bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis
Authors: Abu-Bonsrah Nancy , Goodwin C. Rory , Ortega Gezzer , Abdullah Fizan , Cornwell Edward , De la Garza-Ramos Rafael , Groves Mari L. , Ain Michael , Sponseller Paul D. , Sciubba Daniel M. 
Published: October 2017

OBJECTIVESpinal arthrodesis is routinely performed in the pediatric population. However, there is limited information on the short-term outcomes of pediatric patients who have undergone spine fusion. Thus, the authors conducted a retrospective review of the Pediatric National Surgical Quality Improvement Program (NSQIP) database to determine the short-term mortality, complication, reoperation, and readmission rates of pediatric patients who underwent spinal arthrodesis for all indications.METHODSThe Pediatric NSQIP database was queried for all patients who underwent spinal arthrodesis between 2012 and 2014. Patient demographics, comorbidities, body mass index, American Society of Anesthesiologists classification, and operative time were abstracted. Short-term mortality, reoperation, and readmission rates and complications were also noted. Univariate and multivariate analyses were performed to delineate patient risk factors that influence short-term mortality, complications, reoperation, and readmission rates.RESULTSA total of 4420 pediatric patients who underwent spinal fusion were identified. Common indications for surgical intervention included acquired/idiopathic scoliosis or kyphoscoliosis (71.2%) and genetic/syndromic scoliosis (10.7%). The mean patient age was 13.7 ± 2.9 years, and 70% of patients were female. The overall 30-day mortality was 0.14%. Multivariate analysis showed that female sex and pulmonary comorbidities significantly increased the odds of reoperation, with odds ratios of 1.43 and 1.78, respectively.CONCLUSIONSIn the NSQIP database for pediatric patients undergoing spinal arthrodesis for all causes, there was a 3.6% unplanned reoperation rate, a 3.96% unplanned readmission rate, and a 9.0% complication rate. This analysis provides data for risk stratification of pediatric patients undergoing spinal arthrodesis, allowing for optimized care.
The impact of curve severity on obstetric complications and regional anesthesia utilization in pregnant patients with adolescent idiopathic scoliosis: a preliminary analysis
Authors: Chan Emily W. , Gannon Stephen R. , Shannon Chevis N. , Martus Jeffrey E. , Mencio Gregory A. , Bonfield Christopher M. 
Published: October 2017

OBJECTIVEAdolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman’s childbearing years; however, research investigating the impact of AIS on women’s health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression.METHODSRecords of all pregnant patients diagnosed with AIS at the authors’ institution who delivered between January 2002 and September 2016 were retrospectively reviewed. Demographic information, pre- and postpartum radiographic Cobb angles, and clinical data for each pregnancy and delivery were recorded and analyzed. The Wilcoxon rank-sum test and the Wilcoxon signed-rank test were used for statistical analyses.RESULTSFifty-nine patients (84 deliveries) were included; 14 patients had undergone prior posterior spinal fusion. The median age at AIS diagnosis was 15.2 years, and the median age at delivery was 21.8 years. Overall, the median major Cobb angle prior to the first pregnancy was 25° (IQR 15°–40°). Most births were by spontaneous vaginal delivery (n = 45; 54%); elective caesarean section was performed in 17 deliveries (20%). Obstetric complications included preterm birth (n = 18; 21.4%), induction of labor (n = 20; 23.8%), and urgent/emergency caesarean section (n = 12; 14.0%); none were associated with severity of scoliosis curve or prior spinal fusion. Attempts at spinal anesthesia were successful 99% of the time (70/71 deliveries), even among the patients who had undergone prior spinal fusion (n = 13). There were only 3 instances of provider refusal to administer spinal anesthesia. In the subset of 11 patients who underwent postpartum scoliosis radiography, there was no statistically significant change in curve magnitude either during or immediately after pregnancy.CONCLUSIONSThe results of this study suggest that there was no effect of the severity of scoliosis on delivery complications or regional anesthetic decision making in pregnant patients with AIS. Moreover, scoliosis was not observed to progress significantly during or immediately after pregnancy. Larger prospective studies are needed to further investigate these outcomes, the findings of which can guide the prenatal education and counseling of pregnant patients with AIS.
Single-stage deformity correction in children with neurogenic kyphoscoliosis: nuances and a proposal for risk stratification
Authors: Udayakumaran Suhas , Menon Sajesh K. , Onyia Chiazor U. , Tahasildar Naveen 
Published: October 2017

