bluuebunny/crossref_metadata_2025 huggingface dataset:
Resistive memory devices based on novel functionalized poly(aryl ether)s with pendant azobenzene
Authors: Sun Hejing , Zhang Haibo , Pang Jinhui , Chen Zheng , Han Yuntao , Li Su , Han Xiaocui , Jiang Zhenhua
Published: March 2018

We designed and synthesized two novel azobenzene functionalized poly(aryl ether)s (PAEs), PAE-azo-1 and PAE-azo-2, from a new azobenzene monomer via nucleophilic aromatic substitution polycondensation. This direct polymerization approach via azobenzene monomer has the advantages of controlling the distribution and amount of the azobenzene chromophores in the polymer. Both of the polymers showed very good thermal stability and excellent solubility for future application in the electronics industry. These polymers were fabricated as films by simple spin-coating and both of them were then prepared as sandwich memory devices. PAE-azo-1 and PAE-azo-2 exhibit write-once-read-many-times-type memory behavior, which can be encoded as “0” and “1,” and possess the low operation voltage below −3.0 V. The memory mechanism was investigated through ultraviolet–visible optical absorption spectrum and the cyclic voltammetry. These obtained results indicate that the novel azobenzene functionalized PAEs are a promising candidate for low power consumption and high-performance materials for data storage.
Benefits of wonder process craft on engine valve train performance
Authors: Abdullah M Usman , Shah Samiur Rahman , Bhutta M Usman , Mufti Riaz Ahmad , Khurram Muhammad , Najeeb M Huzaifa , Arshad Waseem , Ogawa Kiyo
Published: March 2018

The performance and durability of tribological components in roller follower valve train is governed mainly by the roller rotational behaviour. Pure rolling of roller on the camshaft surface is essential to achieve the optimum valve train efficiency. The increase in roller slip can lead to high valve train power loss due to increase in sliding friction and can increase the wear rate of mating surfaces of camshaft and roller. In this research work, a modern gasoline engine having end-pivoted roller finger follower valve train configuration has been instrumented to investigate the effects of Wonder Process Craft surface treatment on roller slip. Comprehensive test programme has been undertaken at transient camshaft speeds by employing the New European Drive Cycle under different oil temperatures and pressures. Remarkable reduction in roller slip was recorded for Wonder Process Craft surface treated roller as compared to the original unmodified roller indicating its strong potential of employment in engine valve train. The test rig, surface treatment of roller, instrumentation, experimentation, results and discussion have been presented in detail in this paper.
Fretting–corrosion at the modular tapers interface: Inspection of standard ASTM F1875-98
Authors: Bingley Rachel , Martin Alan , Manfredi Olivia , Nejadhamzeeigilani Mahdiyar , Oladokun Abimbola , Beadling Andrew Robert , Siddiqui Sohail , Anderson James , Thompson Jonathan , Neville Anne , Bryant Michael
Published: March 2018

Interest in the degradation mechanisms at the modular tapers interfaces has been renewed due to increased reported cases of adverse reactions to metal debris and the appearance of wear and corrosion at the modular tapers interfaces at revision. Over the past two decades, a lot of research has been expended to understand the degradation mechanisms, with two primary implant loading procedures and orientations used consistently across the literature. ASTM F1875-98 is often used as a guide to understand and benchmark the tribocorrosion processes occurring within the modular tapers interface. This article presents a comparison of the two methods outlined in ASTM F1875-98 as well as a critique of the standard considering the current paradigm in pre-clinical assessment of modular tapers.
Pope Gregory VII and Count Eblous II of Roucy’s Proto-Crusade in Iberia c. 1073
Authors: Villegas-Aristizábal Lucas
Published: March 2018

This article surveys the surviving material regarding Gregory VII and Eblous of Roucy’s expedition to Iberia c. 1073. This is an expedition that usually has been overlooked which provides a glimpse in to Gregory VII’s mindset with regard to the Iberian wars against the Muslims. This article assesses how Gregory attempted to use the current arguments for ‘Holy War’ to encourage Eblous and his followers to fight in the Christian–Muslim frontier. It also compares the papal plans with Eblous’ probable motives as they can be discerned from sources and the circumstantial evidence. Furthermore, it addresses whether Eblous went to Iberia to fight the Muslims since some of the accounts seem to contradict each other. It will also explore the significance of this episode in the development of Holy War as a preamble to the First Crusade, especially in comparison with the better-known siege of Barbastro of 1064. Lastly, it will also analyse how Eblous’ filial relations with the Aragonese rulers would help create family networks between the Burgundian and Norman nobility and the ruling houses of the Iberian Peninsula in the following decades, and the effect of these on the later involvement of Frankish contingents in the Iberian wars against the Muslims.
Presence into Participation and Representation
Authors: Kalaramadam Sreevidya
Published: March 2018

Over the last two decades, women’s ‘political participation’ has emerged as a major marker of democracy around the world. This is frequently operationalized through the policy of ‘gender quotas’ that seek to enhance women’s presence within national and subnational institutions of governance. Since 1993, India has implemented a large programme of decentralization (panchayati raj) and gender quotas, which enabled more than a million elected women representatives (EWRs) to become part of the political process. This article engages feminist theorizations of gender quotas using the Indian context. While affirming the need for gender quotas for increasing presence of women in politics, it argues that the presence of EWRs in local governance does not easily assure their effective political participation or political representation. This is because of the ‘social embeddedness of policy’ in local contexts. Effective participation and representation depend upon the ‘relative agency’ of EWRs who continually negotiate and construct their political subjectivities within everyday life situations, specifically three processes—patriarchal family relations, caste relations at the workplace and discursively produced marked identities.
Testing the Dimensionality of Low Self-Control Across Three Groups of Chinese Adolescents
Authors: Ren Ling , Zhao Jihong , Luo Yuchun
Published: March 2018

