bluuebunny/crossref_metadata_2025_split huggingface dataset:
The long-term efficacy and safety of fluocinolone acetonide intravitreal implant 190 μg (ILUVIEN®) in diabetic macular oedema in a multi-ethnic inner-city population
Authors: Panos Georgios D , Arruti Natalia , Patra Sudeshna 
Published: January 2020

Purpose: The purpose of this study is to report the long-term efficacy and safety of 0.19 mg fluocinolone acetonide intravitreal implant (ILUVIEN®) in pseudophakic eyes with diabetic macular oedema in a multi-ethnic patient cohort. Methods: This is a single-centre retrospective analysis of patients with persistent diabetic macular oedema, despite previous anti-vascular endothelial growth factor and/or steroid treatment, treated with the ILUVIEN implant according to national guidelines. Patients with follow-up of less than 24 months were excluded. Best corrected visual acuity, central retinal thickness and intraocular pressure were evaluated at baseline and month 3, 12, 24 and 36 post-treatment. A sub-group analysis was performed on eyes with 36-month follow-up data. Results: In total, 24 eyes (24 patients) completed at least 24 months of follow-up, of which 9 completed 36 months of follow-up. Three-fourths of the patients were black or South Asian (blacks, Asians and minority ethnic). Improvement in mean best corrected visual acuity was seen at year 1 and year 3 improving from 0.62 LogMAR at baseline to 0.55 LogMAR at year 1 and 0.47 LogMAR at year 3 (all p > 0.05). Mean central retinal thickness also showed a progressive reduction from 471 μm at baseline to 397 μm at year 1 and 339 μm at year 3 (all p < 0.05). Four eyes required intraocular pressure–lowering drops post-implant. Supplementary treatment for persistent or recurrent diabetic macular oedema was necessary in 13 eyes over the total study period of 3 years. Blacks, Asians and minority ethnic patients had a worse response compared with white patients. Conclusion: The ILUVIEN implant was effective and safe in the treatment of multi-ethnic patients with diabetic macular oedema refractory to conventional therapies, improving the vision and macular anatomy, without significant adverse events up to 36 months post-treatment.
The fate of sagittal alignment in tapered uncemented femoral components in total hip arthroplasty: 889 hips followed for a minimum of 10 years
Authors: García-Rey Eduardo 
Published: January 2020

Purpose: Aseptic loosening is rare after primary total hip arthroplasty (THA) with mostly uncemented tapered stems; however, different factors can modify the results. We question whether 3 different current femoral components and/or the surgical technique affect the clinical and radiological outcome after a minimum follow-up of 10 years. Methods: 889 uncemented tapered stems implanted from 1999 to 2007 were evaluated for a minimum follow-up of 10 years. Group 1 (273 hips) shared a conical shape and a porous-coated surface, group 2 (286 hips) a conical splined shape and group 3 (330 hips) a rectangular grit-blasted stem. Groups 1 and 2 were implanted through a posterolateral approach and group 3 using an anterolateral approach. Clinical outcomes and anteroposterior and sagittal radiographic analyses were compared. Results: No thigh pain was reported in unrevised patients. Mean Harris Hip score was lower for patients in group 3 for pain and function at all intervals. 14-year implant survival for aseptic loosening was 98.2% (95% confidence interval [CI] 96.2–100) in group 3. No revision for aseptic loosening was found with the other designs. A stem position outside neutral limits in the sagittal alignment ( p = 0.001, hazard ratio: 6.17, 95% CI, 2.05–18.61) was associated with aseptic loosening in group 3. Conclusions: Most current uncemented straight tapered femoral components can provide adequate bone fixation in primary THA after 10 years. Conical stems inserted through a posterolateral approach are more reliable than rectangular ones inserted through an anterolateral approach.
Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response
Authors: Simon-Martinez Cristina , Mailleux Lisa , Hoskens Jasmine , Ortibus Els , Jaspers Ellen , Wenderoth Nicole , Sgandurra Giuseppina , Cioni Giovanni , Molenaers Guy , Klingels Katrijn , Feys Hilde 
Published: January 2020