OBJECTIVENeurogenic kyphoscoliosis in pediatric patients has varied causes and diverse management options. The most common management strategy is to stage the orthopedic and neurosurgical aspects of the correction at an interval of 3–6 months from each other. The aim of this study was to report the authors’ experience with correction of deformity in children with associated neurological abnormalities requiring intervention as a single-stage surgical treatment.METHODSOf 591 pediatric patients with scoliosis treated at the Amrita Institute of Medical Sciences and Research Centre between January 2001 and January 2011, the authors identified all patients with neurogenic kyphoscoliosis who underwent deformity correction and a neurosurgical procedure in the same surgical session when they were younger than 15 years. Data regarding the demographic details, preoperative Cobb angle/kyphotic angle, surgical details, postoperative complications, cost of the procedure, and long-term neurological outcome were collected for each case and analyzed. Based on the results of this analysis, the authors propose a 2-category risk stratification system for the timing of deformity correction depending on the primary neurogenic etiology.RESULTSTen cases involving patients with neurogenic kyphoscoliosis requiring both deformity correction and neurosurgical procedure met the criteria and were included in the analysis. All 10 patients were younger than 15 years; their mean age was 10.8 years. The average Cobb angle was 59.5°. Five patients underwent foramen magnum decompression, 5 patients underwent spinal cord detethering, and 1 patient had intraspinal intradural tumor excision. The mean estimated blood loss was 1177 ml (range 700–1550 ml), and the mean operative time was 4.4 hours (range 3–5.5 hours). There were no intraoperative complications. None of the patients had any new postoperative neurological deficits. The mean postoperative Cobb angle of the main thoracic curve was 12.6°.CONCLUSIONSSimultaneous deformity correction along with a definitive neurosurgical procedure in patients with neurogenic kyphoscoliosis can be performed without added morbidity and avoids both the added costs and the risk of complications associated with a second surgery. The risk stratification system proposed in this paper may serve as a guideline for case selection and help to optimize outcome.
Intraoperative neuromonitoring alerts in a pediatric deformity center
Authors: Zuccaro Maria , Zuccaro James , Samdani Amer F. , Pahys Joshua M. , Hwang Steven W. 
Published: October 2017

OBJECTIVEIntraoperative neuromonitoring (IONM) involves the use of somatosensory evoked potentials (SSEPs) and transcranial electric motor evoked potentials (TceMEPs). In this retrospective study the authors examined the sensitivity and specificity of both SSEPs and TceMEPs during pediatric spinal deformity surgeries.METHODSThe authors performed a retrospective quantitative analysis of data obtained in 806 patients (197 males and 609 females) treated from December 2011 until October 2015. All patients were diagnosed with scoliosis that was classified as one of the following: adolescent idiopathic scoliosis (AIS) (38%), congenital scoliosis (22%), or syndromic scoliosis (40%). Also, 53 patients underwent vertebral column resection (VCR). All surgeries were monitored by high-level neuromonitoring specialists and were performed with total intravenous anesthesia. Alerts were described as a decrease in amplitude by 50% or greater (bilateral or unilateral) in SSEPs, TceMEPs, or both.RESULTSTrue-positive alerts for TceMEPs were observed in 60 of the 806 patients (7.4%). True-positive alerts for SSEPs were observed in 7 of the 806 patients (0.9%). In contrast, there were no false-positive or false-negative outcomes. Only 1 case (0.1%) was reported with a permanent postoperative deficit. No reported false negatives or false positives were observed, and thus sensitivity was 100% and specificity was 93%–100% for TceMEPs. The rate of sensitivity was 13.2% and the rate of specificity was 100% for SSEPs. The breakdown of total alert was as follows: 6.6% in AIS cases, 24.5% in congenital scoliosis cases, and 10.2% in syndromic scoliosis cases. Neurological injury rates were significantly lower than in previous studies, as there were 0% for AIS cases (p = 0.12), 0.6% for congenital scoliosis cases (p = 0.17), and 0% for syndromic scoliosis cases (p = 0.07). One injury in a patient with congenital scoliosis occurred during a VCR procedure, which brought the injury rate to 1.9% (p < 0.005). IONM alerts occurred during 34% of rod/correction cases, 25% of thoracic screw placements, 20% of the osteotomies, 17% of the resections, 3% of the cage insertions, and 2% of the sublaminar wiring procedures.CONCLUSIONSThe authors hypothesize that the results of this study will support the necessity, as a standard of care, of multimodality neuromonitoring during high-risk pediatric spinal deformity surgery because of the decrease in postoperative deficits. Their data suggest that the TceMEPs are more sensitive than SSEPs, but when used in combination, they offer the patient a level of safety that would otherwise not exist. Last, these findings support the notion that better outcomes are achieved with high-level IONM professionals.
Neuromuscular scoliosis complication rates from 2004 to 2015: a report from the Scoliosis Research Society Morbidity and Mortality database
Authors: Cognetti Daniel , Keeny Heather M. , Samdani Amer F. , Pahys Joshua M. , Hanson Darrell S. , Blanke Kathy , Hwang Steven W. 
Published: October 2017

