bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Morphogenetic Protein-2 Rapidly Heals Two Distinct Critical Sized Segmental Diaphyseal Bone Defects in a Porcine Model
Authors: McKinley Todd O , Childress Paul , Jewell Emily , Griffin Kaitlyn S , Wininger Austin E , Tucker Aamir , Gremah Adam , Savaglio Michael K , Warden Stuart J , Fuchs Robyn K , Natoli Roman M , Shively Karl D , Anglen Jeffrey O , Gabriel Chu Tien-Min , Kacena Melissa A 
Published: September 2021

ABSTRACT

Introduction
Segmental bone defects (SBDs) are devastating injuries sustained by warfighters and are difficult to heal. Preclinical models that accurately simulate human conditions are necessary to investigate therapies to treat SBDs. We have developed two novel porcine SBD models that take advantage of similarities in bone healing and immunologic response to injury between pigs and humans. The purpose of this study was to investigate the efficacy of Bone Morphogenetic Protein-2 (BMP-2) to heal a critical sized defect (CSD) in two novel porcine SBD models.

Materials and Methods
Two CSDs were performed in Yucatan Minipigs including a 25.0-mm SBD treated with intramedullary nailing (IMN) and a 40.0-mm SBD treated with dual plating (ORIF). In control animals, the defect was filled with a custom spacer and a bovine collagen sponge impregnated with saline (IMN25 Cont, n = 8; ORIF40 Cont, n = 4). In experimental animals, the SBD was filled with a custom spacer and a bovine collage sponge impregnated with human recombinant BMP-2 (IMN25 BMP, n = 8; ORIF40 BMP, n = 4). Healing was quantified using monthly modified Radiographic Union Score for Tibia Fractures (mRUST) scores, postmortem CT scanning, and torsion testing.

Results
BMP-2 restored bone healing in all eight IMN25 BMP specimens and three of four ORIF40 BMP specimens. None of the IMN25 Cont or ORIF40 Cont specimens healed. mRUST scores at the time of sacrifice increased from 9.2 (±2.4) in IMN25 Cont to 15.1 (±1.0) in IMN25 BMP specimens (P &lt; .0001). mRUST scores increased from 8.2 (±1.1) in ORIF40 Cont to 14.3 (±1.0) in ORIF40 BMP specimens (P &lt; .01). CT scans confirmed all BMP-2 specimens had healed and none of the control specimens had healed in both IMN and ORIF groups. BMP-2 restored 114% and 93% of intact torsional stiffness in IMN25 BMP and ORIF40 BMP specimens.

Conclusions
We have developed two porcine CSD models, including fixation with IMN and with dual-plate fixation. Porcine models are particularly relevant for SBD research as the porcine immunologic response to injury closely mimics the human response. BMP-2 restored healing in both CSD models, and the effects were evident within the first month after injury. These findings support the use of both porcine CSD models to investigate new therapies to heal SBDs.
A Retrospective Study of Foot Biomechanics and Injury History in Varsity Football Athletes at the U.S. Naval Academy
Authors: Windsor Jennifer , Jeffries Joshua , Sorensen Jeff , Bach Kelly , Benedek Evan , Bicher Jessica , Pasquina Paul 
Published: September 2021

ABSTRACT

Introduction
The six-item Foot Posture Index (FPI-6) was previously developed as an assessment tool to measure the posture of the foot across multiple segments and planes. It was derived from a criterion-based observational assessment of six components of each foot during static standing. The association between abnormal foot posture and musculoskeletal injuries remains unclear and is in of need further exploration.

Hypothesis/Purpose
The purpose of this study was to assess the association between foot biomechanics and self-reported history of musculoskeletal pain or injury.

Study Design
Retrospective, cross-sectional study of collegiate football players at the U.S. Naval Academy.

Materials and Methods
For each athlete, data were recorded on height, weight, self-reported history of pain or injury, and foot posture, which was measured using a FPI-6 with each item measuring the degree of pronation/supination. The primary outcome was each athlete’s maximum deviation from neutral posture across the six-item index (FPImax). The prespecified primary analysis used generalized linear models to measure the association between FPImax and self-report history of pain or injury. Exploratory analyses measured the association using penalized regression (L1-norm) and a type of tree-based ensemble known as extreme gradient boosting (XGBoost).

