bluuebunny/crossref_metadata_2025_split huggingface dataset:
Educational Impact of Notebook Covers on the Knowledge of Sixth-Grade Primary Pupils About Tooth Avulsion and Replantation: A Randomized Trial
Authors: Sedlaceck Paulo , Poi Wilson Roberto , Amaral Marina Fuzette , Castilho Lithiene Ribeiro , Panzarini Sônia Regina , Saito Célia Tomiko Matida Hamata , Brandini Daniela Atili 
Published: February 2021

Background Tooth avulsion is a common cause of tooth loss. However, there is a significant lack of knowledge about dental trauma and the appropriate emergency procedures to handle these cases. Aim The aim of this study was to evaluate the educational effect of notebook covers illustrated with figures and informative texts about tooth avulsion and replantation in sixth-grade primary school pupils. Material and Methods Sixth-grade pupils of two public school participated in this study. An experimental group consisting of 134 pupils received notebook covers illustrated with figures and informative texts about tooth avulsion and replantation, while a control group of 108 pupils received notebooks with neutral covers. An assessment of the educational effects on pupils was performed after 9 months, with a standardized questionnaire normally used to evaluate dental trauma. Statistical analysis was conducted with SPSS 21.0 (α = .05) for group description and comparison using chi-square and Student t tests. Results Compared with the control group, the experimental group showed statistically significant improvements in correct meaning of dental trauma (38% vs. 58.2%); procedures to follow in the case of dental avulsion (2.8% vs. 70.9%); storing the avulsed tooth in milk (18.5% vs. 76.9%); general knowledge about dental anatomy (61.1% vs. 95.5%); and the ideal time for the tooth to remain outside the mouth prior to replantation (20.4% vs. 59.7%). Conclusion The use of notebook covers illustrated with figures and informative texts about dental trauma led to a significant increase in the knowledge of schoolchildren about tooth avulsion, first aid, and replantation.
Plasma neurofilament light chain levels are predictors of disease activity in multiple sclerosis as measured by four-domain NEDA status, including brain volume loss
Authors: Szilasiová Jarmila , Mikula Pavol , Rosenberger Jaroslav , Fedičová Miriam , Gdovinová Zuzana , Urban Peter , Frigová Lýdia 
Published: February 2021

Background: The research is focused on sensitive biomarkers in multiple sclerosis (MS). Objective: The aim of the study was to assess the relationship between plasma neurofilament light chain (pNfL) and disease activity as defined by the concept NEDA (no evident disease activity), including brain volumetry, in a cohort of MS patients treated with disease-modifying treatment (DMT). Methods: Levels of pNfL (Single Molecule Array (SIMOA) technology) were examined in 95 RRMS (relapsing-remitting multiple sclerosis) patients and analyzed in relationship to NEDA-3 status and NEDA-BVL (brain volume loss; NEDA-3 extended by brain volumetry) during the last 12 months. The statistical model was developed using logistic regression analysis, including the independent variables: demographic, clinical, and magnetic resonance imaging (MRI) data. Dependent variables were NEDA-3 and NEDA-BVL status. Results: The mean age of the study participants ( n = 95, 62% females) was 37.85 years (standard deviation (SD) = 9.62) and the median disability score was 3.5 (2.5–4.1). Receiver operating characteristics (ROC) analysis showed that pNfL predicts NEDA-3 (the sensitivity and specificity of the model were 92% and 78%, respectively, p < 0.001) and NEDA-BVL status (the sensitivity and specificity were 80% and 65%, respectively, p < 0.001). Conclusion: The results show that pNfL levels are a useful biomarker of disease activity determined by NEDA-BVL status, including brain MRI-volumetry in patients with RRMS.
Development and validation of a scale to measure the resilience of schools: Perspectives of young people from vulnerable and challenging territories
Authors: Milheiro Silva Ana , Marques da Silva Sofia 
Published: February 2021