OBJECTIVEPostoperative complications are one of the most significant concerns in surgeries of the spine, especially in higher-risk cases such as neuromuscular scoliosis. Neuromuscular scoliosis is a classification of multiple diseases affecting the neuromotor system or musculature of patients leading to severe degrees of spinal deformation, disability, and comorbidity, all likely contributing to higher rates of postoperative complications. The objective of this study was to evaluate deformity correction of patients with neuromuscular scoliosis over a 12-year period (2004–2015) by looking at changes in postsurgical complications and management.METHODSThe authors queried the Scoliosis Research Society (SRS) Morbidity and Mortality (M&M) database for neuromuscular scoliosis cases from 2004 to 2015. The SRS M&M database is an international database with thousands of self-reported cases by fellowship-trained surgeons. The database has previously been validated, but reorganization in 2008 created less-robust data sets from 2008 to 2011. Consequently, the majority of analysis in this report was performed using cohorts that bookend the 12-year period (2004–2007 and 2012–2015). Of the 312 individual fields recorded per patient, demographic analysis was completed for age, sex, diagnosis, and preoperative curvature. Analysis of complications included infection, bleeding, mortality, respiratory, neurological deficit, and management practices.RESULTSFrom 2004 to 2015, a total of 29,019 cases of neuromuscular scoliosis were reported with 1385 complications, equating to a 6.3% complication rate when excluding the less-robust data from 2008 to 2011. This study shows a 3.5-fold decrease in overall complication rates from 2004 to 2015. A closer look at complications shows a significant decrease in wound infections (superficial and deep), respiratory complications, and implant-associated complications. The overall complication rate decreased by approximately 10% from 2004–2007 to 2012–2015.CONCLUSIONSThis study demonstrates a substantial decrease in complication rates from 2004 to 2015 for patients with neuromuscular scoliosis undergoing spine surgery. Decreases in specific complications, such as surgical site infection, allow us to gauge our progress while observing how trends in management affect outcomes. Further study is needed to validate this report, but these results are encouraging, helping to reinforce efforts toward continual improvement in patient care.
Novel primary care treatment package for patients with medically unexplained symptoms: a cohort intervention study
Authors: Röhricht Frank , Zammit Ivan , Papadopoulos Nina 
Published: October 2017