The concept of Low Self-Control (LSC) has been a major focus of criminological theories since the publication of Gottfredson and Hirschi’s work in 1990. Although there is an increasing amount of literature devoted to exploring the precise theoretical construct of LSC, no consensus has been reached on the factorial structure of Grasmick et al.’s LSC measures. The purpose of this study is to investigate the factorial dimensionality of Grasmick et al.’s LSC measures in the Chinese setting. The data for this study come from three distinct samples collected in a Chinese province with a population of 47 million. The three samples represent high school students, troubled teens incarcerated in jail, and adjudicated juvenile offenders in prison in this province. Confirmatory factor analyses are utilized to conduct the factorial structure tests. Results provide strong support for a second-order or hierarchical model of LSC across the three groups. The key findings are discussed in terms of methodological, theoretical, and cultural dimensions.
Weight-Bearing Cone-Beam CT Scan Assessment of Stability of Supination External Rotation Ankle Fractures in a Cadaver Model
Authors: Lawlor Mark C. , Kluczynski Melissa A. , Marzo John M.
Published: March 2018

Background:

The utility of computed tomography (CT) for measuring medial clear space (MCS) for determination of the stability of supination external rotation (SER) ankle fractures and in comparison to standard radiographs is unknown. We compared MCS on gravity stress (GS) radiographs to GS and weight bearing (WB) cone-beam CT (CBCT).

Methods:

An AO SER 44B3.1 ankle fracture was simulated in 10 human cadavers, also serving as controls. MCS was measured on GS radiographs, GS CBCT, and a simulated WB CBCT scan. Specimens were stable if MCS was <5 mm and unstable if MCS was ≥5 mm. Paired t tests were used to compare MCS from each imaging modality for controls versus SER injuries and stable versus unstable specimens.

Results:

Compared with controls assessed by GS radiographs, MCS was greater for an SER injury when assessed by GS radiograph and GS CBCT scan within the stable group. Compared with controls assessed by GS radiographs, MCS was greater for SER injuries when assessed by GS radiograph, GS CBCT scan, and WB CBCT within the unstable group. MCS was reduced for stable versus unstable SER injuries assessed by WB CBCT.

Conclusion:

In a cadaveric model of SER ankle fracture, the medial clear space was statistically significantly greater for the experimental condition when assessed by gravity stress radiograph and gravity stress CBCT scan. Under weight-bearing conditions, the cone-beam CT scanner distinguished between stable and unstable ankles in the experimental condition.

Clinical Relevance:

This study suggests that a WB cone-beam CT scan may be able to distinguish between stable and unstable SER ankle fractures and influence operative decision making.
Food Insecurity and Violence in the Home: Investigating Exposure to Violence and Victimization Among Preschool-Aged Children
Authors: Jackson Dylan B. , Lynch Kellie R. , Helton Jesse J. , Vaughn Michael G.
Published: March 2018

Children experiencing or witnessing violence in the home are at risk of a number of cognitive, social, and behavioral challenges as they age. A handful of recent studies have suggested that food insecurity may be one factor associated with violence against children in the home. The present study uses data from the Early Childhood Longitudinal Study–Birth Cohort to explore the link between household food insecurity during the first three waves of data collection (i.e., the first few years of life) and witnessing or being the victim of violence in the home among very young children (~ age 4). The results suggest that the predicted probability of early childhood exposure to violence and/or victimization in the home is nearly 6 times greater in persistently food-insecure households (i.e., households that are food insecure across all three waves) relative to food secure households. Limitations and avenues for future research are noted.
A survey of vaccine history in German cats and owners’ attitudes to vaccination
Authors: Gehrig Anne-Claire , Hartmann Katrin , Günther Felix , Klima André , Habacher Gabriele , Bergmann Michèle
Published: March 2018

Objectives

Vaccination is the most important measure for prevention of feline infectious diseases. Cat owner compliance with vaccination recommendations has been investigated in the UK but not in other European countries. The aim of the present study was to determine cat owners’ attitudes towards vaccination in cats in Germany, to identify factors that are associated with the vaccination status of their cats and to compare the results with those of the UK survey.

Methods

The survey was conducted using an online questionnaire and was aimed at respondents throughout Germany. Respondents under 16 years of age, cats that were less than 9 weeks old and veterinarians were excluded. A total of 920 questionnaires were evaluated, and information about cats and respondents was assessed with respect to the current vaccination status of the cats using a linear logistic regression model.

Results

The majority of cats (77.9%; n = 717) were vaccinated according to current guidelines; only 5.4% (n = 50; 95% confidence interval [CI] 5.00–9.00) of cats had never received a vaccine. Having visited a cattery, a cat show or travelled abroad in the past 12 months (n = 96/773; odds ratio [OR] 6.95; 95% CI 1.65–52.19) had the highest positive impact on the vaccination status of cats. In addition, detailed veterinary advice about vaccination had a positive impact (n = 275/773; OR 2.09; 95% CI 0.67–6.25) on the attitude of owners towards vaccinating their cats.