This article presents the development and validation of a scale for young people, which measures the resilience of schools in ensuring the educational pathways of students in vulnerable and challenging territories. This scale was developed within a national-level project, conducted in Portuguese border regions with Spain, which are peripheral contexts with economic, social, cultural, and educational disadvantages, but with locally-situated promising dynamics. Resilient schools, from an ecological perspective, are sensitive and committed to their internal and external settings. These schools act as a whole to face problem solving and risk situations, while also needing to support youth educational pathways and fulfill their role. This is particularly important in contexts with territorial disparities and specificities, as is the case of border regions. The Resilience Scale of Schools – Youth Version (RSS-Y) integrates dimensions related to schools’ focus and priorities, as well as practices and resources. Its development took into consideration that schools in vulnerable territories deal with specific constraints and fewer opportunities. In addition, this scale seeks to study the characteristics of resilience that young people identify in their schools and how they perceive their schools’ support. This quantitative scale was developed following a multi-step approach and was applied to 3,968 young people (9th to 12th grade). It comprises 17 items, rated on a five-point Likert scale to assess agreement. Statistical analysis ensure the internal consistency (Factor 1, α = .846; Factor 2, α = .845; Factor 3, α = .789) and the validity of this scale, indicating adequate psychometric properties to measure students’ perspectives on the resilience characteristics of schools. A Principal Component Analysis (PCA) proposes a three-factor structure that explains 57.393% of the total variance. A Confirmatory Factor Analysis (CFA) indicates that this model is a good fit with the data. The RSS-Y can provide an important contribution to educational research developed in more deprived territories, but also to school contexts, since it recognizes the importance of schools’ differentiated approaches and highlights characteristics that promote the resilience and quality of schools.
A nationwide analysis on the effects of chronic obstructive pulmonary disease following primary total shoulder arthroplasty for glenohumeral osteoarthritis
Authors: Amirian Brandon , Akhnoukh Kyrillos M , Ashraf Asad M , Swiggett Samuel J , Rosato Francis E , Vakharia Rushabh M , Sadeghpour Ramin , Razi Afshin E 
Published: February 2021

Background Chronic obstructive pulmonary disease patients have been shown in orthopedic literature to have poorer outcomes and higher rates of complications from surgery. In this retrospective review, medical complications, length of stay, and costs were obtained to explore the effects of chronic obstructive pulmonary disease on patients undergoing primary total shoulder arthroplasty. Methods Total shoulder arthroplasty cases from January 2005 to March 2014 were queried and analyzed from a nationwide database. Study patients were matched 1:5 to controls by age, sex, and medical comorbidities associated with chronic obstructive pulmonary disease. In-hospital length of stay, 90-day medical complications, day of surgery, and total global 90-day episode of care costs were obtained for comparison. Results Chronic obstructive pulmonary disease patients were found to have higher incidence and odds (53.91 vs. 11.95%; OR: 3.58, 95%CI: 3.18–3.92, p < 0.0001) of 90-day medical complications, longer in-hospital length of stay (3 vs. 2 days, p < 0.0001), and significantly higher 90-day costs ($14,768.37 vs. $13,379.20, p < 0.0001) following primary total shoulder arthroplasty compared to matched controls. Discussion Chronic obstructive pulmonary disease patients undergoing primary total shoulder arthroplasty have higher rates of medical complications, in-hospital length of stay, and costs of care. This represents an important factor that will allow orthopedic surgeons to adequately manage expectations and educate chronic obstructive pulmonary disease patients of the potential complications which may occur following total shoulder arthroplasty.
High-Energy Achilles Tendon Rupture With Associated Medial Malleolus Fracture and Traumatic Peroneal Dislocation: A Case Report
Authors: Bowers Mark , Hunt Kenneth J. , Metzl Joshua 
Published: February 2021

Fracture, Achilles tendon rupture, or traumatic dislocation of the peroneal tendons are often seen in isolation after a trauma or sports-related injury. However, in rare circumstances, a combination of these injuries can occur simultaneously. Multiple previous case reports describe a combination of 2 of these injuries. Missed or delayed diagnosis is common in these combination injuries and can lead to significant patient morbidity and result in long-term consequences. We report a case of a 35-year-old man who sustained an Achilles tendon rupture with an associated medial malleolus fracture and traumatic peroneal dislocation after a snowboarding injury. These injuries were treated surgically, and at 9 months postoperatively, the patient had returned to all activities. Clinicians should have a high index of suspicion for concomitant injuries with higher-energy trauma to the ankle and should perform a thorough history, physical examination, and plain radiographs at a minimum. Levels of Evidence: LEVEL 5
Changes in Immunologic Indicators During Allergen-Specific Immunotherapy for Allergic Rhinitis and Determinants of Variability: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Jiang Zihan , Xiao Hao , Liu Shixi , Meng Juan 
Published: February 2021

