bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Exploring the Influence of Social Media Influencers on Intention to Attend Cervical Screening in the UK: Utilising the Theory of Planned Behaviour’
Authors: Fielden Naomi , Holch Patricia 
Published: April 2022

Objectives Cervical cancer is 99.8% preventable when detected early; however, uptake of screening in the United Kingdom is at a 20-year low. Recently, a number of social media influencers have video logged about their experiences of cervical screening through narrative communication with their audience. Here we aimed to explore if accessing cervical screening information from a social media influencer can impact the theory of planned behaviour variables and predict intention to attend cervical screening appointments. Design Utilising a cross-sectional design a volunteer sample of 102 UK women (mean age = 28; SD = 3.10; range = 25–35) took part in an online questionnaire study. Results Hierarchical regression modelling revealed attitude as a significant predictor of intention to attend a cervical screening appointment and that social media influencers affect attitudes of their audience, indirectly influencing intention to attend. Conclusion Health messages communicated by social media influencers are effective in promoting positive attitudes but not directly influence intention to attend towards cervical screening. Further research should explore influencer impact on attitudes towards this health behaviour with the ultimate aim of increasing attendance and consequently saving lives.
Knowledge, Attitude, and Practice Toward Cervical Cancer Screening and Associated Factors Among College and University Female Students in Dire Dawa City, Eastern Ethiopia
Authors: Bekele Henok Tesfaye , Nuri Aliya , Abera Legesse 
Published: April 2022

Introduction: Cervical cancer is preventable and, in most cases, curable if identified at an early stage. Cervical cancer is the second leading cause of cancer-related mortality Ethiopia with screening accounting for only 0.8%. Furthermore, female students and young adults in colleges and universities’ have a high prevalence of genital HPV infection because of their risky sexual behavior, lack of knowledge on screening and very few students receive screening services. This study aimed to assess the Knowledge, attitudes, and practice toward cervical cancer screening and its associated factors among female college students in Dire Dawa City, Ethiopia. Methods: An institutional-based cross-sectional study was conducted using a multistage sampling technique from November to December 2020, among 730 female college students in Dire Dawa. Descriptive statistics and binary logistic regression were used to describe each variable and identify associations between the dependent and independent variables respectively. Adjusted odds ratio with 95% confidence interval and P-value <.05 used to determine the association. Results: The results showed, only 64 (9.3%) participants were knowledgeable, 413 (60.1%) had positive attitudes and 17 (2.5%) were screened in their lifetime. Age group, years of study, and history of cervical cancer practice were significantly associated with knowledge of cervical cancer screening. The year of study was based on cervical cancer smears and the number of screenings was significantly associated with attitude. Conclusion: This study showed that students’ knowledge of cervical cancer screening is low. Overall attitudes toward cervical cancer screening among female students were good, but only a small proportion of students had undergone cervical cancer screening. The most common reasons for the low screening practice were lack of information and undecided. There is a need to promote different campaigns for cervical cancer screening programs, in order to increase awareness.
Effect of Adenosine Receptor Antagonists on Adenosine-Pretreated PC12 Cells Exposed to Paraquat
Authors: Shang Liangcheng , Huang Yaobiao , Xie Xin , Ye Sudan , Chen Chun 
Published: April 2022

Previous studies evaluated the adenosine receptor antagonists alone to determine their effects on oxidative stress, but little is known about adenosine’s protective efficacy when oxidative injury occurs in vivo. Adenosine is a crucial signaling molecule recognized by four distinct G-protein-coupled receptors (GPCRs) (i.e., A1R, A2AR, A2BR, and A3R) and protects cells against pathological conditions. The present study was performed to evaluate the role of antagonist modulation in the setting of paraquat toxicity with adenosine pretreatment. First, PC12 cells were exposed to paraquat (850 μM) and adenosine (30 μM) to develop an in vitro model for the antagonist effect assay. Second, we found that the A1R antagonist DPCPX enhanced the viability of paraquat-induced PC12 cells that underwent adenosine pretreatment. Moreover, the A2AR antagonist ZM241385 decreased the viability of paraquat-induced PC12 cells that underwent adenosine pretreatment. Our findings indicate that adenosine protection requires a dual blockade of A1R and activation of A2AR to work at its full potential, and the A2B and A3 adenosine receptor antagonists increased paraquat-induced oxidative damage. This represents a novel pharmacological strategy based on A1/A2A interactions and can assist in clarifying the role played by AR antagonists in the treatment of neurodegenerative diseases.
Mitigation of blast effects through novel energy-dissipating connectors
Authors: Seica Michael V , Packer Jeffrey A , Walker Martin G , Gow Matthew I 
Published: April 2022

