bluuebunny/crossref_metadata_2025_split huggingface dataset:
514 F1-taught Orthopaedic Teaching for Students (FOTS)
Authors: Hashmi Y , Kumar P R , Beedham W 
Published: October 2021

Abstract

Introduction
F1 doctors, despite being expected to teach, have had reduced opportunity to do so during COVID-19. Medical students have also become increasingly concerned for upcoming exams due to time away from placements. A national orthopaedic teaching programme was designed to provide F1 doctors with opportunities to develop their teaching skills and synergistically improve students’ confidence in performing clinical orthopaedic examinations.

Method
A University Trauma & Orthopaedics society coordinated the teaching programme consisting of 6-weekly online sessions on each joint examination (shoulder, hip, knee, hand, ankle and lumbar spine). Each session was delivered by two F1 tutors. Pre- and post-session MCQs were provided to students to assess improvement in knowledge. Anonymous feedback forms were also disseminated.

Results
From the 341 students that attended, 87.1% provided feedback. 86.2% felt that they had de-skilled due to time off, with a mean 15 weeks off from placement. Based on a 5-point Likert scale, students displayed a mean improvement in confidence (1.9±1.1, p &lt; 0.001) and MCQ scores (1.4±1.3, p &lt; 0.001) before and after the sessions. 91.6% of students agreed that the use of online teaching increased attendance. Of the 10 tutors, all reported improvement in confidence to teach and teaching skills.

Conclusions
We demonstrate that online delivery of clinical orthopaedic examinations is effective and present our findings to encourage similar teaching programmes to be adopted at other locations and specialities.
613 The Floating Hip: A Distinct Injury Pattern? A Descriptive Study and Case-Control Analysis
Authors: Wong M , Ghobrial M , Han W M , Alsousou J , Chou D , Carrothers A , Hull P , Rawal J 
Published: October 2021

Abstract

Aim
A “Floating Hip” injury describes a simultaneous ipsilateral fracture of the femur and pelvis. We performed a descriptive study of the injury patterns, management, and outcomes of floating hip patients, and compared these patients to those with similar pelvic fractures without femoral involvement.

Method
This was a retrospective case-series review with secondary case-control analysis. Medical records of patients presenting with a floating hip injury to our tertiary orthopaedics department between 2015 and 2020 were reviewed. The control group comprised of patients with pelvic fractures but without associated femoral fractures, matched by age, sex, pelvic fracture classification, and mechanism of injury.

Results
46 Floating Hip cases were identified (34 males), of average age 39 (15-86) years. 20 had acetabular fractures, 21 had pelvic ring fractures and 5 had both fractures, concomitant with ipsilateral femoral fractures. The most common site of femoral fracture was mid-shaft (21.7%), followed by distal (19.6%). 69.6% of P/A fractures were managed surgically, with ORIF (43%) the most common option. 4 (12.50%) patients suffered complications, including 2 infections and 1 DVT. Compared to controls, Floating Hip patients were more likely to require surgical management (67.6% vs 47.8%, p = 0.03), and had higher rates of surgical complications (12.5% vs 4.6%), though not statistically significant (p = 0.3).

Conclusions
Our study describes the patterns, management, and outcomes of Floating Hip injuries, and observes differences in the management and complications compared to similar pelvic fractures without femoral involvement. These findings suggest Floating Hip cases may warrant consideration as a distinct injury pattern.
Values, Ethics and Theoretical Perspectives of the Hartford Social Competency Scale-II: Factorial Structure and Reliability of a Portuguese Version
Authors: Daniel Fernanda , Espirito-Santo Helena 
Published: October 2021

Abstract
Social work practice with the older population demands assessing gerontological competencies, for which values and ethics are central. This study aimed to test the adjustment of the Portuguese version of the Hartford Geriatric Social Work Competency Scale II subscale—values, ethics and theoretical perspectives (GSWCS-II-VEPT) to a bifactor structure and to analyse its reliability in a sample of social workers. The study enrolled 534 social workers employed in older adults’ care organisations. The confirmatory factorial analysis showed that the items presented factorial loads more than 0.60, and the bifactorial component model fitted well with the data. The two components consisted of ‘nuclear competencies’ and ‘specialised skills’. The GSWCS-II-VEPT presented excellent reliability (Cronbach’s α = 0.90). However, high interfactor correlations demanded the test of a single-factor solution. The single-factor model did not fit the data as well as the two-factor solution, and the Akaike information criterion value was smaller in the two-factor model, indicating a superior fit. The results support adequate psychometric properties of GSWCS-II-VEPT in evaluating ethical skills, values and theoretical perspectives in Portuguese social workers and can be used as a tool for self-evaluation of these professionals’ ethical behaviour.
Metamorphosis of flora and vegetation during ontogeny of the Juan Fernández (Robinson Crusoe) Islands
Authors: Stuessy Tod F , Crawford Daniel J , Greimler Josef , López-Sepúlveda Patricio , Ruiz Eduardo A , Baeza Carlos M , Takayama Koji 
Published: October 2021

