Miracle-dz/UniFAR-FTUs huggingface dataset:
Radiographical and Clinical Evaluation of Extreme Lateral Interbody Fusion: Effects of Cage Size and Instrumentation Type With a Minimum of 1-Year Follow-up

Study Design. Prospective single-cohort observational study. Objectives. To compare cage settling rates after extreme lateral interbody fusion (XLIF) across various implant sizes and fixation types. Secondary objectives were to detect factors associated with cage settling and correlation with clinical and radiographical improvement. Summary of Background Data. Intervertebral cage settling can occur postoperatively after interbody fusion, limiting the long-term correction achieved with surgery. Methods. Clinical and radiographical data were collected on 140 consecutive patients treated with extreme lateral interbody fusion at 223 levels (range, 1–5). All patients received supplemental pedicle screw fixation or lateral plating. Results. Average follow-up was 15.5 months (range, 12–36 mo). At 12 months, disability improved by 44%, low back pain improved by 49%, leg pain improved by 48%, and quality of life improved by 50% (P < 0.001). Foraminal height improved from 15.7 mm to 21.2 mm, disc height improved from 4.6 mm to 9.4 mm, discal lordosis improved from 4.0 to 8.1, and segmental lordosis improved from 10.7 to 13.7 (P < 0.001). Cage settling 1 mm or more occurred in 20% of cages immediately postoperatively and in 62% at 12 months. Settling more than 4 mm occurred in 5% of cages immediately postoperatively and in 24% at 12 months postoperatively. Pedicle screw fixation was associated with a higher rate of cage settling 1 mm or more compared with lateral plating, though magnitude of settling at the anterior inferior endplate was higher for lateral plating (4.9 mm vs. 3.5 mm). Taller cage height, narrower cage width, and shorter cage length were significantly associated with increased risk of cage settling more than 4 mm at 12 months postoperatively. In patients with no cage settling immediately postoperatively, risk of settling more than 4 mm at 12 months was 6.8 times greater with narrower cages. Conclusion. Risk of cage settling after extreme lateral interbody fusion may be reduced with the use of wider cages to engage more central endplate bone, longer cages to span the ring apophysis and osteophytes, and avoid overdistraction of the intervertebral disc space with shorter cages. Level of Evidence: 3
Is the Sedimentation Sign Associated With Spinal Stenosis Surgical Treatment Effect in SPORT?

Study Design. Subgroup analysis of the lumbar spinal stenosis (LSS) without degenerative spondylolisthesis diagnostic cohort of the Spine Patient Outcomes Research Trial multicenter randomized clinical trial with a concurrent observational cohort. Objective. To determine if sedimentation sign on magnetic resonance image can help with LSS treatment decisions. Summary of Background Data. LSS is one of the most common reasons for surgery in the US elderly, but there is a dearth of reliable diagnostic tools that give a clear indication for surgery. Recent studies have suggested that positive sedimentation sign on magnetic resonance image may be a possible prognostic indicator. Methods. All patients with LSS in both the randomized and observational cohorts had imaging-confirmed stenosis, were surgical candidates, and had neurogenic claudication for at least 12 weeks prior to enrollment. Patients were categorized as “mild,” “moderate,” or “severe” according to stenosis severity. Of the 654 patients with LSS enrolled in Spine Patient Outcomes Research Trial, complete T2-weighted axial and sagittal digitized images of 115 patients were available for retrospective review. An independent orthopedic spine surgeon evaluated these deidentified Digital Imaging and Communications in Medicine files for the sedimentation sign. Results. Sixty-six percent (76/115) of patients were found to have a positive sedimentation sign. Those with a positive sedimentation sign were more likely to have stenosis at L2–L3 (33% vs. 10% P = 0.016) or L3–L4 76% vs. 51%, P = 0.012), and to have severe (72% vs. 33%, P < 0.0001) central stenosis (93% vs. 67% P < 0.001) at 2 or more concurrent levels (57% vs. 18%, P = 0.01). In multivariate models, the surgical treatment effect was significantly larger in the positive sedimentation sign group for Oswestry Disability Index (−16 vs. −7; P = 0.02). Conclusion. A positive sedimentation sign was associated with a small but significantly greater surgical treatment effect for Oswestry Disability Index in patients with symptomatic LSS, after adjusting for other demographic and imaging features. These findings suggest that positive sedimentation sign may potentially be a useful adjunct to help guide an informed treatment choice regarding surgery for LSS. Level of Evidence: 2
Budesonide instillation immediately after reperfusion ameliorates ischemia/reperfusion-induced injury in the transplanted lung of rat