Introduction: Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatment response. Methods: A total of 44 children with uCP (mean 9 years 6 months, SD 1 year 10 months) participated in a 9-day camp wearing a splint for 6 h/day and were allocated to the CIMT + AOT ( n = 22) and the CIMT + placebo group ( n = 22). The CIMT + AOT group received 15 h of AOT (i.e. video-observation) and executed the observed tasks, whilst the CIMT + AOT group watched videos free of biological motion and executed the same tasks. The primary outcome measure was bimanual performance. Secondary outcomes included measures of body function and activity level assessed before (T1), after the intervention (T2), and at 6 months follow-up (T3). Influencing factors included behavioural and neurological characteristics. Results: Although no between-groups differences were found ( p > 0.05; η2 = 0–16), the addition of AOT led to higher gains in children with initially poorer bimanual performance ( p = 0.02; η2 = 0.14). Both groups improved in all outcome measures after the intervention and retained the gains at follow up ( p < 0.01; η2 = 0.02–0.71). Poor sensory function resulted in larger improvements in the total group ( p = 0.03; η2 = 0.25) and high amounts of mirror movements tended to result in a better response to the additional AOT training ( p = 0.06; η2 = 0.18). Improvements were similar irrespective of the type of brain lesion or corticospinal tract wiring pattern. Conclusions: Adding AOT to CIMT, resulted in a better outcome for children with poor motor function and high amounts of mirror movements. CIMT with or without AOT seems to be more beneficial for children with poor sensory function. Trial registration: Registered at ClinicalTrials.gov on 22nd August 2017 (ClinicalTrials.gov identifier: NCT03256357).
Nurses’ Satisfaction With Patient Room Lighting Conditions: A Study of Nurses in Four Hospitals With Differences in the Environment of Care
Authors: Davis Robert G. , McCunn Lindsay J. , Wilkerson Andrea , Safranek Sarah 
Published: January 2020

Purpose: The present study aims to contribute to current knowledge about nurses’ perceived importance of lighting in patient rooms and to compare these perceptions across different ages, work shifts, (day and night), and environments of care (traditional and contemporary). Background: Creating an environment of care in patient rooms that successfully balances energy efficiency concerns with the holistic needs of patients, families, and caregivers poses a major challenge for future lighting systems. This study adds to a growing evidence base on the effects of lighting on nurses’ job performance, job satisfaction, and overall perceptions of the environment. Method: Survey responses from 138 participants working in medical–surgical units in four hospitals were analyzed using a mixed-methods approach, with three of the hospitals having lighting systems characterized as providing a traditional environment of care (TEC) and the other hospital having lighting systems characterized as providing a contemporary environment of care (CEC). Results: No significant differences were found based on age or work shift, but several significant differences were found between participants working in the hospital with a CEC and those working in hospitals with a TEC. Participants from the hospital with a CEC lighting system consistently reported higher lighting quality, fewer patient complaints, and less need for supplemental lighting than the participants from the three hospitals with TEC lighting systems. Conclusion: The results of this study provide evidence that innovative lighting approaches and technologies are worth considering as an investment by hospital administrators looking to improve perceptions of the patient room environment.
Developing a Pedagogy of Education for Sustainable Futures: Experiences and Observations from Danish Preschools
Authors: Broström Stig , Frøkjær Thorleif 
Published: January 2020

Purpose: This article aims to outline an approach to education for sustainability based on play and science activities. Design/Approach/Methods: While deviated from traditional academic articles, this article has combined knowledge drawn from various action research projects and personal observations from a number of preschool settings. Findings: The article results in the development of an educational method: a scientific playworld to support emergent science and sustainability. Originality/Value: The constructed educational approach is value -oriented and challenges children to strike a balance between pessimism and optimism in addressing major societal themes.
Patient-Reported Outcomes Following Lumbar Decompression Surgery: A Review of 2699 Cases
Authors: Sunderland Geraint , Foster Mitchell , Dheerendra Sujay , Pillay Robin 
Published: January 2020