AbstractColonization, levels of speciation and vegetational metamorphosis during ontogeny of oceanic islands over geological time are central evolutionary and biogeographic concerns. A suitable archipelago in which to examine such events is the Juan Fernández (Robinson Crusoe) Archipelago, located at 33° S latitude off the coast of continental Chile and consisting of three major islands: Robinson Crusoe Island, 667 km west of the coastline; Santa Clara Island, 1.6 km off the south-western end of the former island and Alejandro Selkirk Island, 181 km directly further west into the Pacific Ocean. The two largest islands are c. 50 km2, with Santa Clara Island being only 2.1 km2. Radiometric dating for the three islands reveals the ages of Robinson Crusoe Island and Santa Clara Island to be c. 4 My, whereas that of Alejandro Selkirk Island is c. 1 My. Molecular clock estimates of crown-group divergences of endemic taxa fall mostly in these geological ages. Recent investigations have brought together a detailed inventory of the vascular flora of the archipelago with biological, evolutionary and biogeographic information that now supports examining metamorphosis of the vegetation and flora during the 4 My of island ontogeny. Geological dating and geomorphological models are used to infer changes in the landscape on both major islands. It is suggested that the original Robinson Crusoe Island may have been substantially larger and higher than at present (3000 vs. 915 m). Subsidence and erosion of the island led to loss of vegetation zones, especially impacting plants between 1000 and 3000 m. Some species may have adapted to this restructuring, but many would have gone extinct. Alejandro Selkirk Island, now 1 My, is only slightly smaller and lower than the original island (1319 vs. 2000 m), but it has probably lost some higher elevation habitats. The present vegetation of the two islands correlates with these suggestions, with Alejandro Selkirk Island retaining broad zones, but Robinson Crusoe Island having a flora that has been compacted and substantially intermixed with invasive species in recent centuries. Floristic inventory reveals 11 endemic genera, but most of these occur only on Robinson Crusoe Island, which has been the centre of cladogenesis in contrast to greater levels of anagenesis on Alejandro Selkirk Island. The ferns, due to their high dispersability, show almost no cladogenesis. Total endemic species diversity is higher on Robinson Crusoe Island (87) than on Alejandro Selkirk Island (62), and this difference is probably due to the greater age of the island and initial environmental heterogeneity. It is also probable that during this ontogeny, numbers of endemic species on Robinson Crusoe Island have been lost through island subsidence and erosion, loss of habitat and human impact.
Trefoil factor family 2 inhibits cholangiocarcinogenesis by regulating the PTEN pathway in mice
Authors: Hasebe Keiji , Yamaguchi Junpei , Kokuryo Toshio , Yokoyama Yukihiro , Ochiai Yosuke , Nagino Masato , Ebata Tomoki 
Published: October 2021

Abstract
Trefoil factor family 2 (TFF2) is one of three trefoil factor family proteins and is expressed abundantly in the gastrointestinal epithelium. Recent studies have shown that TFF2 acts as a tumor suppressor in gastric and pancreatic carcinogenesis; however, little is known about its function in cholangiocarcinogenesis. To investigate the function of TFF2 in cholangiocellular carcinoma (CCC), immunohistochemistry of surgically resected human CCC samples was performed. TFF2 expression was upregulated in the early stage and lost in the late stage of cholangiocarcinogenesis, suggesting the association of TFF2 and CCC. A TFF2 expression vector was then transfected into a CCC cell line (HuCCT1) in vitro, revealing that TFF2 functions as a tumor suppressor not only by inhibiting proliferation and invasion but also by promoting the apoptosis of cancer cells. In addition, PTEN signaling activity was downregulated by TFF2, suggesting an association between TFF2 and PTEN. Next, hepatic carcinogenesis model mice (KC; albumin-Cre/Lox-Stop-Lox KRASG12D) were bred with TFF2-knockout mice to generate a TFF2-deficient mouse model (KC/TFF2−/−). Although the incidence of hepatocellular carcinoma was not different between KC/TFF2−/− mice and control mice, biliary intraepithelial neoplasm (BilIN), the precursor of CCC, was frequently found in the biliary epithelium of KC/TFF2−/− mice. Immunohistochemistry revealed that BilIN samples from these mice did not express PTEN. In addition, two KC/TFF2−/− mice developed CCC adjacent to BilIN, suggesting that TFF2 functions to inhibit the development of CCC in vivo. These results indicate that TFF2 acts as a tumor suppressor to inhibit the development of CCC by regulating PTEN activity.
Fault-Tolerant Strongly Hamiltonian Laceability and Hyper-Hamiltonian Laceability of Cayley Graphs Generated by Transposition Trees
Authors: Xue Shudan , Deng Qingying , Li Pingshan 
Published: October 2021

