bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Independent Interobserver Reliability and Intraobserver Reproducibility Evaluation of the New Pilon Fracture Classification System Based On CT-Scan
Authors: Palma Joaquin , Nussbaum Jorge Filippi , Mery Pablo , Abarca Mario , Mora Andres , Peña Andres 
Published: September 2018

Category: Trauma Introduction/Purpose: Objective: To perform an independent inter-observer and intra-observer agreement assessment of the new pilon fracture classification system based on CT-scan. Summary of Background Data: Multiple classification systems have been proposed for pilon fractures, with no consensus to date of which is the most useful tool nor the one that provides the best prognostic orientation. Currently, pilon fractures are classified according to AO and Ruedi Allgower systems based on X-rays. A new pilon fracture classification system based on CT-Scan was recently described by Leonetti and Tigani in 2017. It showed substantial inter- and intra-observer agreement in the study describing it; however, an independent evaluation has not yet been performed, which is required for its wide use in clinical practice and research. Methods: CT-scans of 71 patients with acute traumatic pilon fractures were selected and classified using the morphologic grading of the new pilon fracture classification system by six evaluators (three foot and ankle surgeons and three orthopaedic surgery residents). After a six-week interval, the 71 cases were presented to the same evaluators in a random sequence for repeat evaluation. The Kappa coefficient (k) was used to determine the inter- and intra-observer agreement. Results: The inter-observer agreement was substantial when considering the fracture main types (I, II, III or IV), with k= 0.635 (0.59 - 0.67), but moderate when considering the sub-types (I, IIF, IIS, IIIF, IIIS or IV): k= 0.588 (0.56 - 0.61). The intra-observer agreement was substantial considering the fracture types, with k= 0.65 (0.62 - 0.71) and considering sub-types, k= 0.62 (0.57 - 0.66). No significant differences were observed between foot and ankle surgeons and orthopaedic residents in the overall inter- and intra-observer agreement, or in the inter- and intra-observer agreement of specific I, II, III or IV type of injuries. Conclusion: The new pilon fracture classification system based on CT-scan allows adequate agreement among different observers and by the same observer on separate occasions. Therefore, studies that use this system should be considered reliable. Future prospective studies should determine whether this classification allows surgeons to decide the best treatment for patients with tibial pilon fractures.
Comparison of outcomes of osteosynthesis in type II accessory navicular by variable fixation methods
Authors: Park Hyun-woo , Jang Ho-seong , Suh Jae Wan , Kim Sunghyun 
Published: September 2018

Category: Midfoot/Forefoot Introduction/Purpose: To compare the outcomes of fixation methods for osteosynthesis of a type II symptomatic accessory navicular between screw and tension band wiring. Methods: Forty-four patients (mean age, 29.2 years; range, 13–54 years; 21 males and 23 females) who had undergone operative treatment after failed conservative treatment were chosen for the study between 2007 and 2014. The patients were divided into two groups by the method of osteosynthesis: group 1 (screw) and group 2 (tension band wiring). Pre and postoperative evaluations were performed, using the midfoot scale from the American Orthopaedic Foot & Ankle Society (AOFAS), a visual analog scale, time to return to social activities, and plain radiography. Results: The AOFAS midfoot and visual analog scale scores of both groups were improved at the last postoperative follow-up. The time to return to social activities was 12.3 weeks in the screw group and 11.9 weeks in the tension band wiring group (p = 0.394). A broken screw was observed in one case in the screw group and a broken k-wire was detected in two cases in the tension band wiring group. Nonunion was observed in two cases in each group. Conclusion: The tension band wiring technique could be another treatment choice of osteosynthesis for fixation of the accessory navicular bone.
The impact of smoking, diabetes and the site of surgery on post-operative infection in foot and ankle surgery
Authors: Tomlinson Clare , Mangwani Jitendra 
Published: September 2018