Study Design: Retrospective case series. Objective: Despite numerous advances in the technology and techniques available to spinal surgeons, lumbar decompression remains the mainstay of degenerative lumbar spine surgery. It has proven efficacy in trials, but only limited evidence of advantage over conservative management in large scale systematic reviews. We collated data from a large surgically managed cohort to evaluate the patient-reported outcomes. Methods: We performed a retrospective analysis of a prospectively populated database. Patient demographics, surgical details, and patient outcomes (Spine Tango core outcome measures index [COMI]–Low Back) were collected for 2699 lumbar decompression surgeries. Results: Lumbar decompression was shown to be successful at improving leg pain (mean improvement in visual analogue scale [VAS] at 3 months = 4) and to a lesser extent, back pain (mean improvement in VAS at 3 months = 2.61). Mean improvement in COMI score was 3.15 for all-comers. Minimal clinically important improvement (MCID) in COMI score (−2 points) was achieved in 73% of patients by 2-year follow-up. Primary surgery was more effective than redo surgery: odds ratio 0.547 (95% CI 0.408-0.733, P < .001). The benefits across all outcomes were maintained for the 2-year follow-up period. Patients can be classified according to their outcome as “early responders”; achieving MCID by 3 months (61% primary vs 41% redo), “late responders”; achieving MCID by 2 years (15% vs 20%) or nonresponders (24% vs 39%). Conclusions: Lumbar decompression is effective in improving quality of life in appropriately selected patients. Patient-reported outcome measures collected routinely and collated within a registry are a powerful tool for assessing the efficacy of lumbar spine interventions and allow accurate counseling of patients perioperatively.
Update on the Biomechanics of the Craniocervical Junction—Part I: Transverse Atlantal Ligament in the Elderly
Authors: Ishak Basem , Dupont Graham , Lachkar Stefan , Yilmaz Emre , Glinski Alexander Von , Altafulla Juan , Kikuta Shogo , Iwanaga Joe , Chapman Jens R , Oskouian Rod , Tubbs R. Shane 
Published: January 2020

Study Design: In vitro biomechanical study. Objective: The transverse ligament is the strongest ligament of the craniocervical junction and plays a critical role in atlanto-axial stability. The goal of this cadaveric study, and the subsequent study (part II), was to reevaluate the force required for the transverse ligament and alar ligament to fail in a more physiological biomechanical model in elderly specimens. Methods: Twelve C1-2 specimens were harvested from fresh-frozen Caucasian cadavers with a mean age at death of 81 years (range 68-89 years). Only the transverse ligament was preserved, and the bony C1-2 complex was left intact. The dens was pulled away from the anterior arch of C1 using a strength test machine that applies controlled increasing force. After testing, the axis was split in half to check for hidden pathologies and osteoporosis. The differences in the failure force between sex and age groups (group 1: <80 years, group 2: >80 years) were compared. Results: The mean force required for the transverse ligament to fail was 236.2 ± 66 N (range 132-326 N). All but 2 specimens had significant osteoporotic loss of trabecular bone. No significant differences between sex and age groups were found. Conclusions: The transverse ligament’s failure in elderly specimens occurred at an average force of 236 N, which was lower than that reported in the previous literature. The ligament’s failure force in younger patients differs and may be similar to the findings published to date.
Daily blood loss transition after total knee arthroplasty with topical administration of tranexamic acid: Paradoxical blood loss after action of tranexamic acid
Authors: Song Sang Jun , Lee Hyun Woo , Bae Dae Kyung , Park Cheol Hee 
Published: January 2020

