bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk of Brain Arteriovenous Malformation Hemorrhage Before and After Stereotactic Radiosurgery
Authors: Ding Dale , Chen Ching-Jen , Starke Robert M. , Kano Hideyuki , Lee John Y.K. , Mathieu David , Feliciano Caleb , Rodriguez-Mercado Rafael , Almodovar Luis , Grills Inga S. , Kondziolka Douglas , Barnett Gene H. , Lunsford L. Dade , Sheehan Jason P.
Published: May 2019

Background and Purpose—

Understanding the hemorrhage risks associated with brain arteriovenous malformations (AVMs) before and after stereotactic radiosurgery (SRS) is important. The aims of this multicenter, retrospective cohort study are to evaluate and compare the rates of pre- and post-SRS AVM hemorrhage and identify risk factors.

Methods—

We pooled AVM SRS data from 8 institutions participating in the International Radiosurgery Research Foundation. Predictors of post-SRS hemorrhage were determined using a multivariate logistic regression model. Pre- and post-SRS hemorrhage rates were compared using Fisher exact test. Ruptured and unruptured AVMs were matched in a 1:1 ratio using propensity scores, and their outcomes were compared.

Results—

The study cohort comprised 2320 AVM patients who underwent SRS. Deep AVM location (odds ratio, 1.86; 95% CI, 1.19–2.92;
P
=0.007), the presence of an AVM-associated arterial aneurysm (odds ratio, 2.44; 95% CI, 1.63–3.66;
P
<0.001), and lower SRS margin dose (odds ratio, 0.93; 95% CI, 0.88–0.98;
P
=0.005) were independent predictors of post-SRS hemorrhage. The post-SRS hemorrhage rate was lower for obliterated versus patent AVMs (6.0 versus 22.3 hemorrhages/1000 person-years;
P
<0.001). The AVM hemorrhage rate decreased from 15.4 hemorrhages/1000 person-years before SRS to 11.9 after SRS (
P
=0.001). The outcomes of the matched ruptured versus unruptured AVM cohorts were similar.

Conclusions—

SRS appears to reduce the risk of AVM hemorrhage, although this effect is predominantly driven by obliteration. Deep-seated AVMs are more likely to rupture during the latency period after SRS. AVM-associated aneurysms should be considered for selective occlusion before SRS of the nidus to ameliorate the post-SRS hemorrhage rate of these lesions.
Balloon Guide Catheter Is Beneficial in Endovascular Treatment Regardless of Mechanical Recanalization Modality
Authors: Baek Jang-Hyun , Kim Byung Moon , Kang Dong-Hun , Heo Ji Hoe , Nam Hyo Suk , Kim Young Dae , Hwang Yang-Ha , Kim Yong-Won , Kim Yong-Sun , Kim Dong Joon , Kwak Hyo Sung , Roh Hong Gee , Lee Young-Jun , Kim Sang Heum , Baik Seung Kug , Jeon Pyoung , Yoo Joonsang , Suh Sang Hyun , Kim Byungjun , Kim Jin Woo , Suh Sangil , Jeon Hong-Jun
Published: May 2019

Background and Purpose—

Based on its mechanism, the use of balloon guide catheters (BGCs) may be beneficial during endovascular treatment, regardless of the type of mechanical recanalization modality used—stent retriever thrombectomy or thrombaspiration. We evaluated whether the use of BGCs can be beneficial regardless of the first-line mechanical endovascular modality used.

Methods—

We retrospectively reviewed consecutive acute stroke patients who underwent stent retriever thrombectomy or thrombaspiration from the prospectively maintained registries of 17 stroke centers nationwide. Patients were assigned to the BGC or non-BGC group based on the use of BGCs during procedures. Endovascular and clinical outcomes were compared between the BGC and non-BGC groups. To adjust the influence of the type of first-line endovascular modality on successful recanalization and favorable outcome, multivariable analyses were also performed.

Results—

This study included a total of 955 patients. Stent retriever thrombectomy was used as the first-line modality in 526 patients (55.1%) and thrombaspiration in 429 (44.9%). BGC was used in 516 patients (54.0%; 61.2% of stent retriever thrombectomy patients; 45.2% of thrombaspiration patients). The successful recanalization rate was significantly higher in the BGC group compared with the non-BGC group (86.8% versus 74.7%, respectively;
P
<0.001). Furthermore, the first-pass recanalization rate was more frequent (37.0% versus 14.1%;
P
<0.001), and the number of device passes was fewer in the BGC group (2.5±1.9 versus 3.3±2.1;
P
<0.001). The procedural time was also shorter in the BGC group (54.3±27.4 versus 67.6±38.2;
P
<0.001). The use of BGC was an independent factor for successful recanalization (odds ratio, 2.18; 95% CI, 1.54–3.10;
P
<0.001) irrespective of the type of first-line endovascular modality used. The use of BGC was also an independent factor for a favorable outcome (odds ratio, 1.40; 95% CI, 1.02–1.92;
P
=0.038) irrespective of the type of first-line endovascular modality used.