Conclusions and relevance

A history of travelling abroad or visiting cat shows or a cattery, and thus regulatory requirements, had the greatest positive impact on the current vaccination status of the cats. Veterinary consultation on preventive measures, including vaccination, is crucial for protecting the cat population against infectious diseases.
The effect of clinical severity and eyelid rash on ocular involvement in primary varicella infection
Authors: Sungur Gulten , Hazirolan Dicle , Duran Serkan , Şatana Banu , Arikan Inci , Duman Sunay
Published: March 2018

Purpose

To describe ocular manifestations in primary varicella infection and their relationship to systemic severity and the associated eyelid rash.

Methods

One hundred consecutive children with primary varicella were examined prospectively. The cases were classified as mild, moderate, and severe according to the severity of clinical presentation. Excluding the presence of eyelid rash, children with ocular findings were assigned to group 1 (G1), and those without ocular findings were assigned to group 2 (G2). Patients in G1 were also evaluated according to the nature of ocular manifestations and the course of uveitis.

Results

Twenty-one percent of patients had ocular involvement (G1) and 79% had no ocular involvement (G2). While chickenpox had a mild course in 85.7% of patients in G1 and 88.6% of patients in G2, all others had a moderate course. None of the children had a severe course. A varicella eyelid rash was present in 28.6% of patients in G1 and 13.9% in G2. Among ocular findings, 38.1% of patients had conjunctivitis, 57.1% had anterior uveitis, and 4.8% had disciform keratouveitis. There was no significant association between severity of chickenpox and severity of ocular involvement (p=0.712). There was also no relationship between eyelid rash and ocular involvement (p=0.787).

Conclusions

There is neither an association between the severity of chickenpox and the severity of ocular involvement nor an association between the presence of a varicella eyelid rash and the development of uveitis. As the prognosis regarding sequelae of ocular involvement in varicella infection is good, only those patients with ocular signs and symptoms need be referred by pediatricians for an ophthalmologic examination.
Subconjunctival application of regenerative factor-rich plasma for the treatment of ocular alkali burns
Authors: De Aracena Del Cid Rafael Márquez , De Espinosa Escoriaza Ignacio Montero
Published: March 2018

Purpose

To study the efficiency of the subconjunctival application of autologous regenerative factor-rich plasma (RFRP) in patients with different degrees of ocular alkali burns.

Methods

Thirty-five eyes of 35 patients with ocular alkali burns were analyzed. They were classified into moderate and relevance groups according to the severity of the burn. A control group was established for each with conventional topical medical treatment; subconjunctival regenerative factor rich plasma (RFRP) was applied to the other groups. A further group was added to the severe chemical burn group, which received autohemotherapy. The clinical evolution of the lesions and the period in which the pathology prevented the patient from working were studied; monitoring was carried out until the patient had healed.

Results

In the moderate chemical burns, there was a significant reduction in corneal and conjunctival epithelization times, sick leave duration, and healing time when the patients were treated with RFRP in comparison to the control group. With regard to the severe burns, significant reduction in time to corneal scarring in those treated with RFRP in comparison to traditional treatment was reported. RFRP showed, at least as effective and less side effects than the autohemotherapy.

Conclusions

Subconjunctival infiltration with autologous RFRP can be considered an effective, straightforward, and economical form of treatment for burns of the ocular surface.
Primary low-risk trabeculectomy augmented with low-dose mitomycin-C
Authors: Alwitry Amar , Abedin Asyia , Patel Vick , Moodie Jonathan , Rotchford Alan , King Anthony J.
Published: March 2018

Purpose

To present outcome data on low risk primary trabeculectomy augmented with low dose peroperative (0.1 mg/mL for 1 minute) mitomycin-C (MMC).

Methods

Retrospective case note review. All cases of trabeculectomy utilizing MMC augmentation at a concentration of 0.1 mg/mL with an application time of 1 minute and at least 1 year follow-up during the study period were included. Only first eyes were included. Patient demographics and postoperative course including complications, interventions, and outcomes were documented and analyzed.

Results

Fifty-nine trabeculectomies that met the inclusion criteria were identified. Mean age of cases was 70.8 years. Mean follow-up time was 19.3 months. Bleb leaks occurred in 16 (27.1%) cases. Only one case required surgical intervention in the form of resuturing after 14 days. At 1 year, there was a reduction in mean number of topical medications from 2.70 to a mean of 0.07. Unqualified success (intraocular pressure [IOP] at 1 year of less than 16 mmHg without medication) was achieved in 49 cases (83.1%). Mean IOP was reduced from the preoperative value of 23.1 mmHg (SD 5.8) to 13.5 mmHg (SD 5.0) (p<0.001).

Conclusions

Our data suggest that a primary trabeculectomy augmented with a low dose of MMC is a safe and effective procedure for IOP reduction in patients with a low risk of trabeculectomy failure.
Scleral buckle removal associated with pars plana vitrectomy for recurrent retinal detachment
Authors: Rossi Tommaso , Boccassini Barbara , Iossa Mario , Lesnoni Guido , Mutolo P. Alessandro
Published: March 2018

Purpose

Scleral buckle (SB) removal is rarely performed due to extrusion, infection, or diplopia. We report a series of patients with recurrent retinal detachment (RRD) after primary SB due to new breaks occurring at sites where the presence of a pre-existing SB was judged counterproductive. All patients were treated by means of pars plana vitrectomy (PPV) and SB removal with the sole purpose of achieving a more favorable retinal profile.

