bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Muslim Conquest of the City of al-Ubulla
Authors: Ramini Irsan , Al-Zuraiqi Heba 
Published: March 2020

Abstract
This paper discusses the dating of the Muslim conquest of the southern Iraqi port city of al-Ubulla. Arab historians give two conflicting accounts of the event: one puts it in the year 14 ah; the other in the year 16 ah. Modern scholars for their part have made no serious attempt to reconcile the two accounts. They have linked the disagreement with the traditional rivalry between Basran and Kufan historians and, generally, tended to prefer the latter account (16 ah). This paper takes a different approach to the issue. It rejects the interpretation of the disagreement given by modern scholars and, instead, reconciles the two accounts through close examination of other aspects of the Ubulla conquest. The argument conlcudes that the port city was conquered twice, once in the year 14 ah before the battle of al-Qādisiyya and then again in 16 ah after that battle. This conclusion puts us in a good position, first, to reconcile other disagreements on the sequence of events regarding the conquest of southern Iraq and, secondly, to draw some judgments as to the tribal identity of the Muslim troops who implemented that conquest and established the garrison city of Basra.
13-Hour progression of emphysematous hepatitis as depicted on repeat computerized tomography
Authors: Calderon Holly , Serfin Jennifer 
Published: March 2020

Abstract
Emphysematous hepatitis is a rare, rapidly progressive and often fatal condition, which occurs predominantly in patients with uncontrolled diabetes mellitus. It results in the replacement of liver parenchyma by a collection of gas. Emphysematous infections of other abdominal and pelvic organs have long been established, but relatively little is known about the equivalent emphysematous infection of the liver with very few examples in the published literature. A review of the literature shows variability regarding timing of presentation and implicated organisms. To date, computerized tomography imaging has been purported to be diagnostic and vital to early management, as it clearly shows the characteristic appearance of air bubbles within the liver parenchyma. We report a case with inconclusive initial radiographic findings.
Transcription factor Tcf4 is the preferred heterodimerization partner for Olig2 in oligodendrocytes and required for differentiation
Authors: Wedel Miriam , Fröb Franziska , Elsesser Olga , Wittmann Marie-Theres , Lie D Chichung , Reis André , Wegner Michael 
Published: March 2020

AbstractDevelopment of oligodendrocytes and myelin formation in the vertebrate central nervous system is under control of several basic helix-loop-helix transcription factors such as Olig2, Ascl1, Hes5 and the Id proteins. The class I basic helix-loop-helix proteins Tcf3, Tcf4 and Tcf12 represent potential heterodimerization partners and functional modulators for all, but have not been investigated in oligodendrocytes so far. Using mouse mutants, organotypic slice and primary cell cultures we here show that Tcf4 is required in a cell-autonomous manner for proper terminal differentiation and myelination in vivo and ex vivo. Partial compensation is provided by the paralogous Tcf3, but not Tcf12. On the mechanistic level Tcf4 was identified as the preferred heterodimerization partner of the central regulator of oligodendrocyte development Olig2. Both genetic studies in the mouse as well as functional studies on enhancer regions of myelin genes confirmed the relevance of this physical interaction for oligodendrocyte differentiation. Considering that alterations in TCF4 are associated with syndromic and non-syndromic forms of intellectual disability, schizophrenia and autism in humans, our findings point to the possibility of an oligodendroglial contribution to these disorders.
Standardized Urine-Based Tuberculosis (TB) Screening With TB-Lipoarabinomannan and Xpert MTB/RIF Ultra in Ugandan Adults With Advanced Human Immunodeficiency Virus Disease and Suspected Meningitis
Authors: Cresswell Fiona V , Ellis Jayne , Kagimu Enock , Bangdiwala Ananta S , Okirwoth Michael , Mugumya Gerald , Rutakingirwa Morris , Kasibante John , Quinn Carson M , Ssebambulidde Kenneth , Rhein Joshua , Nuwagira Edwin , Tugume Lillian , Martyn Emily , Skipper Caleb P , Muzoora Conrad , Grint Daniel , Meya David B , Bahr Nathan C , Elliott Alison M , Boulware David R 
Published: March 2020

Abstract

Background
Diagnosis of extrapulmonary tuberculosis (TB) remains challenging. We sought to determine the prevalence of disseminated TB by testing urine with TB-lipoarabinomannan (TB-LAM) lateral flow assay and Xpert MTB/RIF Ultra (Ultra) in hospitalized adults.

