bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Complex Proximal Humeral Fractures in the Elderly with Reverse Shoulder Arthroplasty
Authors: Tian Xu , Xiang Ming , Wang Guangyu , Zhang Bo , Liu Junyang , Pan Chao , Liu Lintao , Dong Jingming 
Published: October 2020

ObjectiveTo assess the short‐term efficacy of reverse shoulder arthroplasty in the treatment of complex proximal humeral fractures in the elderly.MethodsForty‐three elderly patients treated operatively for complex proximal humeral fractures with reverse shoulder arthroplasty from July 2017 to January 2019 were retrospectively reviewed. To be specific, 12 males and 31 females were reviewed with an average age of 72.0 years (range, 66–78 years). All fractures were attributed to trauma and treated for 8.0 days on average (range, 6–11 days). As suggested from Neer classification, 21 cases (48.8%, 21/43) were three‐part fractures, and 22 (51.2%, 22/43) were four‐part fractures. To assess the postoperative efficacy, Visual Analog Scale (VAS), American Society of Shoulder and Elbow Surgery Shoulder Joint Score (ASES), Constant–Murley score and radiological examination were adopted. The Neer three‐part fracture group and the Neer four‐part fracture group were compared.ResultsThere was no significant difference in age, gender, operation time, and follow‐up period between Neer three‐part fracture group and Neer four‐part fracture group. All operations were successfully performed, and the average operation time was 120–170 min, with an average of 141.3 min. Besides, the mean blood loss was 407.0 mL (250–700 mL), and the average intraoperative blood transfusion reached 446.5 mL (400–800 mL). All patients received the follow‐up for 6 to 16 months, that is for 10.9 months on average. All patients were discharged in 7 days after operation, and no wound‐related complications were identified. In 8 weeks, the greater and lesser tuberosities of all patients healed completely. During the last follow‐up, no loosening or dislocation of prosthesis was detected, and the forward elevation of 133.0 (100°‐ 165°), the external rotation of 29.5° (20°–35°), the internal rotation of 46.7°(30°–60°), the VAS score of 0.8(0–3), the ASES score of 89.1(78.8–100.0) were achieved. Constant‐Murley score reached 88.7 (range, 70–98). There was no significant difference between Neer three‐part fracture group and Neer four‐part fracture group (P > 0.05). A 71‐year‐old patient developed the symptoms of axillary nerve injury after operation; he recovered completely at 6 weeks after the operation, which had not adversely affected the functional rehabilitation exercise or the stability of the prosthesis. At the follow‐up, no other complications (e.g., infection, acromial stress fracture, and scapular notching) were identified in all patients.ConclusionThe short‐term efficacy of one‐stage reverse shoulder arthroplasty to treat complex proximal humeral fractures in the elderly is satisfactory.
Arthroscopic Treatment of Posttraumatic Elbow Stiffness Due to Soft Tissue Problems
Authors: Dai Junxi , Zhang Guofeng , Li Shulin , Xu Jianguang , Lu Jiuzhou 
Published: October 2020

ObjectivesTo evaluate the effectiveness of arthroscopic management of posttraumatic elbow stiffness due to soft tissue problems.MethodsA retrospective review of 30 consecutive arthroscopic elbow releases for posttraumatic stiff elbow from November 2011 to December 2019 was conducted. Stiff elbows with bony problems, such as heterotopic ossification, intraarticular nonunion or malunion, and cartilage lesions were excluded from this study. Contracture and adhesion of soft tissue around the elbow were identified. Surgical treatments included arthroscopic capsulectomy, ligaments and muscle release, and ulnar nerve release. The results were evaluated using the Mayo elbow performance score (MEPS) and range of motion of the elbow. Surgery‐related complications were assessed.ResultsPatients who underwent arthroscopic release were followed up for between 6 and 35 months, with a mean follow‐up time of 10.1 months. The postoperative elbow ROM was 123.2° ± 19°, which was significantly different compared to the preoperative value of 68° ± 32°. In addition, the MEPS score improved from 71.2 ± 10.3 preoperatively to 93.7 ± 6.6 at the final follow‐up, a mean improvement of 22.5 (range, 0–55; P < 0.05). Postoperative complications included five cases of prolonged drainage from the portal site, three transient nerve palsies, and one hematoma in the medial elbow.ConclusionWith full recognition by the surgeon of the pathologic changes of the soft tissue around the elbow, arthroscopic release is usually safe and effective for posttraumatic elbow stiffness without symptomatic bony problems.
Installation of C4 photosynthetic pathway enzymes in rice using a single construct
Authors: Ermakova Maria , Arrivault Stéphanie , Giuliani Rita , Danila Florence , Alonso‐Cantabrana Hugo , Vlad Daniela , Ishihara Hirofumi , Feil Regina , Guenther Manuela , Borghi Gian Luca , Covshoff Sarah , Ludwig Martha , Cousins Asaph B. , Langdale Jane A. , Kelly Steven , Lunn John E. , Stitt Mark , von Caemmerer Susanne , Furbank Robert T. 
Published: October 2020

