bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex-Dependent Association of Vitamin D With Insulin Resistance in Humans
Authors: Chen Xin , Chu Chang , Doebis Cornelia , von Baehr Volker , Hocher Berthold 
Published: April 2021

AbstractBackgroundAnimal studies suggested that vitamin D might decrease insulin resistance. Estrogen increased insulin sensitivity and glucose tolerance in rodents. However, sex-specific association of vitamin D with insulin resistance in humans remains unclear.ObjectivesTo investigate the sex-dependency of the association of insulin resistance and 25-hydroxyvitamin D [25(OH)D] in a large Caucasian population.MethodsCross-sectional study from out-patients’ blood samples with measurements of 25(OH)D and homeostatic model assessment of insulin resistance (HOMA-IR) drawn at exactly the same day (n = 1887). This cohort was divided into 3 groups: (1) group with vitamin D deficiency (n = 1190), (2) group with vitamin D sufficiency (n = 686), and (3) vitamin D excess groups (n = 11); the vitamin D excess group was excluded from further analysis due to the small size.ResultsAnalysis of the entire study population showed that serum 25(OH)D was inversely associated with HOMA-IR [Spearman correlation coefficient (rs) = −0.19, P &lt; 0.0001]. When considering the vitamin D status, this association was only seen in the vitamin D deficiency group but not in the vitamin D sufficient group. The correlation was sex-dependent: HOMA-IR was inversely correlated with vitamin D in women with vitamin D deficiency (rs = −0.26, P &lt; 0.0001) but not in men with vitamin D deficiency (rs = 0.01, P = 0.714). After multivariate linear regression analysis considering confounding factors, this relationship was again only seen in women.ConclusionVitamin D was inversely and independently associated with insulin resistance only in women with vitamin D deficiency. Based on our data, we suggest that in particular vitamin D deficient women might benefit from vitamin D substitution by improving insulin resistance. This, however, needs to be proven in adequately designed double-blind placebo-controlled clinical studies.
Episodic Positional Dizziness
Authors: Kerber Kevin A. 
Published: April 2021

ABSTRACT

PURPOSE OF REVIEW
This article provides a summary of the evaluation and treatment of patients presenting with episodic positional dizziness.

RECENT FINDINGS
Positional components are nearly ubiquitous among diagnoses of dizziness, so it can be challenging to classify patients with episodic positional dizziness simply based on the history of present illness. Overreliance on the presence of a report of positional components has likely resulted in misapplication or misinterpretation of positional testing and negative experiences with maneuvers to treat positional dizziness. The prototypical episodic positional dizziness disorder is benign paroxysmal positional vertigo (BPPV). BPPV is caused by free-floating particles in a semicircular canal that move in response to gravity. The diagnosis is made by identifying the characteristic patterns of nystagmus on the Dix-Hallpike test. Particle repositioning for BPPV is supported by randomized controlled trials, meta-analyses, and practice guidelines. Other disorders that can present with episodic positional dizziness are migraine dizziness, central lesions, and light cupula syndrome.

SUMMARY
Episodic positional dizziness is a common presentation of dizziness. Neurologists should prioritize identifying and treating BPPV; doing so provides an important opportunity to deliver effective and efficient care. Providers should also recognize that positional components are common in most causes of dizziness and, therefore, should not over-rely on this part of the history of presentation when considering the diagnosis and management plan.
Vertigo Related to Central Nervous System Disorders
Authors: Saha Kamala 
Published: April 2021

ABSTRACT

PURPOSE OF REVIEW
This article provides an overview of the numerous causes of vertigo and dizziness that are due to central nervous system (CNS) pathology and guides clinicians in formulating a differential diagnosis and treating patients with CNS causes of vertigo.

RECENT FINDINGS
Specific autoimmune vestibulocerebellar syndromes may now be tested for, and this article discusses the antibodies known to cause such syndromes. Superficial siderosis can be more accurately diagnosed with imaging studies, and treatment using iron chelation has recently been studied but has not yet been established as an effective treatment. Central autonomic network damage in the brain can cause central orthostatic hypotension in some neurodegenerative diseases, and medication has been approved for treatment.

