bluuebunny/crossref_metadata_2025_split huggingface dataset:
Educational opportunities for postgraduate medical trainees during the COVID-19 pandemic: deriving value from old, new and emerging ways of learning
Authors: Kumar Kartik , Groom Katherine , Martin Laura , Russell Georgina K , Elkin Sarah L 
Published: August 2021

AbstractThe COVID-19 pandemic has had a significant impact on postgraduate medical training across all specialties. Although some traditional learning opportunities have been curtailed, there have been numerous examples of highly valuable educational experiences that have arisen during this time. Here, from a trainee perspective, we consider the educational merits of the re-emergence of ‘firm-based’ teams, new online learning opportunities, use of digital technologies and the rise of telephone clinics and new COVID-19 clinical services. As health services continue to recover from surges in COVID-19 cases, it is important to reflect on and recognise the value of these educational experiences so that helpful elements can be retained and embedded into training programmes for the benefit of both trainees and patients.
Macrophage migration inhibitory factor: a potential biomarker for chronic low back pain in patients with Modic changes
Authors: Gjefsen Elisabeth , Gervin Kristina , Goll Guro , Bråten Lars Christian Haugli , Wigemyr Monica , Aass Hans Christian D , Vigeland Maria Dehli , Schistad Elina , Pedersen Linda Margareth , Pripp Are Hugo , Storheim Kjersti , Selmer Kaja Kristine , Zwart John Anker 
Published: August 2021

BackgroundLow back pain (LBP) is a leading cause of disability worldwide, but the aetiology remains poorly understood. Finding relevant biomarkers may lead to better understanding of disease mechanisms. Patients with vertebral endplate bone marrow lesions visualised on MRI as Modic changes (MCs) have been proposed as a distinct LBP phenotype, and inflammatory mediators may be involved in the development of MCs.ObjectivesTo identify possible serum biomarkers for LBP in patients with MCs.MethodsIn this case control study serum levels of 40 cytokines were compared between patients with LBP and MC type 1 (n=46) or type 2 (n=37) and healthy controls (n=50).ResultsAnalyses identified significantly higher levels of six out of 40 cytokines in the MC type 1 group (MC1), and five in the MC type 2 group (MC2) compared with healthy controls. Six cytokines were moderately correlated with pain. Principal component analyses revealed clustering and separation of patients with LBP and controls, capturing 40.8% of the total variance, with 10 cytokines contributing to the separation. Macrophage migration inhibitory factor (MIF) alone accounted for 92% of the total contribution. Further, receiver operating characteristics analysis revealed that MIF showed an acceptable ability to distinguish between patients and controls (area under the curve=0.79).ConclusionsThese results suggest that cytokines may play a role in LBP with MCs. The clinical significance of the findings is unknown. MIF strongly contributed to clustering of patients with LBP with MCs and controls, and might be a biomarker for MCs. Ultimately, these results may guide future research on novel treatments for this patient group.
Mass-Zero constrained dynamics and statistics for the shell model in magnetic field
Authors: Girardier D. D. , Coretti A. , Ciccotti G. , Bonella S. 
Published: August 2021

AbstractIn several domains of physics, includingfirst principlesimulations and classical models for polarizable systems, the minimization of an energy function with respect to a set of auxiliary variables must be performed to define the dynamics of physical degrees of freedom. In this paper, we discuss a recent algorithm proposed to efficiently and rigorously simulate this type of systems: the Mass-Zero (MaZe) Constrained Dynamics. In MaZe, the minimum condition is imposed as a constraint on the auxiliary variables treated as degrees of freedom of zero inertia driven by the physical system. The method is formulated in the Lagrangian framework, enabling the properties of the approach to emerge naturally from a fully consistent dynamical and statistical viewpoint. We begin by presenting MaZe for typical minimization problems where the imposed constraints are holonomic and summarizing its key formal properties, notably the exact Born–Oppenheimer dynamics followed by the physical variables and the exact sampling of the corresponding physical probability density. We then generalize the approach to the case of conditions on the auxiliary variables that linearly involve their velocities. Such conditions occur, for example, when describing systems in external magnetic field and they require to adapt MaZe to integrate semiholonomic constraints. The new development is presented in the second part of this paper and illustrated via a proof-of-principle calculation of the charge transport properties of a simple classical polarizable model of NaCl.
Effect of Heat Softening versus Ultrasonic Removal of Root-End Gutta-Percha on the Quality of Root-End Preparation for Endodontic Microsurgery
Authors: Ling Zhiting , Zheng Ziting , Zeng Yuting , Jiang Lifang , Wu Yuan , Wu Buling , Yan Wenjuan 
Published: August 2021