Explosions generate overpressures that can cause irreparable damage to structures. For many buildings, especially critical infrastructure, continued operation after an explosive attack is essential. The use of energy-dissipating methods will enable the protection of a structure and occupants from a blast and permit the timely repair and re-occupation of the building after an event. The concept behind the system presented is the creation of panels that can be used as cladding for structures. The panels are connected to the main structure using energy-dissipating component assemblies around the panel edge. When subjected to a blast load the panels transfer the blast pressure through the assemblies, thereby reducing the forces transmitted to the underlying structure. After an event, the panels and energy-dissipating component assemblies can be replaced quickly and easily, allowing the building to be reoccupied in a short time after an attack. This study focuses on the characterization of energy-dissipating component assemblies using static and dynamic laboratory testing. A predictive theory, supported by a single degree of freedom model, is developed and a general evaluation method proposed. Further laboratory testing expands the characterization of behaviour of the assemblies through experiments, with a blast generator in tension tests and in simulated blast panel tests. The time histories developed from tension tests are then compared to examine the effect of loading rate. The investigations on blast panels also include a comparison with predictions to determine whether the latter can describe the global behaviour of the system. Lastly, the response of the energy-dissipating component assemblies is evaluated in full-scale field blast tests on cladding panels.
A Meta-Analysis on the Safety and Immunogenicity of Covid-19 Vaccines
Authors: Ashmawy Rasha , Hamdy Noha A. , Elhadi Yasir Ahmed Mohammed , Alqutub Sulafa T , Esmail Ola Fahmy , Abdou Marwa Shawky Mohammed , Reyad Omar Ahmed , El-ganainy Samar O. , Gad Basma Khairy , Nour El-Deen Ahmed El-Sayed , Kamal Ahmed , ElSaieh Haider , Elrewiny Ehab , Shaaban Ramy , Ghazy Ramy Mohamed 
Published: April 2022

Objective: The presented meta-analysis (MA) aims at identifying the vaccine safety and immunogenicity in published trials about SARS-CoV-2 vaccines. Methods: All relevant publications were systematically searched and collected from different databases (Embase, Scopus, EBSCO, MEDLINE central/PubMed, Science Direct, Cochrane Central Register for Clinical Trials (CENTRAL), Clinical Trials.gov, WHO International Clinical Trials Registry Platform (ICTRP), COVID Trial, COVID Inato, Web of Science, ProQuest Thesis, ProQuest Coronavirus Database, SAGE Thesis, Google Scholar, Research Square, and Medxriv) up to January 10, 2021. The pooled vaccine safety and immunogenicity following vaccination in phase 1 and 2 vaccine clinical trials, as well as their 95% confidence intervals (CI), were estimated using the random-effects model. Results: The predefined inclusion criteria were met in 22 out of 8592 articles. The proportion of anti-severe acute respiratory distress coronavirus 2 (SARS-CoV-2) antibody responses after 7 days among 72 vaccinated persons included in 1 study was 81% (95% CI: 70-89), after 14 days among 888 vaccinated persons included in 6 studies was 80% (95% CI: 58-92), after 28 days among 1589 vaccinated persons included in 6 studies was 63% (95% CI: 59-67), after 42 days among 478 vaccinated persons included in 5 studies was 93% (95% CI: 80-98), and after 56 days among 432 vaccinated persons included in 2 studies was 93% (95% CI: 83-97). Meta regression explains more than 80% of this heterogeneity, where the main predictors were; the inactivated vaccine type (β = 2.027, P = 0.0007), measurement of antibodies at week 1 (β = −4.327, P < 0.0001) and at week 3 of the first dose (β = −2.02, P = 0.0025). Furthermore, the pooled proportion adverse effects 7 days after vaccination was 0.01 (0.08-0.14) for fever, headache 0.23 (0.19-0.27), fatigue 0.10 (0.07-0.13), and 0.18 (0.14-0.23) for muscle pain. Conclusion: Immunogenicity following vaccination ranged from 63% to 93% depending on the time at which the antibody levels were measured.
Implant-Related Complications after Spinal Fusion: A Multicenter Study
Authors: Koshimizu Hiroyuki , Nakashima Hiroaki , Ohara Tetsuya , Tauchi Ryoji , Kanemura Tokumi , Shinjo Ryuichi , Machino Masaaki , Ito Sadayuki , Ando Kei , Imagama Shiro 
Published: April 2022