SUMMARY
CNS causes of vertigo are numerous and important for clinicians to recognize. Examination findings are still an extremely valuable way to diagnose central vertigo; therefore, learning how to differentiate central from peripheral vertigo based on examination is an important skill. CNS causes of vertigo often have available treatments.
Neutrophil transendothelial migration hotspots – mechanisms and implications
Authors: Grönloh Max L. B. , Arts Janine J. G. , van Buul Jaap D. 
Published: April 2021

ABSTRACT
During inflammation, leukocytes circulating in the blood stream exit the vasculature in a process called leukocyte transendothelial migration (TEM). The current paradigm of this process comprises several well-established steps, including rolling, adhesion, crawling, diapedesis and sub-endothelial crawling. Nowadays, the role of the endothelium in transmigration is increasingly appreciated. It has been established that leukocyte exit sites on the endothelium and in the pericyte layer are in fact not random but instead may be specifically recognized by migrating leukocytes. Here, we review the concept of transmigration hotspots, specific sites in the endothelial and pericyte layer where most transmigration events take place. Chemokine cues, adhesion molecules and membrane protrusions as well as physical factors, such as endothelial junction stability, substrate stiffness, the presence of pericytes and basement membrane composition, may all contribute to local hotspot formation to facilitate leukocytes exiting the vasculature. In this Review, we discuss the biological relevance of such hotspots and put forward multiple mechanisms and factors that determine a functional TEM hotspot.
A thermal stressor, propranolol and long-term memory formation in freshly collected Lymnaea
Authors: Swinton Cayley , Swinton Erin , Phillips Iain , Lukowiak Ken 
Published: April 2021

ABSTRACT
A heat stressor (1 h at 30°C) in Lymnaea stagnalis before operant conditioning training of aerial respiration is sufficient to enhance long-term memory (LTM) formation in ‘average’ cognitive ability, laboratory-reared, inbred snails. However, in freshly collected outbred snails, the same heat stressor blocks LTM formation in ‘smart’ cognitive phenotype but not in average cognitive phenotype strains. Here, we hypothesize that (1) preventing the stress associated with the heat stressor before training allows LTM to form in the smart phenotype strains; and (2) alleviating the stress before a memory recall session allows a formed LTM to be recalled in the smart phenotype strains. We found that an injection of propranolol, which mitigates the stressor, before snails experience the heat stressor enabled two strains of the smart phenotype snails to form LTM, consistent with our first hypothesis. However, the injection of propranolol before a memory test session did not alleviate a memory recall block in the smart phenotype snails. Thus, our second hypothesis was not supported. Therefore, smart cognitive phenotype snails encountering a heat stressor have an inability to form LTM, but this inability can be overcome by the pre-injection of propranolol.
Drosophila acquires seconds-scale rhythmic behavior
Authors: Ikarashi Masayoshi , Tanimoto Hiromu 
Published: April 2021

ABSTRACT
Detection of the temporal structure of stimuli is crucial for prediction. While perception of interval timing is relevant for immediate behavioral adaptations, it has scarcely been investigated, especially in invertebrates. Here, we examined whether the fruit fly, Drosophila melanogaster, can acquire rhythmic behavior in the range of seconds. To this end, we developed a novel temporal conditioning paradigm utilizing repeated electric shocks. Combined automatic behavioral annotation and time–frequency analysis revealed that behavioral rhythms continued after cessation of the shocks. Furthermore, we found that aging impaired interval timing. This study thus not only demonstrates the ability of insects to acquire behavioral rhythms of a few seconds, but highlights a life-course decline of temporal coordination, which is also common in mammals.
Heat Injury in Open-Water Swimming: A Narrative Review
Authors: Murphy Micheal , Polston Keith , Carroll Michael , Alm John 
Published: April 2021