AbstractA bipartite graph is Hamiltonian laceable if any two of its vertices in different partite sets are connected by a Hamiltonian path. A Hamiltonian laceable graph $G$ is called strongly Hamiltonian laceable if any two of its vertices in the same partite set are connected by a path of length $|V(G)|-2$. A Hamiltonian laceable graph $G$ (with two partite sets $V_0, V_1$) is called hyper-Hamiltonian laceable, if for any vertex $v \in V_{i}$ for $i \in \{0,1\}$, there is a Hamiltonian path of $G-\{v\}$ between any two vertices in $V_{1-i}$. In this paper, we focus on the edge-fault-tolerant strongly Hamiltonian laceability and hyper-Hamiltonian laceability on the class of Cayley graphs generated by transposition trees, which are a generalization of star graph and bubble-sort graph. For every $n$-dimensional Cayley graph generated by a transposition tree $\Gamma _n$, we show that $\Gamma _{n}-F$ is strongly Hamiltonian laceable for any $F \subseteq E(\Gamma _{n})$ with $|F|\leq n-3$, which generalizes results in [ 1, 11], and show that $\Gamma _{n}-F$ is hyper-Hamiltonian laceable for any $F \subseteq E(\Gamma _{n})$ with $|F|\leq n-4$.
Acute pericarditis, Graves’ disease, and thymic hyperplasia: a case report
Authors: Acquaro Mauro , Breviario Federico , Greco Alessandra , Ghio Stefano 
Published: October 2021

Abstract

Background
Acute pericarditis as a sign of mediastinal mass is rare and aetiological diagnosis can be challenging without adequate imaging.

Case summary
An 18-year-old woman came to our attention describing acute sharp chest pain radiated to the left arm, exacerbated with supine positioning and attenuated while sitting or leaning forward. The electrocardiogram showed diffuse ST elevation and PR depression, with sinus tachycardia. Cardiac biomarkers and D-dimer were negative; echocardiography showed no abnormalities and the absence of pericardial effusion. Her blood work revealed no sign of inflammation or bacterial infection (PCR and procalcitonin were normal); thyroid-stimulating hormone plasma levels were suppressed, showing decompensated thyrotoxicosis. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Epstein–Barr virus, human immunodeficiency virus, hepatitis C virus, Enterovirus, Parvovirus B19, and Adenovirus tests were normal. Her past medical history was silent, apart from Grave’s disease on treatment with methimazole. Chest computed tomography (CT) was performed and showed the presence of slightly increased density pericardial effusion, with a maximum thickness of 15 mm in the upper mediastinum. Finally, cardiac magnetic resonance (MR) identified a mass of 73 × 51 mm located in the upper mediastinum. The mass was subsequently biopsed with video-assisted thoracoscopic surgery and the histological analysis showed thymic hyperplasia.

Discussion
This case shows the importance of an adequate clinical suspicion of thymic hyperplasia in the context of acute pericarditis symptoms and known Graves’ disease. In this case, a negative chest CT finding may not be sufficient to rule out the diagnosis and cardiac MR imaging is necessary.
Treatment stability with bonded versus vacuum-formed retainers: a systematic review of randomized clinical trials
Authors: Bellini-Pereira Silvio Augusto , Aliaga-Del Castillo Aron , dos Santos Cibelle Cristina Oliveira , Henriques José Fernando Castanha , Janson Guilherme , Normando David 
Published: October 2021

Summary

Background
In orthodontics, the retention phase can be considered challenging and unpredictable. Therefore, evidence obtained from different retention protocols is important to facilitate clinical decision-making.