Study Design Retrospective analysis of prospectively database Objective Implant-related complications are an extremely important issue because they pose a burden to patients who underwent surgery. An understanding of these complications can help improve the postoperative management of patients undergoing spinal surgery. The current large-scale multicenter study aimed to identify postoperative implant-related complications that may require revision surgery. Methods In total, 3447 patients who underwent spinal fusion surgery were included in the analysis. Data about age at surgery, sex, preoperative diagnosis, surgical level, type of implant-related complications, causes of reoperation, and time from the initial to revision surgery were reviewed. Moreover, the characteristics of reoperation in 3 periods (within 30, 31–90, and over 90 days) were assessed. Result The overall incidence of implant-related complications was 4.6%. Adult spinal deformity was the most common diagnosis (9.9%), and thoracic-lumbar-sacral (42.9%) was the most common surgical level among patients with implant-related complications. Further, screw malposition was the most frequent implant-related complication (42.8%). In total, 89 (2.6%) patients underwent reoperation due to implant-related complications. The main causes of reoperation within 30, 31–90, and over 90 days were screw malposition (72.2%), screw loosening or pull out (81.8%), and rod or screw fracture (60.9%), respectively. Conclusion To the best of our knowledge, this was the first large-scale multicenter study that assessed the characteristics of patients who underwent reoperation due to spinal implant-related complications. The study results could improve the preoperative informed consent procedure about spinal fusion.
Increased Complication and Hardware Removal Rates with Headed Screws in Ankle or Subtalar Arthrodesis
Authors: Bailey Evan , Hoch Caroline P. , Goodloe Jonathan B. , Scott Daniel J. , Gross Christopher E. 
Published: April 2022

Category: Ankle; Hindfoot Introduction/Purpose: A large variety of hardware can be used for ankle or subtalar (ST) joint arthrodesis, with very little data available to guide which implants might be most effective for these indications. Hardware removal rates in the setting of calcaneal fixation have been shown to vary widely from 9-47%, which can impose an added economic and surgical burden on both the patient and the healthcare system. The purpose of this study was to determine if there was a difference in the outcomes between two different versions of cannulated screws (i.e., headless, variable-pitched; headed), as reflected by patient-reported outcome measures (PROMs), and postoperative complication and reoperation rates. Methods: A retrospective chart review identified 126 patients (135 feet) who underwent ankle or ST arthrodesis with a single fellowship-trained foot and ankle surgeon between December 2015 and February 2021. These patients met the following inclusion criteria: isolated tibiotalar or ST arthrodesis; receipt of a headless, variable-pitched screw made by Acutrak or headed screw made by Orthohelix; and minimum 3 months of postoperative radiographic follow-up. Overall, 76 procedures used headless, variable- pitched screws (ankle=13, ST=63) and 59 used headed (ankle=18, ST=41). Results: Overall, there was a significantly higher rate of complications among headed screws (54.2%), as compared to the headless, variable-pitched screws (35.5%; p=.030). There was no difference in any treatment duration or postoperative PROM between groups. There was a significant difference in reoperation rates between cohorts (headless, variable-pitched=11.8%, headed=32.2%; p=.004), but no difference in nonunion rate (headless, variable-pitched=22.4%, headed=35.6%; p=.090). There were also significantly more screw issues (i.e., break, movement, impingement) with headed screws (headless, variable- pitched=0.0%, headed=5.1%; p=.047). (Table 1) Of the nine patients who underwent a reoperation, headed screws were removed six (66.7%) times, with half attributable to nonunion, whereas headless, variable-pitched hardware was only removed once (1.11%) due to infection. Conclusion: Overall, the use of headed screws in ankle or ST arthrodesis is associated with significantly higher rates of complication and hardware removal, as compared to headless, variable-pitched screws. Even in the examination of the few patients in this cohort who underwent two procedures, headed screws were removed more often. Surgeons should place emphasis on these results when selecting the best hardware to fuse the ankle and ST joints.
Impact of Weber B Fracture Displacement on Medial Clear Space Volume: How Much Displacement Matters?
Authors: Bhimani Rohan , Mullen Marguerite A. , Ashkani-Esfahani Soheil , Waryasz Gregory R. , Kerkhoffs Gino , DiGiovanni Christopher W. , Guss Daniel 
Published: April 2022

