bluuebunny/crossref_metadata_2025_split huggingface dataset:
352 Did the Discontinuation of Pulse-Lavage Have A Detrimental Effect on The Quality of Hip Hemiarthroplasties Performed During the First COVID-19 Wave?
Authors: Sharma D , Spacey K , Sharma V 
Published: October 2021

Abstract

Introduction
The standard of practice for performing hip hemiarthroplasty is to thoroughly wash and dry the femur with pulse-lavage. With the COVID-19 pandemic we were issued with guidance to minimise Aerosol Generating Procedures (AGPs) and discontinued the use of pulse lavage. Instead, we used a bladder syringe to wash the femoral canal.

Method
We retrospectively assessed 100 post-operative radiographs following hemiarthroplasties for neck of femur fractures. We used the Barrack classification to assess the bone cement mantle which is an indicator of aseptic loosening. We assessed 50 radiographs pre-covid (using pulse lavage) and 50 radiographs during covid (without pulse lavage).

Results
Pre-COVID-19, 30% of hemiarthroplasties were deemed as being ‘at risk’. During COVID-19, 64% of hips were deemed as being ‘at risk’. This represents an absolute increase of 34%.

Conclusions
This forced service change had a detrimental effect on the quality of the bone cement mantle following hip hemiarthroplasty. We recommend following these patients up at 2 years to assess for signs of aseptic loosening. In future pandemics, we recommend carefully weighing up the dangers of using AGPs against the detriment in patient outcomes likely to be experienced.
399 Complex Limb Injuries – Limb Salvage vs Amputation: An Overview of the Factors Influencing Decision-Making and Outcomes
Authors: Jamal S , Sheeraz A 
Published: October 2021

Abstract

Aim
Complex limb injuries usually comprise of a combination of osseous, soft tissue, vascular and neural damage, necessitating prompt and accurate initial examination and decision-making to maximise optimal patient outcomes. We present the factors affecting the decision-making as well as the outcomes following primary limb amputation or salvage of complex extremity injuries, with an emphasis on the various scoring systems present that endeavour to offer prognostic and therapeutic guidance to orthopaedic surgeons.

Method
We performed the literature search on PubMed and Embase, and collated the relevant data comprising of demographics, injury, scoring system, primary and secondary outcome metrics and complications.

Results
Many scoring systems, each with variable factors, have been proposed to predict limb salvage vs amputation in complex extremity injury (MESS, PSI, LSI, NISSSA, HFS-97), however the landmark LEAP trial concluded in its final analysis that they could not validate them. Whilst the scores were useful in predicting limb salvage, they were inaccurate and unreliable in predicting amputation with low sensitivities

Conclusions
Many scoring systems attempt to provide guidance regarding decision-making in limb salvage vs primary amputation, however the LEAP study has shown poor predictive standards of these systems. As such, there is no gold standard algorithmic approach or scoring system when making this difficult decision – instead, the poor predictors of limb salvage have been identified, and the surgeons need to be judicious and make a joint decision considering these variables and other patient factors (social, economic, and psychological status).
414 Informed Consent for Neck of Femur Fracture Surgery During the Covid-19 Pandemic: An Evidence-Based Approach
Authors: Cuthbert R , Ferguson D , Kayani B , Haque S , Ali A , Parkar A , Bates P , Vemulapalli K 
Published: October 2021

Abstract

Background
Surgical intervention for neck of femur fractures continues to be prioritised during the Covid-19 pandemic. However, there remains a lack of clarity for clinicians during the consent process. This study quantifies additional perioperative risks for Covid-19 positive patients undergoing neck of femur fracture surgery and establishes an evidence-based framework for facilitating informed consent during the Covid-19 pandemic.

Method
259 patients undergoing neck of femur fracture surgery in four hospitals at the epicentre of the United Kingdom’s first wave of Covid-19 were recruited. 51 patients were positive for Covid-19. Predefined outcomes were recorded in a 30-day postoperative period.

Results
Odds of intensive care admission were 4.64 times higher (95% CI 1.59-13.50, p = 0.005) and odds of 30-day mortality were 3 times higher (95% CI 1.22-7.40, p = 0.02) in Covid-19 positive patients. 74.5% of Covid-19 positive patients suffered post-operative complications. 35.3% of Covid-19 positive patients developed lower respiratory tract infection with 13.7% progressing to acute respiratory distress syndrome. 9.8% of Covid-19 positive patients experienced symptomatic thromboembolic events with a 3.9% incidence of pulmonary emboli.