SummaryIntroduction of a C4 photosynthetic mechanism into C3 crops offers an opportunity to improve photosynthetic efficiency, biomass and yield in addition to potentially improving nitrogen and water use efficiency. To create a two‐cell metabolic prototype for an NADP‐malic enzyme type C4 rice, we transformed Oryza sativa spp. japonica cultivar Kitaake with a single construct containing the coding regions of carbonic anhydrase, phosphoenolpyruvate (PEP) carboxylase, NADP‐malate dehydrogenase, pyruvate orthophosphate dikinase and NADP‐malic enzyme from Zea mays, driven by cell‐preferential promoters. Gene expression, protein accumulation and enzyme activity were confirmed for all five transgenes, and intercellular localization of proteins was analysed. 13CO2 labelling demonstrated a 10‐fold increase in flux though PEP carboxylase, exceeding the increase in measured in vitro enzyme activity, and estimated to be about 2% of the maize photosynthetic flux. Flux from malate via pyruvate to PEP remained low, commensurate with the low NADP‐malic enzyme activity observed in the transgenic lines. Physiological perturbations were minor and RNA sequencing revealed no substantive effects of transgene expression on other endogenous rice transcripts associated with photosynthesis. These results provide promise that, with enhanced levels of the C4 proteins introduced thus far, a functional C4 pathway is achievable in rice.
The nature of attachment systems
Authors: Barbaro Nicole 
Published: October 2020

AbstractAttachment theory is an enduring and generative framework for understanding infant and romantic relationships. As a lifespan phenomenon, attachment research has focused largely on developmental processes and how to link the infant attachments with later close relationships, but there has been comparably less scholarly attention targeted at the evolutionary origins and functionality of romantic attachments, in particular. Here, I advance a two‐system approach to attachment, proposing that infant attachments and romantic attachments constitute etiologically distinct systems that evolved in response to different selection pressures, serve different evolutionary functions, and are fundamentally different in nature with regard to operation and necessity toward their respective evolutionary goals. This two‐system approach has downstream implications for future attachment research, most notably with regard to how the romantic attachment system develops over the lifespan, and the extent to which romantic attachments guide the formation of relationships in adulthood.
Topical treatment of equine sarcoids with imiquimod 5% cream or Sanguinaria canadensis and zinc chloride – an open prospective study
Authors: Pettersson Carina M. , Broström Hans , Humblot Patrice , Bergvall Kerstin E. 
Published: October 2020

RésuméContexteLes sarcoïdes équins sont la tumeur cutanée la plus prévalente chez le cheval dans le monde entier. Bien que plusieurs traitements soient disponibles, aucun n’est totalement efficace et les récidives sont fréquentes.ObjectifsDéterminer l’efficacité et l’innocuité de la crème imiquimod 5% et Sanguinaria canadensis + chloride de zinc dans le traitement de sarcoïdes équins et étudier les effets systémiques potentiels sur les sarcoïdes distants non traités.Sujets/tumeursVingt‐cinq chevaux de propriétaires avec un total de 164 tumeurs ont été inclus dans l’étude. Cinquante‐sept tumeurs ont été traitées et 107 non traitées.Matériels et méthodesDes biopsies ont été prélevées, au moins une par cheval, les autres étaient diagnostiquées comme probablement des sarcoïdes à partir de l’aspect clinique. L’imiquimod 5% (A) a été appliquée trois fois par semaine, tandis que Sanguinaria canadensis + chloride de zinc (X) a été appliqué tous les quatre jours après une phase d’initiation d’une fois par jour pendant six jours. Le traitement a été poursuivi jusqu’à rémission clinique ou pendant 45 semaines maximum, avec une période de suivi longue (34 mois en moyenne). Des biopsies des sarcoïdes ont été renouvelées après la fin du traitement et en suivi si le propriétaire donnait son consentement.RésultatsUne rémission complète a été enregistrée dans 84.4% (A) et 75.0% (X) des tumeurs. Une récidive a été observée dans 7.3% (A) et 21.4% (X). Une rémission spontanée a été observée dans 1,9% des tumeurs non traitées. Aucun effet systémique indésirable sur les tumeurs non traitées n’a été détecté. Au cours du traitement des degrés variables d’inflammation locale étaient fréquents.Conclusion et importance cliniqueLes deux traitements sont considérés comme surs et efficaces. Les plus petites tumeurs répondaient plus favorablement au traitement. Le taux de récidive était faible et non observée au sein des biopsies répétées après la fin du traitement.
Do females and males exhibit a similar sarcopenic response as a consequence of normoxic and hypoxic bed rest?
Authors: Mekjavic Igor B. , Eiken Ola , Mekjavic Polona Jaki , McDonnell Adam C. 
Published: October 2020