This study is aimed at comparing the efficacy of heat softening and ultrasonic removal of root-end gutta-percha during retrograde preparation for root apical microsurgery. Recently extracted single-rooted premolars (

n
=
40

) were prepared with standardized endodontically treated and root-end resection and then randomly divided into four groups that received root-end cavity preparation using four different instruments: a diamond-coated ultrasonic tip (AS3D; SACTEON, Paris, France), AS3D with the modified plugger of cordless heat carrier (MSE; B&L Biotech, Bala Cynwyd, PA, USA), stainless steel ultrasonic tip (Jetip-2; B&L Biotech, Bala Cynwyd, PA, USA), or Jetip-2 with MSE. The time required for root-end preparation was recorded. The root apex samples were examined by scanning electron microscopy to assess root surface microcracks and marginal integrity. The remnants of gutta-percha on the cavity walls were evaluated using a stereomicroscope. Statistical analysis was performed using Student’s

t

-test and Wilcoxon rank-sum test (

P
<
0.05

). Usage of MSE with Jetip-2 significantly reduced preparation time from

99.8
±
6.8

s

to

32.4
±
1.0

s

(

P
=
0.009

), the number of microcracks from 42 to 13 (

P
=
0.036

), and the remnants of gutta-percha from 80% to 20% (

P
=
0.041

). Similar results were observed for AS3D with MSE. The heat softening of MSE was effective in cleaning gutta-percha, thus greatly improving the efficiency of the root-end preparation, thereby producing a root-end cavity with fewer microcracks and better marginal integrity.
Máscaras ao rosto e tampões à boca: implicações na voz para a performance do professor que canta
Authors: Vieira Márlon Souza , Miguel Fabio 
Published: August 2021

Neste trabalho, propõe-se discutir as interferências causadas à voz do professor, nesse momento de pandemia e isolamento social, em que instituições educativas têm buscado soluções para essa nova realidade. Neste cenário, considera-se que a performance do professor tem sido afetada e que os processos pedagógicos, que tem a voz como elemento comunicativo fundamental, encontram-se prejudicados em seus objetivos. De igual modo, avalia-se ser fundamental conhecer as estruturas e os aspectos formativos da voz: elementos que geram a ação performática do “professor que canta”. Portanto, busca-se refletir como a voz é importante para o educador e, igualmente, ao olhar o prejuízo imposto à capacidade performática nessa atualidade, conscientizar-se a respeito de como deverá se comportar, quando for estabelecido a normalidade.
Linear Rainfall Features and Their Association with Rainfall Extremes near Melbourne, Australia
Authors: Hitchcock Stacey M. , Lane Todd P. , Warren Robert A. , Soderholm Joshua S. 
Published: August 2021

AbstractLinear precipitation systems are a prominent contributor to rainfall over Melbourne, Australia, and the surrounding region. These systems are often convective in nature, frequently associated with cold fronts, and in some cases can lead to significant rainfall and flash flooding. Various types of linearly organized systems (e.g., squall lines, quasi-linear convective systems) have been the subject of much research in the United States and elsewhere, but thus far relatively little analysis has been done on linear systems in Australia. To begin to understand rainfall extremes and how they may change in this region in the future, it is useful to explore the contribution of these types of systems and the characteristics that define them. To this end, we have examined the recently developed Australian Radar Archive (AURA), identifying objects that meet a specific set of relevant criteria, and used multiple methods to identify heavy and extreme daily rainfall. We found that on average, days with linear systems contribute over half of the total rainfall and 70%–85% of heavy/extreme rainfall in the Melbourne region. The linear systems that occur on heavy rainfall days tend to be larger, slower-moving, and longer-lived, while those on extreme rainfall days also tend to be more intense and have a greater degree of southward propagation than linear systems on other days.
Sinus Radiological Findings in General Asymptomatic Populations: A Systematic Review of Incidental Mucosal Changes
Authors: Razi Basil , Perkovic Adam , Alvarado Raquel , Stroud Anna , Ho Jacqueline , Kalish Larry H. , Campbell Raewyn G. , Sacks Raymond , Harvey Richard J. 
Published: August 2021

