bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lorlatinib induced proteinuria: A case report
Authors: Lee Chung-Shien , Wanchoo Rimda , Seetharamu Nagashree 
Published: September 2020

Introduction Lorlatinib is an oral anaplastic lymphoma kinase (ALK) and C-ros oncogene (ROS1) tyrosine kinase inhibitor with excellent central nervous system (CNS) penetrability. It is currently approved for use as second line therapy for those with ALK positive non-small cell lung cancer (NSCLC). Given its CNS penetrating effects, lorlatinib has shown to cause CNS adverse events such as seizures, hallucinations, and changes in cognitive function. To our knowledge proteinuria has not been previously described with this medication. Case Report We report a case lorlatinib induced proteinuria in a patient receiving lorlatinib as second line treatment for ROS1 rearranged NSCLC. Management & Outcome: The patient’s dose was reduced from 100 mg to 75 mg and further down to to 50 mg daily. At that point the proteinuria improved. Other adverse events attributable to the medication, specifically hallucinations and peripheral neuropathy also improved. Discussion Our case demonstrates objective evidence for proteinuria induced by lorlatinib, which may also be dose dependent.
Living Heritage: An Experimental Model Mixing Heritage and Entertainment
Authors: Saxe David W. 
Published: September 2020

The living heritage model is portable and may be replicated by venues of all sizes and budgets. The model may also be scaled to match venue space requirements as well as be adjusted to available human, tangible, and financial resources. Led by Colonial Williamsburg, Mount Vernon, Old Sturbridge Village, and other history-heritage sites, the museum, history-heritage industry is poised to fully embrace the opportunities and potentials that scripted entertainment projects hold for their institutions. The living heritage model is one example of what might be done to instill and invigorate historical interest among the general public.
Beyond the Basics
Authors: Buck Olivia 
Published: September 2020

Much has been written about accessible text, regarding word counts, active rather than passive tense, straightening out sub-clauses and so on. This is now becoming embedded in good museum writing practice. At the British Museum, our aim is to maximize visitors’ engagement with our collections. Beyond the basic guidelines outlined above and in the light of the results of recent visitor research and evaluation we have begun to look again at the way in which we write interpretive text. This article focuses on writing text for permanent galleries, rather than temporary exhibitions, and uses the recent Japan Gallery as a case study. The article also aims to provide some practical tips for writing and the interpretation process.
Reflections on Educational Leadership & Innovation: An Agenda for New Research
Authors: Wolins Inez S. 
Published: September 2020

Park Service and museum professionals live by a multitude of calendar demands that seem to define their days; from grant submissions to shipping dates, from project reports to newsletter deadlines, it isn't easy to build in time for reflection and analysis, let alone the development of strategies that help visitors have meaningful connections and experiences with our resources. In addition, organizational cultures can sometimes feel chaotic, or they can move at a snail's pace, so when professionals are identified as real innovators, they're “Googled,” “friended,” or “followed,” and they're invited to present and publish. There is no doubt in my mind that innovators have resolve and push the limits. They tackle challenges, question assumptions, create richer visitor experiences, get results, and raise the bar for the field. So how do we achieve dramatic outcomes as a result of, or in spite of, organizational cultures?
Analysis of Best Practices for Interpretation Development at Public Gardens
Authors: Tschaenn Nate M. , Lyons Robert E. , Miles Dottie , Bruck Jules 
Published: September 2020

Interpretation can be the most effective way for public gardens to communicate with their audiences. However, many public gardens struggle to understand interpretation and how to best develop it. A survey conducted of professionals at 174 different public gardens investigated various approaches to interpretation development and their effect on the perceived quality of interpretation and interpretation development practices of the organization. These approaches included staff and volunteer training, planning documents, evaluation, and staff composition. The results of this study revealed many interpretive development practices that are yielding significant benefits for public gardens. The data also revealed that the majority of public gardens have significant room for improvement with regard to interpretation development. For instance, organizations were more likely to be satisfied with the interpretive media that they routinely evaluated, but few routinely conducted evaluation. Recommendations that should help guide decision-making at public gardens resulting from this research are discussed.
An Investigation into the Impact of Environmental Education Certification on Perceptions of Personal Teaching Efficacy
Authors: Harrison Mandy , Gross Lisa , McGee Jennifer 
Published: September 2020

