bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thirty-Day Hospital Readmission and Surgical Complication Rates for Shunting in Normal Pressure Hydrocephalus: A Large National Database Analysis
Authors: Nadel Jeffrey L , Wilkinson D Andrew , Linzey Joseph R , Maher Cormac O , Kotagal Vikas , Heth Jason A 
Published: July 2019

Abstract

BACKGROUND
Research on age-related complications secondary to shunts in normal pressure hydrocephalus (NPH) is primarily limited to single-center studies and small cohorts.

OBJECTIVE
To determine the rates of hospital readmission and surgical complications, and factors that predict them, following shunt surgery for NPH in a large healthcare network.

METHODS
Surgical procedures, complications, and readmissions for adults undergoing ventricular shunting for NPH were determined using de-identified claims from a privately insured United States healthcare network in years 2007-2014. Univariate and multivariate statistics were used to determine factors that predict poor surgical outcomes. The primary outcome variable was surgical complications or readmissions (composite variable for any major perioperative complication or 30-d readmission).

RESULTS
The 30-d readmission rate for 974 patients with NPH who underwent ventricular shunting was 7.29%; the most common reasons for readmission were shunt-related complications, infection, hemorrhage, altered mental status, and cardiopulmonary and musculoskeletal problems. The perioperative complication rate was 21.15%, including intraparenchymal hemorrhage (5.85%) and extra-axial (subdural or epidural) hematoma (5.54%). The overall rate of having a surgical complication or 30-d readmission was 25.15%. Age did not predict surgical complication or 30-d readmission. Preoperative comorbidities independently associated with poor outcome were myocardial infarction within 1 yr (OR = 3.984, 95% CI = 1.105-14.368); existing cerebrovascular disease (odds ratio [OR] = 2.206, 95% CI = 1.544-3.152); and moderate/severe renal disease (OR = 2.000, 95% CI = 1.155-3.464).

CONCLUSION
The rate of complications or readmission within 30 d of ventricular shunting for NPH is 25.15%. Preoperative comorbidities of myocardial infarction within 1 yr, cerebrovascular disease, and moderate/severe renal disease are independent risk factors for poor outcome.
Reform and Consolidation: A New Perspective on Commons Select Committees 1960–1980
Authors: Aylett Philip 
Published: July 2019

Abstract
The ‘departmental’ select committees of the Commons established from 1979 onwards are often represented as a radical and distinctive departure in the history of parliamentary scrutiny, and a clear improvement on the arrangements of previous decades. The article argues that this view needs to be revised, in light of a substantial shift in thinking about select committee scrutiny from the 1960s. Whereas select committees in 1960 were seen as primarily restricted to financial matters, politicians and others later began successfully to promote committee interventions in wider questions of policy and administration. The introduction of departmental committees should therefore be seen as part of a broader long-term process of committee development.
Toward the design of efficient transglycosidases: the case of the GH1 of Thermus thermophilus
Authors: David Benoit , Arnaud Philippe , Tellier Charles , Sanejouand Yves-Henri 
Published: July 2019

AbstractUsing the information available in the sequences of well-characterized transglycosidases found in plants, mutations were introduced in the glycoside hydrolase of the bacterium Thermus thermophilus, with the aim of turning it into an efficient transglycosidase. All mutants happen to have fair catalytic efficiencies, being at worst 25 times less efficient than the wild type. Noteworthy, W120F, one of our high transglycosylation yield (≈ 50%) mutants, is only two times less efficient than the wild type. Interestingly, while in the wild type the sidechain of the acid–base is only found able to sample a pair of equivalent conformations during 0.5-μs-long molecular dynamics simulations, its flexibility is much higher in the case of the high transglycosylation yield mutants. Our results thus suggest that engineering the flexibility of the acid–base of a retaining glycoside hydrolase could be a general way to turn it into an efficient transglycosidase.
(Not) Like Aeneas: Allusions to the Aeneid in Laʒamon’s Brut
Authors: Burek Jacqueline M 
Published: July 2019