Methods
We prospectively enrolled human immunodeficiency virus (HIV)-positive adults with suspected meningitis in Uganda during 2018–2020. Participants underwent standardized urine-based TB screening. Urine (60 mcL) was tested with TB-LAM (Alere), and remaining urine was centrifuged with the cell pellet resuspended in 2 mL of urine for Xpert Ultra testing.

Results
We enrolled 348 HIV-positive inpatients with median CD4 of 37 cells/mcL (interquartile range, 13–102 cells/mcL). Overall, 26% (90 of 348; 95% confidence interval [CI], 21%–30%) had evidence of disseminated TB by either urine assay. Of 243 participants with both urine TB-LAM and Ultra results, 20% (48 of 243) were TB-LAM-positive, 12% (29 of 243) were Ultra-positive, and 6% (14 of 243) were positive by both assays. In definite and probable TB meningitis, 37% (14 of 38) were TB-LAM-positive and 41% (15 of 37) were Ultra-positive. In cryptococcal meningitis, 22% (40 of 183) were TB-LAM-positive and 4.4% (6 of 135) were Ultra-positive. Mortality trended higher in those with evidence of disseminated TB by either assay (odds ratio = 1.44; 95% CI, 0.83–2.49; P = .19) and was 6-fold higher in those with definite TB meningitis who were urine Ultra-positive (odds ratio = 5.67; 95% CI, 1.13–28.5; P = .04).

Conclusions
In hospitalized Ugandans with advanced HIV disease and suspected meningitis, systematic screening with urine TB-LAM and Ultra found a high prevalence of urine TB test positivity (26%). In those with TB meningitis, urine tests were positive in over one third. There was little concordance between Ultra and TB-LAM, which warrants further investigation.
Dynamic human and avatar facial expressions elicit differential brain responses
Authors: Kegel Lorena C , Brugger Peter , Frühholz Sascha , Grunwald Thomas , Hilfiker Peter , Kohnen Oona , Loertscher Miriam L , Mersch Dieter , Rey Anton , Sollfrank Teresa , Steiger Bettina K , Sternagel Joerg , Weber Michel , Jokeit Hennric 
Published: March 2020

Abstract
Computer-generated characters, so-called avatars, are widely used in advertising, entertainment, human–computer interaction or as research tools to investigate human emotion perception. However, brain responses to avatar and human faces have scarcely been studied to date. As such, it remains unclear whether dynamic facial expressions of avatars evoke different brain responses than dynamic facial expressions of humans. In this study, we designed anthropomorphic avatars animated with motion tracking and tested whether the human brain processes fearful and neutral expressions in human and avatar faces differently. Our fMRI results showed that fearful human expressions evoked stronger responses than fearful avatar expressions in the ventral anterior and posterior cingulate gyrus, the anterior insula, the anterior and posterior superior temporal sulcus, and the inferior frontal gyrus. Fearful expressions in human and avatar faces evoked similar responses in the amygdala. We did not find different responses to neutral human and avatar expressions. Our results highlight differences, but also similarities in the processing of fearful human expressions and fearful avatar expressions even if they are designed to be highly anthropomorphic and animated with motion tracking. This has important consequences for research using dynamic avatars, especially when processes are investigated that involve cortical and subcortical regions.
Postoperative Single-shot Epidural Fentanyl and Bupivacaine for Postoperative Analgesia After Lumbar Decompression
Authors: Alican Mannuel Feliciano B. , Ver Mario R. , Ramos Miguel Rafael D. , Mamaril Lulu Joan C. 
Published: March 2020

Study Design.
Randomized clinical trial.

Objective.
To evaluate the efficacy of the postoperative single-shot bolus of epidural Fentanyl and Bupivicaine in providing pain relief postlumbar decompression surgery.

Summary of Background Data.
Despite lumbar decompression's success in alleviating symptoms of sciatica, radiculopathy, and neurogenic claudication, transient back and buttock pain has been a common complaint postoperatively. Providing good postoperative pain alleviation predicts patient's quality of recovery.