Conclusions
The implications of Covid-19 on the informed consent process for neck of femur fracture surgery are profound. Covid-19 positive patients should be consented for increased risk of postoperative complications (including lower respiratory tract infection, acute respiratory distress syndrome and thromboembolic events), longer inpatient stay, increased frequency of intensive care admission and higher risk of mortality.
519 Outcomes of Management with Ilizarov Frames in Bone Infection: An Observational Study
Authors: Marshall C , Butler J 
Published: October 2021

Abstract

Aim
The successful treatment and eradication of bone infection requires a multifaceted approach and may recur even after excision if resultant bone void is not managed effectively. This paper aims to review the clinical effectiveness of antibiotic-impregnated bone void filler and current empirical antibiotic guidelines.

Method
We report a retrospective study of 18 patients with chronic osteomyelitis following injury or surgery managed via Ilizarov Ring Fixator (IRF). All patients were managed by IRF stabilisation procedures with debridement, microbiological sampling, and bone void filling with antibiotic-impregnated biocomposite material, in addition to culture-specific systemic antimicrobial therapy.

Results
Patients were followed up for a mean of 15.9 months. Infection was eradicated in 94.1% of patients in a grossly comorbid demographic. Comorbidities associated with increased risk of osteomyelitis were noted in 72.2% of patients. Anaerobic bacteria were identified in culture for four (22.2%) of the 18 patients.

Conclusions
We detected a higher than suspected growth of anaerobes in our samples, suggesting the need for metronidazole in empirical antibiotic treatment. This study would suggest that the use of STIMULAN® may be preferable in this National Health Service from a cost-effect perspective, as our results are comparable to those using other bone void fillers.
565 Predictors of Single Versus Multi-Level Lumbar Spinal Fusion: A Retrospective Cohort Study
Authors: Wong J , Baliga S 
Published: October 2021

Abstract

Aim
Degenerative spine disease (DSD) of the lumbar spine is a common disorder among the aging population in the world, with a substantial humanistic and economic burden. Although lumbar spinal fusion is currently the mainstay surgical management of DSD, surgery is also associated with adjacent segment disease due to the modification of spinal biomechanics. Therefore, it is important to identify potential risk factors of DSD in order to prevent progressive deterioration and provide early intervention before the surgical option is absolutely necessary.

Method
Adult patients who underwent posterior lumbar spinal fusion from 2006-2016 were identified via OPCS-4codes. Smoking status, weight, age of operation, gender, diagnosis of ischaemic heart disease (IHD) were obtained via TrakCare®. The degree of deprivation was extrapolated using the Scottish Index of Multiple Deprivation (SIMD) 2020 quintile score. Data were analysed using logistic regression.

Results
In total, 313 met inclusion criteria and had data available, of which 205 and 108 patients underwent single and multi-level lumbar fusion respectively. Within the study population, 66.8% (206) and 33.2% (104) were female and male. Adjusted for all outcome measures, age of operation achieved statistical significance (p = 0.040). There was a 1.021-fold increase in risk of multi-level spinal fusion with each additional year of age. Weight was approaching statistical significance (p = 0.068).

Conclusions
Lumbar spinal health declines over time, but some patients experience more progressive deterioration. While some components of the spine are irreparable, early prescription of regimented exercise programs may strengthen spinal musculature to maintain a healthy sagittal balance, particularly in older, overweight, female patients.
A novel predictor of ACE2-binding ability among betacoronaviruses
Authors: Dixson Jamie D , Azad Rajeev K 
Published: October 2021

Abstract

Background
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in ~4.8 million deaths worldwide as of this writing. Almost all conceivable aspects of SARS-CoV-2 have been explored since the virus began spreading in the human population. Despite numerous proposals, it is still unclear how and when the virus gained the ability to efficiently bind to and infect human cells. In an effort to understand the evolution of receptor binding domain (RBD) of the spike protein of SARS-CoV-2, and specifically, how the ability of RBD to bind to angiotensin-converting enzyme 2 receptor (ACE2) of humans evolved in coronaviruses, we have applied an alignment-free technique to infer functional relatedness among betacoronaviruses. This technique, concurrently being optimized for identifying novel prions, was adapted to gain new insights into coronavirus evolution, specifically in the context of the ongoing COVID-19 pandemic. Novel methods for predicting the capacity for coronaviruses, in general, to infect human cells are urgently needed.