BackgroundExisting care models for patients with persistent medically unexplained symptoms (MUS) do not adequately address the needs of these patients. New and innovative intervention strategies are necessary to achieve better health and corresponding economic outcomes.AimTo explore the feasibility of implementing a pragmatic care package that provides primary care treatment for patients with persistent MUS and to evaluate recruitment, retention, and acceptability as well as the potential impact on clinical outcomes and service utilisation.Design & settingProspective cohort intervention study involving a cluster of seven GP surgeries in Newham, East London, providing a 'One-Stop-Shop' primary care treatment service.MethodThe care package included: identification, assessment, engagement, psychoeducation, and a choice of group interventions (mindfulness-based stress reduction [MBSR] and body-oriented psychological therapy [BOPT]). Baseline and follow-up data on somatic symptom levels (PHQ-15), health-related quality of life (SF-36, EQ-5D) and service utilisation was analysed.ResultsIn total, 145 patients were referred and assessed for eligibility, and 93 were included in the study. Participants engaged well with different components of the care package and gained significant improvements in somatic symptom levels with corresponding increases of quality-of-life ratings and a reduction in healthcare utilisation (GP contacts and referrals to specialist services) as well as associated healthcare costs.ConclusionThe primary care treatment package can be successfully implemented in primary care at a relatively low cost and easily adopted into routine care. The body-oriented approach is well accepted by clinicians and patients. Controlled trials should be conducted to test the efficacy of the treatment package.
Molecular-cloud-scale Chemical Composition. II. Mapping Spectral Line Survey toward W3(OH) in the 3 mm Band
Authors: Nishimura Yuri , Watanabe Yoshimasa , Harada Nanase , Shimonishi Takashi , Sakai Nami , Aikawa Yuri , Kawamura Akiko , Yamamoto Satoshi 
Published: October 2017

Abstract
To study a molecular-cloud-scale chemical composition, we conducted a mapping spectral line survey toward the Galactic molecular cloud W3(OH), which is one of the most active star-forming regions in the Perseus arm. We conducted our survey through the use of the Nobeyama Radio Observatory 45 m telescope, and observed the area of 16′ × 16′, which corresponds to 9.0 pc × 9.0 pc. The observed frequency ranges are 87–91, 96–103, and 108–112 GHz. We prepared the spectrum averaged over the observed area, in which eight molecular species (CCH, HCN, HCO+, HNC, CS, SO, C18O, and 13CO) are identified. On the other hand, the spectrum of the W3(OH) hot core observed at a 0.17 pc resolution shows the lines of various molecules such as OCS, H2CS CH3CCH, and CH3CN in addition to the above species. In the spatially averaged spectrum, emission of the species concentrated just around the star-forming core, such as CH3OH and HC3N, is fainter than in the hot core spectrum, whereas emission of the species widely extended over the cloud such as CCH is relatively brighter. We classified the observed area into five subregions according to the integrated intensity of 13CO, and evaluated the contribution to the averaged spectrum from each subregion. The CCH, HCN, HCO+, and CS lines can be seen even in the spectrum of the subregion with the lowest 13CO integrated intensity range (<10 K km s−1). Thus, the contributions of the spatially extended emission is confirmed to be dominant in the spatially averaged spectrum.
KASCADE-Grande Limits on the Isotropic Diffuse Gamma-Ray Flux between 100 TeV and 1 EeV
Authors: Apel W. D. , Arteaga-Velázquez J. C. , Bekk K. , Bertaina M. , Blümer J. , Bozdog H. , Brancus I. M. , Cantoni E. , Chiavassa A. , Cossavella F. , Daumiller K. , Souza V. de , Pierro F. Di , Doll P. , Engel R. , Feng Z. , Fuhrmann D. , Gherghel-Lascu A. , Gils H. J. , Glasstetter R. , Grupen C. , Haungs A. , Heck D. , Hörandel J. R. , Huege T. , Kampert K.-H. , Kang D. , Klages H. O. , Link K. , Łuczak P. , Mathes H. J. , Mayer H. J. , Milke J. , Mitrica B. , Morello C. , Oehlschläger J. , Ostapchenko S. , Pierog T. , Rebel H. , Roth M. , Schieler H. , Schoo S. , Schröder F. G. , Sima O. , Toma G. , Trinchero G. C. , Ulrich H. , Weindl A. , Wochele J. , Zabierowski J. ,   KASCADE-Grande Collaboration
Published: October 2017

Abstract
KASCADE and KASCADE-Grande were multi-detector installations to measure individual air showers of cosmic rays at ultra-high energy. Based on data sets measured by KASCADE and KASCADE-Grande, 90% C.L. upper limits to the flux of gamma-rays in the primary cosmic ray flux are determined in an energy range of

eV. The analysis is performed by selecting air showers with a low muon content as expected for gamma-ray-induced showers compared to air showers induced by energetic nuclei. The best upper limit of the fraction of gamma-rays to the total cosmic ray flux is obtained at

eV with

. Translated to an absolute gamma-ray flux this sets constraints on some fundamental astrophysical models, such as the distance of sources for at least one of the IceCube neutrino excess models.
Rebound in Measures of Disease Activity and Symptoms in Corrona Registry Patients with Psoriatic Arthritis Who Discontinue Tumor Necrosis Factor Inhibitor Therapy after Achieving Low Disease Activity
Authors: Harrold Leslie R. , Stolshek Bradley S. , Rebello Sabrina , Collier David H. , Mutebi Alex , Wade Sally W. , Malley Wendi , Greenberg Jeffrey D. , Etzel Carol J. 
Published: October 2017