Abstract
Swimming is one of the most popular sports in the world with open-water swimming (OWS) gaining more and more prominence since being featured in the Federation Internationale De Natation World Aquatics Championships in 1992 and the Olympic Games in 2000. The aim of this review is to analyze the existing literature on heat injury in OWS. Relevant literature was located via computer-generated citations during November of 2020 through online computer searches of multiple major databases. Athletes participating in OWS are exposed to environmental conditions that place them at risk for unique medical conditions such as heat injury. Clinicians providing care for OWS athletes should be educated and trained to recognize these conditions and minimize risks to optimize athlete safety. This article identifies medical challenges related to heat injury in OWS while investigating water temperature recommendations, physiological effects of hyperthermia, risk mitigation strategies, and treatment measures.
Organochlorine pesticide exposure and risk of prostate cancer development and progression: a systematic review
Authors: Brureau Laurent , Multigner Luc , Hamdy Freddie , Blanchet Pascal , Bryant Richard 
Published: April 2021

Background: There is an increasing body of evidence linking the exposure of an individual to pesticides such as organochlorine pesticides (OPCs) and an increased risk of developing diseases such as cancer. Exposure to OPCs has been suggested to increase the risk of developing hormone-dependant cancers such as prostate cancer (PCa). However, there is a relative paucity of information about the influence of exposure to these pesticides on the evolution of PCa, including risk of tumour development, progression to metastasis, and disease recurrence following therapy. Methods: We used several databases such as PubMed MEDLINE Database, Web of Science, and Scopus, in order to conduct a systematic review of the available epidemiological data implicating an association between exposure to OCPs and biochemical recurrence (BCR) of PCa. We searched all peer-reviewed articles published up to July 31st 2020. Pre-defined eligibility criteria for the inclusion of studies were that they be original studies, reviews, previous meta-analyses, or case–control or cohort studies. Results: Agent Orange is the most widely-studied OCP in the context of any possible causal role in the recurrence of PCa following radical prostatectomy, or in the progression to advanced disease. Only two studies didn’t demonstrate a significant association between exposure to OCPs and subsequent BCR following radical prostatectomy. Another study identified a significant association between exposure to Oxychlordane and PCB44 and progression to advanced PCa. Conclusion: This review confirmed a relative lack of high-quality evidence regarding this topic. However, the available evidence to date suggests the presence of a potential causal relationship between exposure to OPCs and PCa development and progression.
Trajectory Tracking with Input Constraint based on LMI Approach of a Nonholonomic Mobile Robot
Authors: Nabila Auliya , Agustinah Trihastuti 
Published: April 2021

Nonholonomic Mobile Robot (NMR) is a mode of transportation that is widely used in industry. To achieve flexibility in carrying out its duties, an adequate control system is needed in transportation arrangements so that it is used as an object of research. The problem that is taken in this study is about tracking control for several reference trajectories with input constraint.To solve this problem two controllers were designed, kinematics controller and dynamics controller. Kinematics controller is designed so that the additional speed converges to the desired speed by adjusting the gain value , , and . Dynamic controller is designed using performance to overcome the input constraint and the Lyapunoc inequality is soleved by Linear Matric Inequalities (LMI) so the gain state-feedback can be obtained. Simulation results show that the designed controller is capable of tracking according to the reference trajectory with input constraint given.
Knowledge of postpartum depression among mothers at immunisation clinics in Mushin, Nigeria
Authors: Abazie Ogechi Helen , Usoro Iniobong Inyang 
Published: April 2021