Category: Ankle; Sports; Trauma Introduction/Purpose: Numerous radiographic studies examining Weber B fibular fractures demonstrate no change in tibiotalar contact area until the deltoid ligament is disrupted. In contrast, more recent studies using weight-bearing CT scan (WBCT) and 3D volume analysis suggest that medial clear space (MCS) volume can in fact increase in the setting of a Weber B fibular fracture even if initial radiographs are reassuring, possibly due to a loss of fibular buttress. This study aims to evaluate the ability of WBCT to quantify the impact of isolated Weber B fractures on MCS volume (3D), as well as understand the implication of increasing fibular displacement among patients with symmetric MCS distance (1D) on initial radiographs. Methods: The study group included 18 patients with unilateral Weber B ankle fractures who underwent preoperative bilateral foot and ankle WBCT. The control group consisted of 60 patients without ankle injury who underwent similar imaging. Measurements on WBCT images included: 1) MCS distance, 2) syndesmotic area, 3) anterior, middle, and posterior distal tibiofibular distance, 4) fibular rotation, 5) distance from fibular tip to plafond, and 6) fibular fracture displacement. Additionally, volumetric measurements included: 1) MCS volume 2) syndesmotic joint volume from the tibial plafond extending to 3cm and 5 cm proximally, and 3) lateral clear space volume were calculated. Area under the receiver operating characteristic (ROC) curve analysis and Delong test were used, and optimal cutoff values to distinguish between stable and unstable Weber B fractures without syndesmotic instability and MCS widening were determined using Youden's J statistic. Results: Among patients with unilateral Weber B ankle fractures, all WBCT measurements showed no side-to-side difference in any parameter, except MCS volume (p-values <0.001). When compared to the uninjured side, fibular displacement up to 2cm and up to 4cm increased lateral MCS volume by 37.1% (0.23cm3) and 51.8% (0.3cm3), respectively. Based on ROC analysis and Youden's J statistic, the optimal threshold for differentiating stable from an unstable Weber B fracture was 2.3 mm of displacement (AUC 0.81; sensitivity 77.8%; specificity 80%). The control group showed no difference in any of the measurements between the two sides. Conclusion: When using WBCT, 3D MCS volume increases significantly with Weber B fibular fractures, even if 1D distance measurements at the medial clear space are reassuring. This is especially true with fibular displacement greater than 2.3mm and may have an important role in the management of SER II ankle fractures.
Osteochondral and Ligament Injury Patterns in Ankle Fractures: A Prospective Multi-Center Study
Authors: Carreira Dominic S. , Shaw Daniel B. , Harris Thomas G. , McCullough Kirk A. , Kreulen Christopher D. , Martin RobRoy , Acevedo Jorge I. 
Published: April 2022