Results
Data were collected on 101 athletes, 99 of whom had sufficient body mass index (BMI) data to be included for analysis. Among the 99 athletes, higher FPImax was associated with a prior history of musculoskeletal pain (odds ratio [OR] 1.15, 95% confidence interval [CI] 0.97 to 1.35), although the sample size was too small for the association to be significant with 95% CI (P = .107). FPImax was not associated with a history of knee injury/pain (OR 0.98, 95% CI 0.83 to 1.15, P = .792), nor with a history of ankle/foot injury or pain (OR 1.04, 95% CI 0.90 to 1.21, P = .599). From the L1-penalized model, the FPI components with the strongest linear associations were the L6, R2, R1-squared, and FPImax. From the XGBoost model, the most important variables were FPItotal, BMI, R1, and R2.

Conclusions
The U.S. Naval Academy football players whose foot postures deviated from neutral were more likely to have reported a previous history of musculoskeletal pain. However, this deviation from normal was not strongly associated with a specific history of pain or injury to the knee, ankle, or foot.

Clinical Relevance
The information ascertained from this study could be used to better inform clinicians about the value of the FPI in predicting or mitigating injuries for varsity football athletes.
A combination of mRNA features influence the efficiency of leaderless mRNA translation initiation
Authors: Bharmal Mohammed-Husain M , Gega Alisa , Schrader Jared M 
Published: September 2021

Abstract
Bacterial translation is thought to initiate by base pairing of the 16S rRNA and the Shine–Dalgarno sequence in the mRNA’s 5′ untranslated region (UTR). However, transcriptomics has revealed that leaderless mRNAs, which completely lack any 5′ UTR, are broadly distributed across bacteria and can initiate translation in the absence of the Shine–Dalgarno sequence. To investigate the mechanism of leaderless mRNA translation initiation, synthetic in vivo translation reporters were designed that systematically tested the effects of start codon accessibility, leader length, and start codon identity on leaderless mRNA translation initiation. Using these data, a simple computational model was built based on the combinatorial relationship of these mRNA features that can accurately classify leaderless mRNAs and predict the translation initiation efficiency of leaderless mRNAs. Thus, start codon accessibility, leader length, and start codon identity combine to define leaderless mRNA translation initiation in bacteria.
Prime-Boost Vaccination With BNT162b2 Induces High Neutralizing Activity Against SARS-CoV-2 Variants in Naïve and COVID-19-Convalescent Individuals
Authors: Luczkowiak Joanna , Labiod Nuria , Rivas Gonzalo , Rolo Marta , Lasala Fátima , Lora-Tamayo Jaime , Mancheno-Losa Mikel , Rial David , Pérez-Rivilla Alfredo , Folgueira María D , Delgado Rafael 
Published: September 2021

Abstract

Background
The objective of this study was to investigate the neutralizing response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VoC) during coronavirus disease 2019 (COVID-19) convalescence and after vaccination.

Methods
COVID-19-convalescent and -naïve individuals were tested for neutralizing activity against SARS-CoV-2 VoC Alpha, Beta, Gamma, and Delta at 1 and 7 months postinfection and 4–6 weeks after BNT162b2 vaccination.

Results
Vaccination induced a high neutralizing response in naïve individuals. Interestingly, vaccination of convalescent patients induced a boosted response that was able to neutralize all VoC at high titers.

Conclusions
Vaccination with BNT162b2 induced high levels of neutralization against SARS-CoV-2 VoC in most patients; this is especially beneficial in COVID-19-convalescent individuals.
Structural Equation Model of Emotional Labor, Work–Home Interaction, and Well-Being
Authors: Ballentine Kess L , Woo Jihee 
Published: September 2021

AbstractSocial work best practices encourage empathy. However, empathy may both prevent and contribute to negative effects of work on worker well-being through emotional labor and spillover into home life. Theory and research suggest that work–family interaction (WFI) may mediate the relationship between emotional labor and worker well-being. The current work examines this framework using structural equation modeling. Authors hypothesized emotional labor to directly and indirectly relate to worker well-being through WFI. Data are from an online survey of 218 Pennsylvanian social workers. The structural equation model was a good fit: χ2(185) = 298.373, p &lt; .001, comparative fit index = .940, Tucker–Lewis index = .926, root mean square error of approximation = .055, 90% confidence interval [0.044, 0.067], standardized root mean square residual = .050. Results show that emotional labor is directly associated with well-being. Negative WFI played a role in mediating the relationship between emotional labor and worker well-being. These results suggest that workplace policy and practice changes could improve worker well-being by adjusting both emotional labor and WFI.
Global phylogeny of the inquilinous gall wasp tribe Synergini (Hymenoptera: Cynipoidea: Cynipidae): first insights and establishment of a new cynipid tribe
Authors: Lobato-Vila Irene , Bae Jongmin , Roca-Cusachs Marcos , Kang Minjoon , Jung Sunghoon , Melika George , Pénzes Zsolt , Pujade-Villar Juli 
Published: September 2021

