bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Lipofilling Does Not Pose Evidence of Chronic Inflammation in Rats
Authors: Claro Francisco , Morari Joseane , Moreira Luciana R , Sarian Luis O Z , Velloso Licio A 
Published: September 2018

Abstract

Background
Laboratory reports on adipose tissue suggest that fat grafting to the breast may pose an oncologic risk. One possible reason for this is the theoretic chronic inflammation due to adipokynes released by grafted white adipose tissue (WAT).

Objectives
The aim of this study was to analyze inflammatory activity in lipofilled breast through the use of proinflammatory markers.

Methods
Fifty-four paired-breasts of female rats were divided into 4 groups: control, sham, and breasts grafted with either autologous subcutaneous (SC) WAT or autologous omentum (OM). The WAT was prepared through centrifugation, and the grafting was performed with the use of 0.9-mm blunt-tip cannula. The rats were killed 8 weeks postoperatively, and their breasts were harvested for immunohistochemical staining for CD68-expressing macrophages, gene expression (real-time PCR) for monocyte chemoattractant protein 1 (MCP-1), F4/80, Cox-2, and IL-6.

Results
The weights of the rats that underwent a procedure differed from those of the unmanipulated control group (P &lt; 0.01). The macrophage counts of CD68 differed only between breasts lipofilled with OM and control (P &lt; 0.01). MCP-1, F4/80, and Cox-2 were similarly expressed among the groups (P = 0.422, P = 0.143, and P = 0.209, respectively). The expression of IL-6 differed between breast samples grafted with SC and OM WAT (P = 0.015), but not between samples of control and OM (P = 0.752), and control and SC (P = 0.056).

Conclusions
No inflammation activity was identified in the microenvironment of lipofilled breasts, indicating that chronic inflammation does not seem to be triggered by the breast lipofilling procedure.
Assessing animal individuality: links between personality and laterality in pigs
Authors: Goursot Charlotte , Düpjan Sandra , Kanitz Ellen , Tuchscherer Armin , Puppe Birger , Leliveld Lisette M C 
Published: September 2018

Abstract
Animal individuality is challenging to explain because individual differences are regulated by multiple selective forces that lead to unique combinations of characteristics. For instance, the study of personality, a core aspect of individuality, may benefit from integrating other factors underlying individual differences, such as lateralized cerebral processing. Indeed, the approach-withdrawal hypothesis (the left hemisphere controls approach behavior, the right hemisphere controls withdrawal behavior), may account for differences in boldness or exploration between left and right hemispheric dominant individuals. To analyze the relationships between personality and laterality we tested 80 male piglets with established laterality patterns for 2 motor functions (tail curling direction and the side of the snout used for manipulation) and a combined classification integrating both motor functions using cluster analysis. We analyzed basal salivary testosterone and cortisol along with their behavior in standardized tests as pre-established indicators of different personality traits (Boldness, Exploration, Activity, Sociability, and Coping). We found that the direction of the single motor biases showed significant associations with few personality traits. However, the combined laterality classification showed more, and more robust, significant associations with different personality traits compared with the single motor biases. These results supported the approach-withdrawal hypothesis because right-biased pigs were bolder and more explorative in a context of novelty. Additionally, right-biased pigs were more sociable than left-biased pigs. Therefore, the present study indicates that personality is indeed related to lateralized cerebral processing and provides insight into the multifactorial nature of individuality.
Learning relevance models for patient cohort retrieval
Authors: Goodwin Travis R , Harabagiu Sanda M 
Published: September 2018

Abstract

Objective
We explored how judgements provided by physicians can be used to learn relevance models that enhance the quality of patient cohorts retrieved from Electronic Health Records (EHRs) collections.

Methods
A very large number of features were extracted from patient cohort descriptions as well as EHR collections. The features were used to investigate retrieving (1) neurology-specific patient cohorts from the de-identified Temple University Hospital electroencephalography (EEG) Corpus as well as (2) the more general cohorts evaluated in the TREC Medical Records Track (TRECMed) from the de-identified hospital records provided by the University of Pittsburgh Medical Center. The features informed a learning relevance model (LRM) that took advantage of relevance judgements provided by physicians. The LRM implements a pairwise learning-to-rank framework, which enables our learning patient cohort retrieval (L-PCR) system to learn from physicians’ feedback.

