bluuebunny/crossref_metadata_2025_split huggingface dataset:
rAAV-Mediated sox9 Overexpression Improves the Repair of Osteochondral Defects in a Clinically Relevant Large Animal Model Over Time In Vivo and Reduces Perifocal Osteoarthritic Changes
Authors: Lange Cliff , Madry Henning , Venkatesan Jagadeesh K. , Schmitt Gertrud , Speicher-Mentges Susanne , Zurakowski David , Menger Michael D. , Laschke Matthias W. , Cucchiarini Magali 
Published: October 2021

Background: Gene transfer of the transcription factor SOX9 with clinically adapted recombinant adeno-associated virus (rAAV) vectors offers a powerful tool to durably enhance the repair process at sites of osteochondral injuries and counteract the development of perifocal osteoarthritis (OA) in the adjacent articular cartilage. Purpose: To examine the ability of an rAAV sox9 construct to improve the repair of focal osteochondral defects and oppose perifocal OA development over time in a large translational model relative to control gene transfer. Study Design: Controlled laboratory study. Methods: Standardized osteochondral defects created in the knee joints of adult sheep were treated with rAAV-FLAG-h sox9 relative to control (reporter) rAAV- lacZ gene transfer. Osteochondral repair and degenerative changes in the adjacent cartilage were monitored using macroscopic, histological, immunohistological, and biochemical evaluations after 6 months. The microarchitecture of the subchondral bone was assessed by micro–computed tomography. Results: Effective, prolonged sox9 overexpression via rAAV was significantly achieved in the defects after 6 months versus rAAV- lacZ treatment. The application of rAAV-FLAG-h sox9 improved the individual parameters of defect filling, matrix staining, cellular morphology, defect architecture, surface architecture, subchondral bone, and tidemark as well as the overall score of cartilage repair in the defects compared with rAAV- lacZ. The overexpression of sox9 led to higher levels of proteoglycan production, stronger type II collagen deposition, and reduced type I collagen immunoreactivity in the sox9- versus lacZ-treated defects, together with decreased cell densities and DNA content. rAAV-FLAG-h sox9 enhanced semiquantitative histological subchondral bone repair, while the microstructure of the incompletely restored subchondral bone in the sox9 defects was not different from that in the lacZ defects. The articular cartilage adjacent to the sox9-treated defects showed reduced histological signs of perifocal OA changes versus rAAV- lacZ. Conclusion: rAAV-mediated sox9 gene transfer enhanced osteochondral repair in sheep after 6 months and reduced perifocal OA changes. These results underline the potential of rAAV-FLAG-h sox9 as a therapeutic tool to treat cartilage defects and afford protection against OA. Clinical Relevance: The delivery of therapeutic rAAV sox9 to sites of focal injuries may offer a novel, convenient tool to enhance the repair of osteochondral defects involving both the articular cartilage and the underlying subchondral bone and provide a protective role by reducing the extent of perifocal OA.
Acute Effects of High-Dose Furosemide on Residual Renal Function in CAPD Patients
Authors: Van Olden Rudolf W. , Guchelaar Henk-Jan , Struijk Dirk G. , Krediet Raymond T. , Arisz Lambertus 
Published: October 2021