Background Postpartum depression is the most common psychological disorder affecting women during the postpartum period, yet this condition often goes undiagnosed. Studies show that the onset of postpartum depression can occur at any time following delivery, up to three months postpartum; in some cases, up to a year postpartum. This study aimed to assess knowledge of postpartum depression in mothers attending immunisation clinics at selected primary healthcare centres in Mushin, Nigeria. This study will help identify areas for improvement in educating women on postpartum depression, leading to early identification, treatment and reduced cases of the illness. Methods This was a descriptive quantitative study using multistage sampling to select participants from two purposively selected comprehensive health centres. Simple random sampling was used to select 240 mothers to participate in the study, who were given self-structured questionnaires on sociodemographic data and knowledge of postpartum depression. Data were analysed using the Statistical Package for Social Sciences version 22. Descriptive statistics were used to present demographic variables and objectives. Inferential statistics, the chi-square test, was used to test hypotheses at P<0.005. Results The majority of participants (60.8%) had poor knowledge of postpartum depression. There is a statistically significant relationship between age and knowledge of postpartum depression (P=0.000). There is no significant relationship between education level and knowledge of postpartum depression. Conclusions The majority of women in this study had poor knowledge of postpartum depression. To tackle this, midwives should aim to reinforce health education on mental and emotional health and assess the emotional and mental health status of women during the antenatal and postpartum periods. It is also key for midwives to refer women on time if they suspect postpartum depression.
The three pathways to becoming a midwife: self-assessed confidence in selected competencies in intrapartum care from seven African countries
Authors: Lindgren Helena , Hildingsson Ingegerd , Christensson Kyllike , Bäck Lena , Mudokwenyu–Rawdon Christina , Maimbolwa Margaret C , Laisser Rose Mjawa , Omoni Grace , Chimwaza Angela , Mwebaza Enid , Kiruja Jonah , Sharma Bharati 
Published: April 2021

Background/Aims Globally, there are three pathways to become a midwife: midwifery post nursing, direct entry midwifery and integrated nursing and midwifery. There is limited knowledge on the effectiveness of pre-service midwifery education. The aim of this study was to describe and compare midwifery students' confidence in intrapartum skills and associated factors such as type and level of education. Methods A multi-country cross-sectional study was conducted, where midwifery students were approached in the final months of their education programme. Data were collected using a questionnaire, based on the basic skills by the International Confederation of Midwives. Intrapartum care comprised 40 skills. Results In total, 1407 midwifery students from seven sub-Saharan countries responded. The 40 skills were grouped into six domains; three related to care during the first and second stage of labour and three related to care during the third stage of labour. Sex and age were significantly associated with confidence, with female students and those 26–35 years old having higher levels of confidence. Students enrolled in a direct entry programme were more confident than other students in all three domains of care related to the first and second stage of labour. Conclusions Direct entry was found to result in higher confidence for midwifery students than post nursing programmes or integrated programmes. Further research is needed for evaluation of competence.
Glenoid erosion is a risk factor for recurrent instability after Hill-Sachs remplissage
Authors: Cavalier Maxime , Johnston Tyler Robert , Tran Laurie , Gauci Marc-Olivier , Boileau Pascal 
Published: April 2021

Aims The aim of this study was to identify risk factors for recurrent instability of the shoulder and assess the ability to return to sport in patients with engaging Hill-Sachs lesions treated with arthroscopic Bankart repair and Hill-Sachs remplissage (ABR-HSR). Methods This retrospective study included 133 consecutive patients with a mean age of 30 years (14 to 69) who underwent ABR-HSR; 103 (77%) practiced sports before the instability of the shoulder. All had large/deep, engaging Hill-Sachs lesions (Calandra III). Patients were divided into two groups: A (n = 102) with minimal or no (< 10%) glenoid bone loss, and B (n = 31) with subcritical (10% to 20%) glenoid loss. A total of 19 patients (14%) had undergone a previous stabilization, which failed. The primary endpoint was recurrent instability, with a secondary outcome of the ability to return to sport. Results At a mean follow-up of four years (1.0 to 8.25), ten patients (7.5%) had recurrent instability. Patients in group B had a significantly higher recurrence rate than those in group A (p = 0.001). Using a multivariate logistic regression, the presence of glenoid erosion of > 10% (odds ratio (OR) = 35.13 (95% confidence interval (CI) 8 to 149); p = 0.001) and age < 23 years (OR = 0.89 (0.79 to 0.99); p = 0.038) were associated with a higher risk of recurrent instability. A total of 80 patients (78%) could return to sport, but only 11 athletes (65%) who practiced high-risk (collision or contact-overhead) sports. All seven shoulders which were revised using a Latarjet procedure were stable at a mean final follow-up of 36 months (11 to 57) and returned to sports at the same level. Conclusion Patients with subcritical glenoid bone loss (> 10%) and younger age (≤ 23 years) are at risk of failure and reoperation after ABR-HSR. Furthermore, following this procedure, one-third of athletes practicing high-risk sports are unable to return at their pre-instability level, despite having a stable shoulder. Cite this article: Bone Joint J 2021;103-B(4):718–724.
Factors influencing periprosthetic femoral fracture risk
Authors: Konow Tobias , Baetz Johanna , Melsheimer Oliver , Grimberg Alexander , Morlock Michael 
Published: April 2021