Methodology
proposed method utilizes physicochemical properties of amino acids to develop fully dynamic waveform representations of proteins that encode both the amino acid content and the context of amino acids. These waveforms are then subjected to dynamic time warping (DTW) and distance evaluation to develop a distance metric that is relatively less sensitive to variation in sequence length and primary amino acid composition.

Results and Conclusions
Using our proposed method, we show that in contrast to alignment-based maximum likelihood (ML) and neighbor-joining (NJ) phylogenetic analyses, all bat betacoronavirus spike protein RBDs known to bind to the ACE2 receptor are found within a single physicochemical cluster. Further, other RBDs within that cluster are from pangolin coronaviruses, two of which have already been shown to bind to ACE2 while the others are suspected, yet unverified ACE2 binding domains. This finding is important because both severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2 use the host ACE2 receptor for cell entry. Surveillance for coronaviruses belonging to this cluster could potentially guide efforts to stifle or curtail potential and/or early zoonotic outbreaks with their associated deaths and financial devastation.

Lay Summary
Robust methods for predicting human ACE2 receptor binding by the spike protein of coronaviruses are needed for the early detection of zoonotic coronaviruses and biosurveillance to prevent future outbreaks. Here we present a new waveform-based approach that utilizes the physicochemical properties of amino acids to determine the propensity of betacoronaviruses to infect humans. Comparison with the established phylogenetic methods demonstrates the usefulness of this new approach in the biosurveillance of coronaviruses.
“You Still Want to Go Lots of Places”: Exploring Walking Interviews in Research With Older Migrants
Authors: Lőrinc Magdolna , Kilkey Majella , Ryan Louise , Tawodzera Obert 
Published: October 2021

Abstract

Background and Objectives
Walking interviews have become prevalent in social sciences; however, their use in research with older people is limited. This article offers a reflexive account of our ethical and methodological choices and practices while conducting walking interviews with older migrants, and considers the potential of this method in researching migrants’ aging in place.

Research Design and Methods
The study had a longitudinal, multisited (London and Yorkshire), qualitatively driven multimethod research design. In 2018–2019, in-depth interviews were conducted with 45 older migrants originally from the Caribbean, Ireland, and Poland, followed by walking interviews with a subsample of 9 participants 6–12 months later. The majority of participants were older than 80 years.

Results
Our study demonstrated that walking interviews are a promising method to explore in depth a variety of relevant issues including older migrants’ mobility, and health and well-being; navigating places through everyday activities; interactions with local neighborhoods over time; and the meanings associated with such experiences. Through direct exposure to the physicality of places, walking interviews can elicit rich and complex data that would be difficult to collect through other methods.

Discussion and Implications
Conducting walking interviews with older migrants has unique thematic potential. However, a range of ethical and practical challenges need to be considered, including a risk to revealing participants’ identities and adopting an ethics-in-practice approach. The method has some limitations, especially with less-mobile participants. Implications for researchers, policymakers, and practitioners are suggested.
Comment on ‘Evidence for a large strike-slip component during the 1960 Chilean earthquake’ by H. Kanamori, L. Rivera and S. Lambotte
Authors: Savage J C 
Published: October 2021