ABSTRACT Purpose: Lung ischemia-reperfusion injury (LIRI) after lung transplantation can lead to primary graft dysfunction. Budesonide can improve endothelial function to reduce lung injury. This study was aimed to examine the effects of budesonide on LIRI and potential mechanisms. Methods: Wistar rats were randomized and transplanted with syngeneic left lung or received the sham surgery. The recipients were instilled with saline or budesonide immediately after reperfusion. The mean arterial pressure (MAP), blood gas, and lung histology were analyzed. The ratios of wet to dry lung weights, the levels of total proteins, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-10, and neutrophil elastase in bronchoalveolar lavage fluid (BALF) were measured. The levels of malondialdehyde (MDA), myeloperoxidase (MPO), and xanthine oxidase (XO) in the lung, and the levels of plasma lymphocyte function-associated antigen (LFA)-1 and P-selectin were determined. Results: Compared with the saline group, treatment with budesonide significantly increased blood PaO2, but reduced PaCO2, and mitigated lung damages after reperfusion, the levels of BALF proteins, and the ratios of wet to dry lung weights in rats. Furthermore, treatment with budesonide significantly decreased the levels of MDA, MPO, and XO in the lung and the levels of TNF-α, IL-1β, IL-6, and neutrophil elastase, but increased IL-10 in the BALF, accompanied by significantly reduced levels of serum P-selectin and LFA-1 in rats. Conclusions: Budesonide effectively mitigated LIRI and ameliorated the lung function by attenuating oxidative stress and inflammation following syngeneic lung transplantation.
New Approach for Static Bone Histomorphometry: Confocal Laser Scanning Microscopy of Maxillo-Facial Normal Bone

To define the value of confocal laser scanning mcroscopy (CLSM) as a practical method for a qualitative and quantitative analysis of hard tissue, the authors have analyzed normal maxillo-facial bone. They obtained and analyzed 58 bone samples from 28 patients who underwent to implant surgery. All the samples presented intense autofluorescence primarily ascribed to collagen. Variable degrees of autofluorescence have been identified between osteones and interosteonic bone. CLSM allowed improved tissue imaging, bidimensional pictures with better resolution at cellular level, and, in particular, the possibility of different histomorphometric evaluation. The application of CLSM to bone histomorphometry represents a new and never described technique, which might produce many insights in the study of normal and pathological bone.
Model‐based cell number quantification using online single‐oxygen sensor data for tissue engineering perfusion bioreactors

Online and non‐invasive quantification of critical tissue engineering (TE) construct quality attributes in TE bioreactors is indispensable for the cost‐effective up‐scaling and automation of cellular construct manufacturing. However, appropriate monitoring techniques for cellular constructs in bioreactors are still lacking. This study presents a generic and robust approach to determine cell number and metabolic activity of cell‐based TE constructs in perfusion bioreactors based on single oxygen sensor data in dynamic perfusion conditions. A data‐based mechanistic modeling technique was used that is able to correlate the number of cells within the scaffold (R2 = 0.80) and the metabolic activity of the cells (R2 = 0.82) to the dynamics of the oxygen response to step changes in the perfusion rate. This generic non‐destructive measurement technique is effective for a large range of cells, from as low as 1.0 × 105 cells to potentially multiple millions of cells, and can open‐up new possibilities for effective bioprocess monitoring. Biotechnol. Bioeng. 2014;111: 1982–1992. © 2014 Wiley Periodicals, Inc.
Construction of a yeast‐based signaling biosensor for human angiotensin II type 1 receptor via functional coupling between Asn295‐mutated receptor and Gpa1/Gi3 chimeric Gα