The purpose of this study is to examine how participation in the North Carolina Environmental Educator (NCEE) program influences the individual's perceived self-efficacy. Specifically, this study examines the impact of NCEE certification on participants’ perceived personal teaching self-efficacy. This study compared personal teaching efficacy scores of certified environmental educators, non-certified environmental educators, and licensed schoolteachers. The study found significant differences in teaching efficacy between certified and non-certified environmental educators, as well as certified environmental educators and licensed school teachers. In addition, the study found no significant difference in efficacy scores between NCEE certified licensed school teachers and NCEE certified environmental educators. Results of this study indicate a link between environmental education certification and higher personal teaching efficacy.
Capsular bag performance of a novel hydrophobic acrylic single-piece intraocular lens: Two-year results of a randomised controlled trial
Authors: Fișuș Andreea D , Hirnschall Nino D , Maedel Sophie , Fichtenbaum Maria , Draschl Petra , Findl Oliver 
Published: September 2020

Purpose: To determine the visual outcome, intraocular lens (IOL) stability and posterior capsule opacification (PCO) rate of a hydrophobic acrylic intraocular lens. Setting: Vienna Institute for Research in Ocular Surgery, Hanusch Hospital, Vienna, Austria Design: This double-masked randomised study included patients who underwent standard cataract surgery. Method: Patients received either the hydrophobic acrylic IOL (iPure, PhysIOL) or the hydrophobic acrylic control IOL (Tecnis ZCB00, Johnson&Johnson). Subjective refraction, uncorrected and corrected distance visual acuity (UDVA, CDVA), IOL tilt and decentration (Purkinje meter) and PCO intensity using retroillumination images with automated image analysis (automated quantification of after-cataract, AQUA), were evaluated for both groups 2 years after surgery. Results: A total number of 31 patients completed the 2-year follow-up, 16 in the study group and 15 in the control group. The CDVA was 0.0 logMAR (standard deviation – SD: 0.1) for the study IOL and 0.1 logMAR (SD: 0.2) for the control IOL, p = 0.001. The AQUA PCO score for the study group was 2.1 and 1.4 for the control group, p = 0.44. Mean IOL tilt was 2.9° (SD: 1.8) in the study group and 5.0° (SD: 4.5) in the control group, whilst the mean decentration was 0.37 mm (SD: 0.18) and 0.45 mm (SD: 0.3), p = 0.610. Conclusion: The studied parameters revealed a good performance for both IOLs. Both IOLs had good CDVA, a small amount of tilt and decentration and none of the patients required laser capsulotomies during the follow-up time of 2 years after surgery. Presented at the 37th ESCRS Congress Paris, France, September 2019
Analysis of intravitreal bevacizumab treatment for macular oedema due to retinal vein occlusion
Authors: Balla Szabolcs , Zold Eszter , Potor Laszlo , Lukucz Balazs , Vajas Attila , Ujhelyi Bernadett , Nagy Valeria 
Published: September 2020

Purpose: Our aim was to analyse the clinical effect of intravitreal bevacizumab treatment for macular oedema due to central/branch retinal vein occlusion (CRVO/BRVO). The end points were final best-corrected visual acuity (BCVA), BCVA improvement, final central 1-mm macular subfield thickness (CST) and change in CST. Methods: Our study included 34 CRVO and 25 BRVO patients. Patients received intravitreal bevacizumab (IVB) treatment at our department. Our control group consisted of 50 CRVO and 30 BRVO patients, who had not received this treatment because their disease developed before the anti-VEGF treatment became available. For statistical analysis, two-sample t-test, Pearson’s correlation, and ANOVA were used. The level of significance was defined at p < 0.05. Results: With the two-sample t-test we found significant improvement of BCVA in the IVB-treated group (CRVO: 0.171 ± 0.270, p1 = 3.25×10-4; BRVO: 0.215 ± 0.282, p2 = 5.52×10-4). The difference in BCVA improvement was also significant compared to the control group (CRVO: p1 = 3.46×10-4; BRVO: p2 = 0.003). Significant decrease was observed in the CST in the treated group (CRVO: -345.114 ± 280.577, p1 = 6.94×10-9; BRVO: –151.875 ± 174.341, p2 = 1.67×10-4). In case of BRVO patients the final BCVA was significantly better in the treated group (0.617 ± 0.334) compared to the control group (0.406 ± 0.357), p = 0.016. Conclusion: IVB treatment results in significantly better final visual acuity and leads to significantly increased BCVA improvement compared to patients with RVO-induced macular oedema receiving no treatment.
Prehospital tele-electrocardiographic triage improves the management of acute coronary syndrome in rural populations: A systematic review and meta-analysis
Authors: Lazarus Gilbert , Kirchner HL , Siswanto Bambang B 
Published: September 2020