New Findings

What is the central question of this study?
Do females and males exhibit a similar sarcopenic response as a consequence of normoxic and hypoxic bed rest?

What is the main finding and its importance?
During 10‐day bed rest, exposure to a simulated (normobaric hypoxia) altitude of ∼4000 m does not exert additional significant structural or functional effect on the weight‐bearing muscles in females compared to those noted under normoxic conditions. Whereas males and females exhibit decrements in muscle cross‐sectional area and mass during normoxic and hypoxic bed rest, a concomitant strength decrement was only observed in males.

AbstractThis study investigated the effects of hypoxia on the known processes of adaptation of body composition and muscle function to normoxic inactivity. Females (n = 12) and males (n = 11) took part in the following interventions: hypoxic ambulation (HAMB; ∼4000 m); hypoxic bed rest (HBR; ∼4000 m) and normoxic bed rest (NBR). Prior to and immediately following each intervention, body composition, thigh and lower leg cross‐sectional area (CSA) and isometric muscular strength were recorded. Participants lost body mass (HAMB: male −1.5 ± 0.9 kg, female −1.9 ± 0.7 kg; HBR: male −2.0 ± 1.8 kg, female −2.4 ± 0.8 kg; NBR: male −1.4 ± 1.3 kg, female −1.4 ± 0.9 kg) and lean mass (HAMB: male −3.9 ± 3.0%, female −3.4 ± 2.0%; HBR: male −4.0 ± 4.4%, female −4.1 ± 2.0%; NBR: male −4.0 ± 3.4%, female −2.2 ± 2.7%) with no between‐condition or sex differences. Knee extension decreased for males in NBR compared to HAMB (HAMB: male −0.2 ± 9.1%, female 1.3 ± 4.9%; HBR: male −7.8 ± 10.3%, female −3.3 ± 10.9%; NBR: male −14.5 ± 11%, female −3.4 ± 6.9%). Loss of force during maximal voluntary contraction (MVC) in the knee extensors was significantly different between males and females following NBR. There were no other significant changes noted following the experimental interventions. There were no differences recorded between sexes in maximal MVC for elbow or ankle joints. Female lower leg CSA decreased following bed rest (HAMB: ‐4.5 ± 2.0%; HBR: ‐9.9 ± 2.6%; NBR: ‐8.0 ± 1.6%). These findings indicate that a 10‐day hypoxic bed rest does not exert any significant additional effect on muscle atrophy when compared to NBR, except for female thigh CSA. In contrast to males, who exhibited a significant loss of muscle strength, no such decrement in strength was observed in the female participants.
Influence of cuff‐occlusion duration on contrast‐enhanced ultrasound assessments of calf muscle microvascular blood flow responsiveness in older adults
Authors: Young Grace Marie , Krastins Digby , Chang David , Lam Jeng , Quah Jing , Stanton Tony , Russell Fraser , Greaves Kim , Kriel Yuri , Askew Christopher David 
Published: October 2020