♦ Background High doses of furosemide can increase urine volume in chronic peritoneal dialysis (CAPD) patients. However, no information is available about effects on urinary solute excretion in relation to residual glomerular filtration rate (GFR), urinary furosemide excretion, and peritoneal solute kinetics. ♦ Methods Diuretic response and the effect on peritoneal fluid and solute transport parameters were investigated in 7 stable CAPD patients with residual renal function (median urine volume 350 mL/24 hours, range 140–1900 mL/24 hours). Comparisons were made during two clearance periods of 24 hours: one without (P1) and one during 2 g furosemide (P2). ♦ Results The median increase in urine volume was 400 mL (range 270 – 910 mL, p < 0.02) and the increase in sodium excretion was 54 mmol (range 25 –118 mmol, p < 0.02). No change in GFR was found between P1 (2.4 mL/minute, range 0.6 – 5.7 mL/min) and P2 (2.0 mL/min, range 1.0 – 4.8 mL/min). An increase in fractional clearance was found for volume, sodium, potassium, and osmolality ( p < 0.02). No change was found in the fractional clearance of urea and electrolyte-free water. Furosemide excretion in urine was 8.7 mg/24 hours (range 2.1 – 38 mg/24 hours) and in dialysate 4.9 mg/24 hours (range 1.9 – 7.8 mg/24 hours). Plasma furosemide concentration was 29.5 mg/L (range 6.2 – 43.9 mg/L). A positive correlation was found between residual GFR and total urine furosemide excretion ( r=0.93, p < 0.005). Efficiency, expressed as the increase in fractional sodium clearance (percent) per milligram of furosemide excreted per 24 hours, was 1.2%/mg (range 0.3%–11.3%/mg). ♦ Conclusion High-dose furosemide is effective in CAPD patients in increasing urine volume and electrolyte excretion without affecting urea and creatinine clearance. In CAPD patients, the individual response to an identical high dose of furosemide is dependent on the magnitude of residual GFR.
Transparent low-flammability epoxy resins using a benzoguanamine-based DOPO derivative
Authors: Han Xiao , Chen Rui , Yang Mei , Sun Chuanbo , Wang Kun , Wang Yinsong 
Published: October 2021

We successfully prepared a highly effective flame-retardant additive called hsalbenzoguanamine phosphaphenanthrene (HDPD) through salicylaldehyde and nitrogen-rich benzoguanamine. The introduction of HDPD into epoxy resin (EP) sharply enhanced the flame retardancy of EP/HDPD thermosets. The introduction of 6 wt% HDPD into EP succeeded in reaching the V-0 rating. Limited oxygen index results revealed the high flame-retarding performance of HDPD. Cone calorimeter test data revealed that heat and smoke released from EP/6 wt% HDPD thermoset were significantly restrained. In addition, EP/6 wt% HDPD thermoset demonstrated excellent transmittance and mechanical strength. The transmittance of EP/6 wt% HDPD was assessed from 520 to 800 nm. The results showed that transmittance of EP/6 wt% HDPD were nearly 90% of the control group.
An In-Service Educational Package Improves Alarm Management in the Neonatal Intensive Care Unit (NICU): Before and After Study
Authors: Hedda Suryaprakash , A. Shashidhar , Nesargi Saudamini , Balla Kalyan Chakravarthy , Y. N. Prashantha , P. N. Suman Rao 
Published: October 2021

Background: Monitoring in neonatal intensive care unit (NICU) largely relies on equipment which have a number of alarms that are often quite loud. This creates a noisy environment, and moreover leads to desensitization of health-care personnel, whereby potentially important alarms may also be ignored. The objective was to evaluate the effect of an educational package on alarm management (the number of alarms, response to alarms, and appropriateness of settings). Methods: A before and after study was conducted at a tertiary neonatal care center in a teaching hospital in India involving all health-care professionals (HCP) working in the high dependency unit. The intervention consisted of demo lectures about working of alarms and bedside demonstrations of customizing alarm limits. A pre- and postintervention questionnaire was also administered to assess knowledge and attitude toward alarms. The outcomes were the number and type of alarms, response time, appropriateness of HCP response, and appropriateness of alarm limits as observed across a 24-h period which were compared before and after the intervention. Findings: The intervention resulted in a significant decrease in the number of alarms (11.6-9.6/h). The number of times where appropriate alarm settings were used improved from 24.3% to 67.1% ( P < .001). The response time to alarm did not change significantly (225 s vs 200 s); however, the appropriate response to alarms improved significantly from 15.6% to 68.8%. Conclusion: A simple structured intervention can improve the appropriate management of alarms. Application to Practice: Customizing alarm limits and nursing education reduce the alarm burden in NICUs
Current Substances Use Among Students in Ethiopia: A Systematic Review and Meta-Analysis of 20-Years Evidence
Authors: Roba Hirbo Shore , Gebremichael Berhe , Adem Hassen Abdi , Beyene Addisu Shunu 
Published: October 2021