Category: Diabetes Introduction/Purpose: Smoking and diabetes are thought to increase the risk of post-op infection. Surgery on the hindfoot and ankle is also thought to carry an increased risk. This study looks at whether this is demonstrated in a cohort of patients undergoing foot and ankle (F&A) surgery. Methods: Six hundred and twenty patients underwent F&A surgery between 2013 and 2016. Patients either underwent surgery electively (group 1; n= 383) or had open reduction and internal fixation for ankle fracture (group 2; n= 237). Data was collected on patient demographics, site of surgery, smoking and diabetes. The primary outcome was the rate of surgical site (SSI) and deep infection. A standard statistical online package was used for statistical analysis. Results: The mean age was 50.8 years and the standard deviation was 17.1 years. The incidence of SSI was 4.2%; 0.48% developed a deep infection. There was no significant difference in infection prevalence between group 1 and 2 (p = 1.0). When comparing the site of surgery, no significant differences were found for forefoot, midfoot, hindfoot or ankle surgery (p=0.16, p=0.22, p=1.0, p=0.48 respectively). There was no significant difference in the prevalence of smoking or diabetes in those who developed an SSI in the overall cohort (p=1, p=1) or in separate analysis within groups 1 and 2 (p=1). Conclusion: Both trauma and elective patients had a similar rate of SSI and deep infection; neither diabetes nor smoking had an impact on this rate. For elective patients, there wasn’t a relationship between site of surgery and infection incidence. However, due to the low SSI rate, group sizes were small for this comparison. There was no increase in the incidence of SSI in hindfoot or ankle surgery contrary to common belief.
Cadaveric anatomical study of anterior and posterior ankle arthroscopic portals in ankle plantarflexion and dorsiflexion positions
Authors: Tonogai Ichiro 
Published: September 2018

Category: Arthroscopy Introduction/Purpose: Arthroscopy of the foot and ankle, which is minimally invasive technique, is able to be used in the treatment of various foot and ankle pathologies. However, complications after anterior or posterior ankle arthroscopies have been described, such as neurovascular structures injury around portals. On the other hand, plantarflexion and dorsiflexion of the ankle joint leads movement of the neurovascular structures. However, there were a few reports about the change of the distance between each portal and nerves or vessels during motion of the ankle. The purpose of this study was to evaluate the distance between each anterior or posterior portal and neurovascular structures, to elucidate the change of the distance between each portal and neurovascular structures in ankle plantarflexion and dorsiflexion positions. Methods: Six feet of 6 fresh cadavers (3 males and 3 females) were enrolled in this study. The mean age was 81.5 years. Standard antero-lateral (AL), antero-medial (AM), postero-lateral (PL) and postero-medial (PM) portals were identified using needles. Skin was dissected from the underlying soft tissue to visualize neurovascular structures clearly as little as possible. The distances were assessed in ankle plantarflexion position and dorsiflexion position, from AL portal to superficial peroneal nerve (SPN), from AM portal to saphenous nerve (SpN), great saphenous vein (SpV), from PL portal to sural nerve (SN) and lesser SpV, and from PM portal to flexor hallux longus, posterior tibial artery PTA and tibial nerve (TN). Results: SPN was the closest structure to any of the anterior portals (3.2 /8.3 mm in ankle plantarflexion position and 5.2 /10.8 mm in ankle dorsiflexion position from AL portal as Fig.1 was showing), followed by SpN in anterior ankle arthroscopy. Distances from SPN to AL portal, and from SpN and great SpV to AM portal increased with ankle dorsiflexion and decreased with plantarflexion. SN was the closest structure to any of the posterior portals (10.4 mm in ankle plantarflexion position and 8.5 mm in ankle dorsiflexion position from PL portal), followed by lesser SpV in posterior ankle arthroscopy. Distances from SN, SpN and lesser SpV to PL portal, and from FHL, PTA and TN to PM portal increased with ankle plantarflexion and decreased with dorsiflexion. Conclusion: Results of this study showed the distances from each anterior or posterior arthroscopic portal to neurovascular structures, and elucidated the change of the distances between each portal and neurovascular structures in ankle plantarflexion and dorsiflexion positons in ankle plantarflexion and dorsiflexion positions. The ankle dorsiflexion position for the standard AL and AM portals placement and the ankle plantarflexion position for PL and PM portals placement might be recommended. Results of this study might be useful to prevent injury to the neurovascular structures during anterior or posterior ankle arthroscopy.
The Use of Modern Intramedullary Nailing in Distal Fibula Fracture Fixation
Authors: Tracey Joseph , Vovos Tyler , Adams Samuel , Parekh Selene 
Published: September 2018