Angiotensin II (Ang II) type 1 receptor (AGTR1) is a G‐protein‐coupled receptor (GPCR). Its natural ligand, Ang II, is an important effector molecule controlling blood pressure and volume in the cardiovascular system, and is consequently involved in various diseases such as hypertension and heart failure. Thus, the signaling mediator, AGTR1, is a significant molecular target in medicinal and therapeutic fields. Yeast is a useful organism for sensing GPCR signaling because it provides a simplified version of the complicated machinery used by mammalian cells for signal transduction. Although yeast cells can successfully transmit a signal through a variety of human GPCRs expressed in the cell membrane, there have been no reports of the functional activation of AGTR1‐mediated signaling in yeast cells. In the present study, we introduced a single mutation into human AGTR1 and used yeast‐human chimeric Gα to exert the functional activation of AGTR1 in yeast cells. The engineered yeast cells expressing AGTR1 mutated at Asn295 and the chimeric Gα successfully transmitted the signal inside the yeast cells in response to Ang II peptide and its analogs (Ang III and Ang IV peptides) added to the assay medium. Further, we demonstrated that the autocrine Ang II peptide and its analog, produced and secreted by the engineered yeast cells, could by themselves promote AGTR1‐mediated signaling. This means that screening for agonistic peptides with various sequences from a self‐produced genetic library would be a viable strategy. Thus, the constructed yeast biosensor, integrating an Asn295‐mutated AGTR1 receptor, will be valuable in the design of drugs to treat AGTR1‐related diseases. Biotechnol. Bioeng. 2014;111: 2220–2228. © 2014 Wiley Periodicals, Inc.
Fractional factorial design to investigate stromal cell regulation of macrophage plasticity

Understanding the regulatory networks which control specific macrophage phenotypes is essential in identifying novel targets to correct macrophage mediated clinical disorders, often accompanied by inflammatory events. Since mesenchymal stromal cells (MSCs) have been shown to play key roles in regulating immune functions predominantly via a large number of secreted products, we used a fractional factorial approach to streamline experimental evaluation of MSC mediated inflammatory macrophage regulation. Our macrophage reprogramming metrics, human bone marrow MSC attenuation of macrophage pro‐inflammatory M1 TNFα secretion and simultaneous enhanced expression of the M2 macrophage marker, CD206, were used as analysis endpoints. Objective evaluation of a panel of MSC secreted mediators indicated that PGE2 alone was sufficient in facilitating macrophage reprogramming, while IL4 only provided partial reprogramming. Inhibiting stromal cell PGE2 secretion with Indomethacin, reversed the macrophage reprogramming effect. PGE2 reprogramming was mediated through the EP4 receptor and indirectly through the CREB signaling pathway as GSK3 specific inhibitors induced M1 macrophages to express CD206. This reprogramming pathway functioned independently from the M1 suppression pathway, as neither CREB nor GSK3 inhibition reversed PGE2 TNF‐α secretion attenuation. In conclusion, fractional factorial experimental design identified stromal derived PGE2 as the factor most important in facilitating macrophage reprogramming, albeit via two unique pathways. Biotechnol. Bioeng. 2014;111: 2239–2251. © 2014 Wiley Periodicals, Inc.
Validação de um instrumento que classifica os pacientes em quatro graus de dependência do cuidado de enfermagem

Esta pesquisa apresenta o processo de validacao de um instrumento que classifica os pacientes em quatro graus de dependencia do cuidado de enfermagem realizado em um hospital universitario publico. O estudo proporcionou aos enfermeiros participantes a oportunidade para analisar as necessidades dos pacientes, tornando-se o instrumento uma ferramenta de trabalho eficiente na pratica de enfermagem.
Packaging guest proteins into the encapsulin nanocompartment from Rhodococcus erythropolis N771