Category: Ankle; Arthroscopy; Sports; Trauma; Other Introduction/Purpose: When treating ankle fractures, the presence of talar osteochondral lesions and the extent of ligamentous injury are associated with the severity of injury. The Danis-Weber classification system has been used to predict potential ligament damage. The purpose of this study is to validate the ligament injury patterns that have been proposed to occur with the Danis-Weber Classification and identify the cartilage injury pattern that occurs on the talus with each fracture type. Methods: A prospective, multi-center foot and ankle arthroscopy registry was queried for patients who underwent arthroscopic treatment of ankle fractures. Preoperative and intraoperative findings were noted, including the Danis-Weber fracture classification, presence and location of osteochondral damage, and unstable deltoid, and/or syndesmotic ligaments. Kendall's tau-b, a nonparametric correlation coefficient for ordinal variables, was used to measure the strength and direction of association between Weber fracture type and the presence of a syndesmotic injury, deltoid ligament tear, medial malleolus fracture, or osteochondral lesion. The locations of osteochondral damage were compared as percentages. Results: 73 subjects were prospectively collected as part of a multicenter ankle arthroscopy database. Average subject age was 43 years (SD = 17) with 59% female and 41% male. A significant association between the presence of a syndesmotic injury and fracture type was identified, with syndesmotic injuries more likely occurring with a Weber C fracture (p < 0.0005). A significant association was not identified between Weber classification and a deltoid tear or medial malleolus fracture (p = 0.47, p = 0.79). Location of the talar osteochondral lesions were as follows: 22% medial-anterior, 22% lateral-anterior, 22% lateral-central, 17% central-anterior, 9% medial-central, 4% later-posterior, 4% central. There was no significant association identified between Weber classification and the location of the osteochondral injury (p = 0.99). Conclusion: Concurrent injuries with syndesmotic disruption, deltoid ligament tears, medial malleolus fractures, and osteochondral lesions have been proposed to be associated with Weber C ankle fractures. However, in this multicenter study, only syndesmotic injuries were associated with the Weber C classification. This study found similar rates of medial malleolus fractures and osteochondral lesions in Weber B and C type fractures.
Role of the Lateral Ankle Ligaments in the Vertical Stability of the Fibula
Authors: Filippi Jorge , Gutierrez Paulina , Silvestre Rony A. , Bastias Gonzalo F. , Morales Jose Ignacio Quezada , Melo Rodrigo , Munoz Gerardo , Cuchacovich Mikenberg Natalio R. 
Published: April 2022

Category: Basic Sciences/Biologics; Ankle; Trauma Introduction/Purpose: In unstable ankle fractures, syndesmosis and the deltoid ligament have been widely studied, and their importance in their pathophysiology and treatment is recognized. This is not the case of the ankle lateral ligaments, and in particular, their role in the vertical stability of the fibula is unknown. Given their anatomical position, they should avoid proximal translation of the distal fragment of the fibula fracture. Purpose: To quantify the superior translation of the fibula by applying a constant proximal traction force as the syndesmosis and lateral ankle ligaments are sectioned sequentially. Methods: Eleven human ankle cadaveric specimens were used (6 female, 5 male). Removal of the skin and muscles was performed down to the ankle level, preserving the interosseous membrane (IOM). A deep dissection was performed to identify the inferior tibiofibular ligaments and the lateral ligaments of the ankle. Each piece was mounted on a platform specially designed for this work (fig 1), fixing the foot with an axial load of 25 kg, and a proximal traction force of 50 N was applied to the fibula. The syndesmotic ligaments, IOM, anterior talofibular ligaments (ATFL), and calcaneofibular ligament (CFL) were sequentially sectioned. The proximal displacement of the fibula was measured after each sequential section. Normality analysis was performed with the Kolmogorov-Smirnov and Shapiro-Wilkins tests. Differences between groups were evaluated with the ANOVA test with Dunnett and Newman-Keuls post-test. Results: When applying 50 N of proximal traction, the proximal and vertical displacement of the fibula was as follows; no sectioning 1.96 +- 1.19 mm, syndesmosis/IOM sectioning 3.96 +- 1.33 mm, ATFL sectioning 5.9 +- 1.73 mm and 10.2 +- 2.76 mm after sectioning the CFL. Normal distribution was observed in all groups. All measurements had a statistically significant difference between each group (p <0.05). Conclusion: In this model, a complete syndesmosis/IOM lesion produces a mean fibular proximal displacement of 3.96 mm. By adding the ATFL and CFL complete injury, it reaches 10.2 mm. Clinical relevance: In an unstable ankle dislocation with a significant fibular proximal displacement, there is probably a severe compromise of the lateral ligament complex, which could have clinical relevance as it is part of the bone and ligamentary stability ring of the ankle. This is the first study that describes the role of the lateral ligament complex in fibular vertical stability.