bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synovial Fluid Alpha-defensin Lateral Flow Assay is Specific but Not Sensitive for Periprosthetic Joint Infection in Revision Arthroplasty: A Propensity Score-matched Analysis
Authors: Yu Sze Hon , Yuen Chiu Kwong , Wong Constance , Amy Cheung , Hong Cheung Man , Kwan Chan Vincent Wai , Hilda Luk Michelle , Keung Chan Ping , Fu Henry 
Published: June 2024

Abstract

Background:
Synovial fluid alpha-defensin lateral flow assay (ADLFA) is a quick adjunctive test in diagnosing periprosthetic joint infection (PJI) after primary arthroplasty. However, evidence is lacking for postrevision arthroplasty cases. Thus, we investigated the performance of ADLFA in revision cases and compared it to a control cohort of primary arthroplasty cases.

Methods:
One hundred eleven suspected PJI cases with previous total knee or hip arthroplasty between 2017 and 2021 were retrospectively included; they were minimally followed up for 12 months after joint aspiration. Cases were stratified into the revision and control (primary) group using propensity score matching in a 1:2 ratio. The 2018 Musculoskeletal Infection Society criteria were the gold standard for PJI and the Delphi-based consensus criteria for persistent infection.

Results:
After matching, the two groups exhibited comparable baselines. The sensitivity and specificity for revision cases were 50.0% (95% confidence interval [CI] =23.0%–77.0%) and 100.0% (95% CI = 83.2%–100.0%), respectively, and for primary cases, it was 75.0% (95% CI = 55.1%–89.3%) and 100.0% (95% CI = 90.3%–100.0%), respectively. Thus, ADLFA was less sensitive for revision arthroplasty but equally specific for both primary and revision cases. Furthermore, the sensitivity for ADLFA varied considerably between revision surgeries for septic causes and aseptic causes, but specificity remained 100.0%.

Conclusion:
ADLFA was highly specific but not sensitive in diagnosing PJI in postrevision arthroplasty cases. It is suited as a convenient confirmatory adjunct alongside the existing criteria.
Assessment of Femoral and Tibial Component Rotation in Total Knee Arthroplasty Performed Using “Tensioned Gap” and “Free-floating Range of Motion” Techniques: A Computed Tomography-based Observational Study
Authors: Chandel Aaditya , Saini Naresh Kumar , Pankaj Amite 
Published: June 2024

Abstract

Background:
Total knee arthroplasty (TKA) has an excellent success rate for the treatment of advanced arthritis of the knee. Component malrotation is one of the main causes of poor outcomes. We performed this study to assess the accuracy of the “Tensioned gap” and “Free-floating Range of Motion” techniques in TKA for rotational alignment of femoral and tibial components, respectively, which do not depend on anatomical landmarks.

Materials and Methods:
This prospective observational study included 64 TKA performed on 36 patients (24 females and 12 males), during 2015–2018. The average age was 59.9 ± 7.12 years (range 50–71 years). All patients were operated on with cemented fixed-bearing cruciate substituting TKA with posterior stabilization. Femoral component rotation was determined by the “Tensioned Gap” technique, and tibial component rotation was determined by the “Free-floating Range of Motion” technique. The measurement of femoral and tibial component rotation was performed on a computed tomography scan.

Results:
The mean femoral component rotation was 2.73° ± 0.93° of external rotation, range: 1.0°–4.7° of external rotation. The mean tibial component rotation was 0.30° ± 3.97° of internal rotation, range: 10° of internal rotation to 6° of external rotation.

Conclusion:
We concluded that the “tensioned gap technique” is found to be a reliable and reproducible technique for the rotational alignment of the femoral component. Considering the number of TKA performed annually, and the data derived from the present study, the “Range of Motion” technique is not found to be a notable intraoperative method for determining the rotational position of the tibial component in relation to tibial tuberosity.
Pattern of Presentation of Retinal Vein Occlusion in a Referral Eye Hospital in Dhaka, Bangladesh
Authors: Otabor-Olubor Osayem Joseph , Anyika Fidelis Uzozie 
Published: June 2024

Abstract

Background:
Retinal vein occlusion (RVO) is an important cause of loss of vision of vascular origin, second only to diabetes retinopathy.

Aim:
This study aims to determine the pattern of presentation of RVO in a tertiary ophthalmic hospital.

Study Design:
The study design involves a hospital-based retrospective observational study.

Materials and Methods:
This study was carried out at the Retina Eye Hospital in Dhaka, Bangladesh, from June 2017 to December 2017. Details of bio-data, ophthalmic and systemic history, and ophthalmic findings were collected from the case files of 89 patients and analyzed.