Category: Trauma Introduction/Purpose: Lateral malleolus (LM) fixation is necessary for unstable ankle fractures. Traditional fixation relies on the use of plates through a lateral incision, wound healing can be an issue for such incisions. A novel intramedullary (IM) fixation device has been developed that can be placed through a minimal incision. The purpose of this study was to demonstrate the clinical efficacy of this device. Methods: A retrospective analysis was performed on patients who received IM fixation for isolated fibula, bimalleolar (BM), and trimalleolar (TM) fractures. Pertinent demographic information, operative factors, complications, and clinical outcomes were recorded. Results: Sixteen patients were included in the study with an average age of 59 (Range of 35 to 86). Six patients presented with isolated LM fractures, four patients had a BM fracture with a syndesmotic injury, two patients sustained a LM fracture with an associated syndesmotic injury, two patients had a BM fracture, and two patients had a TM fracture with a syndesmotic injury. There was a 100% healing rate of the lateral malleolus without any cases of malunion or shortening. There were no cases of sural nerve or peroneal tendon injuries, nor any wound complications found. Conclusion: These findings demonstrate the safe and efficacious use of a novel intramedullary fixation device for fibula fractures with a lower wound complication and infection rates compared to published outcomes found with lateral fibular plating. The features of this device allow for reliable fixation of the fibula, maintaining length and minimizing wound issues.
Childhood maltreatment and adult medical morbidity in mood disorders: comparison of unipolar depression with bipolar disorder
Authors: Hosang Georgina M. , Fisher Helen L. , Hodgson Karen , Maughan Barbara , Farmer Anne E. 
Published: September 2018

BackgroundThe medical burden in mood disorders is high; various factors are thought to drive this pattern. Little research has examined the role of childhood maltreatment and its effects on medical morbidity in adulthood among people with unipolar depression and bipolar disorder.AimsThis is the first study to explore the association between childhood maltreatment and medical morbidity in bipolar disorder and in unipolar depression, and examine whether the impact of abuse and neglect are distinct or combined.MethodThe participants consisted of 354 psychiatrically healthy controls, 248 participants with recurrent unipolar depression and 72 with bipolar disorder. Participants completed the Childhood Trauma Questionnaire and received a validated medical history interview.ResultsAny type of childhood maltreatment, child abuse and child neglect were significantly associated with the medical burden in bipolar disorder, but not unipolar depression or for controls. These associations worked in a dose–response fashion where participants with bipolar disorder with a history of two or more types of childhood maltreatment had the highest odds of having a medical illness relative to those without such history or those who reported one form. No such significant dose–response patterns were detected for participants with unipolar depression or controls.ConclusionsThese findings suggest that childhood maltreatment may play a stronger role in the development of medical illnesses in individuals with bipolar disorder relative to those with unipolar depression. Individuals who had been maltreated with a mood disorder, especially bipolar disorder may benefit most from prevention and intervention efforts surrounding physical health.Declaration of interestNone.
Bicuspid aortic valve formation: Nos3 mutation leads to abnormal lineage patterning of neural crest cells and the second heart field
Authors: Peterson Joshua C. , Chughtai Mary , Wisse Lambertus J. , Gittenberger-de Groot Adriana C. , Feng Qingping , Goumans Marie-José T. H. , VanMunsteren J. Conny , Jongbloed Monique R. M. , DeRuiter Marco C. 
Published: September 2018

ABSTRACT
The bicuspid aortic valve (BAV), a valve with two instead of three aortic leaflets, belongs to the most prevalent congenital heart diseases in the world, occurring in 0.5-2% of the general population. We aimed to understand how changes in early cellular contributions result in BAV formation and impact cardiovascular outflow tract development. Detailed 3D reconstructions, immunohistochemistry and morphometrics determined that, during valvulogenesis, the non-coronary leaflet separates from the parietal outflow tract cushion instead of originating from an intercalated cushion. Nos3−/− mice develop a BAV without a raphe as a result of incomplete separation of the parietal outflow tract cushion into the right and non-coronary leaflet. Genetic lineage tracing of endothelial, second heart field and neural crest cells revealed altered deposition of neural crest cells and second heart field cells within the parietal outflow tract cushion of Nos3−/− embryos. The abnormal cell lineage distributions also affected the positioning of the aortic and pulmonary valves at the orifice level. The results demonstrate that the development of the right and non-coronary leaflets are closely related. A small deviation in the distribution of neural crest and second heart field populations affects normal valve formation and results in the predominant right-non-type BAV in Nos3−/− mice.
Computational genome-wide identification of heat shock protein genes in the bovine genome
Authors: Ajayi Oyeyemi O. , Peters Sunday O. , De Donato Marcos , Sowande Sunday O. , Mujibi Fidalis D.N. , Morenikeji Olanrewaju B. , Thomas Bolaji N. , Adeleke Matthew A. , Imumorin Ikhide G. 
Published: September 2018