Conclusions—

Regardless of the first-line mechanical endovascular modality used, the use of BGC in endovascular treatment was beneficial in terms of both recanalization success and functional outcome.
Topological gene expression networks recapitulate brain anatomy and function
Authors: Patania Alice , Selvaggi Pierluigi , Veronese Mattia , Dipasquale Ottavia , Expert Paul , Petri Giovanni
Published: May 2019

Understanding how gene expression translates to and affects human behavior is one of the ultimate goals of neuroscience. In this paper, we present a pipeline based on Mapper, a topological simplification tool, to analyze gene co-expression data. We first validate the method by reproducing key results from the literature on the Allen Human Brain Atlas and the correlations between resting-state fMRI and gene co-expression maps. We then analyze a dopamine-related gene set and find that co-expression networks produced by Mapper return a structure that matches the well-known anatomy of the dopaminergic pathway. Our results suggest that network based descriptions can be a powerful tool to explore the relationships between genetic pathways and their association with brain function and its perturbation due to illness and/or pharmacological challenges.
Evaluation of Convection-Permitting Precipitation Forecast Products Using WRF, NMMB, and FV3 for the 2016–17 NOAA Hydrometeorology Testbed Flash Flood and Intense Rainfall Experiments
Authors: Snook Nathan , Kong Fanyou , Brewster Keith A. , Xue Ming , Thomas Kevin W. , Supinie Timothy A. , Perfater Sarah , Albright Benjamin
Published: May 2019

During the summers of 2016 and 2017, the Center for Analysis and Prediction of Storms (CAPS) ran real-time storm-scale ensemble forecasts (SSEFs) in support of the Hydrometeorology Testbed (HMT) Flash Flood and Intense Rainfall (FFaIR) experiment. These forecasts, using WRF-ARW and Nonhydrostatic Mesoscale Model on the B-grid (NMMB) in 2016, and WRF-ARW and GFDL Finite Volume Cubed-Sphere Dynamical Core (FV3) in 2017, covered the contiguous United States at 3-km horizontal grid spacing, and supported the generation and evaluation of precipitation forecast products, including ensemble probabilistic products. Forecasts of 3-h precipitation accumulation are evaluated. Overall, the SSEF produces skillful 3-h accumulated precipitation forecasts, with ARW members generally outperforming NMMB members and the single FV3 member run in 2017 outperforming ARW members; these differences are significant at some forecast hours. Statistically significant differences exist in the performance, in terms of bias and ETS, among subensembles of members sharing common microphysics and PBL schemes. Year-to-year consistency is higher for PBL subensembles than for microphysical subensembles. Probability-matched (PM) ensemble mean forecasts outperform individual members, while the simple ensemble mean exhibits substantial bias. A newly developed localized probability-matched (LPM) ensemble mean product was produced in 2017; compared to the simple ensemble mean and the conventional PM mean, the LPM mean exhibits improved retention of small-scale structures, evident in both 2D forecast fields and variance spectra. Probabilistic forecasts of precipitation exceeding flash flood guidance (FFG) or thresholds associated with recurrence intervals (RI) ranging from 10 to 100 years show utility in predicting regions of flooding threat, but generally overpredict the occurrence of such events; however, they may still be useful in subjective flash flood risk assessment.
Aus den Gemeinden von Burgenland: Revisiting the question of Adolf Hitler’s paternal grandfather
Authors: Sax Leonard
Published: May 2019

Hans Frank was Adolf Hitler’s personal attorney. In Frank’s memoir, published seven years after his execution in 1946 at the International Military Tribunal at Nuremberg, Frank claimed to have uncovered evidence in 1930 that Hitler’s paternal grandfather was a Jewish man living in Graz, Austria, in the household where Hitler’s grandmother was employed. Contemporary historians have largely dismissed Frank’s claim, primarily on the grounds that there were purportedly no Jews living in Graz in 1836, when Hitler’s father Alois Schicklgruber was conceived. This consensus can be traced to a single historian, Nikolaus von Preradovich, who claimed that ‘not a single Jew’ ( kein einziger Jude) was living in Graz prior to 1856. No independent scholarship has confirmed Preradovich’s conjecture. In this paper, evidence is presented that there was in fact eine kleine, nun angesiedelte Gemeinde – ‘a small, now settled community’ – of Jews living in Graz before 1850. The contemporary consensus regarding Hitler’s paternal grandfather does not have a strong evidentiary basis. Other evidence, deriving from earlier sources, suggests that the contemporary consensus may be incorrect. Avenues for further research which might help to clarify the question are suggested.
When Domains Spill Over: The Relationships of Work–Family Conflict With Indian Police Affective and Continuance Commitment
Authors: Qureshi Hanif , Lambert Eric G. , Frank James
Published: May 2019

Policing is a stressful occupation that may give rise to work–family conflict (WFC). WFC arises when the work domain encroaches into the family domain, or vice versa, causing officers to become less attached to their job and the police organization. Using survey data collected from a sample of police officers in India, we examined the relationship between four dimensions of WFC (time-based, strain-based, behavior-based, and family-based WFC) and two dimensions of organizational commitment (continuance and affective). Family-based WFC was found to reduce continuance commitment, while strain-based WFC reduced affective commitment. Time-based, strain-based, and behavior-based WFC increased continuance commitment. We examined the implications of these findings for police policy makers and administrators. In addition, we also discussed our findings in the context of cross-cultural comparisons.
Self-perceived attention deficit and hyperactivity symptom levels and risk of non-migraine and migraine headaches among university students: A cross-sectional study
Authors: Carpenet Claire , Guichard Elie , Tzourio Christophe , Kurth Tobias
Published: May 2019

Objectives

The aim was to evaluate the association of self-perceived levels of attention deficit and hyperactivity symptoms with non-migraine and migraine headaches among university students. We also evaluated their association with migraine aura.