The encapsulin nanocompartment from Rhodococcus erythropolis N771 (Reencapsulin) was expressed and purified in wild‐type and C‐terminally His‐tagged forms. Negative‐stained transmission electron microscopy, field‐flow fractionation combined with multi‐angle light scattering and dynamic light scattering analyses showed that 60 Reencapsulin monomers were assembled as a spherical particle with a diameter of 28 nm. Heterogeneous guest proteins such as EGFP and firefly luciferase were packaged into the internal cavity of the Reencapsulin nanocompartment by fusing the C‐terminal 37‐amino‐acid sequence of the R. erythropolis N771 DypB peroxidase to the C‐terminus. Reencapsulin has the potential to package target proteins in its internal cavity and/or display them on its external surface, making it a feasible carrier for nanotechnology applications. Biotechnol. Bioeng. 2015;112: 13–20. © 2014 Wiley Periodicals, Inc.
Diagnosis and implications of human cytomegalovirus infection in pregnancy

Early this century, the term cytomegalic inclusion disease (CID) was used to designate the cellular changes characterized by enlargement and typical intranuclear inclusions observed in tissues of fetuses and infants with a fatal illness. In 1957, Smith and Weller et al, identified the causative agent of CID, which was named cytomegalovirus (CMV) by Weller in 1960. By 1971, it was clear that congenital human CMV (HCMV) infection was an important health problem. Since then, many advances have been made in the diagnosis, therapy, and knowledge of the epidemiology of congenital HCMV infection. However, most of these improvements, particularly those concerning diagnostic technologies and development of antiviral drugs, have been the result of the powerful effort to reduce the devastating impact of HCMV infections in AIDS and transplanted patients. Indeed, it is disappointing to observe that in the year 2000 CID does still occur, that HCMV is still recognized as the leading cause of congenital infection and the leading infectious cause of mental retardation and deafness, and, most important, that no active prevention is available for seronegative women. Moreover, because of the limited possibilities of prophylaxis and treatment, and the misuse of the currently available serologic assays, the issue of whether the determination of HCMV antibody status for women of childbearing age is justified has become a matter of debate.
“In for the Long Haul”: Responses of Parents Caring for Children With Sturge-Weber Syndrome

This descriptive study explores from a family perspective the positive and negative reactions of parents caring for children with Sturge-Weber Syndrome, a rare, progressive, congenital disease. The study, using three standardized instruments, considers perceptions of family functioning and the degree of the children’s independence. In addition, parental perceptions of their children’s disease, their stressors, and their unique caregiving roles were elicited through four open-ended items. A total of 125 primary care-givers and 89 secondary caregivers returned mailed questionnaires, of which 539 were mailed; their responses are reported and discussed within the perspective of the caregiver literature. Quantitative and qualitative data were triangulated for a more extensive picture of parental caregiver reaction. The findings contribute to knowledge on the manner in which families manage the challenges of a chronically ill child’s care and implications for ways nurses can help families achieve optimal family health are discussed.
Trajectories of Symptoms and Function in Older Adults With Low Back Disorders

Study Design. Prospective cohort study. Objective. To determine whether there are distinct trajectories of back pain and function among older adults and to identify characteristics that distinguish among patients with substantially different prognoses. Summary of Background Data. Although the differential diagnosis and course of low back pain among older adults may differ from middle-aged adults, there is little evidence. Better understanding variability in recovery among older adults may help target patients for more intensive clinical interventions, plan resource use, and design clinical studies of more homogeneous patient groups. Methods. Patients aged 65 years or older with a new episode of care for back pain were recruited at 3 geographically diverse sites. Patients completed pain intensity and Roland-Morris Disability measures at baseline and 3, 6, and 12 months later. We used latent class analysis to identify distinct trajectories of pain and function and then logistic regression to identify predictors of membership in the improving trajectories. Results. There were 3929 participants who completed outcome measures at every follow-up interval. Latent class analysis identified subgroups with low, intermediate, or high pain or disability scores who remained relatively stable over time. However, small subgroups showed dramatic improvement from baseline to 1 year (17% with major improvement in Roland score, pain intensity, or both). Shorter pain duration, higher patient confidence in improvement, and fewer comorbid conditions at baseline were each associated independently with favorable prognosis. Conclusion. Although most patients remained relatively stable over a year, latent class analysis identified small groups with major improvement in pain, function, or both. This technique may, therefore, be useful for studying back pain prognosis. Our results should help assemble more prognostically homogeneous groups for research, and the technique may help identify subgroups of patients with uniquely successful responses to investigational interventions. Level of Evidence: 3
Measures of Parent Engagement for Children Receiving Developmental or Rehabilitation Interventions: A Systematic Review