SUMMARY
Based on numerous studies of the relevant geodetic data, a low-angle thrusting mechanism has been assigned to the 1960 Chile earthquake. Kanamori, Rivera and Lambotte recently suggested that a component of dextral slip comparable to the thrusting be included in the mechanism to satisfy long-period, teleseismic observations. The absence of geodetic evidence for that huge strike-slip component is the subject of this comment. The geodetic data are largely measurements of coseismic uplift associated with the earthquake but include eight measurements of the coseismic change in shear strain. Because strike-slip produces relatively little uplift except near the end points of the rupture, identification of that strike-slip component in the geodetic data depends upon the measured, shear-strain change. I consider elastic, half-space models of oblique slip on the plate interface possibly supplemented by simultaneous dextral slip on the nearby, intra-arc Liquiñe-Ofqui Fault Zone. Slip is assumed to be uniform along strike. The best fits to the geodetic data for these models furnish little evidence for strike-slip on those structures. To satisfy the long-period, teleseismic data, Kanamori et al. proposed six examples, each of which requires a large amount of dextral slip. Because the long-period, teleseismic data do not define the slip distributions, I have used the best fits of those examples to the geodetic data to define those distributions. The large thrusting near the deformation front required by those slip distributions implies large uplift there, contrary to the uplift inferred from the inversion of tsunami data. However, an acceptable fit to the geodetic data and the tsunami data for the six examples suggested by Kanamori et al. can be obtained if the seismic moments specified by them are reduced by a factor ∼1.8, a factor within the uncertainties in estimating seismic moments of the 1960 Chile earthquake. The presence of strike-slip in those reduced-moment examples despite the lack of geodetic evidence for strike-slip is due to a remarkable coincidence that requires careful balancing of contributions from the shallower (depths &lt; 70 km) coseismic sources against those from the deeper coseismic sources to nullify the geodetic evidence for strike-slip. Such balancing is possible, but it is remarkable that the balancing is so nearly perfect that it nullifies the geodetic evidence for strike-slip and thereby confounds the interpretation of the geodetic data.
Analytical Performance and Quality Indicators of Fully Automated Immunoassays for sFlt-1 and PlGF
Authors: Higgins Victoria , Ma Liyan , Ragosnig Bonny Lem , Melamed Nir , Hladunewich Michelle , James Tim , Leite Joao , Rozmanc Mary , Barrett Jon , Zaltz Arthur , Yip Paul M , Fu Lei 
Published: October 2021

Abstract

Background
The ratio of the antiangiogenic factor, soluble fms-like tyrosine kinase 1 (sFlt-1), to the proangiogenic factor, placental growth factor (PlGF), is associated with increased risk of preeclampsia. Here, we describe an analytical evaluation of the Elecsys sFlt-1 and PlGF assays at the first North American site in which they were clinically implemented.

Methods
The analytical evaluation included short- and long-term imprecision, method comparison, accuracy, linearity, sample stability, limit of quantification verification, and measurement uncertainty. Quality indicators were also evaluated, including turnaround time and repeat test frequency.

Results
Short-term (13-day) and long-term (12-month) imprecision for sFlt-1 and PlGF were &lt;4% CV. Method comparison (n = 40) between Roche cobas e602 and e411 exhibited r &gt; 0.99 and bias &lt;10%. sFlt-1/PlGF ratio rule-out cutoffs (≤33 and ≤38) and rule-in cutoffs (&gt;38, &gt;85, and &gt;110) exhibited negative percent agreement and positive percent agreement of 100%, respectively (n = 40). During the first 12 months, 257 orders were placed, repeat test frequency was 17.5%, mean time between repeat orders was 23 days, and 72.0% of results were reported within 2 h from sample receipt when quality control was run continuously.

Conclusions
We describe analytical performance parameters and quality indicators of the Elecsys sFlt-1 and PlGF assays, which was the first North American clinical laboratory site to implement these assays in support of the institution’s high-risk obstetrical unit.
A Farnese acquisition: Ribera, Genovesino and other paintings and bronzes from Governor Carlo Luzzi’s collection
Authors: Cocconi Giulia 
Published: October 2021

Abstract
This article focuses on the works of art – bronzes and paintings – listed in an inventory of 1655 detailing the collection of Carlo Luzzi, governor of Piacenza. This document has enabled the identification of a hitherto unpublished acquisition by Ranuccio II Farnese (1630–1694), and the tracing of many of Luzzi’s objects in the Farnese inventories drafted in Parma in 1680 and 1708. It also allows us to identify a number of bronzes and to offer some observations concerning the patronage of paintings attributed to artists such as Jusepe de Ribera, Bartolomeo Schedoni and Luigi Miradori.
Effects of Trans-ancestry Schizophrenia Risk Gene Polymorphisms on Working Memory and Underlying Brain Mechanisms
Authors: Su Yanyan , Zhang Qiumei , Zhao Wan , Chen Xiongying , Li Yang , Du Boqi , Deng Xiaoxiang , Ji Feng , Dong Qi , Chen Chuansheng , Li Jun 
Published: October 2021