Methods.
We performed a randomized, double-blinded, clinical trial. Forty-five patients scheduled for lumbar decompression for a year's period who were randomly assigned to receive a postoperative bolus of 10-mL solution of 50 mcg of Fentanyl, 0.125% Bupivacaine, and 0.9% saline solution via an intraoperatively placed epidural catheter immediately after wound closure, before dressing application. Facial pain scale scores (from 0 to 10) were measured at three time points after surgery (fully awake at recovery room, transfer to ward, first postoperative day). Postoperative need for oral analgesics, time to independent ambulation, associated adverse events, and time to hospital discharge were also evaluated.

Results.
Pain scores were noted to be significantly lower at all time points in the epidural group (P < 0.001). In turn, they also received less on-demand oral pain medications than those in the control group (P = 0.000). The mean time to ambulation was 0.09 days in the epidural group and 0.91 days in the decompression-alone group (P = 0.000). Criteria for hospital discharge were usually met on Day 0 in the epidural and Day 1 in the control group (P = 0.000). Within the study period, only one infection was noted in the epidural group which necessitated additional lumbar spine surgery (4.3%). No adverse events or complications related to Fentanyl use were observed.

Conclusions.
A postoperative bolus of Fentanyl and Bupivacaine is effective in reducing early postoperative pain without the related complications of opiod administration.

Level of Evidence: 2
Machine Learning for Predictive Modeling of 90-day Readmission, Major Medical Complication, and Discharge to a Facility in Patients Undergoing Long Segment Posterior Lumbar Spine Fusion
Authors: Jain Deeptee , Durand Wesley , Burch Shane , Daniels Alan , Berven Sigurd 
Published: March 2020

Study Design.
Retrospective case control study.

Objective.
To develop predictive models for postoperative outcomes after long segment lumbar posterior spine fusion (LSLPSF).

Summary of Background Data.
Surgery for adult spinal deformity is effective for treating spine-related disability; however, it has high complication and readmission rates.

Methods.
Patients who underwent LSLPSF (three or more levels) were identified in State Inpatient Database. Data was queried for discharge-to-facility (DTF), 90-day readmission, and 90-day major medical complications, and demographic, comorbid, and surgical data. Data was partitioned into training and testing sets. Multivariate logistic regression, random forest, and elastic net regression were performed on the training set. Models were applied to the testing set to generate AUCs. AUCs between models were compared using the method by DeLong et al.

Results.
37,852 patients were analyzed. The DTF, 90-day readmission, and 90-day major medical complication rates were 35.4%, 19.0%, and 13.0% respectively. For DTF, the logistic regression AUC was 0.77 versus 0.75 for random forest and 0.76 for elastic net (P < 0.05 for all comparisons). For 90-day readmission, the logistic regression AUC was 0.65, versus 0.63 for both random forest and elastic net (P < 0.05 for all comparisons). For 90-day major medical complications, the logistic regression AUC was 0.70, versus 0.69 for random forest and 0.68 for elastic net (P < 0.05 for all comparisons).

Conclusion.
This study created comprehensive models to predict discharge to facility, 90-day readmissions, and 90-day major medical complications after LSLPSF. This information can be used to guide decision making between the surgeon and patient, as well as inform value-based payment models.

Level of Evidence: 3
Hepatitis C Virus Infection as a Predictor of Complications and Increased Costs Following Primary Lumbar Fusion Surgery
Authors: Donnally Chester J. , Patel Parthik D. , Canseco Jose A. , Shenoy Kartik , Divi Srikanth N. , Goz Vadim , Arain Abdul R. , Vaccaro Alexander R. 
Published: March 2020

Study Design.
Retrospective cohort study.

Objective.
The aim of this study was to identify whether hepatitis C virus (HCV) diagnosis influences in-hospital lengths of stay (LOS), postoperative complications, readmission rates, or costs following primary posterior lumbar fusions in an elective setting.

Summary of Background Data.
Although joint arthroplasty literature has shown increased complication rates and costs for patients seropositive with HCV without liver disease compared to those without HCV, this comorbidity has not been explored in the spine literature. To our knowledge, this is the first publication in the lumbar spine literature to solely focus on HCV as the disease burden.