Methods

We retrospectively reviewed all patients undergoing PPV and SB removal for RRD due to new breaks occurring at sites hidden by pre-existing exoplants.

Results

Mean age was 52 years and VA on presentation was 20/620 and 20/216 at latest visit (p<0.01), 23 months of follow-up. On presentation, 3/11 (27%) had a VA better than 20/400 and 1/11 (9%) better than 20/40. At the end of follow-up, 9/11 (81%) and 3/11 (27%) saw better than 20/400 and 20/40 (p<0.05). At the end of follow-up, 8/11 (72%) had an attached retina, 2/11 (18%) had a partially attached retina, and 1/11 (9%) had a total RD. Explanted buckles included 5 silicone sponges and 6 solid silicone rubber elements.

Conclusions

Although occasionally cumbersome and time-consuming, SB removal may provide a more favorable retinal profile and improve retina–tamponade contact. Larger series are needed to assess if this translates into a significant benefit in the treatment of selected RRD.
Goldenhar syndrome with unusual association of pre-axial polydactyly
Authors: Mishra Deepak , Sinha Bibhuti P. , Kumar Rakesh
Published: March 2018

Purpose

Goldenhar syndrome is a multiorgan involvement affecting mainly the eyes, auricle, and oral cavity.

Methods

Case report.

Results

A 7-month-old boy presenting with features of Goldenhar syndrome had ocular and auricular manifestations. There were no vertebral anomalies, but he had the unusual association of pre-axial polydactyly, which is not reported in the literature.

Conclusions

Pre-axial polydactyly should also be considered as an association of Goldenhar syndrome.
Spontaneous resolution of Descemet membrane detachment following big-bubble deep anterior lamellar keratoplasty
Authors: Goldich Yakov , Zadok David , Avni Isaac
Published: March 2018

Purpose

To report 2 cases of delayed spontaneous Descemet membrane (DM) reattachment following big-bubble deep anterior lamellar keratoplasty (DALK).

Methods

A 21-year-old man with keratoconus and a 36-year-old woman with corneal macular dystrophy underwent big-bubble DALK. No injury to DM was noted intraoperatively or postoperatively. Postoperatively, the patients developed central DM detachment with double anterior chamber formation. A nonsurgical conservative approach (waiting technique) was adopted.

Results

Three weeks postoperatively, the double anterior chamber resolved spontaneously with complete DM reattachment and a clear donor cornea.

Conclusions

DM detachment and double anterior chamber following big-bubble DALK may resolve spontaneously.
Epiretinal membrane in a 12-year-old immunocompetent girl with cytomegalovirus infection
Authors: Costagliola Ciro , Romano Mario R. , Parmeggiani Francesco , Dell'Omo Roberto , Cultrera Rosario
Published: March 2018

Purpose

To report the case of a 12-year-old immunocompetent girl presenting bilateral epiretinal membrane formation in conjunction with systemic human cytomegalovirus (HCMV) infection.

Methods

The patient had a sudden onset of blurred vision and floaters in both eyes. Her medical history was unremarkable, except for allergic asthma that she had had for several years and that she was treating with inhaler corticosteroids prescribed by her pediatrician. The patient underwent a complete ophthalmic examination and serologic blood test.

Results

The ocular examination revealed an epiretinal membrane confirmed by optical coherence tomography, which showed a band of high optical reflectivity compatible with a proliferation of abnormal tissue on the surface of the retina. The patient had serologic evidence of exposure to HCMV, which was verified by a strongly positive HCMV IgM antibody test result (320 IU), with detectable IgG antibodies against HCMV, which significantly rose further in consecutive blood samples, due to IgG antibody seroconversion.

Conclusions

Our patient had allergic asthma that she was treating with inhaled corticosteroids. The immunosuppressive properties of corticosteroids could induce endogenous reactivation of latent HCMV.
Three-dimensional depiction of the vitreous pocket using triamcinolone acetonide
Authors: Shimada Hiroyuki , Nakashizuka Hiroyuki , Hattori Takayuki , Mori Ryusaburo , Mizutani Yoshihiro , Yuzawa Mitsuko
Published: March 2018

Purpose

To clarify the three-dimensional morphology of the vitreous pocket by direct injection of triamcinolone acetonide (TA) into the vitreous pocket.

Methods

Ten eyes of 10 subjects with incomplete posterior vitreous detachment (PVD) were studied. During vitreous surgery, TA was directly injected into the vitreous pocket. A 25-G cutter was then inserted into the vitreous pocket and TA was removed by aspiration. The anterior surface of the vitreous pocket was removed with the 25-G cutter, and the posterior side of the vitreous pocket was observed.

Results

Injecting TA allowed visualization of the circular vitreous pocket located anterior to the optic disk and macular area in all 10 eyes. The surface of the anterior border had a bright appearance. In 2 eyes without PVD, the posterior side of the vitreous pocket was depicted as a flat plate-like structure encompassing the macular region and the optic disc. In 8 eyes with partial PVD around the optic disc, a larger flat plate with the macula as the center and a smaller plate with the optic disc as the center were observed.

