bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ipsilateral Motor Pathways and Transcallosal Inhibition During Lower Limb Movement After Stroke
Authors: Cleland Brice T. , Madhavan Sangeetha 
Published: March 2021

Background Stroke rehabilitation may be improved with a better understanding of the contribution of ipsilateral motor pathways to the paretic limb and alterations in transcallosal inhibition. Few studies have evaluated these factors during dynamic, bilateral lower limb movements, and it is unclear whether they relate to functional outcomes. Objective Determine if lower limb ipsilateral excitability and transcallosal inhibition after stroke depend on target limb, task, or number of limbs involved, and whether these factors are related to clinical measures. Methods In 29 individuals with stroke, ipsilateral and contralateral responses to transcranial magnetic stimulation were measured in the paretic and nonparetic tibialis anterior during dynamic (unilateral or bilateral ankle dorsiflexion/plantarflexion) and isometric (unilateral dorsiflexion) conditions. Relative ipsilateral excitability and transcallosal inhibition were assessed. Fugl-Meyer, ankle movement accuracy, and walking characteristics were assessed. Results Relative ipsilateral excitability was greater during dynamic than isometric conditions in the paretic limb ( P ≤ .02) and greater in the paretic than the nonparetic limb during dynamic conditions ( P ≤ .004). Transcallosal inhibition was greater in the ipsilesional than contralesional hemisphere ( P = .002) and during dynamic than isometric conditions ( P = .03). Greater ipsilesional transcallosal inhibition was correlated with better ankle movement accuracy ( R2 = 0.18, P = .04). Greater contralateral excitability to the nonparetic limb was correlated with improved walking symmetry ( R2 = 0.19, P = .03). Conclusions Ipsilateral pathways have increased excitability to the paretic limb, particularly during dynamic tasks. Transcallosal inhibition is greater in the ipsilesional than contralesional hemisphere and during dynamic than isometric tasks. Ipsilateral pathways and transcallosal inhibition may influence walking asymmetry and ankle movement accuracy.
Bifurcated bypass in severe chronic limb threatening ischaemia
Authors: Adami Daniele , Marconi Michele , Piaggesi Alberto , Mocellin Davide M , Berchiolli Raffaella N , Ferrari Mauro 
Published: March 2021

Objectives Revascularization according to the angiosome concept is of proven importance for limb salvage in chronic limb threatening ischaemia but it is not always practicable. Bifurcated bypasses could be considered as an option when an endovascular approach is not feasible or has already failed and a single bypass would not allow direct revascularization of the ischaemic area. Bifurcated bypasses are characterized by landing on two different arteries, the main artery (in direct continuity with the foot vessels) and the secondary one (perfusing the angiosome district). The aim of this study is to evaluate the safety and effectiveness of bifurcated bypass in chronic limb threatening ischaemia. Methods Thirty-five patients were consecutively treated with a bifurcated bypass for chronic limb threatening ischaemia from January 2014 to December 2019 in a single vascular surgery centre. Data from clinical records and operative registers were collected prospectively in an electronic database and retrospectively analysed. Primary and primary assisted bypass patency, amputation-free survival, morbidity and mortality rates at 12 and 24 months were analysed. Results Mean follow-up period was 25.1 months (range 2–72 months). Thirty-six bifurcated bypasses were performed on 35 patients (age 75.3 ± 7.2 years; 69.4% were male). According to Wound, Ischemia, foot Infection classification 22.2% belonged to stage 3 and 77.8% to stage 4 and the mean Rutherford’s class was 5.1 ± 0.7. Immediate technical success was 100%. Early mortality and morbidity rates were respectively 5.5%, and 33.3%; foot surgery was performed in 50% of cases with wound healing in all patients. Primary patency and primary assisted bypass patency were 96.7% and 100% at 6 months; 85.2% and 92% at 12 months, 59.9% and 73.4% at 24 months, respectively. Amputation-free survival at 12 and 24 months was, respectively, 95.6% and 78.8%. Overall survival rates at 12 and 24 months were respectively 94.4% and 91.6%. Conclusions Bifurcates bypass can provide good results in patients with chronic limb threatening ischaemia without endovascular option, especially in diabetic ones. Bifurcated bypass is a complex surgical solution, both to be planned and performed, and it is quite invasive for frail patients that should be accurately selected.
Stroke risk following traumatic brain injury: Systematic review and meta-analysis
Authors: Turner Grace M , McMullan Christel , Aiyegbusi Olalekan Lee , Bem Danai , Marshall Tom , Calvert Melanie , Mant Jonathan , Belli Antonio 
Published: March 2021