Background To date, there are no generally recognized biomarkers for allergen immunotherapy (AIT) and even the changes in immunological indicators during AIT are inconsistent in different publications. Objective This study was conducted to quantify the immunological changes that occur during AIT and identify the determinants of heterogeneity. Methods Randomized controlled trials of AIT published in the past 10 years were searched in Medline, Embase and Cochrane CENTRAL. Data on immunological indicators were extracted, and the characteristics of the included studies were collected. Meta-analysis and meta-regression were conducted for each indicator. The study was registered on the PROSPERO website (CRD42020176127). Results We reviewed 1898 studies. Forty-six studies met the inclusion criteria, and 31 studies were included in the quantitative analyses. Subset analyses by time demonstrated that serum allergen-specific IgE (sIgE) of AIT patients increased in the first 12 months, then decreased and became slightly lower than that of control patients. Allergen-specific IgG4 (sIgG4) was elevated in the AIT group during and after treatment. IgE-blocking factor (IgE-BF) was increased and IgE-facilitated allergen binding (IgE-FAB) was reduced in AIT patients. Both of them of the 2 factors were associated with clinical efficacy in the multivariate regression analysis. sIgE/sIgG4 decreased in AIT patients, while there was no change in total IgE. Conclusion The levels of serum sIgE and sIgG4 during AIT showed a time-dependent pattern. IgE-BF and IgE-FAB should be further investigated as biomarkers for predicting and monitoring AIT efficacy.
Expanded access to multiple sclerosis teleneurology care following the COVID-19 pandemic
Authors: McGinley Marisa P , Gales Shauna , Rowles William , Wang Zhini , Hsu Wan-Yu , Amezcua Lilyana , Bove Riley 
Published: February 2021

Background Teleneurology for multiple sclerosis (MS) care was considered feasible, but utilization was limited. Objective To describe how the existing teleneurology populations at two academic MS Centers changed during the COVID-19 pandemic. Methods In this cross-sectional study, we captured all in-person and teleneurology visits at two academic MS Centers between January 2019 and April 2020. We compared group differences between the Centers, and COVID-related changes using T-, chi-squared Kruskal-Wallis and Fisher exact tests. Results 2268 patients completed 2579 teleneurology visits (mean age 48.3 ± 13.3 years, 72.9% female). Pre-COVID, the Centers’ teleneurology populations were similar for age, sex, MS type, and disability level (all p > 0.1), but differed for race (96.5% vs 80.7% white, p ≤ 0.001), MS treatment (49.1% vs 32.1% infusible, p ≤ 0.001), and median distance from Center (72 vs 186 miles, p ≤ 0.001). Post-COVID, both Centers’ teleneurology populations had more black (12.7% vs 4.37%, p ≤ 0.001) and local (median 34.5 vs 102 miles, p ≤ 0.001) patients. Conclusion Teleneurology visits in 2019 reflected the organizational and local teleneurology reimbursement patterns of our Centers. Our post-COVID-19 changes illustrate the potential for payors and policy to change disparities in access to, or utilization of, remote care. Patients’ perception of care quality and value following this shift warrants study.
Government Size and Economic Growth: An Empirical Examination of Selected Emerging Economies
Authors: Jain Megha , Nagpal Aishwarya , Jain Abhay 
Published: February 2021