Conclusions

The vitreous pocket is a disc-shaped liquefied lacuna spreading anterior to the optic disc and macular region, which is surrounded by a dense network of fibrils. In patients with partial PVD around the optic disc, the posterior wall was visualized as being composed of two plate-like structures with the macula and the optic disc at their centers.
Long-Term Refractive and Phoric Changes in Visual Display Unit (VDU) Operators
Authors: Grignolo F.M. , di Bari A. , Bellan B. , Camerino L. , Maina G.
Published: March 2018

Purpose

This study assessed the phoric and refractive changes possibly caused by visual display unit (VDU) activity.

Methods

In a longitudinal trial nearly 6000 VDU operators received two ophthalmological examinations at intervals ranging from 34 to 43 months. The findings from the two examinations were correlated to VDU work (hours daily and years of VDU work), age and sex.

Results

Changes in the refractive state seemed to be mainly age-related. There was a slight tendency toward hyperopia (imbalance of latent hyperopia).

Conclusions

In the analysis of ocular motility, the results show no worsening capable of causing a definitive change from heterophoria to heterotropia. Heterophoric subjects, however, tend to improve both with regular office work and with additional VDU activity.
Analysis of Tear-Protein Patterns as a Diagnostic Tool for the Detection of Dry Eyes
Authors: Grus F.H. , Augustin A.J. , Evangelou N.G. , Toth-Sagi K.
Published: March 2018

Purpose

To analyze the electrophoretic patterns of tear proteins from diabetic (DIDRY) and non-diabetic (DRY) patients with dry-eye disease in comparison with the patterns in healthy subjects (CTRL). The patterns were classified using multivariate statistical methods.

Methods

A total of 119 eyes were examined in this study (50 DIDRY, 39 DRY, 30 CTRL). The patients were primarily grouped according to the results of the basic secretory test (BST) and subjective symptoms (burning, foreign body sensations, tearing, “dryness” of the eyes). Patients with values ≤ 10/5’ plus subjective symptoms were classified as dry-eye patients. Tear proteins were separated by sodium-dodecyl-sulfate poly-acrylamide gel electrophoresis (SDS-PAGE). Digital image analysis was done using the ScanPacK (Biometra, Gottingen, Germany). A data set was created from each electrophoretic pattern. The data were analyzed by multivariate analysis of discriminance, k-means cluster analysis and with a factor analysis before k-means cluster analysis as a data reduction tool.

Results

The protein patterns of the three groups were significantly different (Wilks’ lambda: 0.1425; p<0.01): P < 0.05 (CTRL - DRY), P < 0.00005 (CTRL-DIDRY), and P < 0.0005 (DIDRY-DRY). There were more peaks/electrophoretic lane in the DRY and DIDRY groups (P < 0.05) than CTRL. Classification of all samples as DRY and CTRL gave the following results: known patterns 97% correct; unknown patterns 71.4% correct. Classification in DIDRY, DRY or CTRL was 92% correct for known patterns and 43% for unknown patterns. Using k-means cluster analysis, 72% of patients previously classified as “dry-eye” according to the BST value were classified as “dry-eye” based on their electrophoretic data too.

Conclusions

Analysis of protein patterns and statistical evaluation are suitable for the detection of dry eyes. Tear-protein pattern analysis can provide more information on the pathogenesis of the disease. Thus, this new method might be more reliable than the BST value for both diagnostic and therapeutic purposes.
Ultrastructural Study of the Conjunctiva in Patients with Keratoconjunctivitis Sicca not Associated with Systemic Disorders
Authors: Rivas L. , Toledano A. , Alvarez M. I. , Sanz A. I. , Oroza M. A. , Murube J.
Published: March 2018

Purpose

The aim of this work was to evaluate ultrastructural alterations of the conjunctiva during the clinical course of keratoconjunctivitis sicca (KCS), and to detect its earliest and most characteristic morphological changes.

Methods

The conjunctiva was studied in biopsies from 75 patients and 10 controls. Patients were classified according to the results of the Schirmer I test, break-up time, rose Bengal staining, osmolarity and impression cytology.

Results

The conjunctiva in these KCS patients showed progressive hyperplasia, hypertrophy and cellular flattening, with diminution of goblet cell density and microvilli. In the severe cases, the epithelial cells lost their organelles, and fibrous material increased. From the early phases of KCS, clear nuclear alterations (indentation, binucleation) were found, but pyknotic nuclei or anucleated cells were only observed in the most severe cases. From the earliest stages to the most severe cases of KCS, decreases in cell membrane interdigitations were observed parallel to increases in the number and size of desmosomes. There were also increases in the number of inflammatory cells. Alterations in blood vessels were only observed in the most severe cases.