Methods

Study subjects were all participants in the internet-based Students Health Research Enterprise. Scores were built to evaluate global attention and hyperactivity symptom levels, self-perceived attention deficit levels and self-perceived hyperactivity symptom levels based on the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale (ASRS v1.1.). We used standardised questions to classify headache and group participants into “no headache,” “non-migraine headache,” “migraine without aura” or “migraine with aura”.

Results

A total of 4816 students were included (mean age 20.3 ± 2.8 years; 75.5% women). Compared with participants without headache, we found significant associations between global ADHD scores and migraine. Students in the highest quintile of global ASRS scores had adjusted odds ratio (aOR) of 1.95 (95% CI 1.56–2.45) when compared to the lowest. This association was mainly driven by an association between self-perceived hyperactivity and migraine with aura. The aOR for migraine with aura was 2.83 (95% CI 2.23–3.61) for students in the highest quintile of hyperactivity. No significant association was found for any attention and hyperactivity symptom level measure and non-migraine headache and between self-perceived levels of attention deficit and migraine.

Conclusions

Among students in higher education in France, self-perceived levels of attention deficit and hyperactivity symptoms were selectively associated with migraine. The association was strongest for the hyperactivity domain and migraine with aura.
Prevalence of Rape Myths and Sexual Double Standards Among University Students in Pakistan
Authors: Jamshed Nida , Kamal Anila
Published: May 2019

This study aimed to determine the prevalence of rape myths and sexual double standards among Pakistani university students. The sample size was 500 university students. The results indicated that 76.8 % students had more belief in rape myths, while 23.2 % had less belief on rape myths. In total, 71.4% had less sexual double standards, while 28.6 % had more sexual double standards. Furthermore, results showed that men believed more in rape myths as compared with women. Young adults of age ranging from 17 to 24 years had high sexual double standards as compared with adults of the age range of 25 to 32 years. Moreover, findings of focus group discussions (FGDs) highlighted that rape myths and sexual double standards are highly prevalent. The study revealed that Pakistani students are gender biased, as power and authority are associated with men. They also shared that rape victims in Pakistan do not get any support from family; rather, in most cases, the rape victims are killed in the name of so-called honor to maintain the reputation of family in society.
A Longitudinal Analysis of Disability-Related Interpersonal Violence and Some Implications for Violence Prevention Work
Authors: Liasidou Anastasia , Gregoriou Andros
Published: May 2019

This article explores the extent to which disabled individuals experience interpersonal violence due to victimization. Data on people injured by violence were collated directly from the accident and emergency units in hospitals. High frequency daily data were obtained from computerized records of 26 major accident and emergency departments in London for each day throughout the year of 2016. The final sample consisted of 408,000 observations. A fundamental distinction of our research lies in applying the Generalized Method of Moments system panel estimator to our sample. This makes our empirical estimates robust to endogeneity and joint determination unlike previous empirical research in this area. Data analysis provides strong evidence confirming the victimization of people with disabilities and the necessity to focus on disability equality in violence prevention work.
Leveraging Multiple Theories of Change to Promote Reform: An Examination of the AAU STEM Initiative
Authors: Kezar Adrianna J. , Holcombe Elizabeth M.
Published: May 2019

An emerging body of literature suggests that systemic efforts to change institutions are enhanced when change actors utilize multiple approaches or strategies to change that capitalize on their individual, team, or organizational assets. Given that little research in higher education has examined the ways leaders deploy multiple strategies in service of change, this study sought to fill this gap in the literature by studying an effort that deployed several strategies or theories of change. Building on emerging literature about the value of multiple theories of change, the study followed the Association of American Universities (AAU) science, technology, engineering, and mathematics (STEM) Initiative, which aimed to improve undergraduate teaching in STEM at research universities and utilized multiple theories to inform a complex strategy. This research shows the value of using multiple theories of change and also provides guidance on the best way to harness or use multiple change approaches.
Internal leakage identification of hydraulic cylinder based on intrinsic mode functions with random forest
Authors: Li Lin , Huang Yixiang , Tao Jianfeng , Liu Chengliang
Published: May 2019

Monitoring for internal leakage of hydraulic cylinders is vital to maintain the efficiency and safety of hydraulic systems. An intelligent classifier is proposed to automatically evaluate internal leakage levels based on the newly extracted features and random forest algorithm. The inlet and outlet pressures as well as the pressure differences of two chambers are chosen as the monitoring parameters for leakage identification. The empirical mode decomposition method is used to decompose the raw pressure signals into a series of intrinsic mode functions to obtain the essence in experimental signals. Then, the features extracted from intrinsic mode functions in terms of statistical analysis are formed the input vector to train the leakage detector. The classifier based on random forest is established to categorize internal leakage into proper levels. The accuracy of the internal leakage evaluator is verified by the experimental pressure signals. Moreover, an internal leakage evaluator is established based on the support vector machine algorithm, in which the wavelet transform is applied for feature extraction. The accuracy and efficiency of different classifiers are compared based on leakage experiments. The results show that the classifier trained by the intrinsic mode function features in terms of random forest algorithm may more effectively and accurately identify internal leakage levels of hydraulic cylinders. The leakage evaluator provides probability for online monitoring of the internal leakage of hydraulic cylinders based on the inherent sensors.
Toward an efficient healthcare CloudIoT architecture by using a game theory approach
Authors: de Macedo Douglas Dyllon Jeronimo , de Araújo Gustavo Medeiros , Dutra Moisés Lima , Dutra Silvana Toriani , Lezana Álvaro Guillermo Rojas
Published: May 2019

