bluuebunny/crossref_metadata_2025_split huggingface dataset:
FLAIRectomy in Supramarginal Resection of Glioblastoma Correlates With Clinical Outcome and Survival Analysis: A Prospective, Single Institution, Case Series
Authors: Certo Francesco , Altieri Roberto , Maione Massimiliano , Schonauer Claudio , Sortino Giuseppe , Fiumanò Giuseppa , Tirrò Elena , Massimino Michele , Broggi Giuseppe , Vigneri Paolo , Magro Gaetano , Visocchi Massimiliano , Barbagallo Giuseppe M V 
Published: October 2020

Abstract

Background
Extent of tumor resection (EOTR) in glioblastoma surgery plays an important role in improving survival.

Objective
To analyze the efficacy, safety and reliability of fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) images used to guide glioblastoma resection (FLAIRectomy) and to volumetrically measure postoperative EOTR, which was correlated with clinical outcome and survival.

Methods
A total of 68 glioblastoma patients (29 males, mean age 65.8) were prospectively enrolled. Hyperintense areas on FLAIR images, surrounding gadolinium-enhancing tissue on T1-weighted MR images, were screened for signal changes suggesting tumor infiltration and evaluated for supramaximal resection. The surgical protocol included 5-aminolevulinic acid (5-ALA) fluorescence, neuromonitoring, and intraoperative imaging tools. 5-ALA fluorescence intensity was analyzed and matched with the different sites on navigated MR, both on postcontrast T1-weighted and FLAIR images. Volumetric evaluation of EOTR on T1-weighted and FLAIR sequences was compared.

Results
FLAIR MR volumetric evaluation documented larger tumor volume than that assessed on contrast-enhancing T1 MR (72.6 vs 54.9 cc); residual tumor was seen in 43 patients; postcontrast T1 MR volumetric analysis showed complete resection in 64 cases. O6-methylguanine-DNA methyltransferase promoter was methylated in 8/68 (11.7%) cases; wild type Isocytrate Dehydrogenase-1 (IDH-1) was found in 66/68 patients. Progression free survival and overall survival (PFS and OS) were 17.43 and 25.11 mo, respectively. Multiple regression analysis showed a significant correlation between EOTR based on FLAIR, PFS (R2 = 0.46), and OS (R2 = 0.68).

Conclusion
EOTR based on FLAIR and 5-ALA fluorescence is feasible. Safety of resection relies on the use of neuromonitoring and intraoperative multimodal imaging tools. FLAIR-based EOTR appears to be a stronger survival predictor compared to gadolinium-enhancing, T1-based resection.
Anterior Lumbar Interbody Fusion With Cage Retrieval for the Treatment of Pseudarthrosis After Transforaminal Lumbar Interbody Fusion: A Single-Institution Case Series
Authors: Safaee Michael M , Tenorio Alexander , Haddad Alexander F , Wu Bian , Hu Serena S , Tay Bobby , Burch Shane , Berven Sigurd H , Deviren Vedat , Dhall Sanjay S , Chou Dean , Mummaneni Praveen V , Eichler Charles M , Ames Christopher P , Clark Aaron J 
Published: October 2020

Abstract

BACKGROUND
The treatment of pseudarthrosis after transforaminal lumbar interbody fusion (TLIF) can be challenging, particularly when anterior column reconstruction is required. There are limited data on TLIF cage removal through an anterior approach.

OBJECTIVE
To assess the safety and efficacy of anterior lumbar interbody fusion (ALIF) as a treatment for pseudarthrosis after TLIF.

METHODS
ALIFs performed at a single academic medical center were reviewed to identify cases performed for the treatment of pseudarthrosis after TLIF. Patient demographics, surgical characteristics, perioperative complications, and 1-yr radiographic data were collected.