Conclusions

Morphological studies alone were able even in the earliest phases of KCS, to detect the squamous metaplasia that progresses from the surface of the epithelium to the connective tissue. This degenerative or adaptative cellular process was characterized mainly by marked proliferation of the cytoskeleton and a general loss of organelles, mitochondria being the least affected.
“Silent” Ocular Toxocariasis
Authors: Beiran I. , Cochavi O. , Miller B.
Published: March 2018

We describe an unusual presentation of ocular Toxocara infection. On examination of a 52-year-old asymptomatic male with no previous relevant general or ocular history, a lesion suggestive of a scarred Toxocara worm was found in his right fundus. medical workup revealed normal blood count and blood chemistry. Serologic tests were negative for Toxoplasma and Echinococcus and in 1:4 dilution were positive for Toxocara. The patient appeared to have a subclinical Toxocara infection, resulting in the present picture.
Comparison of Topical 0.05% Levocabastine and 0.1% Lodoxamide in Patients with Allergic Conjunctivitis
Authors: Richard C. , Trinquand C. , Bloch-Michel E. ,   Study Group, Favennec F. , Helleboid L. , Hofmann B. , Lecorvec MP. , Verin P. , Zech JC.
Published: March 2018

Purpose

The aim of the study was to assess the efficacy and safety of 0.05% levocabastine eyedrops (H1 receptor blocker given BID + vehicle BID) compared with 0.1% lodoxamide ophthalmic solution (mast-cell stabilizer instilled QID) in reducing ocular signs and symptoms of allergic conjunctivitis.

Methods

A randomized, double-masked, parallel-group study was conducted in seven centres in France, in which 93 patients suffering from seasonal or perennial allergic conjunctivitis were randomly allocated to either 0.05% levocabastine (n = 47) or 0.1% lodoxamide (n = 46) in both eyes for a 14-day period. Efficacy was evaluated by subjective (prickling, burning, photophobia, itching) and objective (redness, chemosis, eyelid edema, tearing) sign scores at visits on days 7 and 14, and from data noted daily by the patient in a self-evaluation form. Safety was assessed as tolerance upon instillation and adverse event reports.

Results

The ocular allergy symptom and sign scores were comparable in the two treatment groups at baseline. With time, statistically and clinically significant reductions (p < 0.001) from baseline were observed for the subjective and objective scores, with no difference between the treatment groups. After the first instillation, signs were alleviated more rapidly in levocabastine-treated patients than in the lodoxamide group (p < 0.001). Overall assessments by the patient and investigator were similar in both groups. No serious adverse events were reported.

Conclusions

Levocabastine ophthalmic suspension 0.05% (BID) appears to be as effective and safe as lodoxamide 0.1% (QID) in the management of allergic conjunctivitis.
Treatment of Proptosis with Fat Removal Orbital Decompression in Graves’ Ophthalmopathy
Authors: Adenis J.P. , Robert P.Y. , Lasudry J.G.H. , Dalloul Z.
Published: March 2018

Purpose

Retrospective evaluation of 41 proptosis reduction procedures using fat removal orbital decompression (FROD) according to a modified Olivari's technique.

Methods

Trans-septal excision of extraconal and intraconal fat was done under the microscope through the upper and lower eyelid blepharoplasty approach. Proptosis was measured with a Hertel exophthalmometer.

Results

Mean excision of 7.31 + 1.9 ml (range 3.25 - 12 ml) of orbital fat reduced proptosis on average by 4.7 + 2.4 mm (range 1–11 mm). Side effects were few, limited only to ocular motility disturbances. There was no significant effect on visual fileds. A postoperative drop in IOP was noted in patients with preoperative IOP above 21 mmHg. Efficient palpebral lengthening can be achieved with combined section of the levator aponeurosis horns in the upper eyelid, and/or auricular cartilage graft in the lower eyelid.

Conclusions

FROD reduces proptosis in Grave's ophthalmopathy.
Impaction Grafting in Primary Total Hip Arthroplasty: A Pilot Study
Authors: Blom A. , Learmonth I.
Published: March 2018

The quality of bone encountered in the proximal femur at primary total hip arthroplasty varies considerably. It would be advantageous to improve the bone stock quality of patients who are likely to require subsequent revision. Impaction grafting with morsellised autograft was performed at primary total hip arthroplasty on seven patients who had poor proximal femoral bone stock. Minimum follow-up was 33 months. One patient died 5 weeks post-operatively. Radiographic assessment showed improved bone stock in five hips with little or no improvement in one hip. There was no evidence of prosthetic subsidence. Impaction grafting at primary total hip arthroplasty is a viable method of improving bone stock in patients with poor proximal femoral bone quality. The technique would be of particular benefit in the younger patient presenting for total hip arthroplasty with poor bone stock in the proximal femur.
Fracture of Ceramic Components in Total Hip Arthroplasty
Authors: Toni A. , Terzi S. , Sudanese A. , Bianchi G.
Published: March 2018

The authors experienced two cases of alumina prosthetic components fracture among the 2879 implanted in 10 years; these components were part of 1484 prosthetic implants. In both cases ceramic fracture was the result of a surgical technical error: in the first case a 32 mm alumina head was replaced in the same tapered neck with a 28 mm one during cup revision without removing the stem; after 9 months the new head failed. In the second case the prosthesis presented recurrent sub-dislocations causing alumina cup liner chipping. Fracture of a ceramic component is actually an episodic complication (0,08% in our experience), often caused by an uncorrect surgical technique, and shall not limit the use of this material.
DDH Treatment with Pavlik Harness: Weekly Ultrasound Monitoring for Stability
Authors: Hand C.J. , Portinaro N.M. , Richards R.H.
Published: March 2018