Abstract
This article argues that the well-known extended similes in the Arthurian section of Laʒamon’s Brut allude to Vergil’s Aeneid. Most scholars agree that these similes were influenced by the extended similes of Latin epic, but few have claimed that these similes can be traced back to a definitive Latin source, or that this influence is anything other than stylistic in nature. In contrast, this article argues that Laʒamon’s similes allude to the Aeneid’s plot and characters as part of a broader commentary on Arthur’s kingship. Although Laʒamon does not quote specific words or phrases from the Aeneid, he replicates the style, content, and narrative function of Vergil’s epic similes to set up a subtle contrast between British history and Roman history. But while Vergil emphasizes Rome’s ascendance, Laʒamon emphasizes the Britons’ downfall; and whereas Vergil depicts Aeneas as a ruler who prioritizes the welfare of his people, Laʒamon depicts Arthur as a king whose self-centred individualism leads to his people’s downfall. Laʒamon’s allusions to the Aeneid highlight classical epic’s dual function in the Brut: stylistic model and source of political and ethical ideas. Moreover, they reveal how Laʒamon uses epic as a tool for interpreting history.
Between ‘Scientization’ and a ‘Participatory Turn’. Tracing shifts in the governance of policy advice
Authors: Krick Eva , Christensen Johan , Holst Cathrine 
Published: July 2019

AbstractThis study traces the claims of a ‘scientization’ and a ‘participatory turn’ in modern governance within the system of temporary policy advisory committees in Norway. It analyzes whether there is evidence of the two claims in these key governance institutions and to what extent these shifts are compatible with each other. As expressions of a participatory turn, a growing emphasis on citizen involvement and transparency in the committee system is searched for. A growing relevance of researchers and of science-based claims in the committees’ reports are taken as indicators of scientization. The longitudinal study shows an overall shift both towards science- and expertise-based governance and towards an increasing openness and public engagement, as well as some variation between policy fields.
Doxorubicin Exposure Affects Oocyte Meiotic Maturation through DNA Damage-Induced Meiotic Arrest
Authors: Ding Zhi-Ming , Zhang Shou-Xin , Jiao Xiao-Fei , Hua Li-Ping , Ahmad Muhammad Jamil , Wu Di , Chen Fan , Wang Yong-Shang , Zhang Xi-Yu , Meng Fei , Duan Ze-Qun , Miao Yi-Liang , Huo Li-Jun 
Published: July 2019

Abstract
Developments in chemotherapeutics have enhanced the survival rate of cancer patients, however, adverse effects of chemotherapeutics on ovarian functions causes the fertility loss in young female cancer patients. Doxorubicin (DOX), as an anthracycline antitumor antibiotic, is extensively used to cure various malignancies. Recent studies have suggested that DOX can cause ovarian damage and affect the oocyte maturation, nevertheless the mechanism by which DOX on oocytes meiosis is poorly understood. In this study, we explored the mechanism for DOX-induced oocytes meiotic failure in vitro at human relevant exposure levels and time periods. Results described that DOX (100 nM) can interrupt the mouse oocytes meiotic maturation directly with reduced first polar body extrusion. Cell cycle analysis showed that most oocytes were arrested at metaphase I (MI) stage. However, DOX treatment had no effect on spindle structure but chromosomal misalignment. We observed that kinetochore-microtubule structure was affected and the spindle assemble checkpoint was provoked after DOX treatment. Moreover, severe DNA damage was found in DOX-treated oocytes indicated by the positive γ-H2A.X foci signal, which then may trigger oocytes early apoptosis. Besides, metaphase II oocytes with disorganized spindle morphologies and misaligned chromosomes were observed after DOX treatment. In conclusion, DOX have the potential to disrupt oocyte meiotic maturation through DNA damage induced meiotic arrest mediated by spindle assemble checkpoint activation. These findings can contribute to design the new therapies to alleviate DNA damage to preserve fertility for young female cancer patients with chemotherapeutics.
The Prevalence and Case-Fatality Rates of Post-Neonatal Tetanus in a Population of Hospitalized Nigerian Children: An 8-Year Retrospective Review
Authors: Okike Clifford Onuorah , Muoneke Uzoamaka Vivian , Uwaezuoke Samuel Nkachukwu , Mbagwu Emmanuel Nkemjika , Onyeka-Okite Ezinne 
Published: July 2019