Introduction Acute coronary syndrome (ACS) patients residing in rural areas are predisposed to higher risk of poor outcomes due to substantial delays in disease management, emphasising the importance of emerging telecardiology technologies in delivering emergency services in such settings. This meta-analysis aimed to investigate the impacts of prehospital telecardiology strategies on the clinical outcomes of rural ACS patients. Methods A literature search was performed of articles published up to April 2020 through six databases. Included studies were assessed for bias risk using the ROBINS-I tool, and a random-effects model was utilised to estimate effect sizes. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results Twelve studies with a total of 3989 patients were included in this review. Prehospital telecardiology in the form of tele-electrocardiography (tele-ECG) enabled prompt diagnosis and triage, resulting in a decreased door-to-balloon (DTB) time (mean difference = –25.53 minutes, 95% confidence interval (CI) –36.08 to –14.97 minutes; I2 = 98%), as well as lower in-hospital mortality (odds ratio (OR) = 0.57, 95% CI 0.36–0.92) and long-term mortality (OR = 0.52, 95% CI 0.39–0.69) rates, both with negligible heterogeneity ( I2 = 0%). GRADE assessment yielded very low to moderate certainty of evidence. Conclusion Prehospital tele-ECG appeared to be an effective and worthwhile approach in the management of rural ACS patients, as shown by moderate quality evidence on lower long-term mortality. Given the uncertainties of the evidence quality on DTB time and in-hospital mortality, future studies with a higher quality of evidence are required to confirm our findings.
The Effects of Acupuncture on Cancer-Related Fatigue: Updated Systematic Review and Meta-Analysis
Authors: Jang Andrew , Brown Chris , Lamoury Gillian , Morgia Marita , Boyle Frances , Marr Isobel , Clarke Stephen , Back Michael , Oh Byeongsang 
Published: September 2020

Background Several studies have identified fatigue as one of the major symptoms experienced during and after cancer treatment. However, there are limited options to manage cancer related fatigue (CRF) with pharmacological interventions. Several acupuncture studies suggested that acupuncture has a positive impact on CRF. This review aims to assess the evidence of acupuncture for the treatment of CRF. Method Electronic database searches were conducted on 4 English databases (Medline, PubMed, Embase, and ScienceDirect). Search keywords were; “acupuncture” and “cancer,” or “cancer related fatigue.” Studies published as full text randomized controlled trials (RCTs) in English were included. Estimates of change in fatigue cores were pooled using a random effects meta-analysis where randomized comparisons were available for true acupuncture versus sham acupuncture and true acupuncture versus usual care. The quality of original papers were assessed using the Cochrane Collaboration’s tool for assessing risk of bias (ROB). Results Nine RCTs were selected for review with a total of 809 participants and a range of 13 to 302 participants within the studies. Six RCTs reported significant improvement of CRF for the acupuncture intervention compared to the control groups. Pooled estimates suggest Brief Fatigue Inventory scores are 0.93 points lower 95% CI (−1.65, −0.20) in true acupuncture versus sham acupuncture and 2.12 points lower 95% C (−3.21, −1.04) in true acupuncture versus usual care. Six studies had low risk of bias (ROB) and 3 studies had a moderate ROB predominantly in blinding of participants, blinding of assessors and incomplete data outcomes. Among the 9 RCTs, 2 studies have reported the occurrence of minor adverse effects (spot bleeding and bruising) related to acupuncture treatment. No serious adverse reactions related to acupuncture were reported. Conclusion The current literature review suggests that acupuncture has therapeutic potential in management of CRF for cancer survivors. Promotion of acupuncture in cancer care to manage CRF may improve the quality of life of cancer survivors.
Overexpression of p53 accelerates puberty in high-fat diet–fed mice through Lin28/let-7 system
Authors: Chen Ting , Chen Cailong , Wu Haiying , Chen Xiuli , Xie Rongrong , Wang Fengyun , Sun Hui , Chen Linqi 
Published: September 2020

