculature to alter regional flow to sustain neural metabolism (i.e., “neurovascular coupling”). We hypothesized that cerebrovascular responses to a working memory task are impaired in individuals with SCI and can be improved by aerobic exercise training.

Methods
We assessed the effect of injury and 6-month full-body aerobic exercise training on the cerebral blood flow response to cognitive demand (i.e., neurovascular coupling) in 24 individuals with SCI and 16 controls. Cognitive demand was introduced in a graded fashion using a working memory task.

Results
Reaction time tended to be higher in individuals with SCI, especially those with high-level (≥T4) injuries, possibly due to upper motor impairments. Neurovascular coupling was graded across task difficulty (P < 0.01) and followed cognitive demand, and injury itself did not have a significant effect (group effect P = 0.99, interaction P = 0.70). Individuals with low-level injuries (<T4) had higher aerobic capacity than high-level injuries (P < 0.01). Aerobic capacity increased significantly with training in both groups (P < 0.01). Although there was no overall significant improvement in neurovascular coupling with training at the group level, the degree of improvement was closely related to that in aerobic fitness in individuals with high-level injuries (R2
= 0.19, P = 0.03) but not low-level injuries (R2
= 0.04, P = 0.46). Importantly, improvement in neurovascular coupling translated to an increase in reaction time (R2
= 0.16, P = 0.05).

Conclusion
Previously reported cognitive impairment after SCI may reflect a decline in neurovascular coupling primarily due to physical deconditioning rather than injury itself. The latter can be mitigated by aerobic exercise training.
Novel CPET Reference Values in Healthy Adults: Associations with Physical Activity
Authors: WAGNER JONATHAN , KNAIER RAPHAEL , INFANGER DENIS , KÖNIGSTEIN KARSTEN , KLENK CHRISTOPHER , CARRARD JUSTIN , HANSSEN HENNER , HINRICHS TIMO , SEALS DOUGLAS , SCHMIDT-TRUCKSÄSS ARNO 
Published: August 2020

ABSTRACT

Purpose
Cardiopulmonary exercise testing (CPET) is an important measurement in clinical practice, and its primary outcome, maximal oxygen uptake (V˙O2peak), is inversely associated with morbidity and mortality. The purposes of this study are to provide CPET reference values for maximal and submaximal parameters across the adult age spectrum of a healthy European cohort, to compare V˙O2peak values with other reference data sets, and to analyze the associations between physical activity (PA) levels and CPET parameters.

Methods
In this cross-sectional study, we prospectively recruited 502 participants (47% female) from 20 to 90 yr old. The subjects performed a CPET on a cycle ergometer using a ramp protocol. PA was objectively and continuously measured over 14 d using a triaxial accelerometer. Quantile curves were calculated for CPET parameters. To investigate the associations between CPET parameters and PA levels, linear regression analysis was performed.

Results
V˙O2peak values observed in the group of 20–29 yr were 46.6 ± 7.9 and 39.3 ± 6.5 mL·kg−1⋅min−1 for males and females, respectively. On average, each age category (10-yr increments) showed a 10% lower V˙O2peak relative to the next younger age category. V˙O2peak values of previous studies were on average 7.5 mL·kg−1⋅min−1 (20%) lower for males and 6.5 mL·kg−1⋅min−1 (21%) lower for females. There was strong evidence supporting a positive association between the V˙O2peak (mL·kg−1⋅min−1) and the level of habitual PA performed at vigorous PA (estimate, 0.26; P < 0.001].

Conclusion
Maximal and submaximal CPET reference values over a large age range are novel, and differences to other studies are clinically highly relevant. Objectively measured vigorous-intensity PA showed a strong positive association with higher V˙O2peak and other performance-related CPET parameters, supporting the implementation of higher-intensity aerobic exercise in health promotion.
Effects of BMI on Walking Speed and Gait Biomechanics after Anterior Cruciate Ligament Reconstruction
Authors: DAVIS-WILSON HOPE C. , JOHNSTON CHRISTOPHER D. , YOUNG EMMA , SONG KYEONGTAK , WIKSTROM ERIK A. , BLACKBURN J. TROY , PIETROSIMONE BRIAN 
Published: August 2020

ABSTRACT

Purpose
History of an anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong independent risk factors for knee osteoarthritis (KOA) onset. The combination of these risk factors may further negatively affect joint loading and KOA risk. We sought to determine the combined influence of BMI and ACLR on walking speed and gait biomechanics that are hypothesized to influence KOA onset.