The current study attempts to examine the linkage between government (public) spending and economic growth in the broader framework of selected South Asian Nations (SANs), BRICS and other emerging nations by using two sets of empirical modelling over the period 2007–2016 by using inverted U-shaped hypothesis, propounded by Armey curve (1995). The first set has employed system GMM technique to explore the presence of the Armey curve hypothesis using the square term of government size, while the second set has used the threshold regression using system GMM panel modelling to investigate the subsequent reversals (tipping point). The key findings signify the existence of an inverted U-shaped relationship for the selected data set of emerging nations and, therefore, support the Armey curve hypothesis. The projected threshold (tipping) levels (as a percentage of GDP) are 24.31% for the government total expenditures (GTotExp), 12.92% for consumption spending (GConExp) and 7.11% for investment spending (GInvExp). It has been observed that a rise in the public spending (size) resulted in a substantial increase (decrease) in the growth rate when the public spending was before (after) the optimal threshold level, indicating a non-monotonic association. The findings of the study also suggest a policy implication that public spending could only be a short-term measure to deal with crises in any nation, but not a long-term solution. JEL Classification: C23, C33, E60, E62, H00, H50, O40, O50
Performance After Anterior Cruciate Ligament Reconstruction in National Basketball Association Players
Authors: DeFroda Steven F. , Patel Devan D. , Milner John , Yang Daniel S. , Owens Brett D. 
Published: February 2021

Background: Anterior cruciate ligament (ACL) injury in National Basketball Association (NBA) players can have a significant impact on player longevity and performance. Current literature reports a high rate of return to play, but there are limited data on performance after ACL reconstruction (ACLR). Purpose/Hypothesis: To determine return to play and player performance in the first and second seasons after ACLR in NBA players. We hypothesized that players would return at a high rate. However, we also hypothesized that performance in the first season after ACLR would be worse as compared with the preinjury performance, with a return to baseline by postoperative year 2. Study Design: Case series; Level of evidence, 4. Methods: An online database of NBA athlete injuries between 2010 and 2019 was queried using the term ACL reconstruction. For the included players, the following data were recorded: name; age at injury; position; height, weight, and body mass index; handedness; NBA experience; dates of injury, surgery, and return; knee affected; and postoperative seasons played. Regular season statistics for 1 preinjury season and 2 postoperative seasons were compiled and included games started and played, minutes played, and player efficiency rating. Kaplan-Meier survivorship plots were computed for athlete return-to-play and retirement endpoints. Results: A total of 26 athletes underwent ACLR; of these, 84% (95% CI, 63.9%-95.5%) returned to play at a mean 372.5 days (95% CI, 323.5-421.5 days) after surgery. Career length after injury was a mean of 3.36 seasons (95% CI, 2.27-4.45 seasons). Factors that contributed to an increased probability of return to play included younger age at injury (odds ratio, 0.71 [95% CI, 0.47-0.92]; P = .0337) and fewer years of experience in the NBA before injury (odds ratio, 0.70 [95% CI, 0.45-0.93]; P = .0335). Postoperatively, athletes played a significantly lower percentage of total games in the first season (48.4%; P = .0004) and second season (62.1%; P = .0067) as compared with the preinjury season (78.5%). Player efficiency rating in the first season was 19.3% less than that in the preinjury season ( P = .0056). Performance in the second postoperative season was not significantly different versus preinjury. Conclusion: NBA players have a high rate of RTP after ACLR. However, it may take longer than a single season for elite NBA athletes to return to their full preinjury performance. Younger players and those with less NBA experience returned at higher rates.
Noniatrogenic Medial Patellar Dislocations: Case Series and International Patellofemoral Study Group Experience
Authors: Loeb Alexander E. , Farr Jack , Parikh Shital N. , Cosgarea Andrew J. 
Published: February 2021