Background: The use of psychoactive substances is one of the main public health issues worldwide. However, there is a lack of evidence on the magnitude of current substance use among students in Ethiopia. Therefore, this study aimed to provide comprehensive views of the current prevalence of substance use among students in Ethiopia. Methods: We searched PubMed/Medline, Health InterNetwork Access to Research Initiative (HINARI), Google Scholar, and gray literature sources between 2000 and 2019. The prevalence of current substances with a 95% confidence interval (CI) was estimated using the random-effects model. The results were presented using forest plots, and Cochrane Q-test and I2 were used to measure the extents of between-study variations. Results: A total of 1543 study articles were identified from electronic databases, and 32 cross-sectional studies were included in the meta-analysis. The prevalence of current use of at least 1 substance was 37.63% (95% CI: 33.66, 41.69), alcohol 27.61% (95% CI: 22.10, 33.48), khat 17.20% (95% CI: 14.03, 20.62), and smoking 9.74% (95% CI: 7.17, 12.64). The prevalence of any substance use in high school students versus university/college students was 41.55% (95% CI: 38.83, 44.29) versus 36.24% (95% CI: 32.37, 40.20), alcohol 24.21% (95% CI: 14.05, 36.11) versus 25.27% (95% CI: 19.76, 31.20), khat 13.82% (95% CI: 8.61, 20.02) versus 17.30% (95% CI:13.75, 21.16), and cigarette 8.30% (95% CI: 1.89, 18.60) versus 9.80% (95% CI: 7.32, 12.58). Meta-regression analysis revealed publication year, sample size, female proportion, and age were not significantly associated with the current use of substances. Conclusion: Overall, the current substance use of any substance, alcohol, chewing khat, and smoking cigarettes was relatively high. A significant proportion of high school students were already using substances at an early age. Policymakers should formulate and implement regulations to control the pervasive use of substances by young people around educational institutions at all levels. Protocol Registration: The protocol has been registered on 19 August 2019 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CDR42019130560.
Resolving the Near-Infrared Spectrum of Articular Cartilage
Authors: Afara Isaac O. , Oloyede Adekunle 
Published: October 2021

Objective Spectroscopic techniques, such as near-infrared (NIR) spectroscopy, are gaining significant research interest for characterizing connective tissues, particularly articular cartilage, because there is still a largely unmet need for rapid, accurate and objective methods for assessing tissue integrity in real-time during arthroscopic surgery. This study aims to identify the NIR spectral range that is optimal for characterizing cartilage integrity by ( a) identifying the contribution of its major constituents (collagen and proteoglycans) to its overall spectrum using proxy constituent models and ( b) determining constituent-specific spectral contributions that can be used for assessment of cartilage in its physiological state. Design The NIR spectra of cartilage matrix constituent models were measured and compared with specific molecular components of organic compounds in the NIR spectral range in order to identify their bands and molecular assignments. To verify the identified bands, spectra of the model compounds were compared with those of native cartilage. Since water obscures some bands in the NIR range, spectral measurements of the native cartilage were conducted under conditions of decreasing water content to amplify features of the solid matrix components. The identified spectral bands were then compared and examined in the resulting spectra of the intact cartilage samples. Results As water was progressively eliminated from cartilage, the specific contribution of the different matrix components was observed to correspond with those identified from the proxy cartilage component models. Conclusion Spectral peaks in the regions 5500 to 6250 cm−1 and 8100 to 8600 cm−1 were identified to be effective for characterizing cartilage proteoglycan and collagen contents, respectively.
Biomechanical Comparison of Capsular Repair, Capsular Shift, and Capsular Plication for Hip Capsular Closure: Is a Single Repair Technique Best for All?
Authors: De Giacomo Anthony F. , Lu Young , Suh Dong Hun , McGarry Michelle H. , Banffy Michael , Lee Thay Q. 
Published: October 2021