Objectives
This systematic review aimed to compare the clinical effectiveness of bonded versus vacuum-formed retainers (VFRs) regarding their capacity to maintain treatment stability, periodontal effects, and failure rates.

Search methods and eligibility criteria
Ten databases comprising published and unpublished literature were systematically searched up to August 2021. Randomized clinical trials (RCTs) comparing both retainers were included.

Data collection and analysis
The risk of bias (RoB) evaluation was performed with the Cochrane Collaboration RoB Tool 2.0. All steps of the screening phase and RoB assessment were performed independently by two reviewers. The Grade of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of the evidence.

Results
Initial database search yielded 923 studies. After duplicates removal and full-text assessment, five RCTs remained. Overall, the studies presented Low RoB, except one study judged with ‘Some concerns’. Based on the included studies, on a short-term (3–6 months) and long-term (4 years) basis, bonded retainers (BRs) were more effective to maintain treatment stability than VFRs in the lower arch. However, from 12 to 24 months both retainers presented the same efficacy. In the upper arch, the retainers were equally effective. BRs were associated with greater plaque and calculus accumulation than VFRs after 12 months. The retainers’ failure rates were similar in the upper arch on the first year of retention; however, after 2 years VFRs showed significantly greater failure rates. Contrarily, BRs presented greater failure rates in the lower arch than VFRs.

Limitations
The findings of the included studies may be influenced by different factors related to the unpredictability of relapse.

Conclusions
Most of the evidence generated in this systematic review derived from a moderate level of certainty. In the lower arch, BRs are more effective than VFRs to maintain treatment stability in the initial 6 months of retention and in the long term. In the upper arch, both retention protocols are equally effective.

Registration
Regist0ration number: PROSPERO CRD42020199392.

Funding
Coordination for the Improvement of Higher Educational Personnel (CAPES, Process code-001).
An alternative valve for mitral valve replacement in young children: using an NO-REACT® INJECTABLE BIOPULMONIC™ prosthesis as a mitral valve replacement in a 14-month-old child
Authors: Carro Cristina , Marianeschi Stefano , Ghiselli Simone , Uricchio Nicola 
Published: October 2021

Abstract
Mitral valve replacement in infants is challenging and there are limited alternative valves available. Since the Boston group published their first report on alternative valves for mitral valve replacement in infants, there has been a growth in the literature on the topic, mostly based on the use of a stented bovine jugular vein graft (Melody® valve). The challenges of the Melody valve are firstly in its length of 28 mm unexpanded, which has the potential to cause left ventricular outflow tract obstruction, and secondly, the valve needs mechanical dilatation, which is laborious. A modified No-React® Injectable Biopulmonic™ Prosthesis (Bio Integral Surgical, Inc., Mississauga, ON, Canada) which is shorter (19 mm) and simpler in that it is self-expanding was implanted in a 14-month-old child to replace her mitral valve. The operation was successful and the short-term function of the prosthesis is good.
Structural valve deterioration of the Labcor Dokimos aortic prosthesis: a single-centre experience
Authors: Iskandarani Dounia , Chaabo Omar , Gharzeddine Walid , Sfeir Pierre , Obeid Mounir , Ghazzal Ziyad , Rebeiz Abdallah , Sawaya Fadi J 
Published: October 2021

Abstract

OBJECTIVES
The goal of this study was to assess the performance and incidence of the deterioration of the Labcor Dokimos bioprosthetic aortic valve.

METHODS
We performed a retrospective medical chart review of 116 patients who underwent surgical aortic valve replacement with the Labcor Dokimos aortic valve between 2010 and 2018. Abstracted data included patient demographic and echocardiographic data. Patients were divided into 2 groups: patients with structural valve deterioration (SVD) and patients without SVD.

RESULTS
Among the patients with complete follow-up (n = 95), 10 patients were excluded because they died within a year; 85 patients were included in the final analysis. Of the 85 patients, 32 (38%) developed SVD; 22 (26%) had severe SVD, 15 (18%) of whom underwent reintervention. The most common aetiology of SVD was severe central aortic regurgitation, which was detected in 91% of the patients who had severe SVD. The average time from operation to severe SVD was 4.7 years with a minimum of 1.5 years and a maximum of 7.9 years.