High fat intake is one of the most important reasons of the surging prevalence of childhood obesity all over the world. Obesity and high fat intake have been revealed to cause premature activation of hypothalamo-pituitary-gonadal axis and central precocious puberty. The onset of puberty is controlled by neuroendocrine mechanisms containing overlapping and interacting gene networks. The latter contains five major transcriptional level hubs, among which the transcriptional factor p53, a well-established tumor suppressor protein, also plays a crucial role in obesity and metabolic disorders. In the current study, we repeated prior observations that high-fat diet advances vaginal opening in rodents and extended these findings by demonstrating that high-fat diet mice had higher expression of p53 in hypothalami than mice fed with normal chow. More importantly, in high-fat diet mice, hypothalamus-specific overexpression of p53 can make vaginal opening much earlier, while inhibition of p53 expression relatively delayed vaginal opening. The c-Myc and Lin28b levels increased, while let-7a mRNA levels decreased in the high-fat diet mice. Overexpression of p53 reduced c-Myc and Lin28b mRNA and protein levels, whereas elevated let-7a mRNA levels in high-fat diet mice. Inhibition of p53 expression by pifithrin-α elevated c-Myc and Lin28b but reduced let-7a levels in high-fat diet mice. In conclusion, high fat intake can accelerate the onset of puberty by up-regulation of p53 expression in hypothalamus. Overexpressed p53 may accelerate hypothalamo-pituitary-gonadal axis activation partially through the c-Myc/Lin28/let-7 system. Impact statement High-fat intake and subsequent obesity are associated with premature onset of puberty, but the exact neuroendocrine mechanisms are still unclear. The transcriptional factor p53 has been predicted to be a central hub of the gene networks controlling the pubertal onset. Besides, p53 also plays crucial roles in metabolism. Here, we explored p53 in the hypothalami of mice fed a high-fat diet (HFD), which showed an up-regulated expression. Besides, we also revealed that overexpressed p53 may accelerate hypothalamo-pituitary-gonadal (HPG) axis activation partially through the c-Myc/Lin28/let-7 system. These results can deepen our understanding of the interaction between metabolic regulation and puberty onset control, and may shed light on the neuroendocrine mechanisms of obesity-related central precocious puberty.
The association between computed tomography angiography timing and workflow times in patients with acute ischemic stroke
Authors: Dessens Femke M , Groot Adrien E , van der Veen Bas , Treurniet Kilian M , Majoie Charles BLM , Driessen-Waaijer Annet , Weinstein Henry C , Roos Yvo BWEM , Van den Berg-Vos Renske M , Coutinho Jonathan M , van Schaik Sander M 
Published: September 2020

Background In most hospitals, computed tomography angiography (CTA) is nowadays routinely performed in patients with acute ischemic stroke. However, it is unclear whether CTA is best performed before or after start of intravenous thrombolysis (IVT), since acquisition of CTA before IVT may prolong door-to-needle times, while acquisition after IVT may prolong door-to-groin times in patients undergoing endovascular treatment. Methods We performed a before-versus-after study (CTA following IVT, period I and CTA prior to IVT, period II), consisting of two periods of one year each. This study is based on a prospective registry of consecutive patients treated with IVT in two collaborating high-volume stroke centers; one primary stroke center and one comprehensive stroke center. The primary outcome was door-to-needle times. Secondary outcomes included door-to-groin times. Quantile regression analyses were performed to evaluate the association between timing of CTA and workflow times, adjusted for prognostic factors. Results A total of 519 patients received IVT during the study period (246 in period I, 273 in period II). In the adjusted analysis, we found a nonsignificant 1.13 min median difference in door-to-needle times (95% confidence interval: 1.03–3.29). Door-to-groin times was significantly shorter in period II in both unadjusted and adjusted analysis with the latter showing a 19.16 min median difference (95% confidence interval: 3.08–35.24). Conclusions CTA acquisition prior to start of IVT did not adversely affect door-to-needle times. However, a significantly shorter door-to-groin times was observed in endovascular treatment eligible patients. Performing CTA prior to start of IVT seems the preferred strategy.
Inter- and intra-core laboratory variability in the quantitative coronary angiography analysis for drug-eluting stent treatment and follow up
Authors: Ito Shigenori , Kinoshita Kanako , Endo Akiko , Kami Ryoko , Kotake Yuko , Nakamura Masato 
Published: September 2020