Background: In hip arthroscopy, the best capsular closure technique to prevent microinstability in some patients while preventing overconstraints in other patients has yet to be determined. Purpose: To evaluate the biomechanical effects of capsular repair, capsular shift, and combination capsular shift and capsular plication for closure of the hip capsule. Study Design: Controlled laboratory study. Methods: Eight cadaveric hips (4 male and 4 female hips; mean age, 55.7 years) were evaluated in 7 conditions: intact, vented, capsulotomy, side-to-side repair, side-to-side repair with capsular plication (interval closure between iliofemoral and ischiofemoral ligaments), capsular shift repair, and capsular shift repair with plication. Measurements, via a 360° goniometer, included internal and external rotation with 1.5 N·m of torque at 5° of extension and 0°, 30°, 60°, and 90° of flexion. In addition, the degree of maximum extension with 5 N·m of torque and the amount of femoral distraction with 40 N and 80 N of force were obtained. Repeated-measures analysis of variance and Tukey post hoc analyses were used to analyze differences between capsular conditions. Results: At lower hip positions (5° of extension, 0° and 30° of flexion), there was a significant increase in external rotation and total rotation after capsulotomy versus the intact state ( P < .05). At all hip flexion angles, there was a significant increase in external rotation, internal rotation, and total rotation as well as a significant increase in maximum extension after capsulotomy versus capsular shift with plication ( P < .05 for all). At all flexion angles, both capsular closure with side-to-side repair (with or without plication) and capsular shift without capsular plication were able to restore rotation, with no significant differences compared with the intact capsule ( P > .05). Among repair constructs, there were significant differences in range of motion between side-to-side repair and combined capsular shift with plication ( P < .05). Conclusion: At all positions, significantly increased rotational motion was seen after capsulotomy. Capsular closure was able to restore rotation similar to an intact capsule. Combined capsular shift and plication may provide more restrained rotation for conditions of hip microinstability but may overconstrain hips without laxity. Clinical Relevance: More advanced closure techniques or a combination of techniques may be needed for patients with hip laxity and microinstability. At the same time, simple repair may suffice for patients without these conditions.
Proximal Adductor Longus Tendon Repair With a Concomitant Distal Fascial Release for Complete Hip Adductor Tendon Tears: Surgical Technique and Outcomes in 40 Male Athletes
Authors: Lempainen Lasse , Hetsroni Iftach , Kosola Jussi A. , Sinikumpu Jaakko J. , Mazzoni Stefano , Orava Sakari 
Published: October 2021

Background: The optimal treatment for complete avulsions of the proximal adductor longus (AL) is still debatable, and different operative and nonoperative treatment options have been suggested. Purpose: To report surgical techniques and functional outcomes of a series of athletes who were treated operatively for proximal AL tears. Study Design: Case series; Level of evidence, 4. Methods: A retrospective evaluation of patients who underwent surgical repair of complete proximal AL tear with concomitant distal fascial release with or without lesions of the neighboring soft tissue structures was performed. This included preinjury Tegner score, age, number of tendons involved, time interval from injury to surgery, and postoperative complications. Self-reported outcomes were defined based on the ability to regain sports activities (excellent, good, moderate, fair, or poor). Between-group comparisons were performed to identify factors associated with improved outcomes. The Mann-Whitney nonparametric test was used for comparing continuous variables, and the Fisher exact test was used for comparing nominal variables. Results: A total of 40 male athletes were included in the evaluation, with an average follow-up of 11 months (range, 6 months-8 years). Self-reported outcome was excellent in 23 (57.5%), good in 13 (32.5%), and moderate in 4 (10%) patients. Comparisons between patients with excellent versus good/moderate outcomes revealed nonsignificant differences regarding age at injury and preinjury Tegner score. Athletes with excellent outcomes received surgery sooner after the injury compared with athletes with good/moderate outcomes (2.4 ± 1.8 vs 11.4 ± 11.0 weeks, respectively; P < .01). Conclusion: Surgical repair for complete proximal AL tears with a concomitant distal fascial release resulted in outcomes rated as good or excellent in 90% of the cases. This treatment should be considered particularly in high-level athletes with a clear tendon retraction and within the first month after the injury. Further research is nevertheless needed to compare these outcomes with other treatment alternatives to better define criteria advocating surgery.
Effect of COVID-19 Social Isolation Policies on Rehabilitation After Anterior Cruciate Ligament Reconstruction
Authors: Webster Kate E. , Klemm Haydn J. , Devitt Brian M. , Whitehead Timothy S. , Feller Julian A. 
Published: October 2021