New Findings
What is the central question of the study?Cuff‐occlusion duration may influence contrast‐enhanced ultrasound (CEUS) assessments of skeletal muscle microvascular blood flow responsiveness: what are the effects of 1, 3 and 5 min cuff‐occlusion on the magnitude and reliability of calf muscle microvascular blood flow responsiveness in older adults?
What is the main finding and its importance?Calf muscle microvascular blood flow responsiveness was enhanced following 5 min cuff‐occlusion compared with 1 min. The reliability of post‐occlusion CEUS measurements was also improved following 5 min occlusion. The use of a standardized 5 min occlusion period should therefore be considered in future studies and clinical practice.
AbstractContrast‐enhanced ultrasound (CEUS) is increasingly used in assessments of skeletal muscle microvascular blood flow responsiveness. In response to limb cuff‐occlusion, some studies have reported significant impairments in CEUS measurements of microvascular blood flow in older adults with cardiovascular or metabolic disease, whereas others have failed to detect significant between‐group differences, which has brought the reliability of the technique into question. In the absence of a standardized CEUS protocol, there is variance in the duration of cuff‐occlusion used, which is likely to influence post‐occlusion measurements of muscle microvascular blood flow. We aimed to determine the effect of cuff‐occlusion duration by comparing the magnitude and reliability of CEUS measurements of calf muscle microvascular blood flow responsiveness in older adults (n = 15, 67 ± 11 years) following 1, 3 and 5 min occlusion periods. Microvascular blood flow (= microvascular volume × microvascular velocity) within the calf muscle was measured using real‐time destruction–replenishment CEUS. Measurements were made following thigh cuff‐occlusion (200 mmHg) periods of 1, 3 and 5 min in a random order. Microvascular blood flow was higher following 3 min (3.71 ± 1.46 aU s−1) and 5 min (3.47 ± 1.48 aU s−1) compared with 1 min (2.42 ± 1.27 aU s−1, P = 0.002), which corresponded with higher microvascular volumes after 3 and 5 min compared with 1 min. Reliability was good following 5 min (intraclass correlation coefficient (ICC) 0.49) compared with poor following 1 min (ICC 0.34) and 3 min (ICC 0.35). This study demonstrates that the magnitude and reliability of calf muscle microvascular responsiveness is enhanced using a 5 min cuff‐occlusion protocol compared with 1 min in older adults.
Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: a 5-year follow-up of a randomised, placebo surgery controlled clinical trial
Authors: Paavola Mika , Kanto Kari , Ranstam Jonas , Malmivaara Antti , Inkinen Jari , Kalske Juha , Savolainen Vesa , Sinisaari Ilkka , Taimela Simo , Järvinen Teppo L 
Published: October 2020

ObjectivesTo assess the long-term efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy (primary comparison), a placebo surgical intervention, and with a non-operative alternative, exercise therapy (secondary comparison).MethodsWe conducted a multicentre, three group, randomised, controlled superiority trial. We included 210 patients aged 35–65 years, who had symptoms consistent with shoulder impingement syndrome for more than 3 months. 175 participants (83%) completed the 5 years follow-up. Patient enrolment began on 1 February 2005 and the 5-year follow-up was completed by 10 October 2018. The two primary outcomes were shoulder pain at rest and on arm activity measured with Visual Analogue Scale (VAS). Minimally important difference (MID) was set at 15. We used a mixed-model repeated measurements analysis of variance with participant as a random factor, the baseline value as a covariate and assuming a covariance structure with compound symmetry.ResultsIn the primary intention to treat analysis (ASD vs diagnostic arthroscopy), there were no between-group differences that exceeded the MID for the primary outcomes at 5 years: the mean difference between groups (ASD minus diagnostic arthroscopy) in pain VAS were −2.0 (95% CI −8.5 to 4.6; p=0.56) at rest and −8.0 (−17.3 to 1.3; p=0.093) on arm activity. There were no between-group differences in the secondary outcomes or adverse events that exceeded the MID. In our secondary comparison (ASD vs exercise therapy), the mean differences between groups (ASD minus exercise therapy) in pain VAS were 1.0 (−5.6 to 7.6; p=0.77) at rest and −3.9 (−12.8 to 5.1; p=0.40) on arm activity. There were no significant between-group differences for the secondary outcomes or adverse events.ConclusionsASD provided no benefit over diagnostic arthroscopy (or exercise therapy) at 5 years for patients with shoulder impingement syndrome.
Is extensive cardiopulmonary screening useful in athletes with previous asymptomatic or mild SARS-CoV-2 infection?
Authors: Gervasi Salvatore Francesco , Pengue Luca , Damato Luca , Monti Riccardo , Pradella Silvia , Pirronti Tommaso , Bartoloni Alessandro , Epifani Francesco , Saggese Alessio , Cuccaro Francesco , Bianco Massimiliano , Zeppilli Paolo , Palmieri Vincenzo 
Published: October 2020