Purpose: The purpose of this study was to compare the daily blood loss transition between groups with and without topical administration of tranexamic acid (TXA) after cruciate retaining (CR) and posterior stabilized (PS) total knee arthroplasty (TKA). Methods: A total of 220 patients undergoing unilateral TKA were enrolled in CR and PS TKAs, which were divided into groups that received topical administration of TXA (TXA group) or without TXA (non-TXA group). Each group in both types of TKA included 55 patients. The daily transition of blood loss was compared between the TXA and the non-TXA groups in CR and PS TKAs. The blood loss was calculated through Nadler formula using the patient’s blood volume and hemoglobin reduction rate. Results: Total blood loss was significantly lower in the TXA group in both CR and PS TKAs ( p < 0.001, respectively). The blood loss was lower for 0–24 h and 24–48 h after TKA. However, from 48 h to 72 h, it was greater in the TXA group (253.1 vs. 34.6 mL; p < 0.001) in CR TKAs. These tendencies were similar in PS TKAs after 48 h (186.2 vs. 134.9 mL, p = 0.223). Conclusions: Topical administration of TXA for reduction of blood loss seemed to be effective up to 48 h after both CR and PS TKAs. The blood loss after 48 h tended to be even greater in the TXA group. Future studies will be required to identify the pharmacokinetic evidence for this clinical finding. Level of evidence: Level II.
The impact of posterior epidural adipose tissue on postoperative outcomes after posterior decompression surgery for lumbar spinal stenosis: A prospectively randomized non-inferiority trial
Authors: Lee Gun Woo , Mun Jong-Uk , Ahn Myun-Whan 
Published: January 2020

Study design: The present study is a prospectively randomized study. Objective: The objective of the study was to evaluate the impact of posterior epidural adipose tissue (PAT) on postoperative outcome following lumbar decompression surgery for lumbar spinal stenosis (LSS) by whether PAT was removed or preserved during the surgical procedure. Summary of background data: In posterior decompression surgery for LSS, PAT is routinely removed without knowledge of its role and significance. However, considering adipose tissue has regenerative properties of damaged neighboring tissues or itself, PAT, which is adipose tissue located at peridural space, might also have a potential to regenerate the neighboring damaged tissue, including dura and nerve root in the lumbar spine, but this has not been thoroughly studied. Methods: Of the 185 eligible patients screened for the current study, 181 patients were enrolled and randomly allocated into either group A (PAT removal, n = 90) or group B (PAT retention, n = 91). The primary outcome measure was pain intensity on the lower back and lower extremity. The secondary outcome measures were functional outcome based on the Oswestry disability index (ODI) and walking distance, complications during the surgical procedure, and surgical outcomes. Results: Postoperative pain intensity on the lower back and lower extremity was greater in group A than in group B. Functional status on ODI and walking distance was also worse in group B than in group A (64.9% in group A and 66.2% in group B). The number of patients with aggravated pain intensity and deteriorated functional status in postoperative follow-up times was significantly greater in group A than in group B. There were no significant differences in surgical outcome and complications between the groups. Conclusion: Preserving epidural fat may be favorable in postoperative outcomes of posterior decompression surgery for LSS compared to removing epidural fat.
OsFPFL4 is Involved in the Root and Flower Development by Affecting Auxin Levels and ROS Accumulation in Rice (Oryza sativa)
Authors: Guo Yaomin , Wu Qi , Xie Zizhao , Yu Bo , Zeng Rongfeng , Min Qian , Huang Junli 
Published: January 2020

Abstract
Background
FPF1 (flowering-promoting factor 1) is one of the important family involved in the genetic control of flowering time in plant. Until now, limited knowledge concerning FPF1 family in rice has been understood.

Results
As a homologue of AtFPF1, FPF1-like protein 4 of rice (OsFPFL4) is expressed in various tissues of plants. The functions of OsFPFL4 in rice were investigated by the reverse genetics approaches. Plants overexpressing OsFPFL4 have shorter primary root, more lateral roots and adventitious roots than wild type; however, RNA interference (RNAi) of OsFPFL4 significantly inhibits the growth of root system, and also delays the flowering time in rice. Interestingly, increased or repressed expression of OsFPFL4 leads to shrunken anthers and abnormal pollen grains. It is well recognized that auxin plays important roles in plant root and flower development, and the root elongation is also regulated by reactive oxygen species (ROS) homeostasis. Here, our results show that rice plants overexpressing OsFPFL4 accumulate more auxin in the shoot and root, whereas RNAi lines have less auxin than wild type. As expected, the transcript levels of genes responsible for auxin biosynthesis and polar transport are altered in these OsFPFL4 transgenic plants. As to ROS, slightly higher ROS levels were detected in overexpression root and inflorescence than the counterparts of wild type; however, the ROS levels were significantly increased in the RNAi lines, due to increased expression of ROS-producers and reduced expression of ROS-scavengers.