The increasing adoption of the Internet of things and cloud computing in recent years provided the increasing development and improvement of various well-known approaches, such as the ambient assisted living approach. The merging of Internet of things and cloud brought about the so-called CloudIoT paradigm. CloudIoT intends to extend both technologies to make possible developing the next generation of smart environments, such as healthcare applications. New healthcare applications demand an increasing capacity of resources for storing, processing, and transmitting data. Looking at this scenario, along with the growing number of devices connected to the Internet of things, we must consider providing mechanisms to mitigate the excessive data offloading on the network, the latency between nodes, and even the unnecessary waste of computing power. In this article, we present an efficient and effective CloudIoT-based healthcare architecture for ambient assisted living environments. The innovation of our approach lies on the use of a game theory approach (by means of a stochastic search algorithm) to improve efficiency and latency of the CloudIoT network. This proposal aims to provide better availability levels to the whole environment. Experiments performed through simulation have shown us a remarkable improvement of network parameters, by applying a stochastic search algorithm called Gur game, when compared to a baseline application.
Determinants of disability pension applications and awarded disability pensions in Finland, 2009 and 2014
Authors: Perhoniemi Riku , Blomgren Jenni , Laaksonen Mikko
Published: May 2019

Aims: Examining the non-medical determinants of applying for and being awarded disability pension is important for assessing the functionality of the disability pension system. We examined how demographic and socioeconomic factors as well as factors related to the disability process associate with the probability of applying for disability pension and the probability of applicants being awarded pension in 2009 and 2014. Methods: 70% random samples of Finnish non-retired residents aged 18–64 in 2009 ( n = 2,076,881) and in 2014 ( n = 2,097,790) were analysed with logistic regression analysis. The application rates were 0.9% in 2009 and 0.7% in 2014, and the rates of awarded pensions were 80.6% in 2009 and 72.2% in 2014. Results: Being an upper-level non-manual employee and having more employment during the preceding four calendar years decreased the odds of applying for disability pension but increased the odds of being awarded one. Older age increased the odds of both applying for and being awarded pension. Compared to applications based on mental disorders, those applying due to neoplasms and diseases of the circulatory system had increased odds of being awarded pension whereas those applying due to musculoskeletal diseases or injuries had decreased odds. Only minor temporal changes were found in the determinants of applying for or being awarded disability pension. Conclusions: With a greater probability of disability pension applications but also a lower probability of being awarded pension, the occupational disability process involves a comprehensive disadvantage for lower socioeconomic status groups.
Internet use in the home: Digital inequality from a domestication perspective
Authors: Scheerder Anique J , van Deursen Alexander JAM , van Dijk Jan AGM
Published: May 2019

This study uses a domestication approach to digital inequality. The aim is to uncover whether and why less-educated families benefit less from Internet use than highly educated families. The predominantly quantitative approach of digital divide research provides little explanation as to why digital inequalities exist. Interviews were conducted with the heads of 48 Dutch families. The results showed that Internet use and routines in the home are shaped differently for families with different educational backgrounds. In all four phases of domestication, the highly educated demonstrated a critical view toward the Internet, resulting in considered use and redefinition. Less-educated members tended to be less interested in Internet developments and overall have a less reflective stance. Inequalities between different social strata already arise in the early stages of domestication and are magnified in the subsequent phases.
Renal Autotransplant and Celiac Artery Bypass for Aneurysmal Degeneration Related to Neurofibromatosis Type 1
Authors: Drucker Natalie A. , Blaibel Maher F. , Nagaraju Santosh , Wang S. Keisin , Goggins William , Fajardo Andres
Published: May 2019

We present a case of an 18-year-old female with neurofibromatosis type 1 who presented with abdominal pain and weight loss secondary to chronic mesenteric ischemia due to celiac axis occlusion and was subsequently found to have multiple visceral artery aneurysms. Of clinical significance, 2 aneurysms of the right renal artery were noted at the hilum, with the larger one having a diameter of 2.4 cm. After initial endovascular treatment with stenting of a concurrent pancreaticoduodenal artery pseudoaneurysm, staged aorto-hepatic bypass and right nephrectomy with renal autotransplantation after back table resection of the aneurysmal segments were successfully completed.
Risk factors and predisposing conditions for urinary tract infection
Authors: Storme Oscar , Tirán Saucedo José , Garcia-Mora Arturo , Dehesa-Dávila Manuel , Naber Kurt G.
Published: May 2019