AbstractBackgroundAlthough tetanus is a vaccine-preventable disease, reports indicate that it remains a significant cause of morbidity and mortality in both neonatal and post-neonatal periods especially in most developing countries.AimThis study aimed to determine the prevalence and case fatality rates of post-neonatal tetanus among children managed at the Federal Medical Centre Asaba, Delta State, Nigeria over 8 years.MethodThe study was a retrospective review of the records of the children above 1 month of age admitted into Federal Medical Centre, Asaba, with a clinical diagnosis of tetanus from January 2008 to May 2016. Data analysis was conducted on descriptive and inferential statistics using Statistical Package for Social Sciences version 22.0. Mean, standard deviation and other relevant parameters were calculated. Level of significance was set at p &lt; 0.05.ResultsDuring the study period, 32 out of 3693 admitted Paediatric patients had post-neonatal tetanus: giving a prevalence rate of 0.9%. The male : female ratio was 1.9 : 1 and patients’ ages ranged from 2 to 15 years with a mean age 8.9 ± 3.1 years. Twenty-nine percent of them had complete immunization during infancy, but none had booster doses. Also, 60.9% of them presented with lower limb injuries as the portal of entry. Over 17.4% of the patients had very severe tetanus. Of the 32 patients studied, 62.5% resided in the neighbouring rural communities, while 50.0% were admitted for ≤10 days. The calculated case fatality rate was 50%.ConclusionThe prevalence and case fatality rates of post-neonatal tetanus are still relatively high in this clime. Given the prevalent nature of the disease in children aged 5 years and above, there is a need to include the booster doses of tetanus toxoid in the country’s National Programme on Immunization schedule.
Pathogenesis and complications of chronic eye rubbing in ocular allergy
Authors: Ben-Eli Hadas , Erdinest Nir , Solomon Abraham 
Published: July 2019

Purpose of review
To review the updated literature regarding eye rubbing complications and its association with ocular allergy disorders.

Recent findings
Atopy and ocular allergy disorders, mainly vernal keratoconjunctivitis (VKC), are strongly associated with rubbing-related complications, most probably via itching and watery eye sensations that trigger the habit of chronic eye rubbing. Vigorous and prolonged rubbing may lead to establishment of corneal remodeling and ectatic disorders, such as keratoconus. Keratoconus development in rubbed eyes can be caused by mechanical mechanisms of corneal thinning and its loss of rigidity, by elevated temperature of the epithelium during rubbing, by increased intraocular pressure (IOP) because of distending forces, and by inflammatory molecules that may serve as a causal mediator between eye rubbing and keratoconus. Other eye rubbing complications include acute hydrops and perforation, IOP spikes, iris prolapse and iridoschisis rupture of lens capsule and IOL dislocation, and even posterior segment disorders, such as glaucomatous optic neuropathy, retinal detachment and extrusion of implanted silicone oil in the eye.

Summary
Chronic eye rubbing in allergic eye diseases can lead to progression of keratoconus, and to other rare anterior and posterior segment complications. Strategies eliminating eye rubbing and its consequences are vital, mainly among at-risk populations, such as young children and individuals with allergic ocular disorders or corneal transplants.
Effect of Kidney Disease on Hemiarthroplasty Outcomes After Femoral Neck Fractures
Authors: Hsiue Peter P. , Seo Lauren J. , Sanaiha Yas , Chen Clark J. , Khoshbin Amir , Stavrakis Alexandra I. 
Published: July 2019

Objective:
To compare the outcomes of patients with predialysis chronic kidney disease (CKD) or end-stage renal disease (ESRD) with the outcomes of patients with no kidney disease after hemiarthroplasty (HA) for femoral neck fractures (FNF).

Design:
Retrospective review utilizing the Nationwide Readmissions Database.

Setting:
National database incorporating inpatient data from 22 states.

Patients:
Using the Nationwide Readmissions Database, 214,399 patients who underwent HA after FNF between 2010 and 2014 were identified and divided into 3 groups using ICD-9 diagnosis codes: no kidney disease (n = 176,300, 82%), predialysis CKD (n = 34,400, 16%), and ESRD (n = 3,698, 2%).

Intervention:
HA for FNF.

Main Outcome Measurement:
Mortality, blood transfusion, and postoperative complications during index hospitalization. Hospital readmission, postoperative dislocation, periprosthetic fracture, and revision surgery within 90 days of surgery.

Results:
Compared to patients with no kidney disease, ESRD patients had an increased risk of mortality [odds ratio (OR) = 3.76, 95% confidence interval (CI), 2.95–4.78], blood transfusion (OR = 2.35, 95% CI, 2.08–2.64), and postoperative complications (OR = 1.64, 95% CI, 1.45–1.86) during the index hospitalization as well as an increased risk of 90-day hospital readmission (OR = 3.09, 95% CI, 2.72–3.50). Interestingly, even patients with predialysis CKD had an increased risk of mortality (OR = 1.80, 95% CI, 1.59–2.05), blood transfusion (OR = 1.66, 95% CI, 1.59–1.75), and postoperative complications (OR = 2.37, 95% CI, 2.25–2.50) during the index hospitalization as well as an increased risk of 90-day hospital readmission (OR = 1.43, 95% CI, 1.37–1.51).