Background Traumatic brain injury is a global health problem; worldwide, >60 million people experience a traumatic brain injury each year and incidence is rising. Traumatic brain injury has been proposed as an independent risk factor for stroke. Aims To investigate the association between traumatic brain injury and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4 December 2020. We used random-effects meta-analysis to pool hazard ratios for studies which reported stroke risk post-traumatic brain injury compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-traumatic brain injury control group, all found traumatic brain injury patients had significantly increased risk of stroke compared to controls (pooled hazard ratio 1.86; 95% confidence interval 1.46–2.37). Findings suggest stroke risk may be highest in the first four months post-traumatic brain injury, but remains significant up to five years post-traumatic brain injury. Traumatic brain injury appears to be associated with increased stroke risk regardless of severity or subtype of traumatic brain injury. There was some evidence to suggest an association between reduced stroke risk post-traumatic brain injury and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion Traumatic brain injury is an independent risk factor for stroke, regardless of traumatic brain injury severity or type. Post-traumatic brain injury review and management of risk factors for stroke may be warranted.
Prevalence of axial spondyloarthritis in patients with inflammatory bowel disease using cross-sectional imaging: a systematic literature review
Authors: Evans Jobie , Sapsford Mark , McDonald Scott , Poole Kenneth , Raine Tim , Jadon Deepak R. 
Published: March 2021

Background: Patients with inflammatory bowel disease (IBD) have an excess burden of axial spondyloarthritis (axSpA), which, if left untreated, may significantly impact on clinical outcomes. We aimed to estimate the prevalence of axSpA, including previously undiagnosed cases, in IBD patients from studies involving cross-sectional imaging and identify the IBD features potentially associated with axSpA. Methods: PubMed, Embase and Cochrane databases were searched systematically between 1990 and 2018. Article reference lists and key conference abstract lists from 2012 to 2018 were also reviewed. All abstracts were reviewed by two authors to determine eligibility for inclusion. The study inclusion criteria were (a) adults aged 18 years or above, (b) a clinical diagnosis of IBD and (c) reporting identification of sacroiliitis using cross-sectional imaging. Results: A total of 20 observational studies were identified: 12 used CT, 6 used MR and 2 utilised both computed tomography (CT) and magnetic resonance (MR) imaging. Sample sizes ranged from 25 to 1247 (a total of 4096 patients); 31 studies were considered to have low selection bias, 13 included two or more radiology readers, and 3 included rheumatological assessments. The prevalence of sacroiliitis, the most commonly reported axSpA feature, ranged from 2.2% to 68.0% with a pooled prevalence of 21.0% [95% confidence interval (CI) 17–26%]. Associated IBD features include increasing IBD duration, increasing age, male sex, IBD location, inflammatory back pain and peripheral arthritis. No significant difference in the prevalence of sacroiliitis between Crohn’s disease and ulcerative colitis was identified. Study limitations include variability in the individual study sample sizes and patient demographics. Conclusion: This review highlights the need for larger, well-designed studies using more sensitive imaging modalities and multivariable modelling to better estimate the prevalence of axSpA in IBD. An improved knowledge of the IBD phenotype(s) associated with axSpA and use of cross-sectional imaging intended for IBD assessment to screen for axSpA may help clinicians identify those patients most at risk.
Evaluation of the Bond Strength of Different Pulp Capping Materials to Dental Adhesive Systems: An In Vitro Study
Authors: Akbiyik Sema Yazici , Bakir Elif Pınar , Bakir S¸eyhmus 
Published: March 2021

Aim: To evaluate the bond strengths of pulp capping materials (Dycal, ProRoot MTA, Biodentine, TheraCal LC, Calcimol LC, and ApaCal ART) and different adhesive systems (Gluma 2 Bond, Clearfil SE Protect, Gluma Self Etch, Clearfil S 3 Bond Plus, Gluma Bond Universal, Clearfil S 3 Bond Universal). Materials and Methods: Two hundred fifty-two acrylic blocks were prepared in which cylindrical cavities of 4 × 2 mm 3 were formed. Pulp capping materials were placed in the cavities. Different adhesive systems were applied to each pulp capping material group. After applying the composite resin, the shear bond strength (SBS) values of the specimens were determined in the Instron test device. Fracture types were evaluated using a stereomicroscope and a scanning electron microscope. Data were analyzed by Shapiro–Wilk’s and Kruskal–Wallis H test. Results: There is a statistically significant difference between pulp capping materials in terms of SBS values ( P < .05). Dycal’s SBS was found significantly lower than other materials, and the highest bond strength was observed in Calcimol LC material. Although there is no statistically significant difference ( P > .05) between the adhesive agent groups in terms of SBS, Gluma 2 Bond showed the highest bond strength value. Conclusion: In traditional pulp capping materials such as Dycal, MTA, and Biodentine, using a two-step self-etch adhesive system can result in higher bond strength values. In resin-based TheraCal LC,, ApaCal ART, and Calcimol LC materials, it may be recommended to use a two-step etch and rinse adhesive system.
Evaluation of the Perspectives of Orthodontists and Laypersons About the Effect of Orthodontic Treatment on Facial Aesthetics of Young Turkish Patients
Authors: Fidancioglu Ahmet , Malkoc Sıddık , Güler Özge Çelik 
Published: March 2021