Background: Heat shock proteins (HSPs) are molecular chaperones known to bind and sequester client proteins under stress. Methods: To identify and better understand some of these proteins, we carried out a computational genome-wide survey of the bovine genome. For this, HSP sequences from each subfamily (sHSP, HSP40, HSP70 and HSP90) were used to search the Pfam (Protein family) database, for identifying exact HSP domain sequences based on the hidden Markov model. ProtParam tool was used to compute potential physico-chemical parameters detectable from a protein sequence. Evolutionary trace (ET) method was used to extract evolutionarily functional residues of a homologous protein family. Results: We computationally identified 67 genes made up of 10, 43, 10 and 4 genes belonging to small HSP, HSP40, HSP70 and HSP90 families respectively. These genes were widely dispersed across the bovine genome, except in chromosomes 24, 26 and 27, which lack bovine HSP genes. We found an uncharacterized outer dense fiber (ODF1) gene in cattle with an intact alpha crystallin domain, like other small HSPs. Physico-chemical characteristic of aliphatic index was higher in HSP70 and HSP90 gene families, compared to small HSP and HSP40. Grand average hydropathy showed that small HSP (sHSP), HSP40, HSP70 and HSP90 genes had negative values except for DNAJC22, a member of HSP40 gene family. The uniqueness of DNAJA3 and DNAJB13 among HSP40 members, based on multiple sequence alignment, evolutionary trace analysis and sequence identity dendrograms, suggests evolutionary distinct structural and functional features, with unique roles in substrate recognition and chaperone functions. The monophyletic pattern of the sequence identity dendrograms of cattle, human and mouse HSP sequences suggests functional similarities. Conclusions: Our computational results demonstrate the first-pass in-silico identification of heat shock proteins and calls for further investigation to better understand their functional roles and mechanisms in Bovidae.
Validation of the Polar RS800CX for assessing heart rate variability during rest, moderate cycling and post-exercise recovery
Authors: Tsitoglou Kyriakos I. , Koutedakis Yiannis , Dinas Petros C. 
Published: September 2018

Background: Heart rate variability (HRV) is an autonomic nervous system marker that provides reliable information for both disease prevention and diagnosis; it is also used in sport settings. We examined the validity of the Polar RS800CX heart rate monitor during rest, moderate cycling, and recovery in considering the total of 24 HRV indices. Method: A total of 32 healthy males (age=24.78±6.87 years, body mass index=24.48±3.13 kg/m2) completed a session comprised by three 20-minute time periods of resting, cycling at 60% of maximal heart rate, and recovery using a Polar RS800CX and an electrocardiogram (ECG) monitors. The HRV indices included time-domain, frequency-domain, Poincaré plot and recurrence plot. Bland–Altman plot analysis was used to estimate agreement between Polar RS800CX and ECG. Results: We detected significant associations (r>0.75, p<0.05) in all HRV indices, while five out of 24 HRV indices displayed significant mean differences (p<0.05) between Polar RS800CX and ECG during the resting period. However, for the exercise and recovery periods, we found significant mean differences (p<0.05) in 16/24 and 22/24 HRV indices between the two monitors, respectively. Conclusion: It is concluded that Polar RS800CX is a valid tool for monitoring HRV in individuals at resting conditions, but it displays inconsistency when used during exercise at 60% of maximal heart rate and recovery periods.
Daytime variation in hepatitis C virus replication kinetics following liver transplant
Authors: Zhuang Xiaodong , Lai Alvina G. , McKeating Jane A. , Rowe Ian , Balfe Peter 
Published: September 2018