Methods.
A national database was queried for patients who underwent primary lumbar spine fusion for degenerative lumbar pathology with Medicare insurance from 2005 to 2014. The 90-day postoperative complication rates, readmission rates, and treatment costs were queried. To limit confounding, HCV patients were matched with a control cohort of non-HCV patients using patient demographics, treatment modality, and comorbid conditions, and then analyzed by multivariate logistic regression. Patients with active liver disease were excluded to better isolate HCV as the comorbidity.

Results.
A cohort of 28,841 patients were included in the final analysis. Postoperatively, compared to those without HCV infection, those with HCV had significantly higher odds of blood transfusions (odds ratio [OR]: 3.06), pneumonia (OR: 2.49), respiratory failure (OR: 2.49), urinary tract infections (OR: 1.89), wound-/implant-related infections (OR: 1.74), cerebrovascular events (OR: 1.70), or any postoperative complication within 90 days (OR: 2.93; all P < 0.0001). Furthermore, HCV positive patients had higher day of surgery costs ($28,713.26 vs. $25,448.26, P < 0.0001) and 90-day costs ($33,447.39 vs. $29,016.77, P < 0.0001). There was not a significant difference for patients with HCV infection compared to those without in regard to hospital LOS (10 days vs. 8 days, P = 0.332) and rates of a 90-day readmission (0.37% vs. 0.22%; OR: 1.70, 95% confidence interval: 1.00–2.90, P: 0.050).

Conclusion.
In patients undergoing primary lumbar fusion, a seropositivity for HCV without liver disease is associated with higher costs and complication rates, including higher rates of blood transfusion requirements and pneumonia-related complications. This data shed new light on elective spine surgery in HCV patients and may influence the risks and benefits considerations for surgeons considering lumbar fusion in this population.

Level of Evidence: 3.
Lower Satisfaction After Adult Spinal Deformity Surgery in Japan Than in the United States Despite Similar SRS-22 Pain and Function Scores
Authors: Yagi Mitsuru , Ames Christopher P. , Hosogane Naobumi , Smith Justin S. , Shaffrey Christopher I. , Schwab Frank , Lafage Virginie , Bess Shay , Matsumoto Morio , Watanabe Kota 
Published: March 2020

Study Design.
A multicenter retrospective case series.

Objective.
The purpose of this study was to compare the clinical outcomes of a surgical treatment for adult spinal deformity (ASD) in the United States (US) with those in Japan (JP) in a matched cohort.

Summary of Background Data.
Surgical outcomes of thoracic-lumbar-sacral (TLS) spinal fusions in adult spinal deformity ASD patients who live in Asian countries are poorly understood.

Methods.
A total of 300 surgically treated ASDs of age more than 50 years with the lowest instrumented vertebra at the pelvis and a minimum follow-up of 2 years (2y) were consecutively included. Patients were propensity-score matched for age, sex, levels fused, and 2y postop sagittal spinal alignment. Demographic, surgical, and radiographic parameters were compared between the US and JP groups.

Results.
A total of 186 patients were matched by propensity score and were almost identical within these parameters: age (US vs. JP: 66 ± 8 vs. 65 ± 7 yr), sex (females: 90% vs. 89%), levels fused (10 ± 3 vs. 10 ± 2), 2y C7 sagittal vertical axis (C7SVA) (5 ± 5 vs. 5 ± 4 cm), 2y Pelvic incidence minus lumbar lordosis (9 ± 15° vs. 9 ± 15°), and 2y pelvic tilt (PT) (25 ± 10° vs. 24 ± 10°). Oswestry Disability Index (ODI) scores and Scoliosis Research Society patient questionnaire ((SRS-22) function and pain scores were similar at 2y between the US and JP groups (ODI: 27 ± 19% vs. 28 ± 14%, P = 0.72; SRS-22 function: 3.6 ± 0.9 vs. 3.6 ± 0.7, P = 0.54; SRS-22 pain: 3.6 ± 1.0 vs. 3.8 ± 0.8, P = 0.11). However, significantly lower satisfaction was observed in JP than in the US (SRS-22 satisfaction: 4.3 ± 0.9 vs. 4.0 ± 0.8, P < 0.01).

Conclusion.
Surgical treatment for ASD was similarly effective in patients in the US and in JP. However, satisfaction scores were lower in JP compared with the US. Differences in lifestyle and cultural expectations may impact patient satisfaction following ASD surgery.