Results and Discussion
We evaluated the L-PCR system against state-of-the-art traditional patient cohort retrieval systems, and observed a 27% improvement when operating on EEGs and a 53% improvement when operating on TRECMed EHRs, showing the promise of the L-PCR system. We also performed extensive feature analyses to reveal the most effective strategies for representing cohort descriptions as queries, encoding EHRs, and measuring cohort relevance.

Conclusion
The L-PCR system has significant promise for reliably retrieving patient cohorts from EHRs in multiple settings when trained with relevance judgments. When provided with additional cohort descriptions, the L-PCR system will continue to learn, thus offering a potential solution to the performance barriers of current cohort retrieval systems.
Banking and Industrialization
Authors: Heblich Stephan , Trew Alex 
Published: September 2018

AbstractWe establish a causal role for banking access in the spread of the Industrial Revolution over the period 1817–1881 by exploiting unique employment data from 10,528 parishes across England and Wales and a novel instrument. We estimate that a one standard deviation increase in 1817 finance employment increases annualized industrial employment growth by 0.93 percentage points. We establish the role of structural transformation as an underlying growth mechanism and show that banking access: (i) increases the industrial employment share; (ii) stimulates urbanization; and (iii) fosters inter-industry transition to high TFP, intermediate and capital-intensive sub-sectors.
Genetic Variation in the Psychiatric Risk Gene CACNA1C Modulates Reversal Learning Across Species
Authors: Sykes Lucy , Haddon Josephine , Lancaster Thomas M , Sykes Arabella , Azzouni Karima , Ihssen Niklas , Moon Anna L , Lin Tzu-Ching E , Linden David E , Owen Michael J , O’Donovan Michael C , Humby Trevor , Wilkinson Lawrence S , Thomas Kerrie L , Hall Jeremy 
Published: September 2018

Abstract
Genetic variation in CACNA1C, which encodes the alpha-1 subunit of Cav1.2 L-type voltage-gated calcium channels (VGCCs), has been strongly linked to risk for psychiatric disorders including schizophrenia and bipolar disorder. How genetic variation in CACNA1C contributes to risk for these disorders is however not fully known. Both schizophrenia and bipolar disorder are associated with impairments in reversal learning (RL), which may contribute to symptoms seen in these conditions. We used a translational RL paradigm to investigate whether genetic variation in CACNA1C affects RL in both humans and transgenic rats. Associated changes in gene expression were explored using in situ hybridization and quantitative PCR in rats and the BRAINEAC online human database. Risk-associated genetic variation in CACNA1C in healthy human participants was associated with impairments in RL. Consistent with this finding, rats bearing a heterozygous deletion of Cacna1c were impaired in an analogous touchscreen RL task. We investigated the possible molecular mechanism underlying this impairment and found that Cacna1c +/− rats show decreased expression of Bdnf in prefrontal cortex. Examination of BRAINEAC data showed that human risk-associated genetic variation in CACNA1C is also associated with altered expression of brain-derived neurotrophic factor (BDNF) in the prefrontal cortex in humans. These results indicate that genetic variation in CACNA1C may contribute to risk for schizophrenia and bipolar disorder by impacting behavioral flexibility, potentially through altered regulation of BDNF expression in the prefrontal cortex. Tests of RL may be useful for translational studies and in the development of therapies targeting VGCCs.
Pressure Injury in the Pediatric Population: Cohort Study Using the Braden Q Scale
Authors: Vocci Marcelli Cristine , Fontes Cassiana Mendes Bertoncello , Abbade Luciana Patricia Fernandes 
Published: September 2018

ABSTRACT

OBJECTIVE:
To identify the risk and incidence of pressure injuries in bedridden pediatric patients to determine the most prevalent risk factors and preventive measures and to define the sociodemographic, clinical, and therapeutic profiles in this group.

METHODS:
Prospective cohort study performed between March 2015 and March 2016 in the intensive care unit and the pediatric ward of a public teaching hospital. The study included 85 pediatric patients (45 intensive care unit and 40 pediatric ward patients).

MAIN OUTCOME MEASURE:
Patients’ Braden Q Scale score was assessed at 48-hour intervals until discharge from the aforementioned units, discharge from the hospital, and/or death.