RESULTS
A total of 84 patients were identified with mean age of 59 yr and 37 women (44.0%). A total of 16 patients (19.0%) underwent removal of 2 interbody cages for a total of 99 implants removed with distribution as follows: 1 L2/3 (0.9%), 6 L3/4 (5.7%), 37 L4/5 (41.5%), and 55 L5/S1 (51.9%). There were 2 intraoperative venous injuries (2.4%) and postoperative complications were as follows: 7 ileus (8.3%), 5 wound-related (6.0%), 1 rectus hematoma (1.1%), and 12 medical complications (14.3%), including 6 pulmonary (7.1%), 3 cardiac (3.6%), and 6 urinary tract infections (7.1%). Among 58 patients with at least 1-yr follow-up, 56 (96.6%) had solid fusion. There were 5 cases of subsidence (6.0%), none of which required surgical revision. Two patients (2.4%) required additional surgery at the level of ALIF for pseudarthrosis.

CONCLUSION
ALIF is a safe and effective technique for the treatment of TLIF cage pseudarthrosis with a favorable risk profile.
The Problem of Compliance and the Turn to Quantification
Authors: Merry Sally Engle 
Published: October 2020

AbstractCompliance with law is an inevitable problem, but it is particularly challenging for international legal regulation. An increasingly popular way of tackling this problem is to develop quantitative measures of performance that provide an apparently objective measure of compliance. However, a closer look at how quantitative measures such as indicators work show that they are often oversimplified, inaccurate, and politically influenced. This chapter discusses indicators for corporate social responsibility, human rights, trafficking, and the UN system of Sustainable Development Goals, showing that they are all efforts to produce objective data, but that the results are far from certainty. The difficulty of defining these broad social concepts clearly, the complexity of measuring them in a wide variety of national and local contexts, and widespread limitations on funding for data collection undermine their capacity to provide a full and accurate picture. Statistical knowledge provides one way of promoting global governance through law, but it is hindered by the difficulty of converting such complex social phenomena into numbers. Nor can it entirely escape the influence of politics or the shortage of funds to support adequate data collection.
Critique of Punitive Reason
Authors: Fassin Didier 
Published: October 2020

Abstract
As the world is going through a punitive age, characterized by an increase in the prison population, independently of the evolution of crime, four questions are addressed in this chapter: What is punishment? Why is punishment associated with the infliction of suffering? Which arguments are provided to justify punishment? How is punishment distributed in society? These questions have long been posed by moral philosophers and legal scholars. Here, rather than reiterating their normative stances, a critical approach is proposed based on ethnographic work and genealogical analysis.
Legal Pluralism in Postcolonial, Postnational, and Postdemocratic Times
Authors: Darian-Smith Eve 
Published: October 2020

AbstractSince the nineteenth century anthropologists have been fascinated by law and legal practices in far-off cultures and lands. Legal anthropology, as a subfield of the discipline, has contributed enormously to contemporary sociolegal analyses of legal pluralism across the academy. Be that as it may, this chapter suggests that anthropology’s contribution is ultimately limited by the enduring analytical framing of legal pluralism within colonial/postcolonial contexts. Moreover, this analytical constraint prevents scholars from seeing other forms of legal pluralism of immense importance in analysing contemporary societies in which genealogies of colonialism and modernist units of analysis and assumptions of state power are not so evident or significant. The essay calls for anthropologists to think about legal pluralism in terms, and along lines of inquiry, that move beyond the discipline’s colonial legacies and conventional sites of research and to appreciate the global contexts in which all legal pluralism should be analysed.
DETERMINATION OF EFFECTIVE DOSE FIFTY (ED50) OF SCORPION ANTIVENOM AGAINST SCORPION ENVENOMATION USING THE NEWLY DEVELOPED FORMULA
Authors: Saganuwan Saganuwan Alhaji 
Published: October 2020

About 50 species of scorpions caused fatal scorpionism across the globe, mostly from members of buthidae family, which include but not limited to Mesobuthus eupeus, Androctonus crassicauda, Leiurus abdullahbayrami, Leiurus quinquestriatus, Tityus pachyurus and Androctonus australis. In view of this, literature search was carried out with a view to modifying the formula (LD50‐ = for calculation of LD50 and ED50 of scorpion venom and antivenom, respectively. Whereas Human Equivalent Dose (HED) formula was used to extrapolate LD50 and ED50 from animals to human. The findings showed that the newly developed formula (LD50 = ED501/3 × Wm × 10−4) and HED formula can provide effective doses of scorpion antivenoms. However, the new formula provided ED50 values that are very much close to therapeutic values, confirming the applicability of the formula in treatment of scorpionism.Support or Funding Information: NoneThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Alternative ELISA Using a RNA Aptamer against Calf Intestinal Alkaline Phosphatase
Authors: Huynh Vincent , Wei Eric , Ellington Andrew , Stovall Gwendolyn 
Published: October 2020