Abstract
Previous phylogenetic studies of the tribe Synergini were focused on Palaearctic material, in which the genus Synergus was recovered as monophyletic, despite evidence of non-monophyly when global sampling is considered. A global molecular phylogeny of Synergini, including sequenced material from Nearctic and Neotropical realms, is presented herein for the first time. We assembled DNA data for 120 specimens: 104 representing all genera belonging to Synergini, except for the rare monospecific genus Agastoroxenia (ingroup), and 16 belonging to five other tribes of Cynipidae (outgroup). We obtained sequences for four genes: cytochrome c oxidase subunit I (COI), cytochrome b (Cytb), 28S region D2 (28S D2) and 28S region D3 (28S D3). The evaluated analyses support the non-monophyly of both Saphonecrus and Synergus (with Nearctic and Neotropical Synergus resolved into three clades separated from the Palaearctic species), as well as the monophyly of the rest of the genera in Synergini. Furthermore, the results suggest that neither Saphonecrus s.s. nor Synergus s.s. are present in the New World. The future challenges to separate the clades of Saphonecrus and Synergus into new taxa are discussed. Lastly, Rhoophilus was shown to belong to a new tribe, Rhoophilini trib. nov., on the basis of molecular, morphological and biological data.
The role of the NP in primary care of adults with autism spectrum disorder
Authors: Robert Jacqueline , Duff Elsie 
Published: September 2021

Abstract:
Adults with autism spectrum disorder have poorer physical and psychological health outcomes compared with individuals who are neurotypical and benefit from exceptional primary care. NPs are uniquely positioned to reform primary care and eliminate inequities, and can help influence practice standards and optimize care for these patients through education, advocacy, and health promotion.
The Effect of Morbid Obesity on Complications, Readmission, and Patient-Reported Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Claus Chad F. , Lawless Michael , Lytle Evan , Tong Doris , Bahoura Matthew , Garmo Lucas , Gabrail Joseph , Bono Peter , Kelkar Prashant , Richards Boyd , Carr Daniel A. , Houseman Clifford , Soo Teck M. 
Published: September 2021

Study Design.
Retrospective review of prospectively collected data at a single institution.

Objective.
To compare perioperative and clinical outcomes in morbidly obese patients who underwent minimally invasive transforaminal lumbar interbody fusion (MiTLIF).

Summary of Background Data.
Obesity remains a serious public health concern. Obese patients who undergo lumbar fusion have historically thought to be at higher risk for complications and fare worse regarding quality-of-life outcomes. However, recent literature may demonstrate comparable risk and outcomes in obese patients. An increasing number of patients are categorized as morbidly obese (body mass index [BMI] ≥ 40 kg/m2). Perioperative and patient-reported outcomes (PROs) are lacking in this patient population.

Methods.
The authors retrospectively reviewed a prospectively collected database of all morbidly obese and non-obese patients that underwent MiTLIF between 2015 and 2018 for degenerative conditions who had minimum 1-year follow-up for outcome assessment. An inverse propensity/probability of treatment weighting was utilized to create a synthetic weighted sample in which covariates were independent of obesity designation to adjust for imbalance between groups. Generalized estimating equations (GEE) was used to estimate the association of morbid obesity and complications and 1-year PROs.

Results.
A total of 292 patients were analyzed with 234 non-obese patients and 58 morbidly obese patients. Multivariate analysis failed to demonstrate any association between morbid obesity and achieving minimal clinically important difference (MCID) for Oswestry disability index (ODI), visual analog scale (VAS), or short form-12 (SF-12) physical component score. However, morbid obesity was associated with significant decrease in odds of achieving MCID for SF-12 mental component score (P = 0.001). Increased surgery duration was significantly associated with morbid obesity (P = 0.001). Morbid obesity exhibited no statistically significant association with postoperative complications, readmission, pseudarthrosis, or adjacent segment disease (ASD).