Level of Evidence: 3
Systematic Review of Outcomes Following 10-Year Mark of Spine Patient Outcomes Research Trial (SPORT) for Degenerative Spondylolisthesis
Authors: Oster Brittany A. , Kikanloo Sina Rashidi , Levine Nicole L. , Lian Jayson , Cho Woojin 
Published: March 2020

Study Design.
We performed a comprehensive search of PubMed, MEDLINE, and EMBASE for all English language studies of all levels of evidence pertaining to Spine Patient Outcomes Research Trial (SPORT), in accordance with Preferred Reported Items for Systematic Reviews and Meta-analyses guidelines.

Objective.
We aim to summarize the 10-year clinical outcomes of SPORT and its numerous follow-up studies for degenerative spondylolisthesis.

Summary of Background Data.
The SPORT was a landmark randomized control trial including approximately 2500 patients at 13 clinics across the country. SPORT compared surgical and nonoperative management of the three most common spinal pathologies.

Methods.
Keywords used in the literature search included SPORT, spine patient outcomes research trial, degenerative spondylolisthesis, and surgical outcomes.

Results.
The intent-to-treat analysis failed to show a significant difference between patients treated surgically as compared to those treated nonoperatively. However, as-treated analysis revealed statically greater improvements at 6 weeks, 2 years, and 4 years in patients treated surgically. Secondary outcomes such as low back pain, leg pain, stenosis bothersome scales, overall satisfaction with current symptoms, and self-rated progress were also significantly improved in surgical patients. Regardless of the initial grade of listhesis, disk height, or mobility, patients who had surgical treatment improved more in terms of Oswestry Disability Index, bodily pain, physical function, and low back pain bothersomeness scales. Risk of reoperation increased with age, having two or three moderate or severe stenotic levels, pain predominantly localized to the back, no physical therapy, the absence of neurogenic claudication, and greater leg pain scores. Risk of reoperation was not significantly affected by type of surgery performed, smoking, diabetes, obesity, longer duration of symptoms, or workman's compensation.

Conclusion.
Although intent-to-treat analysis failed to show significant differences in patients treated surgically, results of the as-treated analysis determined statically greater improvements in those patients with spondylolisthesis who were treated surgically as compared to those treated nonoperatively.

Level of Evidence: 2
Lordosis Recreation With PLIF Surgery—What Is the Influence on Adjacent Segment Lordosis?
Authors: Kamalanathan Viknesh , Kieffer Will K.M. , Zhu Mark , Baker Joseph F. , Robertson Peter A. 
Published: March 2020

Study Design.
Retrospective cohort.

Objective.
We aimed to assess the changes in adjacent segmental lordosis (SL) across the intervertebral disc space following single level posterior lumbar interbody fusion (PLIF).

Summary of Background Data.
Adjacent segment degeneration is well documented following fusion surgery as are the spinopelvic parameters. What isn’t known is the effect of fusion surgery on the adjacent SL of the lumbar spine following PLIF.

Methods.
Preoperative and 1-year postoperative erect lateral radiographs were analyzed for lordotic angulation of all lumbar segments and pelvic incidence (PI) in patients undergoing L4/5 or L5/S1 PLIF.

Results.
Fourty seven PLIFs achieved a mean of 7° increase in SL at L4/5 (P < 0.05) and 11° at L5/S1 (P < 0.05). In L5/S1 PLIF the lordosis gain was associated with lordosis reduction at adjacent segments 3° at L4/5 (P < 0.05); 1° at L3/4 (P < 0.05), 0° at L2/3(NS); 0° at L1/2(NS), and modest gain in overall lordosis (3°). At L4/5 PLIF the global lordosis increased by 5°, but less so at the adjacent discs (L5/S1 = 1°; L3/4 ≤ 1°; L2/3 ≤ –1°, and; L1/2 = <–1°). 19% of cases had a PI–LL > 10° preoperatively, reducing to 4° postoperatively.

Conclusion.
SL increased significantly at the PLIF level. At L5/S1 minimal overall lordosis change occurred however there was reduction in lordosis at adjacent levels representing reduced adjacent segment “compensation.” Conversely L4/5 PLIF showed minimal change at adjacent levels but greater overall lordosis increase. Lumbar lordosis (LL) assessment requires monosegmental assessment as well as overall measure of the LL. PLIF surgery changes both LL and SL at adjacent levels.

Level of Evidence: 3