Aim: To evaluate inter-core laboratory variability of quantitative coronary angiography (QCA) parameters in comparison with intra-core laboratory variability in a randomized controlled trial evaluating drug-eluting stents. Methods: A total of 50 patients with 62 coronary lesions were analyzed by four analysis experts belonging to an Angiographic Core Laboratory (ACL: 1 expert) and a Cardiovascular Imaging Core Laboratory (CICL: 3 experts). QCA was based on the same standard operating procedure, but selections of projection and cine frames were at the discretion of each analyst. Inter- and intra-core laboratory variabilities were evaluated by accuracy, precision, Bland Altman analysis, and coefficient of variation. Results: Pre-MLD (minimal lumen diameter) was significantly smaller in results from ACL than those from all CICL experts. Number of analyzed projections did not affect pre-MLD results. Acute gain was larger in ACL than in CICL2. No significant difference was observed in late loss and loss index between inter-core laboratories. Agreement between core labs in the Bland-Altman analysis for each QCA parameter was as follows (mean difference, 95% limits of agreement): pre-MLD (–0.32, –0.74 to 0.10), stent MLD (0.08, –0.28 to 0.44), acute gain (0.22, –0.44 to 0.88), and late loss (–0.07, –0.69 to 0.55). Agreement between analysts in CICL (mean difference, 95% limits of agreement) was: pre MLD (–0.03, –0.37 to 0.31), stent MLD (0.15, –0.15 to 0.45), acute gain (0.05, –0.45 to 0.55), and late loss (0.04, –0.52 to 0.60). The widest limits of agreement among three analyses were shown in both analyses. Width of limited agreement in the intra-core laboratory analysis tended to be smaller than the inter-core laboratory analysis with these parameters. Coefficient of variation tended to be larger in lesion length (LL), acute gain, late loss, and loss index in inter- and in intra- core laboratory comparisons. Conclusion: Inter-core laboratory QCA variability in late loss and loss index analysis could be similar to intra-core laboratory variability, but more strict alignment between core laboratories would be necessary for initial procedural data analysis.
PD-L1 and prognosis in patients with malignant pleural mesothelioma: a meta-analysis and bioinformatics study
Authors: Jin Liu , Gu Weiling , Li Xueqin , Xie Liang , Wang Linhong , Chen Zhongwen 
Published: September 2020

Background: The prognostic value of programmed death-ligand 1 (PD-L1) expression in patients with malignant pleural mesothelioma (MPM) has been controversial according to previous investigations. Therefore, we conducted a meta-analysis to assess the potential prognostic significance of PD-L1 expression in MPM. Methods: PubMed, Embase, Web of Science, Scopus, and the Cochrane Library were thoroughly searched for relevant original articles published before 9 April 2020. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) of overall survival (OS) and progression-free survival (PFS) were calculated. The results of the meta-analysis were verified using The Cancer Genome Atlas (TCGA) dataset. Results: In total 16 studies were included in our meta-analysis. A high PD-L1 expression was associated with a poor OS (HR = 1.53, 95% CI = 1.28–1.83, p < 0.001), but not a grave PFS (HR = 1.07, 95% CI = 0.82–1.39, p = 0.643) in MPM. Furthermore, the PD-L1 expression correlated with the sarcomatoid + biphasic type of MPM (odds ratio = 4.32, 95% CI = 2.16–8.64, p < 0.001). TCGA data indicated that PD-L1 was a significant prognostic factor for OS (HR = 2.069, 95% CI = 1.136–3.769, p = 0.0175), but not for PFS (HR = 1.205, 95% CI = 0.572–2.539, p = 0.624), which was in accordance with the results of the meta-analysis. Conclusion: A high PD-L1 expression is a significant prognostic factor for poor OS of patients with MPM. We therefore suggest that PD-L1 expression levels can be used to predict the clinical outcomes of patients with MPM in the future.