Understanding individual and population-specific risk factors associated with recurrent urinary tract infections (UTIs) can help physicians tailor prophylactic strategies. Frequent intercourse, vulvovaginal atrophy, change of the local bacterial flora, history of UTIs during premenopause or in childhood, family history, and a nonsecretor blood type are substantiated risk factors for recurrent uncomplicated UTIs. This is a narrative review based on relevant literature according to the experience and expertise of the authors. Asymptomatic bacteriuria is generally benign; however, during pregnancy it is more common and is associated with an increased likelihood of symptomatic infection, which may harm the mother or fetus. Screening of pregnant women and appropriate treatment with antimicrobials must be balanced with the potential for adverse treatment-related outcomes; appropriate prophylaxis should be considered where possible. High-quality data are currently lacking on risks related to asymptomatic bacteriuria in pregnancy and further data in this hard-to-study population should be a primary concern for researchers. Incomplete voiding represents the primary risk factor for UTIs associated with conditions such as urinary incontinence and prolapse. Correcting the presence of residual urine remains the most effective prophylaxis in these populations. Bladder function alters throughout life; however, changes in function may be particularly profound in clinical populations at high risk of UTIs. Patients with neurogenic bladder will also likely have other evolving medical issues which increase the risk of UTIs, such as repeated catheterization and increasing residual urine volume. More aggressive antimicrobial prophylactic strategies may be appropriate in these patients. Again, the paucity of data on prophylaxis in these high-risk patients requires the attention of the research community.
The Natural History of Progression in Adult Spinal Deformity: A Radiographic Analysis
Authors: Faraj Sayf S. A. , Hennepe Niek te , van Hooff Miranda L. , Pouw Martin , de Kleuver Marinus , Spruit Maarten
Published: May 2019

Study Design:

Historical cohort study.

Objective:

To evaluate progression in the coronal and sagittal planes in nonsurgical patients with adult spinal deformity (ASD).

Methods:

A retrospective analysis of nonsurgical ASD patients between 2005 and 2017 was performed. Magnitude of the coronal and sagittal planes were compared on the day of presentation and at most recent follow-up. Previous reported prognostic factors for progression in the coronal plane, including the direction of scoliosis, curve magnitude, and the position of the intercrest line (passing through L4 or L5 vertebra), were studied.

Results:

Fifty-eight patients were included with a mean follow-up of 59.8 ± 34.5 months. Progression in the coronal plane was seen in 72% of patients. Mean Cobb angle on the day of presentation and most recent follow-up was 37.2 ± 14.6° and 40.8° ± 16.5°, respectively. No significant differences were found in curve progression in left- versus right-sided scoliosis (3.3 ± 7.1 vs 3.7 ± 5.4, P = .81), Cobb angle <30° versus ≥30° (2.6 ± 5.0 vs 4.3 ± 6.5, P = .30), or when the intercrest line passed through L4 rather than L5 vertebra (3.4 ± 5.0° vs 3.8 ± 7.1°, P = .79). No significant differences were found in the sagittal plane between presentation and most recent follow-up.

Conclusions:

This is the first study that describes progression in the coronal and sagittal planes in nonsurgical patients with ASD. Previous reported prognostic factors were not confirmed as truly relevant. Although progression appears to occur, large variation exists and these results may not be directly applicable to the individual patient.
Evaluation of Heterotopic Ossification After Using Recombinant Human Bone Morphogenetic Protein–2 in Transforaminal Lumbar Interbody Fusion: A Computed Tomography Review of 996 Disc Levels
Authors: Niu Shuo , Anastasio Albert T. , Faraj Razan R. , Rhee John M.
Published: May 2019

Study Design:

Retrospective cohort study.

Objectives:

Reported incidences and complications of heterotopic ossification (HO) after using recombinant human bone morphogenetic protein–2 (rhBMP-2) in transforaminal lumbar interbody fusion (TLIF) have been inconclusive. This study was designed to evaluate both incidences of radiologic and symptomatic HO in a large series of TLIFs using rhBMP-2.

Methods:

A total of 996 disc levels in 927 consecutive TLIF patients were retrospectively evaluated at 6-month postoperative follow-up in a single surgical practice. Subjects were separated into the BMP group and the control group. Operative reports, pre- and postoperative medical records were reviewed. Computed tomography (CT) scans were analyzed and graded independently for ossification at each disc level of TLIF.

Results:

A total of 933 disc levels were in the BMP group, and 63 were in the control group. Six-month fusion rate of interbody was 92.5% in the BMP group, which was significantly higher in contrast to 71.4% in the control group ( P < .001). The incidence of radiologic HO in the BMP group was 13.5%, which was significantly higher than 1.6% in the control group ( P = .006). After controlling for basic demographics and comorbidities, the presence of radiologic HO was significantly associated with the use of rhBMP-2 ( P = .026). However, only one case in the BMP group (0.11%) developed a symptomatic HO (mild-medium left buttock pain, treated nonsurgically) involving left foramen of L5-S1.

Conclusions:

rhBMP-2 can be safely used in TLIF with regard to HO. There was a low rate of radiologic HO and minimal symptomatic HO, with high fusion rates at 6 months postoperative.
Which Factors Increase the Risk of Reoperation After Meniscal Surgery in Children?
Authors: Patel Neeraj M. , Mundluru Surya N. , Beck Nicholas A. , Ganley Theodore J.
Published: May 2019

Background:

Meniscal injuries in children can pose treatment challenges, as the meniscus must maintain its biomechanical function over a long lifetime while withstanding a high activity level. While the adult literature contains a plethora of studies regarding risk factors for failure of meniscal surgery, such reports are scarcer in children.

Purpose:

To determine the rate at which children undergoing meniscal surgery require subsequent reoperation as well as to define risk factors for reoperation in this population.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A retrospective institutional database of 907 first-time meniscal surgical procedures performed between 2000 and 2015 was reviewed. All patients were <18 years old. Demographic and intraoperative information was recorded, as were concurrent injuries or operations and subsequent procedures. Univariate analysis consisted of chi-square and independent-samples t tests. Multivariate logistic regression with purposeful selection was then performed to adjust for confounding factors.