ObjectiveTo determine the range of incidental mucosal changes in a general sinonasally asymptomatic population on radiology.Data SourcesMedline (1996‐present) and Embase (1974‐present) were searched on March 14, 2020, to identify articles that reported radiological sinus mucosal findings in asymptomatic population groups. Bibliographic search of included studies was conducted to identify additional articles.Review MethodsThe review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines and Cochrane Handbook for Systematic Reviews of Interventions. A comprehensive search strategy was formulated and articles screened to extract data reporting Lund‐Mackay (LM) score, presence of mucous retention cysts, and maxillary mucosal thickening. A random‐effects model was used in meta‐analysis.ResultsA total of 950 articles were identified, of which 33 manuscripts met the inclusion criteria. The included studies involved 16,966 sinonasally asymptomatic subjects. The mean LM score was 2.24 (95% CI, 1.61‐2.87), and an LM score of ≥4 in 14.71% (95% CI, 6.86‐24.82%) was present across all general asymptomatic population groups. Mucous retention cysts were noted in 13% (95% CI, 8.33‐18.55%) and maxillary mucosal thickening of ≥2 mm in 17.73% (95% CI, 8.67‐29.08%).ConclusionThe prevalence of incidental mucosal changes in a general asymptomatic population on radiology needs to be considered when making a diagnosis of chronic rhinosinusitis.
An independent inter- and intra-observer agreement assessment of the Eno classification of sacroiliac joint degeneration
Authors: Urrutia Julio , Camino-Willhuber Gaston , Astur Nelson , Valacco Marcelo , Borensztein Matias , Velan Osvaldo , Cikutovic Pablo 
Published: August 2021

Background Recently, a scoring system to grade sacroiliac joint (SIJ) degeneration using computed tomography (CT) scans was described. No independent evaluation has determined the inter- and intra-observer agreement using this scheme. Purpose To perform an independent inter- and intra-observer agreement assessment using the Eno classification and determining gas in the SIJ. Material and Methods We studied 64 patients aged ≥60 years who were evaluated with abdominal and pelvic computed tomography scans. Six physicians (three orthopaedic spine surgeons and three musculoskeletal radiologists) assessed axial images to grade SIJ degeneration into grade 0 (normal), grade 1 (mild degeneration), grade 2 (significant degeneration), and grade 3 (ankylosis). We also evaluated the agreement assessing the presence of gas in the SIJ. After a four-week interval, all cases were presented in a random sequence for repeat assessment. We determined the agreement using the kappa (κ) or weighted kappa coefficient (wκ). Results The inter-observer agreement was moderate (wκ = 0.50 [0.44–0.56]), without differences among surgeons (wκ = 0.53 [0.45–0.61]) and radiologists (wκ = 0.49 [0.42–0.57]). The agreement evaluating the presence of gas was also moderate (κ = 0.45 [0.35–0.54]), but radiologists obtained better agreement (κ = 0.61 [0.48–0.72]) than surgeons (κ = 0.29 [0.18–0.39]). The intra-observer agreement using the classification was substantial (wκ = 0.79 [0.76–0.82]), without differences comparing surgeons (wκ = 0.75 [0.70–0.80]) and radiologists (wκ = 0.83 [0.79–0.87]). The intra-rater agreement evaluating gas was substantial (κ = 0.77 [0.72–0.82]), without differences between surgeons (κ = 0.71 [0.63–0.78]) and radiologists (κ = 0.84 [0.78–0.90]). Conclusion Given the only moderate agreement obtained using the Eno classification, it does not seem adequate to be used in clinical practice or in research.
Longitudinal Changes of Patellar Alignment Before and After Anterior Cruciate Ligament Reconstruction With Hamstring Autograft
Authors: Liao Tzu-Chieh , Pedoia Valentina , Majumdar Sharmila , Souza Richard B. 
Published: August 2021