Background: There is a growing interest in the role of circadian regulated pathways in disease pathogenesis. Methods: In a cohort of hepatitis C virus (HCV) infected patients undergoing liver transplantation, we observed differences in early viral infection kinetics of the allograft that associated with the time of liver transplant. Results: A higher frequency of subjects transplanted in the morning showed a rebound in viral RNA levels (n=4/6) during the first week post-surgery. In contrast, no viral rebound was observed in seven subjects transplanted in the afternoon. None of the other parameters previously reported to influence viral replication in the post-transplant setting, such as donor age, cold-ischemia time and length of surgery associated with viral rebound. Conclusions: These observation highlights a role for circadian processes to regulate HCV infection of the liver and warrants further investigation.
SELECTION OF INDUSTRIAL MAINTENANCE STRATEGY: CLASSICAL AHP AND FUZZY AHP APPLICATIONS
Authors: Ohta Robison 
Published: September 2018

The selection of a maintenance strategy is a decision often made with uncertainty or subjectivity. This decision involves the prioritization of critical factors since there are several factors to be considered simultaneously. Decision-making generally depends on subjective assessments from experts. To deal with multiple factors, Analytic Hierarchy Processes (AHP) is a well-established multiple criteria decision analysis (MCDA) method. This article presents an AHP application for the selection of a maintenance strategy by a real industrial plant. Four maintenance strategies are considered: Corrective Maintenance, Preventive Maintenance, Predictive Maintenance, and Proactive Maintenance. Decision criteria are cost, quality, safety, value added and viability. Then, incorporating the concepts of the fuzzy set theory, fuzzy AHP was applied to the same decision problem. In both applications, Corrective Maintenance was the strategy with the highest priority, and value added was the highest priority criterion. With the classical AHP application, some comparison matrices produced Consistency Ratios (CR) greater than 0.10, possibly generated by mistakes or misunderstandings from experts. However, the same result was obtained from fuzzy AHP and validated the result obtained from classical AHP application. The major contribution of the paper is the evidence that Fuzzy AHP may be a useful tool to solve the consistency problems in classical AHP applications.
An overdetermined problem for the infinity-Laplacian around a set of positive reach
Authors: Greco Antonio 
Published: September 2018

Abstract
We consider an overdetermined problem associated to an inhomogeneous
infinity-Laplace equation. More precisely, the domain of the problem
is required to contain a given compact set K of positive reach, and
the boundary of the domain must lie within the reach of K. We look
for a solution vanishing at the boundary and such that the outer
derivative depends only on the distance from K. We prove that if the
boundary gradient grows fast enough with respect to such distance
(faster than the distance raised to

1
3

{\frac{1}{3}}

), then the problem is
solvable if and only if the domain is a tubular neighborhood of K,
thus extending a previous result valid in the case when K is made up
of a single point.
The ‘Pre–Socratic Section’ Of Philodemus’ On Piety: A New Reconstruction Praesocratica Herculanensia X (Part Ii)
Authors: Vassallo Christian 
Published: September 2018

Abstract
This paper is divided into two parts: the first presents all the papyrological and bibliological observations necessary for a new edition of P.Herc. 1428 (= LDAB 3563; TM 62400) which comes from the large Herculanean roll that contains Philodemus’ treatise On Piety. The second part provides a new critical reconstruction, along with translation and notes, of the ‘pre-Socratic section’ of P.Herc. 1428, in which Philodemus, via his harsh polemics against previous theological thought, critically lays out the Presocratic opinions on the gods, from Thales to the Sophists.
Chaotic Behavior of Duffing Energy Harvester
Authors: Bahrami Amir , Tayarani Majid 
Published: September 2018

Abstract
A wide bandwidth energy harvester is designed with the purpose of operation under multiple excitations, where the excitation frequencies are generally incommensurate and probably spectrally close to each other. Owing this wideness of bandwidth to the nonlinearity of the circuit escalates the jeopardy of chaotic behavior while the circuit is exposed to multiple energy sources. In this study, the recently introduced Duffing based energy harvester is analyzed under multiple excitations and finally, a safe margin is calculated to avoid tumultuous behaviors which may affect adjacent sensitive electrical systems. The mathematical analyses given in this paper can be generalized to other types of nonlinear resonators.