Methods
Walking speed and gait biomechanics (peak vertical ground reaction force [vGRF], peak vGRF instantaneous loading rate [vGRF-LR], peak knee flexion angle, knee flexion excursion [KFE], peak internal knee extension moment [KEM], and peak internal knee abduction moment [KAM]) were collected in 196 individuals with unilateral ACLR and 106 uninjured controls. KFE was measured throughout stance phase, whereas all other gait biomechanics were analyzed during the first 50% of stance phase. A 2 × 2 ANOVA was performed to evaluate the interaction between BMI and ACLR and main effects for both BMI and ACLR on walking speed and gait biomechanics between four cohorts (high BMI ACLR, normal BMI ACLR, high BMI controls, and normal BMI controls).

Results
History of an ACLR and high BMI influenced slower walking speed (F
1,298 = 7.34, P = 0.007), and history of an ACLR and normal BMI influenced greater peak vGRF-LR (F
1,298 = 6.56, P = 0.011). When evaluating main effects, individuals with an ACLR demonstrated lesser KFE (F
1,298 = 7.85, P = 0.005) and lesser peak KEM (F
1,298 = 6.31, P = 0.013), and individuals with high BMI demonstrated lesser peak KAM (F
1,297 = 5.83, P = 0.016).

Conclusion
BMI and history of ACLR together influence walking speed and peak vGRF-LR. History of an ACLR influences KFE and peak KEM, whereas BMI influences peak KAM. BMI may need to be considered when designing interventions aimed at restoring gait biomechanics post-ACLR.
Long-Term and Acute Benefits of Reduced Sitting on Vascular Flow and Function
Authors: HARTMAN YVONNE A. W. , TILLMANS LAURA C. M. , BENSCHOP DAVID L. , HERMANS ASTRID N. L. , NIJSSEN KEVIN M. R. , EIJSVOGELS THIJS M. H. , WILLEMS PETER H. G. M. , TACK CEES J. , HOPMAN MARIA T. E. , CLAASSEN JURGEN A. H. R. , THIJSSEN DICK H. J. 
Published: August 2020

ABSTRACT

Purpose
Sedentary behavior increases the risk for cardiovascular and cerebrovascular disease. To understand potential benefits and underlying mechanisms, we examined the acute and long-term effect of reduced sitting intervention on vascular and cerebrovascular function.

Methods
This prospective study included 24 individuals with increased cardiovascular risk (65 ± 5 yr, 29.8 ± 3.9 kg·m−2). Before and after 16-wk reduced sitting, using a mobile health device with vibrotactile feedback, we examined (i) vascular function (flow-mediated dilation [FMD]), (ii) cerebral blood flow velocity (CBFv, transcranial Doppler), and (iii) cerebrovascular function (cerebral autoregulation [CA] and cerebral vasomotor reactivity [CVMR]). To better understand potential underlying mechanisms, before and after intervention, we evaluated the effects of 3 h sitting with and without light-intensity physical activity breaks (every 30 min).

Results
The first wave of participants showed no change in sedentary time (n = 9, 10.3 ± 0.5 to 10.2 ± 0.5 h·d−1, P = 0.87). Upon intervention optimization by participants’ feedback, the subsequent participants (n = 15) decreased sedentary time (10.2 ± 0.4 to 9.2 ± 0.3 h·d−1, P < 0.01). This resulted in significant increases in FMD (3.1% ± 0.3% to 3.8% ± 0.4%, P = 0.02) and CBFv (48.4 ± 2.6 to 51.4. ±2.6 cm·s−1, P = 0.02), without altering CA or CVMR. Before and after the 16-wk intervention, 3-h exposure to uninterrupted sitting decreased FMD and CBFv, whereas physical activity breaks prevented a decrease (both P < 0.05). CA and CVMR did not change (P > 0.20).