Alkaline Phosphatase (AP) is extensively used in enzyme‐linked immunosorbent assays(ELISA), most requiring expensive and time‐intensive reagents to generate (such as AP‐conjugated antibodies). In addition, these antibodies may have reduced immunoreactivity when conjugated with AP. We seek to address these problems by developing an alternative AP ligand in the form of an aptamer (nucleic acid binding species) against Calf Intestinal AP (CIAP). This CIAP‐aptamer will lead to the development of an alternative reagent that is readily amendable to conjugation, such as conjugation to a primary antibody or perhaps another aptamer.Anti‐CIAP aptamers were isolated using Systematic Evolution of Ligands by Exponential Enrichment (SELEX). A diversified pool of RNA (“R50” pool) was used and iterative rounds of selection were performed to wash away the non‐binding RNA species and enrich RNA species specifically bound to CIAP. After nine rounds of selection, a reoccurring 14‐mer RNA motif (named VDH2.14 and identified in 15 of 40 clones sequenced) presented itself in a similar loop structure for the majority of RNA sequences. Furthermore, aptamers 4‐3, 4‐9, and 3‐6 were bound to CIAP with Kd values of 5 nM, 9.4 nM, 10.8 nM, respectively. In addition, a minimized variant was designed and bound to CIAP with a Kd value of 6.8 nM. The development of anti‐CIAP aptamers will allow us to generate an inexpensive and robust CIAP‐conjugated reagent for ELISA work and additional molecular techniques that are AP‐dependent.
Risk Factors Associated With Failure to Reach Minimal Clinically Important Difference After Correction Surgery in Patients With Degenerative Lumbar Scoliosis
Authors: Yuan Lei , Zeng Yan , Chen Zhongqiang , Li Weishi , Zhang Xinling , Ni Jiajun 
Published: October 2020

Study Design.
A retrospective study.

Objective.
The aim of this study was to evaluate the factors affecting health-related quality of life (HRQOL) after surgery in patients with degenerative lumbar scoliosis (DLS) by minimum clinically important difference (MCID).

Summary of Background Data.
MCID has been introduced in the adult spinal deformity to quantify the absolute minimum change that can be considered a success. There are limited data available to identify factors affecting reaching MCID after DLS surgery.

Methods.
This study reviewed a cohort of 123 DLS patients after correction surgery and with a minimum 2-year follow-up (FU). Inclusion criteria included age ≥40 and minimum five vertebrae fused and the availability of Scoliosis Research Society (SRS)-22 scores and radiographic data at baseline (BL) and FU. Using a multivariate analysis, two groups were compared to identify possible risk factors: those who reached MCID in the all four SRS domains (N = 65) at the last FU and those who missed MCID (N = 58).

Results.
At baseline, patients differed significantly from matched normative data in all SRS-22 domains. The baseline HRQOL was comparable in reached MCID and missed MCID group patients (P > 0.05). The HRQOL scores at FU were significantly higher than those at baseline. Of 123 included patients, 77.2% (N = 95), 72.4% (N = 89), 76.4% (N = 94), and 89.4% (N = 110) reached MCID in SRS pain, activity, appearance, and mental domain, respectively. Pelvic incidence (PI) >55°, lumbar lordosis (LL) loss >4.65°, coronal imbalance at FU, sagittal vertical axis (SVA) at FU >80 mm, and presence of proximal junctional kyphosis (PJK) and distal junctional problem (DJP) had negative effects on the recovery process.

Conclusion.
Factors affecting reaching MCID after surgery for DLS were higher PI, LL loss, coronal imbalance, severe sagittal imbalance, and the occurrence of PJK and DJP.

Level of Evidence: 4
The Prevalence of Back and Leg Pain and the Cross-sectional Association With Adverse Health Outcomes in Community Dwelling Older Adults in England
Authors: Williamson Esther , Sanchez Santos Maria T. , Morris Alana , Garrett Angela , Conway Oliver , Boniface Graham , Fairbank Jeremy , Lamb Sarah E. 
Published: October 2020

Study Design.
Cross-sectional analysis of the Oxford Pain, Activity and Lifestyle (OPAL) Cohort Study.