CONCLUSIONS
Bioprosthetic aortic valve deterioration due to severe aortic regurgitation is common and occurs early with the Labcor Dokimos valve. This occurrence needs to be furthered investigated in larger registries.
Prognostic impact of spread through air spaces in lung adenocarcinoma
Authors: Mantovani Sara , Pernazza Angelina , Bassi Massimiliano , Amore Davide , Vannucci Jacopo , Poggi Camilla , Diso Daniele , d’Amati Giulia , Della Rocca Carlo , Rendina Erino Angelo , Venuta Federico , Anile Marco 
Published: October 2021

Abstract

OBJECTIVE
Spread through air spaces (STAS) is a pattern of invasion present in some adenocarcinomas (ADC). The goal of this study was to assess the impact of STAS in patients treated with different types of surgical resections and on the clinical outcome in patients with ADC of different diameters and with different degrees of nodal involvement.

METHODS
A total of 109 patients were reviewed. Complete surgical resection with systematic nodal dissection was achieved in all patients. The median follow-up was 65 months (3–90 months).

RESULTS
STAS was observed in 70 cases (64.2%); 13 patients (18.5%) had lymph node involvement (N1 and N2). Overall survival and progression-free survival were higher in patients without STAS (P = 0.042; P = 0.027). The presence of STAS in tumours ≤2 cm was a predictor of worse progression-free survival following sublobar resection compared to major resections (P = 0.011). Sublobar resection of N0 STAS-positive tumours was associated with worse long-term survival compared to a major resection (P = 0.04). Statistical analyses showed that age &gt;70 years and recurrence were independent variables for survival; smoking pack-years &gt;20, sublobar resection and nodal involvement were independent variables for recurrence; and smoking pack-years &gt;20 were independent variables for a history of cancer and pleural invasion for local recurrence.

CONCLUSIONS
STAS seems to play a role in long-term survival, particularly for patients with N0 and tumours smaller than 2 cm. Further studies are necessary to validate this hypothesis.
Khinchin-Type Inequalities via Hadamard’s Factorisation
Authors: Havrilla Alex , Nayar Piotr , Tkocz Tomasz 
Published: October 2021

Abstract
We prove Khinchin-type inequalities with sharp constants for type L random variables and all even moments. Our main tool is Hadamard’s factorisation theorem from complex analysis, combined with Newton’s inequalities for elementary symmetric functions. Besides the case of independent summands, we also treat ferromagnetic dependencies in a nonnegative external magnetic field (thanks to Newman’s generalisation of the Lee–Yang theorem). Lastly, we compare the notions of type L, ultra sub-Gaussianity (introduced by Nayar and Oleszkiewicz) and strong log-concavity (introduced by Gurvits), with the latter two being equivalent.
Deep sequencing of HIV-1 reveals extensive subtype variation and drug resistance after failure of first-line antiretroviral regimens in Nigeria
Authors: El Bouzidi Kate , Datir Rawlings P. , Kwaghe Vivian , Roy Sunando , Frampton Dan , Breuer Judith , Ogbanufe Obinna , Murtala-Ibrahim Fati , Charurat Man , Dakum Patrick , Sabin Caroline A. , Ndembi Nicaise , Gupta Ravindra K. 
Published: October 2021

Abstract

Background
Deep sequencing could improve understanding of HIV treatment failure and viral population dynamics. However, this tool is often inaccessible in low- and middle-income countries.

Objectives
To determine the genetic patterns of resistance emerging in West African HIV-1 subtypes during first-line virological failure, and the implications for future antiretroviral options.

Patients and methods
Participants were selected from a Nigerian cohort of people living with HIV who had failed first-line ART and subsequently switched to second-line therapy. Whole HIV-1 genome sequences were generated from first-line virological failure samples with Illumina MiSeq. Mutations detected at ≥2% frequency were analysed and compared by subtype.

Results
HIV-1 sequences were obtained from 101 participants (65% female, median age 30 years, median 32.9 months of nevirapine- or efavirenz-based ART). Thymidine analogue mutations (TAMs) were detected in 61%, other core NRTI mutations in 92% and NNRTI mutations in 99%. Minority variants (&lt;20% frequency) comprised 18% of all mutations. K65R was more prevalent in CRF02_AG than G subtypes (33% versus 7%; P = 0.002), and ≥3 TAMs were more common in G than CRF02_AG (52% versus 24%; P = 0.004). Subtype G viruses also contained more RT cleavage site mutations. Cross-resistance to at least one of the newer NNRTIs, doravirine, etravirine or rilpivirine, was predicted in 81% of participants.

Conclusions
Extensive drug resistance had accumulated in people with West African HIV-1 subtypes, prior to second-line ART. Deep sequencing significantly increased the detection of resistance-associated mutations. Caution should be used if considering newer-generation NNRTI agents in this setting.