Conclusions:
This retrospective cohort study demonstrates that both ESRD and CKD patients have worse outcomes compared to patients with no kidney disease after HA for FNF.

Level of Evidence:
Prognostic Level III. See instructions for authors for a complete description of levels of evidence.
A Prospective, Psychometric Validation of National Institutes of Health Patient-Reported Outcomes Measurement Information System Physical Function, Pain Interference, and Upper Extremity Computer Adaptive Testing in Cervical Spine Patients
Authors: Iyer Sravisht , Koltsov Jayme C.B. , Steinhaus Michael , Ross Thomas , Stein Daniel , Yang Jingyan , LaFage Virginie , Albert Todd , Kim Han Jo 
Published: July 2019

Study Design.
Prospective Cohort Study

Objective.
The aim of this study was to validate the Patient Reported Outcomes Measurement Information System (PROMIS) against existing patient-reported outcomes in the cervical spine.

Summary of Background Data.
Current patient-reported outcomes in cervical spine have substantial limitations. PROMIS offers the potential for improved psychometric properties with reduced questionnaire burden.

Methods.
Adult patients undergoing cervical spine surgery at a single institution between 2016 and 2018 were prospectively enrolled. Patients completed questionnaires (36-Item Short Form Health Survey [SF-36], Neck Disability Index (NDI), Visual Analog Scale arm/neck, and PROMIS pain Interference [PI], physical Function [PF], and Upper Extremity [UE]) preoperatively and at 6 months postoperatively. Demographic data, diagnosis, and procedural data were recorded. Validation of the instruments was completed with a Rasch Model as well as measurement of coverage, efficiency, test–retest reliability, responsiveness, and convergent validity.

Results.
Of 197 patients who completed the preoperative survey, 164 were eligible for 6-month follow-up and 139 completed 6-month postoperative surveys. The most common diagnoses were radiculopathy (37.6%), myeloradiculopathy (30.5%), and myelopathy (28.4%). All studied instruments had acceptable fit to a Rasch model. PROMIS computer adaptive testings (CATs) demonstrated improved average time to completion for PI (39 seconds), PF (47 seconds), and UE (54  seconds), compared to NDI (117 s) and SF-36 PCS (175 seconds). Responsiveness for PROMIS CATs was similar to NDI and SF-36, test–retest reliability was lower for PI (intraclass correlation: 0.68), PF (0.70), and UE (0.59), compared to NDI (0.86) and PCS (0.85). For convergent validity, PI was strongly correlated to NDI and PF to SF-36 PCS. There were no significant floor or ceiling effects for the PROMIS domains, although UE had preoperative clustering (n = 18) at a high score (56.4) and PI had postoperative clustering (n = 27) at a low score (38.7).

Conclusion.
PROMIS CATs demonstrate several advantages, including efficiency and responsiveness, while demonstrating good convergent validity with legacy instruments. Nevertheless, CATs had lower test–retest reliability and had significant clustering at higher levels of function for the PI and UE CATs. These limitations must be considered before broad adoption of CATs in cervical spine patients.

Level of Evidence: 3
What Factors Influence Delayed Referral to Spinal Surgeon in Adolescent Idiopathic Scoliosis?
Authors: Kenner Peter , McGrath Stephen , Woodland Peter 
Published: July 2019

Study Design.
Retrospective review with qualitative phone interview.

Objective.
This study aims to identify the factors leading to delayed diagnosis or referral to a spinal surgeon in patients who subsequently require surgery for adolescent idiopathic scoliosis (AIS).

Summary of Background Data.
AIS can be effectively treated with bracing to prevent curve progression in skeletally immature patients. Australia currently has in place a national self-detection screening program to diagnose AIS.

Methods.
A retrospective review was performed for patients who underwent surgery for scoliosis at Princess Margaret Hospital for Children and Royal Perth Hospital between June 1, 2010 and May 27, 2014. Data were retrieved from the digital medical record and a semistructured phone interview was used to determine path to diagnosis and referral.

Results.
Mean Cobb angle at first specialist review was 49.5° ± 14.0° for patients who subsequently required surgery for AIS. These patients experienced an average interval of 20.7 months from detection of symptoms to review in a specialist clinic.

Conclusion.
In a condition in which early detection and intervention may halt progression of disease, AIS is detected relatively late and there are specific delays to diagnosis and referral to specialist clinics.

Level of Evidence: 4
Minimally Invasive Posterior Cervical Foraminotomy as an Alternative to Anterior Cervical Discectomy and Fusion for Unilateral Cervical Radiculopathy
Authors: Sahai Nikhil , Changoor Stuart , Dunn Conor J. , Sinha Kumar , Hwang Ki Soo , Faloon Michael , Emami Arash 
Published: July 2019

Study Design.
Systematic review and meta-analysis.