Conclusion.
Morbidly obese patients who undergo MiTLIF can achieve meaningful clinical improvement comparable to nonobese patients. Morbid obesity was associated with longer surgical times but was not associated with postoperative complications, readmission, or ASD.

Level of Evidence: 3
The Impact of Radiographic Lower Limb-Spinal Length Proportion on Whole-Body Sagittal Alignment
Authors: Hey Hwee Weng Dennis , Tan Kian Loong Melvin , Lau Eugene Tze-Chun , Ng Jordan Wei Peng , Liu Gabriel Ka-Po , Wong Hee-Kit 
Published: September 2021

Study Design.
A radiographic comparative study.

Objective.
To investigate the influence of radiographic lower limb-spinal length proportion on sagittal radiographic parameters.

Summary of Background Data.
Although lordotic realignment of the lumbar spine is a well-established surgical strategy, its ideal target has not been fully understood. The widely used pelvic incidence-lumbar lordosis discrepancy (PI-LL) method to guide lordotic restoration of the lumber spine in the standing posture, may be further refined using the novel, radiographic lower limb-spinal length proportion parameter in selected subjects.

Methods.
A 100 healthy subjects were imaged in the standing posture using EOS imaging to obtain whole-body lateral radiographs for the measurement of sagittal radiographic parameters. Univariate analyses were performed to compare radiographic parameters between groups with different radiographic lower limb-spinal length proportion. Multivariate analyses were performed to identify the associations between lower limb-spinal length proportions and other radiographic parameters.

Results.
Regardless of lower limb-spinal length proportion (mean = 1.4), global lumbar angle (GLA) differed from spinal lordosis (SL), with the absolute means of SL and GLA larger and smaller than pelvic incidence (PI) respectively. Univariate analysis showed that patients with proportionately larger lower limb-spinal length proportion are more likely to have larger mean T1-slope, global thoracic angle (GTA), spinal kyphosis (SK), GLA, and SL. Multivariate analysis showed that a larger lower limb length-spinal length proportion is predictive of larger GLA is less than –47.69° (Odds Ratio (OR) 2.660, P = 0.026), and larger T1-slope of more than 18.84° (OR 3.695, P = 0.012).

Conclusion.
Larger radiographic lower limb-spinal length proportion results in naturally accentuated spinal curves. These patients balance with a larger lumbar lordosis that is closer to the PI and a higher T1-slope which should be considered for spinal realignment. SL differs from GLA and should be separately assessed.

Level of Evidence: 3
Delineation of Inner Annulus Fibrosus and Nucleus Pulposus on Routine T2-weighted MR Images
Authors: Eldaya Rami W. , Parsons Matthew S. , Rhea Lee , Sharma Aseem 
Published: September 2021

Study Design.
Retrospective study of 150 IVDs.

Objective.
Assessment of costume algorithm ability to delineate the IAF and NP on routine T2 images.

Summary of Background Data.
Central hyperintense region on T2-weighted MR images of normal lumbar IVDs represents a combination of IAF and NP. Ability to identify NP as distinct from IAF can help improve our understanding of IVD morphology in-vivo.

Methods.
Sagittal T2-weighted TSE MR images of 150 lumbar IVDs from 25 patients were analyzed. MR images were processed using a custom algorithm that markedly increased the signal intensity of structures with inherent signal intensity within 2 defined intensity thresholds. Signal intensity and contrast-to- noise ratio between outer annulus fibrosus, IAF, and NP were assessed at baseline and after processing. To assess consistency of underlying T2 differences, similar analysis was done on 108 discs from 18 patients in whom additional sagittal T2-weighted STIR images were available.

Results.
Following image processing, apparent IAF and NP were rendered visible in 86% and 84.3% IVDs on T2-weighted TSE and STIR images respectively. While signal intensity of these 2 regions was inherently different (P< 0.001) before processing on TSE and STIR images, their visualization was facilitated by a significant increase (P<0.001) in contrast-to-noise ratio after processing. Nonvisualization of NP was associated with disc degeneration (P<0.001).