Aim: To compare the perspective of orthodontists and laypersons on the effects of orthodontic treatment on facial aesthetics in young Classes I, II, and III Turkish patients. Materials and Methods: In this cross-sectional study, a total of 60 patients (30 males and 30 females, 9 to 17 years of age) was included using randomization in strata and then divided equally ( n = 15) into four groups according to the Angle classification. Photographs during frontal and lateral resting and also smiling were obtained from each patient before and after orthodontic treatment. A panel consisting 50 laypersons and 50 orthodontists was invited for the evaluation of the initial and final photos by using the visual analogue scale and a five-point scale to determine similarities and differences of their perspectives in the effects of orthodontic treatment on facial aesthetics. The data were analyzed by independent t-test, one-way analysis of variance, and Pearson’s correlation test. Results: The evaluation of facial aesthetics and treatment changes were not affected by the age and gender of the panel members ( P <.05). Angle Class III patients were given lower scores by both orthodontists ( P < .001) and laypersons ( P < .05), but no significant differences were found between any of other classes ( P >.05). Orthodontists reported greater improvement for Class III than in Class II Division 1 ( P < .05) however laypersons did not notice the changes after orthodontic treatment for any of Angle classes ( P >.05). Conclusion: Class III patients received lower scores for aesthetics from both panels. Laypersons may not be concerned about the effects of orthodontic treatment on facial aesthetics in patients with any Angle class. Orthodontists have seen more facial aesthetic changes after orthodontic treatment in Class III patients.
Rinne Test Results: How Badly Can We Be Mistaken?
Authors: Wrobel Maciej J. , Bogacz Bogdan F. 
Published: March 2021

ObjectiveTo establish the extent to which sound amplitudes delivered by a vibrating tuning fork change around its long axis and to evaluate whether such differences in amplitude might change the results of the Rinne test.Study DesignExperimental measurements.SettingLaboratory setting.MethodsSetup I: a vibrating tuning fork was handheld and manually rotated around its long axis next to a sound recording device (the simulated ear) in order to record sound amplitude data at a full range of angles relative to the device; files were split into segments in which sound amplitude changed: A (from a maximum to a minimum) and B (from a minimum to a maximum). Setup II: a vibrating tuning fork was machine‐rotated, and the angle of rotation, along with the sound amplitude, was automatically recorded through a single full rotation.ResultsThe angles of 0° and 180° (which equate to the established best practice in Rinne testing) were associated with the highest sound amplitudes. All other angles decreased sound amplitude. The greatest decrease in amplitude was recorded at 51° and 130°. This difference ranged from 9.8 to 34.7 dB, depending on the initial amplitude.ConclusionThe outcome of a Rinne test can be affected if attention is not paid to the precise angle at which the tuning fork is held relative to the ear. The potential of this effect will be greater when high background noise or patient hearing loss requires that the tuning fork be vigorously excited to obtain high sound amplitudes.
Carbonate and cation substitutions in hydroxylapatite in breast cancer micro-calcifications
Authors: Zhang Yan , Wang Changqiu , Li Yan , Lu Anhuai , Meng Fanlu , Ding Hongrui , Mei Fang , Liu Jianying , Li Kang , Yang Chongqing , Du Jingyun , Li Yanzhang 
Published: March 2021

Abstract
Calcification within breast cancer is a diagnostically significant radiological feature that generally consists of hydroxylapatite. Samples from 30 cases of breast carcinoma with calcification were investigated using optical microscopy, energy-dispersive X-ray analysis, transmission-electron microscopy, Fourier-transform infrared spectroscopy, Raman spectroscopy, synchrotron radiation X-ray diffraction and X-ray fluorescence. Under optical microscopy, the calcifications were found to consist of either irregular aggregates with widths > 200 μm or spherical aggregates similar to psammoma bodies with an average diameter of 30 μm. Transmission-electron microscopy showed that short columnar or dumbbell-shaped crystals with widths of 10–15 nm and lengths of 20–50 nm were the most common morphology; spherical aggregates (~1 μm in diameter) with amorphous coatings of fibrous nanocrystals were also observed. Results indicated that hydroxylapatite was the dominant mineral phase in the calcifications, and both CO32– and cation substitutions (Na, Mg, Zn, Fe, Sr, Cu and Mn) were present in the hydroxylapatite structure. Fourier-transform infrared spectra show peaks at 872 and 880 cm–1 indicating that CO32– substituted both the OH– (A type) and PO43– (B type) sites of hydroxylapatite, making it an A and B mixed type. The ratio of B- to A-type substitution was estimated in the range of 1.1–18.7 from the ratio of peak intensities (I872/I880), accompanied with CO32– contents from 1.1% to 14.5%. Trace arsenic, detected in situ by synchrotron radiation X-ray fluorescence was found to be distributed uniformly in the calcifications in the form of AsO43– substituting for PO43–. It is therefore proposed that identifying these trace elements in breast cancer calcifications may be promising for future clinical diagnostics.
Phagocyte extracellular traps in children with neutrophilic airway inflammation
Authors: King Paul T. , Dousha Lovisa , Clarke Nadeene , Schaefer Jennifer , Carzino Rosemary , Sharma Roleen , Wan Ken L. , Anantharajah Aveena , O'Sullivan Kim , Lu Zhong X. , Holdsworth Stephen R. , Ranganathan Sarath , Bardin Philip G. , Armstrong David S. 
Published: March 2021