Results:

The mean ± SD patient age was 13.2 ± 2.1 years, and 567 (63%) were male. The mean postoperative follow-up duration was 20.1 ± 10.1 months. Overall, 83 patients (9%) required repeat surgery at a mean of 23.2 months after the index operation. After adjustment for confounders in a multivariate model, meniscal repair resulted in 3.1-times higher odds of reoperation when compared with meniscectomy (95% CI, 1.2-8.3; P = .02), while white-white zone tears had 2.8-times lower odds of reoperation (95% CI, 1.01-7.7; P = .04) versus red-red and red-white zone tears.

Conclusion:

Approximately 9% of children undergoing meniscal surgery will require reoperation at a mean 23.2 months after the index operation. Repair carried approximately 3-times higher odds of reoperation than meniscectomy, while white-white zone tears had nearly 3-times lower odds of requiring repeat surgery when compared with tears in other zones.
Fractures of The Tibial Plafond: Does the Presence or Absence of a Fibular Fracture Predict Future Morbidity?
Authors: Boateng Henry , Nwachuku Chinenye , Walley Kempland C. , Walker Justin W. , MacNeille Rhett , Tornetta Paul , Reid Spence
Published: May 2019

Category:

Trauma

Introduction/Purpose:

Surgical management pilon fractures continue to be a challenge for orthopedic surgeons. Despite a staged protocol, anatomic reduction, and stable fixation, many patients will require secondary procedures including ankle arthrodesis to treat painful post-traumatic arthritis. Some investigators have correlated the absorbed energy at the time of the injury with the natural history of the pilon fracture despite the quality of the surgical reconstruction. We hypothesize that the presence of an intact fibula in association with an OTA Type C pilon fracture may be a marker for a strict axial compression mechanism resulting in more severe cartilage compression and a poor late outcome. No studies to date have correlated the presence of an intact fibula to pilon fracture outcome.

Methods:

An IRB approved 7-year retrospective study was performed at three Level I Trauma Centers. Inclusion criteria included all adult patents (=18) with isolated OTA type B or C pilon fractures from 2008 through 2014. All patients were treated in a staged fashion with initial external fixation by fellowship-trained orthopedic traumatologists. The primary outcome measurement was ankle arthrodesis. Secondary measurements included infection. Binary logistic regression models were used to evaluate prognostic factors of arthrodesis and infection. A total of 239 patients met inclusion criteria for a complete case analysis.

Results:

It was found that OTA Type C pilon fractures (OR (95% CI): 6.34 (0.80, 49.98), p=0.08), intact fibulas (OR (95% CI): 1.39 (0.43, 4.53), p=0.58), and open injuries (OR (95% CI): 2.19 (0.56, 8.55), p=0.26) were more likely to result in eventual arthrodesis compared to OTA Type B pilon fractures, fractured fibulas, and closed injuries, respectively. However, none of these unadjusted bivariate associations were statistically significant. An intact fibula was significantly less likely to result in infection compared to having a fractured fibula (OR (95% CI): 0.26 (0.08, 0.90), p=0.03), however this effect was no longer significant after accounting for open versus closed injury status (Adjusted OR (95% CI): 0.35 (0.10, 1.26), p=0.11).

Conclusion:

The results of this study suggest an adverse relationship for closed complex pilon fractures with an intact fibula. This was especially pronounced in C type injuries in comparison to type B injuries with a 6.34 odds ratio of subsequent fusion. The data approached statistical significance and may have clinical relevance in the decision making and patient counselling for managing these fractures. Pilon fractures historically have had poor outcomes and a higher rate of secondary surgeries which was surprisingly low in our current study. Further study needs to determine if this observation correlates with improved patient outcomes.
Intraretinal Migration of Emulsified Silicone Oil: Association With Cystoid Macular Edema and Surgical Treatment
Authors: Chantarasorn Yodpong , Eliott Dean
Published: May 2019

Purpose:

The purpose of this article is to report the detailed stages of intraretinal silicone oil infiltration, and to describe a new surgical treatment for this condition.

Methods:

An observational case series is presented.

Results:

We report 2 patients who had undergone repair of complex diabetic retinal detachment and subsequently developed intraretinal migration of emulsified silicone oil, cystoid macular edema (CME), and lamellar macular hole (LMH). Surgical removal of the incarcerated oil bubbles rapidly restored foveal anatomy in both cases. Possible risk factors for intraretinal oil migration are discussed.