Normal development of the infantile hip joint relies upon the congruent and stable relationship of the femoral head and the acetabulum. Treatment with dynamic bracing for instability of the hip joint is accepted, but the duration of treatment required and the timing of follow up is of current debate. The aim of this study was to determine the outcome of Pavlik Harness treatment in children with early presenting ultrasonographically unstable and dislocated hips, independently of morphological appearance of the joint. Children suspected of having or to be high risk for DDH were assessed by clinical and ultrasound examination. Ultrasonographically unstable and dislocated hips were treated in the Pavlik harness and reviewed weekly with ultrasound. Once reduction had been maintained for six consecutive weeks weaning from the harness over the following 5 weeks was started. Thirty three children (37 hips) were treated. The mean follow up time was 2.9 years (6 weeks - 5.3 years). Six hips failed to remain reduced. There was no statistically difference in age at commencement of Pavlik harness treatment between the successful and unsuccessfully treated groups (p>0.1). Evaluation of the duration of splintage required to achieve reduction of the hip compared against the age of the child at the commencement of splintage revealed no statistically significant correlation (p>0.1) to be present. Early treatment of hip instability within the first weeks of life, even with an apparent normal morphology of the acetabular socket, results in normal joint development, decreasing the need for prolonged compliance with treatment. It may also reduce the incidence of late presentation, without increasing the rate of complications (0 in our series).
Precision of Dual Energy X-ray Absorptiometry in Determining Periprosthetic Bone Mineral Density of the Hydroxyapatite Coated Hip Prosthesis
Authors: Rahmy A.I.A. , Tonino A.J. , Tan W. , Ter Riet G.
Published: March 2018

The objectives of this study were to demonstrate the potential usefulness of dual-energy X-ray absorptiometry (DEXA) in the assessment of dynamic changes in bone mineral density (BMD) around the femoral stem of non cemented hydroxyapatite-coated hip prostheses and to establish our procedures by determining the variabilities associated with error introduced by the machine, operator, and/or subject.

Methods

Regional BMD were measured twice by DEXA for 27 patients. All scans were analysed twice by applying large size regions of interest (ROI's), 7 in total, defined by ‘modified’ Gruen zones. The data of 27 patients were analysed for the second time using smaller size ROI's, 14 in total, 7 small ROI's on each of the medial and lateral sides of the prosthesis. Three patients, all of whom exhibited intense ectopic ossification, were scanned twice. The variation associated with rotation of the femur was assessed by scanning six patients first in neutral rotation, thereafter by ± 15° in internal and external rotation position. Results: The overall coefficient of variation (CV) using ‘modified’ Gruen zones was 2.40% and varied according to the zone assessed. When smaller zones were used, the overall CV was 3.42%. The overall CV in the patients with ectopic ossification was 7.56%. When the leg was rotated by ± 15° externally or internally, the overall CV was approximately 10%.

Conclusions

Patient positioning is probably the most variable condition in the clinical setting. Using large ROI's such as ‘modified’ Gruen zones yields significantly better overall precision than using smaller ROI's. Patients with intense ectopic ossification are not suitable candidates for longitudinal study.
A Tissue Retractor for Hip Fracture Surgery
Authors: Parker M.J. , Patterson R.J.
Published: March 2018

A tissue retractor is described for use during insertion of a sliding hip screw in hip fracture surgery. The retractor enables an unassisted surgeon to have good operative exposure whilst causing minimal tissue damage.
Mechanisms of Bacterial Resistance in Implant Infection
Authors: Cordero J. , García-Cimbrelo E.
Published: March 2018

Although prophylaxis has cut down the infection rate in any type of implant to an average of 2.3% (0.38%-10%), the increased number of orthopaedic implants worldwide results in an extremely high number of cases yearly. Infection is also one of the most serious complications of implant surgery: it provokes life-long clinical sequelae, and greatly increases the difficulty and cost of treatment.

Most bacterial infections respond to antibiotics alone, but implant infections do not. Most of the hypotheses developed over the last 40 years have been confirmed in clinical practice, and the most recent ones have not replaced earlier ones (Tab. I).
Depth of Insertion and Radiographic Fate of Non-Holed Cementless Metal Backed Acetabular Components
Authors: Wright J. , Bostrom M. , Pellicci P. , Salvati E.
Published: March 2018

A retrospective radiographic review of 48 non-holed, factory assembled, cementless metal backed acetabular components, implanted in 45 patients, was performed. Post operative anteroposterior radiographs of the hips were compared to the radiographs at one year follow-up. In addition, measurements were made on 100 post-operative radiographs from patients implanted during the same time period with multiple holed acetabular components whose polyethylene liner was assembled after final impaction of the metal shell. The non-holed cups were implanted at a greater distance from Kohler's line than the multiple holed acetabular components (1.45 ± 1.83 mm [range 0 - 7.89 mm] vs. 0.69 ± 1.70 mm [range 0 -15.26 mm], p = 0.018). A larger percentage of non-holed cups had gaps between the metal shell and the bone bed (67% vs. 17.5%). Impaction through the polyethylene liner of the non-holed acetabular components leads to a higher incidence of radiographic gaps between the metal shell and the bone bed as well as lateralization of the component, since there were no holes to assess the proper seating at surgery. These radiographic findings did not appear to be detrimental, however, as the cups remained radiographically stable at one year follow-up.
The Evolution of Ceramics in Total Hip Replacement
Authors: Willmann G.
Published: March 2018

Today's THR systems have been developed in conjunction with feedback from clinical practice, i.e. by evolution. In the 70s and 80s ceramic stems, monolithic cups, monoblock components, and skirted heads were used. Today, modular hip systems are offered, designed for ceramic heads, which articulate against ceramic or PE cups. The surgeon has the option of choosing a combination suitable to the specific situation. About 70 cups with ceramic inserts have been developed. More than 200,000 ceramic inserts have been used since the mid 80s.