Objective.
The aim of this study was to assess the prevalence of back pain (BP) and leg pain and determine their relationship with adverse health states among older adults in England.

Summary of Background Data.
Epidemiological data describing the prevalence of BP and leg pain in older adults in England is lacking.

Methods.
A total of 5304 community-dwelling adults (aged 65–100 years) enrolled in the OPAL cohort study who provided data on BP and leg pain were included. Participants were classified into four groups based on reports of back and leg pain: no BP, BP only, BP and leg pain which was likely to be neurogenic claudication (NC), and BP and leg pain which was not NC. Adverse health states were frailty, falls, mobility decline, low walking confidence, poor sleep quality, and urinary incontinence. We collected demographic and socioeconomic information, health-related quality of life, and existing health conditions, and estimated the association between BP presentations and adverse health states using regression analysis.

Results.
Thirty-four percent of participants (1786/5304) reported BP only, 11.2% (n = 594/5304) reported BP and NC and 8.3% (n = 441/5304) reported BP and non-NC leg pain. Participants with BP had worse quality of life compared to those without BP. All BP presentations were significantly associated with adverse health states. Those with NC were most affected. In particular, there was greater relative risk (RR) of low walking confidence (RR 3.11, 95% confidence interval [CI] 2.56–3.78), frailty (RR 1.88, 95% CI 1.67–2.11), and mobility decline (RR 1.74, 95% CI 1.54–1.97) compared to no BP.

Conclusion.
Back and leg pain is a common problem for older adults and associated with reduced quality of life and adverse health states. Findings suggest a need to develop more effective treatment for older adults with BP especially for those with neurogenic claudication.

Level of Evidence: 2
Improvement in Gait Pattern and its Relationship With Preoperative Pelvic Compensation After Surgery in Patients With Sagittal Plane Deformity
Authors: Kim Ho-Joong , Park Sang-Min , Kwon Oh Sang , Han Heesoo , Kang Kyoung-Tak , Yeom Jin S. 
Published: October 2020

Study Design.
Prospective observational study.

Objective.
The aim of this study was to investigate the improvement in gait parameters after surgery and whether corrective surgery for sagittal imbalance would be influenced by preoperative pelvic compensation.

Summary of Background Data.
There have been no other studies investigating the influence of preoperative pelvic compensation on surgical outcomes.

Methods.
A total of 32 patients who were scheduled to undergo corrective surgery for sagittal plane deformity were included and were followed-up for 1 year after surgery. Radiological parameters were measured on biplanar full-body imaging. Before surgery and 6 months after surgery, three-dimensional motion analyses were performed to estimate center of gravity (CoG) deviation from the center of mass (CoM), mean trunk kyphosis (TK) angle, gait deviation index (GDI), and kinematic parameters. Before surgery, the patients were classified into CoG+ and CoG− groups. “+” and “−” representing increases and decreases in the distance of CoG from CoM of the pelvic segment from first to third trials, respectively. Oswestry Disability Index (ODI) and EuroQol-5D (EQ-5D) were measured for 1 year after surgery.

Results.
All radiological parameters improved significantly after surgery. For gait parameters, CoG from CoM, mean TK angle, and minimum angle of the hip and knee joints in the stance phase during walking were significantly decreased after surgery and GDI scores significantly improved after surgery. The mean changes of the CoG distance from the CoG and the mean TK from first to third trials of gait analysis significantly decreased postoperatively. There were no significant differences in ODI and EQ-5D scores over 1-year follow-up assessment between CoG+ and CoG− groups.

Conclusion.
Preoperative abnormal stooping gait, and progressive worsening of sagittal imbalance in patients with sagittal plane deformity improved after corrective surgery. Patients with preoperative dynamic sagittal imbalance could have similar surgical results to those without it after corrective surgery.

Level of Evidence: 3
Denosumab Treatment for Giant Cell Tumor of the Spine Including the Sacrum
Authors: Bukata Susan V. , Blay Jean-Yves , Rutkowski Piotr , Skubitz Keith , Henshaw Robert , Seeger Leanne , Dai Tian , Jandial Danielle , Chawla Sant 
Published: October 2020

Study Design.
This was a subanalysis of an international, multicenter, open-label study.