MAIN RESULTS:
Researchers observed that 93.3% of intensive care unit patients and 87.5% of pediatric ward patients were categorized as high-risk patients, and 12 patients presented with 24 pressure injuries with an incidence of 14.1% and a mean of 4 days before pressure injury occurrence. Patients with pressure injuries in the cohort averaged a hospital length of stay of 7.7 days. Of these, the mean age was 4.1 years and most were female, receiving enteral nutrition, and had diagnoses related to neurological and respiratory diseases." Vasopressor use had a statistically significant association (P < .05) with the development of pressure injuries. The primary risk factor identified on the Braden Q Scale for the development pressure injury was a “mobility and activity” deficit.

CONCLUSIONS:
Most patients (hospitalized in either unit) were at high risk of developing pressure injuries. No specific preventive guidelines were in place in this hospital prior to this study; therefore, the authors aimed to develop a protocol for the prevention and reduction of pressure injuries in pediatric patients.
Radiofrequency ablation-induced esophageal perforation
Authors: Mitchell-Brown Fay , McPherrin Mandy 
Published: September 2018

Abstract:
Esophageal perforation (EP) can be a complication of radiofrequency ablation, a standard treatment for certain patients with drug-refractory atrial fibrillation. This article discusses the etiology, clinical manifestations, and diagnosis of EP, as well as nursing care for patients with EP.
Biomechanical Comparison of C1 Lateral Mass—C2 Short Pedicle Screw—C3 Lateral Mass Screw-Rod Construct Versus Goel-Harms Fixation for Atlantoaxial Instability
Authors: Lu Young , Lee Yu-Po , Bhatia Nitin N. , Lee Thay Q. 
Published: September 2018

Study Design.
A biomechanical in vitro study using human cadaveric spines.

Objective.
The aim of this study was to compare atlantoaxial stability and stiffness of a C1 lateral mass – C2 short pedicle – C3 lateral mass screw-rod construct versus C1 lateral mass – C2 pedicle screw-rod construct.

Summary of Background Data.
The C1 lateral mass – C2 pedicle screw-rod construct provides excellent atlantoaxial fixation, but C2 pedicle screw placement is associated with risk of vertebral artery injury. The use of shorter C2 pedicle screws may mitigate the risk of vascular injury but may result in reduced C1-C2 stabilization. Extending C1 lateral mass – C2 short pedicle screw-rod construct with C3 lateral mass screws may mitigate the risk of vascular injury without compromising C1-C2 fixation.

Methods.
Seven cervical spines were tested with internal control experimental design in the following sequence: intact state, and following creation of type II odontoid fracture, the specimen was instrumented with C1 lateral mass - C2 pedicle screw fixation (C2PED), C1 lateral mass - C2 short pedicle screw fixation (C2SPED), and C1 lateral mass - C2 short pedicle - C3 lateral mass screw fixation (C2SPED-C3LM). For each condition, the angular stiffness and range of motion (ROM) with 1.5-Nm load in flexion/extension (FE), lateral bending (LB), and right/left axial rotation (RAR/LAR) were quantified.

Results.
Instrumented conditions demonstrated significantly lower C1-C2 angular ROM and greater stiffness than the intact state. Compared with C2PED, C2SPED-C3LM demonstrated significantly lower C1-C2 ROM during FE and LB, significantly greater C1-C2 stiffness in flexion and right/left LB, similar C1-C2 ROM and stiffness in RAR/LAR, and similar stiffness in extension. C2SPED-C3LM demonstrated significantly greater atlantoaxial stabilization in the sagittal and coronal planes than C2PED construct.

Conclusion.
Compared with C2PED, C2SPED-C3LM may be a suitable alternative surgical strategy for atlantoaxial instability that provides superior atlantoaxial fixation.

Level of Evidence: N/A
Evaluating the Quality, Content, and Readability of Online Resources for Failed Back Spinal Surgery
Authors: Guo Wei-jun , Wang Wei-kang , Xu Ding , Qiao Zhi , Shi Yu-long , Luo Peng 
Published: September 2018

Study Design.
An Internet-based assessment of websites using recognized score systems.

Objective.
To assess the quality, content, and readability of online information for failed back spinal surgery (FBSS).

Summary of Background Data.
A significant amount of patients still suffer from chronic or recurrent back pain with or without radicular symptoms after spinal surgery. More and more patients use the Internet to find health-related information. Low-quality or inaccurate information may not only misleading patients but also have a negative impact on the trust between patients and physicians.