ABSTRACT Aim: To examine the conceptual and clinometric properties of measures for parent engagement in developmental or rehabilitation interventions for children and youth (<18 years of age). Methods: Four electronic databases were searched. Studies were included if they reported measures of at least one domain of parent engagement (i.e. affective, cognitive or behavioral). Reviewers independently identified measures and evaluated studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and the CanChild Outcome Measures Rating Form. Results: A total of 9,500 unique papers were retrieved, and 36 reported parent engagement measurement. Four measures met inclusion criteria: the Parent Involvement Index (PII), the Parent Participation Measure (PPM), the General Adherence subscale of the Medical Outcomes Study (GAMOS) and the Triadic Intervention and Evaluation Rating Scale (TIERS). No measure captured all domains of in-session parent engagement. Two addressed out-of-session parent engagement. There were limitations in validity and reliability. Conclusions: Few measures of parent engagement are available. Existing measures mostly captured the behavioral domain of in-session engagement, and none assessed cognitive or affective aspects of engagement. Out-of-session engagement was infrequently captured. There is currently no comprehensive measure of parent engagement in pediatric developmental and rehabilitation services that demonstrates good clinical utility or is conceptually and psychometrically sound.
Vitamin D Levels and 1-Year Fusion Outcomes in Elective Spine Surgery: A Prospective Observational Study

Study Design. Prospective observational study. Objective. To investigate the association of perioperative vitamin D levels and nonunion rates and time to fusion in patients undergoing elective spine fusion. Summary of Background Data. Although there is a clear link between bone mineral density and the risk of osteoporosis, it is unclear whether low vitamin D levels affect rates and timing of spinal fusion. Methods. Serum 25-OH vitamin D levels were measured perioperatively in adults undergoing elective spinal fusion between 2011 and 2012. Vitamin D levels <20 ng/mL were considered deficient. Univariate and multivariate logistic regression were performed to identify independent predictors of pseudarthrosis/nonunion within a minimum follow-up period of 12 months. Kaplan-Meier analysis was used to compare time to fusion between groups. Results. Of the 133 patients, 31 (23%) demonstrated vitamin D deficiency. Mean patient age was 57 ± 13 years; 44% were female and 94% were Caucasian. The cervical spine was fused in 49%, the lumbar spine in 47%, and the thoracic spine in 4%. Mean construct length was 2 levels (range 1–16). At 12-month follow-up, 112/133 (84%) patients demonstrated fusion (median time to fusion 8.4 mo). Nonunion at 12 months was associated with vitamin D deficiency (20% of patients with adequate vitamin D level vs. 38% of vitamin D-deficient patients, P = 0.063). Kaplan-Meier survival analysis demonstrated time to fusion was significantly longer in the vitamin D-deficient group (12 vs. 6 mo, P = 0.001). On multivariate analysis, vitamin D deficiency was an independent predictor of nonunion (odds ratio 3.449, P = 0.045) when adjusted for age, sex, obesity, fusion length, location, graft type, smoking, and bone morphogenetic protein use. Conclusion. Vitamin D levels may affect nonunion rate and time to fusion. These results offer insight into the importance of the metabolic milieu for bony fusion as well as a potential avenue for therapeutic intervention. Level of Evidence: 3