Conclusion.
Inherent differences exist in signal intensities of normal NP and IAF on T2-weighted MR images. Accentuating these differences using image postprocessing techniques can render these 2 structures visible.
Cervical Myelopathy Screening with Machine Learning Algorithm Focusing on Finger Motion Using Noncontact Sensor
Authors: Koyama Takafumi , Fujita Koji , Watanabe Masaru , Kato Kaho , Sasaki Toru , Yoshii Toshitaka , Nimura Akimoto , Sugiura Yuta , Saito Hideo , Okawa Atsushi 
Published: September 2021

Study Design.
Cross-sectional study.

Objective.
To develop a binary classification model for cervical myelopathy (CM) screening based on a machine learning algorithm using Leap Motion (Leap Motion, San Francisco, CA), a novel noncontact sensor device.

Summary of Background Data.
Progress of CM symptoms are gradual and cannot be easily identified by the patients themselves. Therefore, screening methods should be developed for patients of CM before deterioration of myelopathy. Although some studies have been conducted to objectively evaluate hand movements specific to myelopathy using cameras or wearable sensors, their methods are unsuitable for simple screening outside hospitals because of the difficulty in obtaining and installing their equipment and the long examination time.

Methods.
In total, 50 and 28 participants in the CM and control groups were recruited, respectively. The diagnosis of CM was made by spine surgeons. We developed a desktop system using Leap Motion that recorded 35 parameters of fingertip movements while participants gripped and released their fingers as rapidly as possible. A support vector machine was used to develop the binary classification model, and a multiple linear regression analysis was performed to create regression models to estimate the total Japanese Orthopaedic Association (JOA) score and the JOA score of the motor function of the upper extremity (MU-JOA score).

Results.
The binary classification model indexes were as follows: sensitivity, 84.0%; specificity, 60.7%; accuracy, 75.6%; area under the curve, 0.85. The Spearman rank correlation coefficient between the estimated score and the total JOA score was 0.44 and that between the estimated score and the MU-JOA score was 0.51.

Conclusion.
Our binary classification model using a machine learning algorithm and Leap Motion could classify CM with high sensitivity and would be useful for CM screening in daily life before consulting doctors and telemedicine.

Level of Evidence: 3
Clinical and Radiological Outcomes of Two Modified Open-door Laminoplasties Based on a Novel Paraspinal Approach for Treatment of Multilevel Cervical Spondylotic Myelopathy
Authors: Guo Qian , Xu Yong , Fang Zhong , Guan Hanfeng , Xiong Wei , Li Feng 
Published: September 2021

Study Design.
A case–control study.

Objectives.
The aim of this study was to evaluate the outcomes of two modified laminoplasties (LPs) based on a novel paraspinal approach for treating multilevel cervical spondylotic myelopathy.

Summary of Background Data.
No laminoplasty through a natural intermuscular plane mimicking Wiltse approach to minimize intraoperative injury to extensor muscles has ever been developed and studied.

Methods.
Ninety-two patients were enrolled, including patients treated with either modified LP and patients treated with concurrent conventional LP. Operation time, blood loss, and complications were recorded. Clinical outcomes were evaluated by VAS, JOA scores, and recovery rate. Cervical sagittal alignment was measured on cervical radiographs. Spinal canal expansion was assessed on CT scans. Cross-sectional area (CSA) and atrophy rate (AR) of cervical deep extensors were evaluated on MRI.

Results.
The average follow-up duration was 33.05, 31.55, 33.02, and 32.52 months, respectively in each group. Compared to concurrent conventional procedure, unilateral muscle-preserving procedure displayed similar, whereas bilateral muscle-preserving procedure showed significantly increased operation time and blood loss; each modified procedure resulted in comparable and satisfied perioperative clinical scores, spinal canal expansion while achieving significantly lower axial pain incidence, better cervical lordosis maintenance, and better deep extensor preservation. AR of deep extensors on the open side was significantly lower than that on the hinge side. Bilateral paraspinal approach demonstrated significantly better muscle-preservation on the open side and increased operation duration, with similar clinical scores, axial pain incidence, cervical lordosis maintenance, and spinal canal expansion compared to unilateral paraspinal approach. Loss of cervical lordosis was strongly correlated with AR of deep extensors.

Conclusion.
Paraspinal approach is a good manner to protect deep extensor muscles; the two modified LPs have similar effects on clinical outcomes.

Level of Evidence: 3