Results:
The results revealed that findings from 89 eyes of 89 patients were analyzed comprising 52 females and 37 males giving a female-to-male ratio of 1.4:1 with a mean age of 52.83 years (SD ± 10.444) and with a range of 31–77 years.

Conclusion:
The study revealed that all the patients presented with sudden visual deterioration, with a mean duration of presenting complaints of 6.134 weeks, and a range of 0.3–24 weeks. Branch RVO was the predominant type (69.7%). Hypermetropia was the most common refractive error (40.4%), and hypertension was the most prevalent risk factor for patients with RVO (60.7%).
Chitosan alleviates symptoms of Parkinson’s disease by reducing acetate levels, which decreases inflammation and promotes repair of the intestinal barrier and blood–brain barrier
Authors: Wang Yinying , Chen Rongsha , Shi Guolin , Huang Xinwei , Li Ke , Wang Ruohua , Cao Xia , Yang Zhongshan , Zhao Ninghui , Yan Jinyuan 
Published: June 2024

Abstract
Studies have shown that chitosan protects against neurodegenerative diseases. However, the precise mechanism remains poorly understood. In this study, we administered chitosan intragastrically to an MPTP-induced mouse model of Parkinson's disease and found that it effectively reduced dopamine neuron injury, neurotransmitter dopamine release, and motor symptoms. These neuroprotective effects of chitosan were related to bacterial metabolites, specifically short-chain fatty acids, and chitosan administration altered intestinal microbial diversity and decreased short-chain fatty acid production in the gut. Furthermore, chitosan effectively reduced damage to the intestinal barrier and the blood-brain barrier. Finally, we demonstrated that chitosan improved intestinal barrier function and alleviated inflammation in both the peripheral nervous system and the central nervous system by reducing acetate levels. Based on these findings, we suggest a molecular mechanism by which chitosan decreases inflammation through reducing acetate levels and repairing the intestinal and blood-brain barriers, thereby alleviating symptoms of Parkinson's disease.
Topical administration of GLP-1 eyedrops improves retinal ganglion cell function by facilitating presynaptic GABA release in early experimental diabetes
Authors: Shao Yu-Qi , Wang Yong-Chen , Wang Lu , Ruan Hang-Ze , Liu Yun-Feng , Zhang Ti-Hui , Weng Shi-Jun , Yang Xiong-Li , Zhong Yong-Mei 
Published: June 2024

Abstract
Diabetic retinopathy is a prominent cause of blindness in adults, with early retinal ganglion cell (RGC) loss contributing to visual dysfunction or blindness. In the brain, defects in y-aminobutyric acid (GABA) synaptic transmission are associated with pathophysiological and neurodegenerative disorders, whereas glucagon-like peptide-1 (GLP-1) has demonstrated neuroprotective effects. However, it is not yet clear whether diabetes causes alterations in inhibitory input to RGCs and whether and how GLP-1 protects against neurodegeneration in the diabetic retina through regulating inhibitory synaptic transmission to RGCs. In the present study, we used the patch-clamp technique to record GABA subtype A receptor-mediated miniature inhibitory postsynaptic currents (mIPSCs) in RGCs from streptozotocin-induced diabetes model rats. We found that early diabetes (4 weeks of hyperglycemia) decreased the frequency of GABAergic mIPSCs in RGCs without altering their amplitude, suggesting a reduction in the spontaneous release of GABA to RGCs. Topical administration of GLP-1 eyedrops over a period of 2 weeks effectively countered the hyperglycemia-induced downregulation of GABAergic mIPSC frequency, subsequently enhancing the survival of RGCs. Concurrently, the protective effects of GLP-1 on RGCs in diabetic rats were eliminated by topical administration of exendin-9-39, a specific GLP-1 receptor antagonist, or SR95531, a specific antagonist of the GABA subtype A receptor. Furthermore, extracellular perfusion of GLP-1 was found to elevate the frequencies of GABAergic mIPSCs in both ON- and OFF-type RGCs. This elevation was shown to be mediated by activation of the phosphatidylinositol-phospholipase C/inositol 1,4,5-trisphosphate receptor/Ca2+/protein kinase C signaling pathway downstream of GLP-1 receptor activation. Moreover, multielectrode array recordings revealed that GLP-1 functionally augmented the photoresponses of ON-type RGCs. Optomotor response tests demonstrated that diabetic rats exhibited reductions in visual acuity and contrast sensitivity that were significantly ameliorated by topical administration of GLP-1. These results suggest that GLP-1 facilitates the release of GABA onto RGCs through the activation of GLP-1 receptor, leading to the de-excitation of RGC circuits and the inhibition of excitotoxic processes associated with diabetic retinopathy. Collectively, our findings indicate that the GABA system has potential as a therapeutic target for mitigating early-stage diabetic retinopathy. Furthermore, the topical administration of GLP-1 eyedrops represents a non-invasive and effective treatment approach for managing early-stage diabetic retinopathy.
Chronic dacryocystitis: An insight into bacteriology and antimicrobial sensitivity pattern
Authors: Sethi Vibhuti , Mittal Himanshu Kumar , Tuli Rajeev 
Published: June 2024