Conclusion
Long-term reduction in sedentary behavior improves peripheral vascular function and cerebral blood flow and acutely prevents impaired vascular function and decreased cerebral blood flow. These results highlight the potential benefits of reducing sedentary behavior to acutely and chronically improve cardio- or cerebrovascular risk.
Timing of Rectus Femoris and Biceps Femoris Muscle Activities in Both Legs at Maximal Running Speed
Authors: KAKEHATA GAKU , GOTO YUTA , ISO SHIGEO , KANOSUE KAZUYUKI 
Published: August 2020

ABSTRACT

Purpose
The purpose of this study was to investigate the relationship between spatiotemporal variables of running and onset/offset timing of rectus femoris (RF) and biceps femoris (BF) muscle activities in both legs.

Methods
Eighteen male well-trained athletes (age = 20.7 ± 1.8 yr) were asked to run 50 m at maximal speed. The spatiotemporal variables (running speed, step frequency, and step length) over the distance from 30 to 50 m were measured. In addition, RF and BF muscle activities were obtained from both legs using wireless EMG sensors. To quantify the onset and offset timing of muscle activity, the band-pass filtered (20–450 Hz) EMG signal was processed using a Teager–Kaiser energy operator filter. We calculated RF and BF onset/offset timings (%) in both legs (e.g., ipsilateral leg RF [iRF] and contralateral leg BF [cBF]) during running cycle. Based on those timings, we obtained the EMG timing variables (%) as follows: “Switch1 (iBF-offset to iRF-onset),” “Switch2 (iRF-offset to iBF-onset),” “Scissors1 (cBF-onset to iRF-onset),” and “Scissors2 (iRF-offset to cBF-offset).

Results
We found that “Switch2” had positive (r = 0.495, P = 0.037), “Scissors1” had negative (r = −0.469, P = 0.049), and “Scissors2” had positive (r = 0.574, P = 0.013) correlations with step frequency. However, these variables had no significant correlations with running speed or step length.

Conclusions
These results indicate that higher step frequency would be achieved by smoother switching of the agonist–antagonist muscle activities and earlier iRF activation relative to the cBF activity. To improve sprint performance, athletes and coaches should consider not only muscle activities in one leg but also coordination of muscle activities in both legs.
Dynamic Changes of Performance Fatigability and Muscular O2 Saturation in a 4-km Cycling Time Trial
Authors: AZEVEDO RAFAEL A. , MILIONI FABIO , MURIAS JUAN M. , BERTUZZI ROMULO , MILLET GUILLAUME Y. 
Published: August 2020

ABSTRACT
Exercise intensity variations throughout a cycling time trial (TT) might be influenced by subject’s functional state.

Purpose
The current study characterized the performance fatigability etiology, immediately after exercise cessation, and its relation to the dynamic changes in muscle O2 saturation (SmO2) at different TT phases.

Methods
Twelve males performed three separated TT of different distances, in a crossover counterbalanced design, until the end of the fast-start (FS, 827 ± 135 m), even-pace (EP, 3590 ± 66 m), or end-spurt (ES, 4000 m) TT phases. Performance fatigability was characterized by using isometric maximal voluntary contractions (IMVC), whereas the maximal voluntary activation (VA) and contractile function of knee extensors (e.g., peak torque of potentiated twitches [TwPt]) were evaluated using electrically evoked contractions performed before and immediately after each exercise bouts. SmO2, power output (PO), and EMG were also recorded.

Results
Immediately after the FS phase, there were lower values for IMVC (−23%), VA (−8%), and TwPt (−43%) (all P < 0.001), but no further changes were measured after EP (IMVC, −28%; VA, −8%; TwPt, −38%). After the ES phase, IMVC (−34%) and TwPt (−59%) further decreased compared with the previous phases (P < 0.05). There were lower SmO2 and higher EMG/PO values during FS and ES compared with EP phase.

Conclusion
FS and EP phases had similar performance fatigability etiology, but ES showed further impairments in contractile function. This later finding might be due to the abrupt changes in SmO2 and EMG/PO because of the high exercise intensity during the ES, which elicited maximal decline in contractile function at the finish line.