Conclusions:

Emulsified silicone oil droplets can penetrate the retina, resulting in CME and LMH. While severe CME in this setting is usually recalcitrant to pharmacotherapy, vitrectomy with expression of oil droplets may result in rapid and longstanding resolution.
Structural basis of the leukocyte integrin Mac-1 I-domain interactions with the platelet glycoprotein Ib
Authors: Morgan Juliet , Saleem Muhammad , Ng Ruiqi , Armstrong Caroline , Wong Szu S. , Caulton Simon G. , Fickling Alice , Williams Huw E. L. , Munday Adam D. , López José A. , Searle Mark S. , Emsley Jonas
Published: May 2019

Cell-surface receptor interactions between leukocyte integrin macrophage-1 antigen (Mac-1, also known as CR3, αMβ2, CD11b/CD18) and platelet glycoprotein Ibα (GPIbα) are critical to vascular inflammation. To define the key residues at the binding interface, we used nuclear magnetic resonance (NMR) to assign the spectra of the mouse Mac-1 I-domain and mapped the residues contacting the mouse GPIbα N-terminal domain (GPIbαN) to the locality of the integrin metal ion-dependant adhesion site (MIDAS) surface. We next determined the crystal structures of the mouse GPIbαN and Mac-1 I-domain to 2 Å and 2.5 Å resolution, respectively. The mouse Mac-1 I-domain crystal structure reveals an active conformation that is stabilized by a crystal contact from the α7-helix with a glutamate side chain completing the octahedral coordination sphere of the MIDAS Mg2+ ion. The amino acid sequence of the α7-helix and disposition of the glutamic acid matches the C-terminal capping region α-helix of GPIbα effectively acting as a ligand mimetic. Using these crystal structures in combination with NMR measurements and docking analysis, we developed a model whereby an acidic residue from the GPIbα leucine-rich repeat (LRR) capping α-helix coordinates directly to the Mac-1 MIDAS Mg2+ ion. The Mac-1:GPIbαN complex involves additional interactions consolidated by an elongated pocket flanking the GPIbαN LRR capping α-helix. The GPIbαN α-helix has an HxxxE motif, which is equivalent by homology to RxxxD from the human GPIbαN. Subsequent mutagenesis of residues at this interface, coupled with surface plasmon resonance studies, confirmed the importance of GPIbαN residues H218, E222, and the Mac-1 MIDAS residue T209 to formation of the complex.
Quantitative evaluation method for clarifying ankle plantar flexion angles using anterior drawer and inversion stress tests: a cross‐sectional study
Authors: Kikumoto Takanori , Akatsuka Kazuma , Nakamura Emi , Ito Wataru , Hirabayashi Ryo , Edama Mutsuaki
Published: May 2019

Background

Chronic ankle instability (CAI) may result from repeated, frequent ankle sprains during sports activities. Manual examination for CAI is conducted; however, quantitative methods for the evaluation of CAI have not been established, and the reproducibility of the amount of stress is low. This cross‐sectional study aimed to use a stress device and ultrasound for the quantitative evaluation of the change in the length of the anterior talofibular ligament (ATFL) during simulated anterior drawer and ankle inversion stress tests.

Methods

Questionnaires were provided to 160 healthy college students (86 men, 74 women; 320 ankles). We extracted two groups from them: control subjects without a history of ankle injury (n = 64 ankles) and subjects with CAI (n = 54 ankles). We calculated the change in the length of the ATFL with anterior drawer and inversion stress tests at ankle joint plantar flexions of 0°, 20°, and 45° using ultrasound images.

Results

The anterior length change rates were significantly higher in the CAI group than in the control group at ankle joint plantar flexions of 20° and 45° in men (P < 0.05). The inversion length change rates were significantly higher in the CAI group at ankle joint plantar flexion of 20° in men (P < 0.05). No significant between‐group difference in the anterior and inversion length change rates was observed in women.

Conclusions

Stress ultrasound revealed greater length changes in the ATFL in the CAI group than in the control group. The stress test may be useful at ankle joint plantar flexion of 20° for men.
Annual Meeting Update
Authors: Winters Glenn
Published: May 2019

It's already May, and the 2019 SEG Annual Meeting is now only four months away. If you were unaware that the SEG International Exposition and 89th Annual Meeting is being held 15–20 September in San Antonio, Texas, mark it on your calendar right away and visit https://seg.org/am to learn more. Points of emphasis for this year's Annual Meeting are the unconventional plays in the Permian and Eagle Ford basins and Latin America.
Workshop explores Red Sea region
Authors: Abdelmoaty Samir
Published: May 2019

When you select the right subject to be discussed by the right experts in the right place, you will get fantastic results. That is what the SEG Middle East Advisory Committee has done by forming an outstanding Technical Committee chaired by Maurice Nessim, president of WesternGeco, and Mohamed Abdel Azim, chairman of the South Valley Egyptian Petroleum Holding Company (GANOPE).
The Meeting of Revolutionary Roads: Chilean-Cuban Interactions, 1959–1970
Authors: Pedemonte Rafael
Published: May 2019

Fidel Castro's endorsement of Salvador Allende's revolutionary program in August 1970 was determined by global transformations and changing priorities within both Chile and Cuba. Since 1968, favorable prospects for the Left encouraged Havana to abandon its radicalism premised on the inevitability of armed struggle. Prior to 1970 Chile gradually promoted rapprochement with the socialist world and lessened Cuba's hemispheric isolation, imposed by the Organization of American States. It is within this framework that the meeting between Cuba's and Chile's revolutions has to be understood. Allende, knowing that Castro's support would push the radical Left to side with Popular Unity in the 1970 elections, sent a delegation to convince the Cubans that socialism could be achieved by peaceful means. These events and strategic discussions within Chile and Cuba reveal how the history of the Left needs to be placed in a broad context defined by the complex unfolding of domestic, hemispheric, and international transformations shaping Latin America in the 1960s.
Structural Interpretation of Vector Autoregressions with Incomplete Identification: Revisiting the Role of Oil Supply and Demand Shocks
Authors: Baumeister Christiane , Hamilton James D.
Published: May 2019