Background: Evidence has suggested that after anterior cruciate ligament (ACL) reconstruction (ACLR), individuals exhibit patellar malalignment; however, it is unknown if patellar alignment changes over time. Purpose: To examine the longitudinal changes in patellar alignment before, 6 months after, and 3 years after ACLR and to compare these variations, if present, with patellar alignment in controls. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 35 patients who had ACLR using hamstring autograft (19 male; age, 29.9 ± 7.7 years; body mass index, 23.8 ± 2.5) and 20 controls (13 male; age, 30.4 ± 4.8 years; body mass index, 24.3 ± 2.7) participated. All patients underwent bilateral knee magnetic resonance imaging with the knee in extension and 30° of flexion using sagittal T2-weighted, fat-saturated fast spin-echo images to assess patellar alignment in 6 degrees of freedom: anterior-posterior, medial-lateral, and superior-inferior translations; flexion; tilt; and spin. Patients who had ACLR were assessed before (ACL-deficient state) and 6 months and 3 years after ACLR, while control participants were only assessed once. One-way repeated-measures analysis of variance was used to examine patellar alignment across time in the ACLR group. If changes were present, the independent t test was carried out to examine the differences between ACLR knees and control knees. Results: In the knee-extended condition, greater patellar lateral displacement was observed at the ACL-deficient state and 6 months after ACLR compared with 3 years after ACLR within the ACLR group ( P < .001 and P = .043, respectively) and compared with the control group ( P = .001 and P = .039, respectively). Greater patellar lateral tilt was observed at the ACL-deficient state compared with 3 years after ACLR ( P = .003) and compared with the control group ( P = .018). In the knee-flexed condition, greater anterior displacement was observed at the ACL-deficient state compared with 3 years after ACLR ( P = .001) and compared with the control group ( P = .011), and it was also observed at 6 months after ACLR compared with the control group ( P = .019). Less lateral spin was observed at the ACL-deficient state ( P = .042) and 6 months after ACLR ( P = .004) compared with 3 years after ACLR and compared with the control group ( P = .004 for both). No patellar alignment measures in the ACLR knees at 3 years were significantly different from those of the controls. Conclusion: Patellar malalignment in individuals before and after ACLR subjected to longitudinal changes, and the differences in alignment between ACLR and controls diminished over 3 years.
Improved Healing of Rabbit Patellar Tendon Defects After an Atelocollagen Injection
Authors: Kim Duck Kyu , Ahn Jiyong , Kim Seon Ae , Go Eun Jeong , Lee Dong Hwan , Park Seung Chan , Shetty Asode Ananthram , Kim Seok Jung 
Published: August 2021

Background: Patellar tendinopathy is a common cause of limitations in daily life activities in young and/or active people. The patellar tendon consists of a complex of collagen fibers; therefore, collagen could be used as a scaffold in the treatment of patellar tendinopathy. Purpose: To evaluate the healing capacity of injected atelocollagen as a treatment scaffold for patellar tendon defect and, hence, its potential for the treatment of patellar tendinopathy. Study Design: Controlled laboratory study. Methods: After receiving a full-thickness patellar tendon defect, 24 New Zealand White rabbits were divided into a control group (without treatment) and an experimental group that received an atelocollagen injection into the defect. Six rabbits from each group were subsequently used for either histologic scoring or biomechanical testing. The Mann-Whitney U test was used to compare histologic evaluation scores and load to failure between the 2 groups. Statistical significance was set at P < .05. Results: The experimental group showed excellent repair of the damaged patellar tendon and good remodeling of the defective area. In contrast, the control group showed defective healing with loose, irregular matrix fibers and adipose tissue formation. A statistically significant difference was found between the 2 groups in both histologic scores and biomechanical tests at postoperative week 12. Conclusion: Injection of atelocollagen significantly improved the regeneration of damaged patellar tendons. Clinical Relevance: Atelocollagen gel injections could be used to treat patellar tendinopathy in outpatient clinic settings.
Pre-exposure prophylaxis awareness, use, and intention to use in a regional sample of Latin American geosocial networking application users in 2018–2019
Authors: Blair Kevin J , Segura Eddy R , Garner Alex , Lai Jianchao , Ritterbusch Amy , Leon-Giraldo Sebastian , Guilamo-Ramos Vincent , Lake Jordan E , Clark Jesse L , Holloway Ian W 
Published: August 2021