CONTEXT:
Adequate management of chronic dacryocystitis is an essential prerequisite before any intraocular surgery owing to a grave risk of endophthalmitis. The knowledge of bacteriology of chronic dacryocystitis would accentuate the choice of effective antimicrobial agents and thus help in reducing the irrational use of antimicrobial agents and subsequent development of drug resistance.

AIMS:
We aimed to identify the causative bacterial flora and study the antimicrobial sensitivity and resistance pattern in cases of chronic dacryocystitis.

SETTINGS AND DESIGN:
This was a cross-sectional observational study.

SUBJECTS AND METHODS:
Conjunctival swabs were obtained from both eyes from 102 patients with clinical evidence of chronic dacryocystitis. Specimens for microbiological analysis were obtained, either from the conjunctival cul-de-sac and everted puncta by applying pressure over the lacrimal sac area or from the refluxing material after irrigating the lacrimal sac with sterile saline. The specimens were sent for culture and sensitivity in the department of microbiology. Ethical approvals were duly obtained.

STATISTICAL ANALYSIS USED:
Percentage assessment was used for statistical analysis.

RESULTS:
The cultures showed the presence of Staphylococcus aureus in 50% of bacterial isolates obtained from the involved eyes, followed by coagulase-negative Staphylococcus in 11.53% of isolates and Enterococcus also in 11.53% of isolates. It was observed that cefoxitin was the most sensitive antibiotic against Gram-positive organisms, followed by vancomycin and clindamycin, whereas maximum resistance was seen for penicillin and ofloxacin. For Gram-negative organisms, imipenem was found to be most sensitive, followed by gentamicin and co-amoxiclav, whereas maximum resistance was seen for ciprofloxacin.

CONCLUSIONS:
It was concluded that Gram-positive bacteria predominantly S.
aureus was the most commonly isolated bacteria in cases of chronic dacryocystitis as compared to Gram-negative bacteria and cefoxitin was found to be the overall most effective antibiotic for Gram-positive bacteria.
Boergen modification of Harada-ito surgery with and without vertical muscle surgery for acquired unilateral superior oblique muscle palsy
Authors: Farvardin Hajar , Farvardin Hadi , Farvardin Majid 
Published: June 2024

PURPOSE:The purpose is to report the results of the Boergen modification of the Harada-Ito procedure with and without simultaneous vertical muscle surgery in patients with acquired unilateral superior oblique muscle palsy.PATIENTS AND METHODS:Files of patients with acquired unilateral superior oblique muscle palsy who were treated with Boergen modification of the Harada-Ito procedure were studied retrospectively. For each patient, age at the time of surgery, the presence of diplopia, compensatory head posture, and ocular deviation before and after surgery were retrieved. Results were evaluated 6 months after surgery.RESULTS:A total of 12 patients with a mean age of 32 years at the time of surgery (range 15–45 years) were included. The underlying etiology was head trauma in eleven patients. The modified Harada-Ito procedure alone was done for three cases (Group 1), and a simultaneous combination of this procedure and vertical muscle surgery was performed in nine patients (Group 2). The average intorsional effect in the primary position was 9.2° (8° in Group 1 and 9.6° in Group 2). The average correction of hypertropia in the primary position was 8.2 prism diopters (PD) (1 PD in Group 1 and 10.6 PD in Group 2). Diplopia in the primary position and downgaze were resolved in eleven patients and ten patients, respectively. Four patients had a compensatory head tilt at their last follow-up.CONCLUSIONS:Boergen modification of the Harada-Ito procedure, alone and combined with vertical muscle surgery, successfully corrected primary position diplopia in the majority of the patients.
Exploring the health and ocular hazards of gadget usage in optometry students after COVID-19 lockdown: A qualitative study
Authors: Madheswaran Gopinath , Nair Athira , Balasubramaniam Saranya Sachi , Balasubramaniam Chinnasamy 
Published: June 2024

BACKGROUND:
Prolonged screen time and abnormal postures can cause backache, neck pain, headache, and finger pain. Studies have shown that excessive usage of gadgets has increased during the coronavirus disease 2019 (COVID-19) pandemic, causing health and ocular hazards. This study used qualitative research methods to understand the health and ocular effects of gadget usage following the COVID-19 postlockdown in optometry students.