Methods.
The terms “chronic pain after spinal surgery,” “chronic pain after back surgery,” “failed back surgery syndrome,” “post spinal surgery syndrome,” and “post laminectomy syndrome” were entered into three search engines (Google, Yahoo!, and Bing). The first 25 websites from each search were reviewed. The quality, content, and readability of each website were evaluated using DISCERN score, FBSS-specific content score, and the Journal of the American Medical Association (JAMA) benchmark criteria, the first two score systems were assessed by three reviewers independently. The Flesch-Kincaid grade level (FKGL) was used to assess the readability. Each website with or without the Health on the Net Code (HONcode) was also recorded.

Results.
Seventy-two websites were analyzed in our study. The average DISCERN score for all websites was 35.26 ± 11.45, indicating the quality of the websites was poor. The DISCERN score of physician websites was 31.25 ± 9.08, lower than that of media (36.50 ± 0.71, P = 0.017) and commercial websites (42.55 ± 10.93, P = 0.045). The mean FBSS-specific content score was 9.58 ± 3.90 out of maximum 25. We failed to find any difference of FBSS-specific content score among different type of website. Websites with HONcode certification were associated with higher DISCERN score, FBSS-specific content score, and JAMA benchmark criteria score than non-certified websites. The mean FKGL was 12.19 ± 2.20, and none of the websites’ FKGL was lower than the six grade level.

Conclusion.
The quality and content of available online information for FBSS were poor. The readability of online information in our results showed a significantly higher reading level than the sixth-grade level recommended by the AMA and NIH.

Level of Evidence: 4
Pedicle Screw Placement Using Augmented Reality Surgical Navigation With Intraoperative 3D Imaging
Authors: Elmi-Terander Adrian , Burström Gustav , Nachabe Rami , Skulason Halldor , Pedersen Kyrre , Fagerlund Michael , Ståhl Fredrik , Charalampidis Anastasios , Söderman Michael , Holmin Staffan , Babic Drazenko , Jenniskens Inge , Edström Erik , Gerdhem Paul 
Published: September 2018

Study Design.
Prospective observational study.

Objective.
The aim of this study was to evaluate the accuracy of pedicle screw placement using augmented reality surgical navigation (ARSN) in a clinical trial.

Summary of Background Data.
Recent cadaveric studies have shown improved accuracy for pedicle screw placement in the thoracic spine using ARSN with intraoperative 3D imaging, without the need for periprocedural x-ray. In this clinical study, we used the same system to place pedicle screws in the thoracic and lumbosacral spine of 20 patients.

Methods.
The study was performed in a hybrid operating room with an integrated ARSN system encompassing a surgical table, a motorized flat detector C-arm with intraoperative 2D/3D capabilities, integrated optical cameras for augmented reality navigation, and noninvasive patient motion tracking. Three independent reviewers assessed screw placement accuracy using the Gertzbein grading on 3D scans obtained before wound closure. In addition, the navigation time per screw placement was measured.

Results.
One orthopedic spinal surgeon placed 253 lumbosacral and thoracic pedicle screws on 20 consenting patients scheduled for spinal fixation surgery. An overall accuracy of 94.1% of primarily thoracic pedicle screws was achieved. No screws were deemed severely misplaced (Gertzbein grade 3). Fifteen (5.9%) screws had 2 to 4 mm breach (Gertzbein grade 2), occurring in scoliosis patients only. Thirteen of those 15 screws were larger than the pedicle in which they were placed. Two medial breaches were observed and 13 were lateral. Thirteen of the grade 2 breaches were in the thoracic spine. The average screw placement time was 5.2 ± 4.1 minutes. During the study, no device-related adverse event occurred.

Conclusion.
ARSN can be clinically used to place thoracic and lumbosacral pedicle screws with high accuracy and with acceptable navigation time. Consequently, the risk for revision surgery and complications could be minimized.

Level of Evidence: 3
Surgical Outcomes for Drop Body Syndrome in Adult Spinal Deformity
Authors: Yagi Mitsuru , Fujita Nobuyuki , Okada Eijiro , Tsuji Osahiko , Nagoshi Narihito , Yato Yoshiyuki , Asazuma Takashi , Nakamura Masaya , Matsumoto Morio , Watanabe Kota 
Published: September 2018

Study Design.
A multicenter retrospective case series of patients treated surgically for adult spinal deformity (ASD).