Background: The coronavirus 2019 (COVID-19) pandemic has had a profound impact on health care in Australia. To contain the spread of the virus, strict physical distancing and social isolation policies were implemented from late March 2020. This presented a situation in which patients recovering from anterior cruciate ligament (ACL) reconstruction had limited access to face-to-face supervised rehabilitation and rehabilitation facilities. Purpose: To explore the impact of social distancing and isolation policies on postoperative rehabilitation in patients after ACL reconstruction. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients who had ACL reconstruction from October 2019 until the end of March 2020 (6 months before the implementation of COVID-19 restrictions) completed an online self-report questionnaire containing 5 sections: utilization of health care professionals for rehabilitation, frequency of rehabilitation, patient concerns and attitude, perceived impact on recovery, and changes to employment status. We compared the responses of patients who had surgery in 2019 with those who had surgery in 2020. Statistical analysis was performed using frequency statistics and central tendency measures. Results: A total of 185 patients (97 men, 88 women) completed the survey, for a 73% response rate. Patients had a mean age of 28 years (range, 13-57 years) and had undergone surgery a mean 4.5 months prior (range, 1.5-8 months). Most patients (80%) maintained face-to-face rehabilitation, predominantly with a physical therapist, regardless of whether their surgery took place in 2019 or 2020; rehabilitation with active, supervised exercises was most common. Almost all patients were performing strengthening exercises (164/185), and most were performing range-of-motion (139/185) and aerobic (123/185) activities at their homes. Patients were minimally concerned about access to supervised rehabilitation and knee reinjury, but they were concerned about access to equipment. Because of COVID-19, 30% were working from home; 17% were on reduced hours and 8% on increased hours; 15% were on leave or unemployed; and 30% reported no change in employment status. Conclusion: Patients who had undergone ACL reconstruction just before or during the first few months of the COVID-19 pandemic were able to maintain in-person contact with their health professionals during rehabilitation, and they had a positive outlook and managed well despite the restrictions.
Insight into removals of PARAFAC components from dissolved and particulate organic matter in wastewater treatment process by two-dimensional correlation and structure equation modeling
Authors: Yu Benxin , Liu Dongping , Wang Jian , Sun Yingxue 
Published: October 2021

Abstract
Background
Most particulate organic matter (POM) cannot be directly degraded in the conventional wastewater treatment, which should be transformed into dissolved organic matter (DOM) through a hydrolysis process. However, non-hydrolyzed POM in the biological treatment can limit treated efficiencies for the wastewater treatment plants (WWTPs) facilities. Hence an operational tool is indispensable for insight into removals of DOM and POM factions in the WWTP. In this study, excitation-emission matrix fluorescence spectroscopy (EEM) combined parallel factor analysis (PARAFAC), two-dimensional correlation (2D-COS) and structural equation modeling (SEM) was employed to evaluate removals of DOM and POM in a wastewater treatment plant.

Results
Four fluorescence components were identified in DOM and POM substances from the WWTP by EEM combined with PARAFAC, i.e., tyrosine-like (TYLF), tryptophan-like (TRLF), microbial byproduct-like (MBLF), and fulvic acid-like (FALF). In A2/O process, the TYLF and TRLF of DOM were removed to a larger extent than those of MBLF and FALF in anaerobic tank, while TYLF and MBLF of POM were removed to a great extent than those of TRLF and FALF in primary sedimentation and aerobic tanks. By the 2D-COS, a decreasing variation order of DOM fractions in the wastewater treatment process was UV-FALF → MBLF2 → Vis-FALF → TRLF → TYLF, while the decreasing order of POM fractions was Vis-FALF → UV-FALF → MBLF2 → TYLF → MBLF1 → TRLF. SEM revealed that TRLF and TYLF of DOM were degraded by anaerobic microorganism, and TRLF could be transformed partially into FALF. However, TRFL and TYLF of POM were discomposed by aerobic microorganism.

Conclusions
The 2D-COS and SEM can be practicable tools as EEM-PARAFAC for monitoring DOM and POM in the WWTP. The study could present a theoretical support to improving the retrofit of WWTP and formulating emission standards for organic pollutants.