Background: Most patellar dislocations occur in a lateral direction because of a summed lateral force vector and predisposing anatomic risk factors. Medial patellar instability is rare and is a well-recognized iatrogenic complication of an overly aggressive lateral retinacular release. Noniatrogenic medial patellar dislocations are rare. The management of these injuries is not well described. Purpose: To describe the experience of the International Patellofemoral Study Group with patients with noniatrogenic medial patellar dislocation. Study Design: Case series; Level of evidence, 4. Methods: Members of the International Patellofemoral Study Group (N = 64) were surveyed between October 2018 and April 2019. This group was chosen because of its wide referral base and interest in patellar instability. Specialists who had encountered a patient with medial patellar instability were sent a questionnaire inquiring about details of the case, including patient demographics, medical history, level of athletic competition, injury characteristics, and treatment. Cases were confirmed by physical examination records and, in some cases, with findings on advanced radiographic imaging. Results: The survey response rate was 73% (47/64). Three of the 47 specialists (6.4%) reported they had seen a case of noniatrogenic medial patellar dislocation, for a total of 6 cases. Four cases were described as recurrent medial dislocations in the setting of hypermobile Ehlers-Danlos syndrome; 2 were treated nonoperatively, 1 underwent lateral patellofemoral ligament reconstruction, and 1 underwent derotational osteotomies. Two medial-sided patellar dislocations in collegiate athletes were sports-related injuries that required surgical debridement but no ligamentous reconstruction. None of the patients had persistent or recurrent instability at the time of their most recent follow-up. Conclusion: Noniatrogenic medial patellar dislocations are extremely rare. This case review suggests that the treatment of first-time medial patellar instability in patients without known risk factors should follow the same principles as the treatment of lateral instability with no known risk factors, which is nonoperative management. For patients with documented risk factors and recurrence, surgery to address the risk factors may be appropriate.
Ankle Ligament Reconstruction - Return to Sport after Injury (ALR-RSI): a valid scale to quantify psychological readiness to return to sports after ankle ligament reconstruction
Authors: Sigonney Francois , Lopes Ronny , Bouché Pierre Alban , Stein Alexandra , Hardy Alexandre 
Published: February 2021

Objectives: Chronic instability is the main complication of ankle sprains and requires surgical intervention if non-surgical treatment fails. The aim of this study was to validate a tool to quantify psychological readiness to return to sports after ankle ligament reconstruction. Methods: The form was designed like the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale, and the term "anterior cruciate" was replaced by "ankle". The Ankle Ligament Reconstruction - Return to Sport after Injury Scale (ALR-RSI) was completed by patients who had undergone ankle ligament reconstruction and who practiced a sport. The scale was then validated according to the COSMIN international methodology. The AOFAS and Karlsson scores were used as reference questionnaires. Results: 57 patients (59 ankles) were included, 27 of whom were women. The ALR-RSI scale was highly correlated with the Karlsson score (r=0.79 [0.66-0.87]) and the AOFAS score (r=0.8 [0.66-0.87]). A highly significant difference was noted on the ALR-RSI scale between the subgroup of 50 patients who returned to sports and the 7 who did not: 68.8 (56.5-86.5) versus 45.0 (31.3-55.8), respectively, p = 0.02. The internal consistency of the scale was high (α = 0.96). Reproducibility of the test-retest was excellent (ρ = 0.92, 95% CI [0.86-0.96]). Conclusion: The ALR-RSI is a valid, reproducible scale with which to identify patients who are ready to resume the same sport after ankle ligament reconstruction. This scale can help to identify athletes who will have difficulty returning to sports.
Dynamic Characteristics of Rotor System with a Slant Crack Based on Fractional Damping
Authors: Li Zhinong , Li Yunlong , Wang Dong , Peng Zhike , Wang Haifeng 
Published: February 2021

AbstractThe traditional modeling method of rotor system with a slant crack considers only integer-order calculus. However, the model of rotor system based on integer-order calculus can merely describe local characteristics, not historical dependent process. The occur of fractional order calculus just makes up for the deficiency in integer-order calculus. Therefore, a new dynamic model with a slant crack based on fractional damping is proposed. Here, the stiffness of rotor system with a slant crack is solved by zero stress intensity factor method. The proposed model is simulated by Runge-Kutta method and continued fraction Euler method. The influence of the fractional order, rotating speed, and crack depth on the dynamic characteristics of rotor system is discussed. The simulation results show that the amplitude of torsional excitation frequency increases significantly with the increase of the fractional order. With the increase of the rotating speed, the amplitude of first harmonic component becomes gradually larger, the amplitude of the second harmonic becomes smaller, while the amplitude of the other frequency components is almost invariant. The shaft orbit changes gradually from an internal 8-type shape to an ellipse-type shape without overlapping. With the increase of the slant crack depth, the amplitude of the transverse response frequency in the rotor system with a slant crack increases, and the amplitude in the second harmonic component also increases significantly. In addition, the torsional excitation frequency and other coupling frequency components also occur. The proposed model is further verified by the experiment. The valuable conclusion can provide an important guideline for the fault diagnosis of rotor system with a slant crack.