AimsPeriprosthetic femoral fractures (PPF) are a serious complication of total hip arthroplasty (THA) and are becoming an increasingly common indication for revision arthroplasty with the ageing population. This study aimed to identify potential risk factors for PPF based on an analysis of registry data.MethodsCases recorded with PPF as the primary indication for revision arthroplasty in the German Arthroplasty Registry (Endoprothesenregister Deutschland (EPRD)), as well as those classified as having a PPF according to the International Classification of Diseases (ICD) codes in patients’ insurance records were identified from the complete datasets of 249,639 registered primary hip arthroplasties in the EPRD and included in the analysis.ResultsThe incidence of PPFs was higher (24.6%; 1,483) than reported in EPRD annual reports listing PPF as the main reason for revision (10.9%; 654). The majority of fractures occurred intraoperatively and were directly related to the implantation process. Patients who were elderly, female, or had comorbidities were at higher risk of PPFs (p < 0.001). German hospitals with a surgical volume of < 300 primary procedures per year had a higher rate of PPFs (p < 0.001). The use of cemented and collared prostheses had a lower fracture risk PPF compared to uncemented and collarless components, respectively (both p < 0.001). Collared prostheses reduced the risk of PPF irrespective of the fixation method and hospital’s surgical volume.ConclusionThe high proportion of intraoperative fractures emphasises the need to improve surgeon training and surgical technique. Registry data should be interpreted with caution because of potential differences in coding standards between institutions. Cite this article: Bone Joint J 2021;103-B(4):650–658.
Improved sizing with image-based robotic-assisted system compared to image-free and conventional techniques in medial unicompartmental knee arthroplasty
Authors: Batailler Cecile , Bordes Maxence , Lording Timothy , Nigues Ana , Servien Elvire , Calliess Tilman , Lustig Sébastien 
Published: April 2021

Aims Ideal component sizing may be difficult to achieve in unicompartmental knee arthroplasty (UKA). Anatomical variants, incremental implant size, and a reduced surgical exposure may lead to over- or under-sizing of the components. The purpose of this study was to compare the accuracy of UKA sizing with robotic-assisted techniques versus a conventional surgical technique. Methods Three groups of 93 medial UKAs were assessed. The first group was performed by a conventional technique, the second group with an image-free robotic-assisted system (Image-Free group), and the last group with an image-based robotic arm-assisted system, using a preoperative CT scan (Image-Based group). There were no demographic differences between groups. We compared six parameters on postoperative radiographs to assess UKA sizing. Incorrect sizing was defined by an over- or under-sizing greater than 3 mm. Results There was a higher rate of tibial under-sizing posteriorly in the conventional group compared to robotic-assisted groups (47.3% (n = 44) in conventional group, 29% (n = 27) in Image-Free group, 6.5% (n = 6) in Image-Based group; p < 0.001), as well as a higher rate of femoral under-sizing posteriorly (30.1% (n = 28) in conventional group, 7.5% (n = 7) in Image-Free group, 12.9% (n = 12) in Image-Based group; p < 0.001). The posterior femoral offset was more often increased in the conventional group, especially in comparison to the Image-Based group (43% (n = 40) in conventional group, 30.1% (n = 28) in Image-Free group, 8.6% (n = 8) in Image-Based group; p < 0.001). There was no significant overhang of the femoral or tibial implant in any groups. Conclusion Robotic-assisted surgical techniques for medial UKA decrease the risk of tibial and femoral under-sizing, particularly with an image-based system using a preoperative CT scan. Cite this article: Bone Joint J 2021;103-B(4):610–618.