Abstract
One of the main goals of the new generation of antipsychotics is to improve cognitive functions of schizophrenia patients, which makes it necessary to identify genes related to not only schizophrenia but also its cognitive impairments. Starting with 58 trans-ancestry risk variants found in a genome-wide association study of Chinese schizophrenia patients, we conducted two studies with four samples to systematically examine these variants’ potential roles in working memory. Study 1 was a behavioral study (Sample I included 510 healthy volunteers who completed the n-back, dot-pattern expectancy [DPX], delayed match-to-sample [DMS], and spatial span tasks; Sample II included 819 healthy volunteers and 893 schizophrenia patients who completed the n-back and DPX tasks). Study 2 was an fMRI study (Sample III included 163 healthy volunteers and 52 schizophrenia patients, who were scanned with fMRI during an n-back task; and Sample IV included 89 healthy volunteers, who were scanned during a spatial span task). Sample I identified rs11210892 as the only SNP that was associated with performance on multiple tasks (n-back, DPX, and DMS) after Bonferroni correction. Sample II replicated this association on the n-back task and the DPX task. FMRI data showed that the risk allele “G” of rs11210892 was associated with an increased activation within the right dorsolateral prefrontal cortex (Sample III) and the bilateral striatum (Sample IV). We conclude that rs11210892 is significantly associated with working memory and its neural underpinnings, so the genes near this SNP might be potential gene targets for treating cognitive impairment associated with schizophrenia.
Children's Behavior and Maternal Parenting Stress in Young Children With Sex Chromosome Trisomies
Authors: Lorini Alessandra , Zampini Laura , Silibello Gaia , Dall'Ara Francesca , Rigamonti Claudia , Ajmone Paola Francesca , Monti Federico , Lalatta Faustina , Costantino Maria Antonella , Vizziello Paola Giovanna 
Published: October 2021

Abstract:

Objective:
Children and adolescents with sex chromosome trisomies (SCTs) usually show a higher frequency of behavioral problems than typically developing (TD) children. However, little is known about the presence of behavioral issues in toddlers with SCT. This study aimed at investigating their behavioral profile in the second year of life and its impact on maternal stress.

Method:
Participants were 87 children ranging in age from 18 to 26 months: 63 children with SCTs (all diagnosed prenatally) and 24 TD children. Their psychomotor and language development and their behavioral profile were assessed. In addition, the level of maternal parenting stress was evaluated.

Results:
Both psychomotor and language development were significantly lower in children with SCTs than in TD children. Conversely, no significantly greater behavioral problems emerged in children with SCTs. However, a significantly higher level of parenting stress related to a dysfunctional interaction with the child emerged in the mothers of children with SCTs. In this population, maternal stress seemed positively related to their children's emotional problems and pervasive disorders and negatively related to their children's psychomotor and linguistic competence.

Conclusion:
Although no significant behavioral issues emerged in the second year of life, the relationships found between children's behavioral profiles and maternal parenting stress highlight the importance of prenatal counseling and support groups for parents of children with SCTs. This might help them recognize the first signs of behavioral problems and become aware of their influence on parenting stress.
In-silico investigation of umami peptides with receptor T1R1/T1R3 for the discovering potential targets: A combined modeling approach
Authors: Wang Wenli , Cui Zhiyong , Ning Menghua , Zhou Tianxing , Liu Yuan 
Published: October 2021

AbstractUmami, providing amino acids/peptides for animal growth, represents one of the major attractive taste modalities. The biochemical and umami properties of peptide are both important for scientific research and food industry. In this study, we did the sequence analysis of 205 umami peptides with 2-18 amino acids, sought the active sites of umami peptides by quantum chemical simulations and investigated their recognition residues with receptor T1R1/T1R3 by molecular docking. The results showed the peptides with 2-3 amino acids accounting for 44% of the total umami peptides. Residues D and E are the key active sites no matter where they in peptides (N-terminal, C-terminal or middle), when umami peptides contain D/E residues. N69, D147, R151, A170, S172, S276 and R277 residues in T1R1 receptor were deem to the key residues binding umami peptides. Finally, a powerful decision rule for umami peptides was proposed to predict potential umami peptides, which was convenient, time saving and efficiently.