MATERIALS AND METHODS:
A qualitative study using a semi-structured face-to-face interview was conducted for undergraduate and postgraduate students in different optometry institutes who underwent at least 3 months of online teaching learning during the pandemic after obtaining informed consent. The interviews were conducted online; the sessions were audio-recorded, transcribed, and analyzed. Thematic analyses were conducted to understand the challenges faced.

RESULTS:
Twenty participants were interviewed, of which 70% (n = 14) were females. Thematic analysis identified seven major themes: gadget usage (frequency of usage, type of device, and time spent), challenges during online classes (comprehension, distraction, and network issues), ocular effects (asthenopic symptoms and ocular symptoms), health effects (musculoskeletal disorders), ways to relieve symptoms, recreational activities (breaks and entertainment), and environment and ergonomics (posture and study area and preferred lighting). All the participants reported ocular/health-related symptoms, including eye strain, burning sensation, headache, back pain, finger pain, and neck pain post the lockdown period due to prolonged gadget usage and poor ergonomic postures.

CONCLUSIONS:
Given the significant increase in digital usage following the pandemic, the study’s findings are currently relevant. The prolonged usage of gadgets and poor ergonomic postures have led to ocular and musculoskeletal problems among optometry students. To improve gadget usage without any health-related consequences, students should have access to information regarding ergonomics, increasing the blink rate, and taking regular digital breaks.
Demographic profile, prevalence, pattern, and risk factors for retinal vein occlusion in Liberia: A retrospective study
Authors: Singh Gurcharan , Pillai Shayri 
Published: June 2024

PURPOSE:
This study aims to describe the demographic profile, prevalence, pattern, and risk factors for retinal vein occlusion (RVO) in patients over 40 years of age presenting to the Liberia Eye Centre, John F Kennedy Memorial Medical Centre, Monrovia, Liberia.

SUBJECTS AND METHODS:
A retrospective study was conducted on patients presenting to Liberia Eye Centre from July 2017 to February 2021. A total of 17506 new patients were examined during this period out of which 10813 patients were over 40 years of age. Data were collected from the electronic medical record system database. The variables in the collected data included age, gender, location, laterality of eye affected, uncorrected visual acuity, best-corrected visual acuity, intraocular pressure, ocular diagnosis, systemic risk factors, and associated complications.

RESULTS:
Of the 10813 patients, RVO was found in 111 patients with an overall prevalence rate of 1.03% (95% confidence interval 0.80–1.2). Central RVO (CRVO) was more common than branch RVO (BRVO) in the defined population with similar proportions of both genders. The mean age for any RVO was 64.45 ± 12.27 standard deviation (SD) years (P = 0.734). Majority of the cases of RVO were from Lofa (n = 20; 18%). Fifty-five (61.1%) patients had hypertension, 5 (5.6%) had diabetes mellitus, and 6 (6.7%) had dyslipidemia. More than one systemic risk factor was present in 24 (26.7%) patients. However, none of the systemic risk factors were statistically significant. Visual acuity was most affected in patients with CRVO, with a visual acuity of <3/60 in 45 (63.4%) patients compared to 12 (30.0%) in BRVO patients. Glaucoma was present in 34 (30.6%) patients. The most common ocular complication was macular edema (n = 62, 55.8%) followed by vitreous hemorrhage (n = 8, 7.2%).

CONCLUSIONS:
RVO was detected in 1.03% of the study population over the age of 40 years in Liberia, CRVO being more common than BRVO. The clinical presentation of RVO in the Liberian population for the first time provides insight into the burden of the disease and opportunity for further research.
Comparison of Calcium, Vitamin D and PTH in Different Subgroups of Steroid Sensitive Nephrotic Syndrome
Authors: Sultana Jakia , Rahman Farhana , Luna Sharmin A. , Hassan Md. Nazmul , Fazal Abul , Rabby Jamal E. , Mamun Abdullah-Al , Jesmin Tahmina , Rahman Habibur , Roy Ranjit R. , Uddin Golam M. , Begum Afroza 
Published: June 2024

Background:
Steroid-sensitive nephrotic syndrome (SSNS) is frequently associated with alteration of calcium and vitamin D metabolism, including hypocalcemia, reduced serum vitamin D metabolites, and elevated levels of parathyroid hormone (PTH). These alterations occur usually due to intestinal malabsorption of calcium as well as excessive urinary losses of various vitamin D metabolites and their binding proteins which, in turn, lead to a decrease in bone mineral density. So, early identification and management of the abnormal levels of calcium, vitamin D, and PTH can ameliorate growth retardation.