Pre-exposure prophylaxis (PrEP) access is increasing in Latin America. We explored PrEP use among Spanish-speaking, Hornet geosocial networking application users from Latin American countries with limited PrEP data via an online survey completed between December 2018 and February 2019. A total of 718 Hornet users from 10 countries were included, of whom 72.1% reported PrEP awareness. Few (5.6%) were currently taking PrEP, though 32.1% intended to take PrEP in the subsequent 6 months. PrEP awareness was lower in 18–25 year olds compared to 26+ (62.4% vs. 75.6%, aOR 0.67, [95% CI 0.46–0.97]), and higher among those living in larger versus smaller cities (74.4% vs. 58.8%, aOR 1.96, [95% CI 1.25–3.07]) or countries with at least partial versus no PrEP policy adoption (79.1% vs. 60.8%, aOR 2.20, [95% CI 1.56–3.12]). Intention to use PrEP was higher among PrEP-eligible respondents (51.8% vs. 29.6%, aOR 2.26, [95% CI 1.26–4.07]) and those recently tested for a sexually transmitted infection (35.4% vs. 25.5%, aOR 1.58, [95% CI 1.01–2.48]). Efforts to expand PrEP use in Latin America should focus on national PrEP policy adoption, and research should explore barriers to awareness and use among young men who have sex with men.
Remote Ischemic Perconditioning Ameliorates Myocardial Ischemia and Reperfusion-Induced Coronary Endothelial Dysfunction and Aortic Stiffness in Rats
Authors: Szabó Petra Lujza , Dostal Christopher , Pilz Patrick Michael , Hamza Ouafa , Acar Eylem , Watzinger Simon , Mathew Shalett , Kager Gerd , Hallström Seth , Podesser Bruno K. , Kiss Attila 
Published: August 2021

Background: Vascular stiffness and endothelial dysfunction are accelerated by acute myocardial infarction (AMI) and subsequently increase the risk for recurrent coronary events. Aim: To explore whether remote ischemic perconditioning (RIPerc) protects against coronary and aorta endothelial dysfunction as well as aortic stiffness following AMI. Methods: Male OFA-1 rats were subjected to 30 min of occlusion of the left anterior descending artery (LAD) followed by reperfusion either 3 or 28 days with or without RIPerc. Three groups: (1) sham operated (Sham, without LAD occlusion); (2) myocardial ischemia and reperfusion (MIR) and (3) MIR + RIPerc group with 3 cycles of 5 minutes of IR on hindlimb performed during myocardial ischemia were used. Assessment of vascular reactivity in isolated septal coronary arteries (non-occluded) and aortic rings as well as aortic stiffness was assessed by wire myography either 3 or 28 days after AMI, respectively. Markers of pro-inflammatory cytokines, adhesion molecules were assessed by RT-qPCR and ELISA. Results: MIR promotes impaired endothelial-dependent relaxation in septal coronary artery segments, increased aortic stiffness and adverse left ventricular remodeling. These changes were markedly attenuated in rats treated with RIPerc and associated with a significant decline in P-selectin, IL-6 and TNF-α expression either in infarcted or non-infarcted myocardial tissue samples. Conclusions: Our study for the first time demonstrated that RIPerc alleviates MIR-induced coronary artery endothelial dysfunction in non-occluded artery segments and attenuates aortic stiffness in rats. The vascular protective effects of RIPerc are associated with ameliorated inflammation and might therefore be caused by reduced inflammatory signaling.
Intraretinal, sub-retinal, and sub-retinal pigmented epithelium fluid in non-exudative age-related macular degeneration: follow-up with OCT imaging
Authors: Samanta Anindya , Jhingan Mahima , Arora Supriya , Singh Sumit , Tucci Davide , Cagini Carlo , Lupidi Marco , Chhablani Jay 
Published: August 2021

Background/objectives: To evaluate the presence and evolution of fluid in non-exudative age-related macular degeneration (AMD) through serial OCT. Subjects/methods: A retrospective analysis of eyes with non-exudative AMD with a minimum of 4 year follow-up was done. Parameters including intraretinal fluid (IRF), subretinal fluid (SRF), and sub-retinal pigment epithelium (RPE) fluid (SRPEF); subfoveal choroidal thickness (SFCT) and type of drusen were evaluated using optical coherence tomography (OCT) scans at baseline and follow up visits. Results: Seventy-two eyes (in 63 patients) were followed up for an average of 5.83 ± 2.17 years. A total of 26/72 (36%) and 29/65 (52%) of the non-exudative eyes had fluid during baseline and the last visit. Seven eyes (10%) out of 72 eyes converted into exudative AMD or neo-vascular AMD (nAMD) during the study period. SRPEF at baseline was most common fluid location for non-exudative eyes that eventually converted to nAMD. Conclusion: Non-exudative fluid including IRF, SRF, and SRPEF is seen in patients with non-exudative AMD with increasing incidence during long term follow-up.