Objective.
The aim of this study was to compare clinical outcomes between propensity score matched ASD patients with or without drop body syndrome (DBS).

Summary of Background Data.
DBS is an extreme primary sagittal-plane deformity often seen in Asian countries. Although the importance of sagittal alignment is widely recognized, surgical outcomes for deformities purely in the sagittal plane are poorly understood.

Methods.
This study included 243 consecutive patients (age 66 ± 17 years; range 22–78) who were treated surgically for ASD and were followed at least 2 years (mean follow-up 3.7 ± 2.3 years). DBS was defined as a primary lumbar kyphosis with PI–LL >40°, Cobb angle <30°, and multifidus cross-sectional area <300 mm2. DBS patients were matched with non-DBS patients by propensity scores for age, gender, lowest instrumented vertebra (LIV) level, and number of levels fused. Demographics, radiographic findings, and clinical outcomes were compared between DBS and non-DBS patients.

Results.
Of 243 patients with ASD, 34 had DBS (14%); 28 of these were propensity-matched with ASD patients without DBS. Baseline bone mineral density (BMD), body mass index (BMI), and frailty were similar in DBS and non-DBS patients. Baseline sagittal alignment was worse in DBS than in non-DBS patients [C7SVA 14 ± 5 vs. 8 ± 5 cm; pelvic incidence (PI) – lumbar lordosis (LL) 60 ± 14 vs. 36 ± 20°], and scoliosis research society (SRS)22 scores were also worse for DBS patients (2.5 ± 0.6 vs. 2.9 ± 0.8). Although DBS patients had more complications (20 DBS vs. 16 non-DBS), the clinical outcomes were similarly improved in both groups after surgery. At the 2-year follow-up, the spinopelvic malalignment was worse in DBS than non-DBS patients (PI–LL 17 ± 16° vs. 8 ± 13°, P < 0.05).

Conclusion.
DBS affected 14% of 234 ASD patients. Although DBS patients had inferior baseline SRS22 scores than non-DBS patients, ASD surgery resulted in similar clinical improvement in both groups. Future studies should examine the influence of lifestyle and genetics on clinical outcomes after surgery for DBS.

Level of Evidence: 3
Patients Cannot Reliably Distinguish the Iliac Crest Bone Graft Donor Site From the Contralateral Side After Lumbar Spine Fusion
Authors: Lehr A. Mechteld , Oner F. Cumhur , Hoebink Eric A. , Kempen Diederik H.R. , van Susante Job L.C. , Castelein René M. , Kruyt Moyo C. 
Published: September 2018

Study Design.
A multicenter, randomized, intrapatient controlled trial.

Objective.
This study investigated whether lumbar fusion patients blinded to the harvest site (A) can identify the iliac crest used for bone harvesting and (B) whether this iliac crest is more painful than the contralateral side.

Summary of Background Data.
Spinal fusion with iliac crest autograft is a frequently performed surgical procedure. A widely reported disadvantage of the harvesting procedure is potential donor site morbidity. This has driven the development of many bone graft substitutes. However, more recently the incidence and severity of donor site pain is debated, especially in lumbar fusion surgery.

Methods.
Ninety-two nontraumatic adult patients underwent a posterolateral (thoraco)lumbar fusion. Iliac crest bone graft was harvested unilaterally through the primary midline incision. At 6 weeks, 3 months, 6 months, and 1 year follow-up, patients were asked to identify the donor site and to rate pain in their back, left iliac crest and right iliac crest on a Visual Analogue Scale (VAS).

Results.
Ninety patients, 44 males and 46 females with a mean age of 54 years, were analyzed. The left/right distribution of the iliac crest donor site was 50/50 and 89% of the patients underwent a lumbar fusion below L3. Only 24% patients identified the harvest site correctly. Moreover, the VAS pain scores for the donor site and contralateral iliac crest did not differ and were at each timepoint lower than the scores for back pain.

Conclusion.
This study showed that, during the first year after lumbar fusion surgery via a single midline incision approach, patients could not reliably identify the iliac crest used for bone graft harvesting and this iliac crest was not more painful than the untouched contralateral iliac crest. Therefore, donor site pain should not be the main reason to use bone graft alternatives for lumbar spinal fusion.

Level of Evidence: 2