Childhood lung infection is often associated with prominent neutrophilic airway inflammation and excess production of proteases such as neutrophil elastase (NE). The mechanisms responsible for this inflammation are not well understood. One potentially relevant pathway is the production of extracellular traps by neutrophils (NETs) and macrophages (METs). The aim of this study was to measure NET and MET expression in children and the effect of deoxyribonculease (DNase) 1 and α1-antitrypsin (AAT) on this process.We studied 76 children (median age of 4.0 years) with cystic fibrosis or chronic cough who underwent investigational bronchoscopy. NETs, METs and neutrophil elastase activity in bronchoalveolar lavage (BAL) samples were measured using confocal microscopy and functional assays. The effects of DNase 1 and AAT on NET/MET expression and neutrophil elastase activity were examinedin vitro.Both subject groups had airway neutrophilia with prominent BAL production of NETs with neutrophil elastase co-expression; the mean %±standard error of the mean of neutrophils expressing NETs in the cystic fibrosis group was 23.3±2.8% and in the non-cystic fibrosis group was 28.4±3.9%. NET expression was higher in subjects who had detectable neutrophil elastase activity (p≤0.0074). The percentage of macrophages expressing METs in the cystic fibrosis group was 10.7±1.2% and in the non-cystic fibrosis group was 13.2±1.9%. DNase 1 decreased NET/MET expression (p<0.0001), but increased neutrophil elastase activity (p≤0.0137). The combination of AAT and DNase 1 reduced neutrophil elastase activity (p≤0.0049).We observed prominent extracellular trap formation in symptomatic children with and without cystic fibrosis. This innate inflammatory response was down-regulated by a combination of currently available therapeutics.
One Novel Hydraulic Actuating System for the Lower-Body Exoskeleton
Authors: Sun Maowen , Ouyang Xiaoping , Mattila Jouni , Yang Huayong , Hou Gang 
Published: March 2021

AbstractThe hydraulic exoskeleton is one research hotspot in the field of robotics, which can take heavy load due to the high power density of the hydraulic system. However, the traditional hydraulic system is normally centralized, inefficient, and bulky during application, which limits its development in the exoskeleton. For improving the robot’s performance, its hydraulic actuating system should be optimized further. In this paper a novel hydraulic actuating system (HAS) based on electric-hydrostatic actuator is proposed, which is applied to hip and knee joints. Each HAS integrates an electric servo motor, a high-speed micro pump, a specific tank, and other components into a module. The specific parameters are obtained through relevant simulation according to human motion data and load requirements. The dynamic models of the HAS are built, and validated by the system identification. Experiments of trajectory tracking and human-exoskeleton interaction are carried out, which demonstrate the proposed HAS has the ability to be applied to the exoskeleton. Compared with the previous prototype, the total weight of the HAS in the robot is reduced by about 40%, and the power density is increased by almost 1.6 times.
Socioeconomic inequalities in life expectancy and disability-free life expectancy among Chilean older adults: evidence from a longitudinal study
Authors: Moreno Ximena , Lera Lydia , Moreno Francisco , Albala Cecilia 
Published: March 2021

Abstract
Background
Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people.

Methods
The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models.

Results
At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6–24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4–19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4–18.2). They also had a DFLE (19.4; 95% CI 17.1–21.7) 4 (15.4; 95% CI 14.6–16.1) and 5.2 (14.2; 95% CI 13.4–14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7–30.8) 4.6 (22.7; 95% CI 21.9–23.5) and 5.6 (21.6; 20.6–22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5–23.3; medium: 16.5; 95% CI 15.8–17.1; low: 15.3; 95% CI 14.6–16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age.

Discussion
Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives.

Conclusion
A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.