ObjectiveDuring the COVID-19 pandemic, it is essential to understand if and how to screen SARS-CoV-2-positive athletes to safely resume training and competitions. The aim of this study is to understand which investigations are useful in a screening protocol aimed at protecting health but also avoiding inappropriate examinations.MethodsWe conducted a cohort study of a professional soccer team that is based on an extensive screening protocol for resuming training during the COVID-19 pandemic. It included personal history, antigen swabs, blood tests, spirometry, resting/stress-test ECG with oxygen saturation monitoring, echocardiogram, Holter and chest CT. We also compared the findings with prior data from the same subjects before infection and with data from SARS-CoV-2-negative players.ResultsNone of the players had positive swab and/or anti-SARS-CoV-2 IgM class antibodies. Out of 30 players, 18 (60%) had IgG class antibodies. None had suffered severe SARS-CoV-2-related disease, 12 (66.7%) had complained of mild COVID-19-related symptoms and 6 (33.3%) were asymptomatic. None of the players we examined revealed significant cardiovascular abnormalities after clinical recovery. A mild reduction in spirometry parameters versus pre-COVID-19 values was observed in all athletes, but it was statistically significant (p<0.05) only in SARS-CoV-2-positive athletes. One SARS-CoV-2-positive player showed increased troponin I level, but extensive investigation did not show signs of myocardial damage.ConclusionIn this small cohort of athletes with previous asymptomatic/mild SARS-CoV-2 infection, a comprehensive screening protocol including blood tests, spirometry, resting ECG, stress-test ECG with oxygen saturation monitoring and echocardiogram did not identify relevant anomalies. While larger studies are needed, extensive cardiorespiratory and haematological screening in athletes with asymptomatic/mild SARS-CoV-2 infection appears unnecessary.
Metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes
Authors: McCarthy Olivia , Pitt Jason , Churm Rachel , Dunseath Gareth J , Jones Charlotte , Bally Lia , Nakas Christos T , Deere Rachel , Eckstein Max L , Bain Stephen C , Moser Othmar , Bracken Richard M 
Published: October 2020

IntroductionThis study sought to compare the metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes (T1D).Research design and methodsThirteen individuals with T1D (hemoglobin; 7.0%±1.3% (52.6±13.9 mmol/mol), age; 36±15 years, duration diabetes; 15±12 years) performed a maximum of 45 min submaximal exercise (60%±6% V̇O2max). Retrospectively identified exercise sessions that ended in hypoglycemia ((HypoEx) blood glucose (BG)≤3.9 mmol/L) were compared against a participant-matched euglycemic condition ((EuEx) BG≥4.0, BG≤10.0 mmol/L). Samples were compared for detailed physiological and hormonal parameters as well as metabolically profiled via large scale targeted ultra-high-performance liquid chromatography coupled to tandem mass spectrometry. Data were assessed using univariate and multivariate analysis techniques with false discovery rate adjustment. Significant results were considered at p≤0.05.ResultsCardiorespiratory and counterregulatory hormone responses, whole-body fuel use and perception of fatigue during exercise were similar under conditions of hypoglycemia and euglycemia (BG 3.5±0.3 vs 5.8±1.1 mmol/L, respectively p<0.001). HypoEx was associated with greater adenosine salvage pathway activity (5’-methylthioadenosine, p=0.023 and higher cysteine and methionine metabolism), increased utilization of glucogenic amino acids (glutamine, p=0.021, alanine, aspartate and glutamate metabolism and homoserine/threonine, p=0.045) and evidence of enhanced β-oxidation (lower carnitine p<0.001, higher long-chain acylcarnitines).ConclusionsExposure to acute hypoglycemia during exercise potentiates alterations in subclinical indices of metabolic stress at the level of the metabolome. However, the physiological responses induced by dynamic physical exercise may mask the symptomatic recognition of mild hypoglycemia during exercise in people with T1D, a potential clinical safety concern that reinforces the need for diligent glucose management.Trial registration numberDRKS00013509.