Traditional approaches to structural vector autoregressions (VARs) can be viewed as special cases of Bayesian inference arising from very strong prior beliefs. These methods can be generalized with a less restrictive formulation that incorporates uncertainty about the identifying assumptions themselves. We use this approach to revisit the importance of shocks to oil supply and demand. Supply disruptions turn out to be a bigger factor in historical oil price movements and inventory accumulation a smaller factor than implied by earlier estimates. Supply shocks lead to a reduction in global economic activity after a significant lag, whereas shocks to oil demand do not. (JEL C32, L71, Q35, Q43)
Walk on the Wild Side: Temporarily Unstable Paths and Multiplicative Sunspots
Authors: Ascari Guido , Bonomolo Paolo , Lopes Hedibert F.
Published: May 2019

We propose a generalization of the rational expectations framework to allow for temporarily unstable paths. Our approach introduces multiplicative sunspot shocks and it yields drifting parameters and stochastic volatility. Then, we provide an econometric strategy to estimate this generalized model on the data. The methodology allows the data to choose between different possible alternatives: determinacy, indeterminacy, and temporary instability. We apply our methodology to US inflation dynamics in the 1970s through the lens of a simple New Keynesian model. When temporarily unstable paths are allowed, the data unambiguously select them to explain the stagflation period in the 1970s. (JEL D84, E12, E31, E32, E52)
Payroll Taxes, Firm Behavior, and Rent Sharing: Evidence from a Young Workers' Tax Cut in Sweden
Authors: Saez Emmanuel , Schoefer Benjamin , Seim David
Published: May 2019

This paper uses administrative data to analyze a large employer-borne payroll tax rate cut for young workers in Sweden. We find no effect on net-of-tax wages of young treated workers relative to slightly older untreated workers, and a 2–3 percentage point increase in youth employment. Firms employing many young workers receive a larger tax windfall and expand right after the reform: employment, capital, sales, and profits increase. These effects appear stronger in credit-constrained firms. Youth-intensive firms also increase the wages of all their workers collectively, young as well as old, consistent with rent sharing of the tax windfall. (JEL H25, H32, J13, J23, J31, M51)
Comprometimento organizacional: estudo com recepcionistas de consultórios médicos de Belo Horizonte-MG
Authors: Ferreira Jesuina Maria Pereira , Rocha Michelle De Souza , Jerônimo Giselle Da Costa
Published: May 2019

O objetivo desta pesquisa foi analisar o comprometimento organizacional por meio do modelo multidimensional de Meyer e Allen (1991), segundo a percepção de mulheres recepcionistas de consultórios médicos em Belo Horizonte-MG. Caracterizou-se esta pesquisa como de método misto (COLLIS; HUSSEY, 2006) e do tipo descritivo-exploratório (VERGARA, 2009). Utilizou-se para análise dos dados quantitativos o software Statistical Package for the Social Science (SPSS) e a análise de conteúdo (AC) (BARDIN, 2008) para apreciação das entrevistas. Na investigação quantitativa, constatou-se o predomínio da dimensão afetiva do comprometimento organizacional com média no nível moderado mais alto. Por outro lado, mesmo que nas análises qualitativas as dimensões afetiva e instrumental tenham sido predominantes nos relatos das mulheres entrevistadas, ao final, é por meio da dimensão afetiva que as recepcionistas permanecem na organização, significando que elas gostam e fazem seu trabalho por amor, valorizando o ambiente de trabalho e os relacionamentos interpessoais conquistados.
Laparoscopic Surgery in the treatment of children with Choledochal Cyst
Authors: Qu Xiushui , Cui Lihua , Xu Junchao
Published: May 2019

Objective: To evaluate the clinical effectiveness of laparoscopic surgery in the treatment of children with choledochal cyst.

Methods: Seventy-six children with congenital choledochal cyst who were admitted to our hospital between February 2016 and April 2017 were selected as research subjects. They were evenly divided into an observation group and a control group using random number table, 38 each group. Patients in the observation group underwent laparoscopic surgery, while patients in the control group underwent the traditional laparotomy. Surgery related indicators and prognosis were compared between the two groups.

Results: The incision size and intraoperative bleeding volume of the observation group were significantly smaller than those of the control group (P<0.05). The time of passage of flatus and time to take food of the observation group were easier than those of the control group, and the duration of hospitalization and parenteral nutrition of the former was significantly shorter than those of the latter, and the difference had statistical significance (P<0.05). The incidence of postoperative complications in the observation group was 2.6%, significantly lower than that in the control group (10.5%) (P<0.05). There was no recurrence in the observation group during the follow-up period, but there were 5 cases of recurrence (13.1%) in the control group; the difference was statistically significant (P<0.05).

Conclusion: Compared with the traditional laparotomy, laparoscopic surgery conforms more to the concept of modern medical minimally invasive treatment and has a significant clinical effect in the treatment of congenital choledochal cyst in children. It can effectively promote the disappearance of clinical symptoms and signs, reduce the incidence of postoperative complications and disease recurrence, and improve the surgical efficacy, suggesting high clinical significance and application values.

doi: https://doi.org/10.12669/pjms.35.3.85

How to cite this:Qu X, Cui L, Xu J. Laparoscopic Surgery in the treatment of children with Choledochal Cyst. Pak J Med Sci. 2019;35(3):807-811.  doi: https://doi.org/10.12669/pjms.35.3.85

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.