The article discusses which combinations of head and cup inserts have been approved by government agencies and which combinations are not recommended
Influence of Region Size on Bone Mineral Measurements along Femoral Stems in THA
Authors: Gehrchen P. M. , Petersen M. M. , Nielsen P. K. , Lund B.
Published: March 2018

The influence of regional size on the precision error in the evaluation of bone mineral changes along femoral components in uncemented THA's was studied methodologically using Dual Energy X-ray Absorptiometry (DEXA) and with a review of the literature. A significant negative relation between region size and precision error was found in experimental studies and the precision error was shown to vary with type of DEXA scanner when reviewing the literature. When using Gruen's zones we found that the precision was best at the tip and poorest in the proximal regions. Guidelines based upon calculations of the approximate percentage changes necessary in a single individual to be statistically significant in a longitudinal study with 95% probability were made for three different types of DEXA scanners.
A Comparison of the Performance of Irradiated and Non-Irradiated Bone Graft in Hip Surgery
Authors: Holt G.M. , Stockley I. , Elson R.A. , Ibbotson C.
Published: March 2018

A retrospective review of notes and radiographs to assess the clinical outcome for two groups of patients undergoing acetabular revision with impacted morsellised allograft bone, was carried out. One group received fresh frozen allograft bone (20 patients, 22 joints), and the other fresh frozen irradiated allograft bone (18 patients, 20 joints). The extent and type of graft used was recorded. Graft performance was assessed radiologically by observing evidence of collapse, incorporation, lucent lines at the site of grafting and component migration. This assessment was repeated by an independent observer. The average follow-up was thirty months for the non-irradiated grafts and fifteen months for the irradiated grafts at the time of this review. The average time taken for the grafts to show signs of incorporation was seven months for non-irradiated grafts and six months for irradiated grafts. The average time for the grafts to show physiological remodelling was similar between groups at sixteen and thirteen months respectively. There was one case of infection after a direct cup exchange with irradiated bone graft. This analysis demonstrated no obvious difference in the clinical performance of irradiated and non-irradiated morsellised bone grafts.
Prevention of Venous Thromboembolism after Hospital Discharge Continued Pharmacological Prophylaxis versus No Prophylaxis in Patients Undergoing Total Hip Replacement
Authors: Haentjens P. , Delincé P.H. ,   Members of the The Belgian Nadroparin Post-Hospital Discharge in Orthopaedics (NPHDO) Study Group (all of the following investigators and institutions also participated in the trial):, Boghemans J. , Borms T. , Brabants K. , Bremen J. , Cuyvers P. , de Brouckére G. , De Groot E , De Smet K. , Debiére I , Delincé Ph. , Demedts D. , Dewijze M. , Dierckxsens J. , Dierickx C. , Eekhaut M. , Gohimont A.-C. , Haentjens P. , Hollaert G. , Meuris S. , Michaux M. , Peck J. , van Backlé B. , van Bouchaute P. , Van Gestel J. , van Hoye M. , van Overschelde J. , Vandevyver D. , Vanlommel D. , Velghe A.
Published: March 2018

After total hip replacement, continued pharmacological prophylaxis following hospital discharge is controversial.

The primary objective of our study was to determine the safety and efficacy of continued prophylaxis with nadroparin three weeks after hospital discharge. The secondary objective was to evaluate the association between a confirmed venous thromboembolism and risk factors for deep venous thrombosis.

This study was an open-label, randomized, multicentre, prospective trial. Patients were evaluated for deep venous thrombosis with duplex ultrasonography at discharge and 3 weeks later. Walking ability (mobility score) was assessed at the same times. Patients without deep venous thrombosis at discharge were randomly assigned to continued nadroparin (n=155) versus no pharmacologic prophylaxis (n=141) for three weeks.

The rate of deep venous thrombosis three weeks post discharge was significantly lower in the nadroparin group: two patients (1.3%) versus nine (6.4%) without prophylaxis (p = 0.021; relative risk reduction = 79%). No significant difference in terms of safety was observed between groups and no major bleeding occurred.

Three weeks after discharge, patients who developed deep venous thrombosis were significantly less mobile (p = 0.018).

In conclusion, after total hip replacement, continued prophylaxis with nadroparin for 3 weeks after hospital discharge is beneficial.
The Elastic Prosthetic Acetabulum. A New Concept and Design of An Acetabular Replacement
Authors: Maumy J.P.
Published: March 2018

Purpose

Description of a new design of acetabular replacement which combines the advantages of a real elasticity of the external metallic cup, following the natural movements of the acetabulum with those of a hard rubbing couple.

Materials

A trifoliate metal back cup is described: one part, zenithal, is firm while the two others, laterals and lowers, work to adapt to movements and to gradual future changes of the acetabulum. Its special design allows the polyethylene (PE) insert to remain independent of the working parts.

Patients and Results

A clinical experimentation of only 33 cases, by precaution, has been carried out, under rules of the French Huriet's law, and is reported after a follow up of three years. This cup has already produced promising results with the average of Mèrle d'Aubigné and Postel score at 17.31/18 and a Harris hip score at 88.4 points.

Conclusion

These results are an encouragement to go ahead with its development.