Conclusion
Our results reveal that OsFPFL4 is involved in modulating the root and flower development by affecting auxin and ROS homeostasis in rice plants. OsFPFL4 controls auxin accumulation via affecting auxin biosynthesis and transport, and also modulates ROS homeostasis by balancing ROS producing and scavenging. Thus, auxin-mediated ROS production might play a role in regulating redox status, which controls plant root and flower development.
Case report: meningitis as a presenting feature of anti-NMDA receptor encephalitis
Authors: Stavrou Maria , Yeo Jing Ming , Slater Alexander David , Koch Oliver , Irani Sarosh , Foley Peter 
Published: January 2020

Abstract
Background
Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual clinical presentation of anti-NMDA receptor encephalitis with a biphasic pattern of meningitis followed by encephalitis and discuss potential mechanisms underlying this presentation. We aim to widen the differential diagnosis to be considered in a patient presenting with clinical meningitis and pyrexia.

Case presentation
This is a case of a 33-year old Caucasian woman who initially presented with a lymphocytic meningitis attributed to a viral infection. She subsequently developed fluctuating consciousness, agitation, visual hallucinations, dyskinetic movements, a generalized tonic-clonic seizure, and autonomic instability. Investigations revealed a diagnosis of anti-NMDA receptor encephalitis secondary to a previously unidentified ovarian teratoma. She made an excellent recovery with immunotherapy and removal of the teratoma.

Conclusion
Clinicians should consider autoimmune encephalitides in individuals with meningitis, particularly where extensive investigations fail to identify a causative pathogen and there is rapid development of an encephalitic phenotype.
Early diagnostic value of serum procalcitonin levels for catheter-related blood stream infection in first-ever acute ischemic stroke patients
Authors: Xu Yicheng , Chen Ruiwei , Qin Wei , Wang Peifu , Li Peiyao , Hu Wenli , Du Jichen 
Published: January 2020

Abstract
Objective
The traditional approaches for diagnosing catheter-related bloodstream infection(CRBSI) is time consuming, which could not meet the clinical requirement. Our aim was to investigate the value of serum procalcitonin(PCT) in predicting CRBSI in first-ever acute ischemic stroke patients with central venous catheters (CVCs).

Methods
This was a retrospective study. First-ever acute ischemic stroke patients hospitalized in neurological intensive care unit(NICU) of Aerospace Center Hospital and NICU of Beijing Chaoyang Hospital during January 2010 and December 2017 with clinically suspected CRBSI were enrolled. Peripheral blood white blood cell (WBC) count, neutrophils percentage(NE%), the levels of serum PCT, dwell time of catheterization and outcome of the patients were collected. According to the diagnosis of CRBSI or not, they were divided into CRBSI group and no CRBSI group. We used receiver operating characteristic curve (ROC) to evaluate the value of serum PCT levels in predicting CRBSI in patients with clinically suspected CRBSI.

Results
Forty-five patients with suspected CRBSI were included in this study, and 13 patients were diagnosed with CRBSI. Comparing to those in no CRBSI group, the maximum body temperature (Tmax) (p = 0.036) and the PCT levels (P = 0.013) in CRBSI group were both significantly higher. The area under ROC of the serum PCT levels and the Tmax to predict the CRBSI were 0.803 (0.95CI,0.660–0.946) and 0.680 (0.95CI,0.529–0.832) respectively. The PCT cut-off value was 0.780 ng/ml, with the sensitivity 69.23%, specificity 87.50%, positive predictive values 69.23% and negative predictive values 87.50%.

Conclusion
It could be helpful to adopt PCT as a rapid diagnostic biomarker for first-ever acute stroke patients with suspected CRBSI.