Objective.
The aim of this study was to assess the efficacy and safety of denosumab in a subset of patients with giant cell tumors of bone (GCTB) of the spine including the sacrum from an international, open-label, single-arm, phase 2 study (ClinicalTrials.gov: NCT00680992).

Summary of Background Data.
Standard GCTB treatment is surgical removal, either by curettage or resection, combined with intraoperative adjuvant therapy; however, some sites may not be amenable to resection (e.g., skull, spine).

Methods.
Adults or skeletally mature adolescents with pathologically confirmed GCTB of the spine including the sacrum, and radiologically measurable evidence of active disease, were included. Patients received denosumab (120 mg subcutaneously) once every 4 weeks during the treatment phase, with loading doses on days 8 and 15 of the first cycle. Patients had surgically unsalvageable GCTB (Cohort 1), had planned surgery expected to result in severe morbidity (Cohort 2), or were enrolled from a previous GCTB study (Cohort 3).

Results.
Overall, 132 patients were included in the safety analysis (103 in Cohort 1, 24 in Cohort 2, and five in Cohort 3); 131 patients were included in the efficacy analysis. Kaplan-Meier estimated probabilities of disease progression or recurrence were 3% (95% confidence interval [CI], 0.0–6.2) at year 1 and 7.4% (95% CI, 2.1–12.7) at years 3 and 5 in Cohort 1, and not estimable in Cohorts 2 and 3. Of 23 patients (Cohort 2) with surgery planned at baseline, 10 (43%) had on-study surgery; of these, one patient had reported disease progression or recurrence after the on-study surgery. Clinical benefit was reported in 83% of patients overall (all cohorts).

Conclusion.
Results from the analysis suggest that denosumab is potentially effective treatment for patients with GCTB of the spine including the sacrum. The adverse event profile was consistent with the full study population.

Level of Evidence: 2
A Nationwide Analysis of Geriatric Odontoid Fracture Incidence, Complications, Mortality, and Cost
Authors: Alluri Ram , Bouz Gabriel , Solaru Samantha , Kang Hyunwoo , Wang Jeffrey , Hah Raymond J. 
Published: October 2020

Study Design.
Retrospective database analysis.

Objective.
To identify nationwide temporal trends in management of geriatric odontoid fractures and to compare comorbidities, inpatient complications, hospital characteristics, and cost between patients receiving operative versus nonoperative management.

Summary of Background Data.
The treatment of geriatric odontoid fractures remains controversial with some studies demonstrating decreased mortality and improved functional outcomes associated with operative management and significant morbidity associated with halo devices during nonoperative management.

Methods.
Patients between ages 65 to 90 years with odontoid fractures who underwent operative or nonoperative management between the years 2003 and 2017 were identified in the National Inpatient Sample (NIS) database. Year of injury, demographic variables, comorbidities, inpatient complications, mortality, length of stay, inpatient cost, and hospital characteristics were compared between operative and nonoperative treatment groups.

Results.
Thirty two thousand four hundred nineteen patients (average age 77 yr, 54% female) were included in the final analysis. Operative treatment occurred in 21,954 (67%) patients and nonoperative treatment occurred in 10,465 (32%). In 2003, operative treatment occurred in 46% of patients and nearly doubled to 86% in 2017, with an average increase of 3.7% per year (P < 0.001). Patients undergoing operative management had a lower prevalence of at least one major medical comorbidity (76% vs. 83%, P < 0.001). Patients undergoing operative treatment demonstrated higher odds of developing most complications, particularly pulmonary, gastrointestinal, and renal (P < 0.01). Inpatient mortality was 3.6% in patients receiving operative treatment and 5.9% in patients receiving nonoperative treatment (P < 0.001). Average cost per episode of care during the study period was $131,855 for operative treatment and $65,374 for nonoperative treatment (P < 0.001).

Conclusion.
This study demonstrates a clear national paradigm shift in the management of geriatric odontoid fractures, wherein operative management nearly doubled from 46% in 2003 to 86% in 2017.

Level of Evidence: 3