Objective.
The aim of this study was to evaluate clinical outcomes, complications, and reoperations of minimally invasive posterior cervical foraminotomy (MI-PCF) for unilateral cervical radiculopathy without myelopathy, in comparison to anterior cervical decompression and fusion (ACDF).

Summary of Background Data.
ACDF is a standard treatment for cervical radiculopathy secondary to lateral disc herniation or foraminal stenosis. Recent studies have suggested MI-PCF to be an effective alternative to ACDF. However, concern for reoperation and whether similar improvements in clinical outcomes can be achieved has led to a debate in the literature.

Methods.
We comprehensively searched PubMed, CINAHL Plus, and SCOPUS utilizing terms related to MI-PCF. Two independent reviewers assessed potential studies and extracted data on clinical outcome scores (neck disability index [NDI], visual analog scale [VAS]-neck, and VAS-arm), reoperation proportion, and complications. Studies included were on noncentral cervical pathology, published in the last 10 years, had a sample size of >10 patients, and reported data on minimally invasive techniques for posterior cervical foraminotomy. Heterogeneity and publication bias analyses were performed. The pooled proportions of each outcome were compared to those of ACDF obtained from two previously published studies.

Results.
Fourteen studies were included with data of 1216 patients. The study population was 61.8% male, with a mean age of 51.57 years, and a mean follow-up of 30 months. MI-PCF resulted in a significantly greater improvement in VAS-arm scores compared to ACDF, and similar improvements in VAS-neck and NDI scores. Proportions of complications and reoperations were similar between the two cohorts. The most common complications were transient neuropraxia, wound-related, and durotomy.

Conclusion.
Our findings suggest that MI-PCF may be utilized as a safe and effective alternative to ACDF in patients with unilateral cervical radiculopathy without myelopathy, without concern for increased reoperations or complications.

Level of Evidence: 3
Disc Wedge and Vertebral Body Tilt Angle Below Lower Instrumented Vertebra After Posterior Correction and Fusion in Patients With a Structural Thoracolumbar/Lumbar Curve
Authors: Cho Jae Hwan , Lee Choon Sung , Lee Dong-Ho , Hwang Chang Ju , Park Jae-Woo , Jung Hyung Seo , Park Kun-Bo 
Published: July 2019

Study Design.
A retrospective cohort study.

Objective.
The purpose of this study was to evaluate the stability of remained lumbar curve by the review of serial changes in L3/L4 disc wedge and L4 body tilt angle in patients with idiopathic scoliosis who underwent posterior-only fusion to L3 lower instrumented vertebra (LIV) for the correction of structural thoracolumbar/lumbar (TL/L) curve for a minimum 5-year follow-up.

Summary of Background Data.
There has been some debate in the selection of L3 or L4 as the LIV for the correction of structural TL/L curve. However, there is a limited information about the changes in disc wedge or vertebral body tilt angles below the L3 LIV.

Methods.
Forty-seven patients were included (mean age 16 yr 7 mo, follow-up 8 yr 2 mo). The Cobb angle of the TL/L curve, L3/L4 disc wedge angle, L4 tilt angle, trunk shift (TS), and apical vertebral translation (AVT) were compared preoperatively and at postoperative 5 days, 1 month, 6 months, 2 years, and final follow-up.

Results.
At postoperative 5 days, Cobb angle of the TL/L curve, L4 tilt angle, and AVT were improved, except TS and L3/L4 disc wedge angle. The L3/L4 disc wedge and L4 tilt angle were most increased at postoperative 6 months and decreased thereafter. L4 tilt angle, AVT, and TS were improved during postoperative follow-up, except L3/L4 disc wedge angle. Finally, Cobb angle of the TL/L curve (11.8° ± 5.1°, P < 0.001), L4 tilt angle (7.6° ± 4.0°, P < 0.001), AVT (19.2 ± 9.3 mm, P < 0.001), and TS (−5.0 ± 10.0 mm, P = 0.041) were improved; however, L3/L4 disc wedge angle (3.3° ± 2.3°, P = 0.442) was not improved compared to the preoperative evaluation.

Conclusion.
When LIV was selected as the L3, the correction of TL/L curve was maintained in a minimum 5-year follow-up with the improvement of L4 tilt angle, AVT, and TS; however, L3/L4 disc wedge angle may remain.

Level of Evidence: 3