Objective:
Our aim is to compare the level of calcium, vitamin D, and PTH in different subgroups of SSNS.

Materials and Methods:
This cross-sectional study was carried out in the Department of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January 2018 to June 2019. A total of 45 patients with previously diagnosed SSNS, aged 2–18 years of both sexes, were included in this study. The children were divided into three groups of 15 each. Group I comprised of 15 patients who presented with infrequent relapse nephrotic syndrome(IRNS), Group II comprised 15 patients who hadfrequent relapse nephrotic syndrome or steroid dependent nephrotic syndrome (FRNS/SDNS), and Group III comprised of 15 patients who were in remission for last 3 months without any medication. Then serum calcium, vitamin D, and PTH levels were compared among the study population.

Results:
A total of 45 patients were studied. Serum calcium was significantly lower in groups I and II compared to group III (P < 0.05). Mean serum PTH levels were 34.02 ± 15.33, 50.52 ± 19.22, and 40.33 ± 14.58 pg/mL in groups I, II, and III, respectively. Among the study group, vitamin D levels were deficient in 26 (58%), insufficient in 14 (31%), and sufficient in 5 (11%) children. Among the subgroups, mean serum vitamin D levels were 8.98 ± 1.96 ng/mL in patients with IRNS, 4.27 ± 1.37 ng/mL in FRNS/SDNS group, and 18.49 ± 7.34 ng/mL in patients who were in remission for more than 3 months. Serum vitamin D levels were low in groups I and II compared to group III, with statistically significance (P < 0.001).

Conclusion:
This study finding concluded that mean serum vitamin D levels were low in all the subgroups of SSNS children which were statistically significant. Specifically, all children with frequent relapse and steroid dependent nephrotic syndrome were vitamin D deficient.
Tumor recurrence and survival prognosis in patients with advanced gastric cancer after radical resection with radiotherapy and chemotherapy
Authors: Nie Shuang-Fa , Wang Chen-Yang , Li Lei , Yang Cheng , Zhu Zi-Ming , Fei Jian-Dong 
Published: June 2024

BACKGROUND
Advanced gastric cancer is a common malignancy that is often diagnosed at an advanced stage and is still at risk of recurrence after radical surgical treatment. Chemoradiotherapy, as one of the important treatment methods for gastric cancer, is of great significance for improving the survival rate of patients. However, the tumor recurrence and survival prognosis of gastric cancer patients after radiotherapy and chemotherapy are still uncertain.
AIM
To analyze the tumor recurrence after radical radiotherapy and chemotherapy for advanced gastric cancer and provide more in-depth guidance for clinicians.
METHODS
A retrospective analysis was performed on 171 patients with gastric cancer who received postoperative adjuvant radiotherapy and chemotherapy in our hospital from 2021 to 2023. The Kaplan-Meier method was used to calculate the recurrence rate and survival rate; the log-rank method was used to analyze the single-factor prognosis; and the Cox model was used to analyze the prognosis associated with multiple factors.
RESULTS
The median follow-up time of the whole group was 63 months, and the follow-up rate was 93.6%. Stage II and III patients accounted for 31.0% and 66.7%, respectively. The incidences of Grade 3 and above acute gastrointestinal reactions and hematological adverse reactions were 8.8% and 9.9%, respectively. A total of 166 patients completed the entire chemoradiotherapy regimen, during which no adverse reaction-related deaths occurred. In terms of the recurrence pattern, 17 patients had local recurrence, 29 patients had distant metastasis, and 12 patients had peritoneal implantation metastasis. The 1-year, 3-year, and 5-year overall survival (OS) rates were 83.7%, 66.3%, and 60.0%, respectively. The 1-year, 3-year, and 5-year disease-free survival rates were 75.5%, 62.7%, and 56.5%, respectively. Multivariate analysis revealed that T stage, peripheral nerve invasion, and the lymph node metastasis rate (LNR) were independent prognostic factors for OS.
CONCLUSION
Postoperative intensity-modulated radiotherapy combined with chemotherapy for gastric cancer treatment is well tolerated and has acceptable adverse effects, which is beneficial for local tumor control and can improve the long-term survival of patients. The LNR was an independent prognostic factor for OS. For patients with a high risk of local recurrence, postoperative adjuvant chemoradiation should be considered.