Objective.Rebound may occur in patients with psoriatic arthritis (PsA) who discontinue TNF inhibitor (TNFi) therapy in low disease activity (LDA).Methods.Using physician and patient reports, we quantified rebound following TNFi discontinuation [defined as Clinical Disease Activity Index (CDAI) score > 10 or TNFi restart] and time to rebound in adults with PsA in LDA (CDAI score ≤ 10) at TNFi discontinuation.Results.Rebound occurred in 73% (69/94) of patients soon after discontinuation (median time to rebound 8.0 mos, 95% CI 6.0–12.0).Conclusion.Rebound occurred frequently in patients with PsA after TNFi discontinuation. TNFi discontinuation after achieving LDA should be carefully considered.
Filiation et transhumanisme
Authors: Arènes Jacques 
Published: October 2017

Ce travail expose une théorie de la filiation pensée comme forme dynamique, et fait le diagnostic d’une souffrance contemporaine à habiter la temporalité. Le rapport actuel au temps est saisi à travers le prisme des théories transhumanistes, afin d’illustrer l’idée d’un présent qui ne se déploie pas, et d’un futur peu investi par l’élan vital, quand bien même la mémoire serait « parfaite ». Une vignette clinique donne à comprendre l’impasse subjective d’une mémoire « totale ».
Situations de guerre
Authors: Douville Olivier 
Published: October 2017

Les montages identité/altérité qui caractérisent des adolescents, dans et sous la guerre, sont extrêmement rétrécis, réduits à des formes de Moi idéal, au détriment de la dette à payer à l’Idéal du moi. La condition de l’enfant et de l’adolescent soldat émerge au moment où ce qui se jouerait dans la guerre ne serait nullement l’effet d’une amplification des guerres fraternelles, mais plus précisément le moment où est réduite à rien la moindre fraternité avec l’adversaire, l’ennemi, l’autre.
La déesse des latrines. La légende de tradition orale de la déesse Zigu vue par les lettrés chinois
Authors: Chia‑Ping Chiu Blanche 
Published: October 2017

La légende de la déesse Zigu est un mythe de tradition orale chinois qui sous-tend le culte honorant la déesse des latrines. Cette légende remonterait au moins au ve siècle, époque à laquelle elle fut collectée par un lettré pour la première fois ; le culte populaire de Zigu se pratiqua jusqu’au début du xxe siècle. La déesse dénommée Zigu véhiculait l’image d’une concubine torturée et assassinée dans les latrines à cause de la rivalité et de la haine qui sévissaient au sein du gynécée. La légende de Zigu fut diffusée dans des récits et poèmes au fil du temps, ce qui favorisa et « officialisa » la transmission orale et fit circuler les variantes (trait caractéristique du récit mythique). Caractérisé par des pratiques divinatoires, ce culte (d’abord rural) accompagné de chants et d’offrandes se déroulait autour des latrines et était pratiqué en priorité par une communauté féminine. Les incantations de la cérémonie pour faire « descendre » l’avatar de la déesse faisaient revivre le mythe. La déesse se présentait sous la forme d’une effigie fabriquée avec des ustensiles ménagers. Les pratiquants posaient des questions à la déesse et interprétaient ses oracles. Le culte s’éteignit avec la modernisation et le déplacement des latrines situées jadis à l’extérieur de l’habitation. Ce changement d’espace provoqua la disparition du culte, mais cette légende demeure encore vive dans la mémoire collective.
Le prophète et la souveraine. Utilisation des récits biographiques de figures historiques par les guérisseurs betsileo (Madagascar)
Authors: Legrip-Randriambelo Olivia 
Published: October 2017

Les figures historiques betsileo, dans les Hautes Terres centrales de Madagascar, renvoient à des religiosités et périodes historiques diverses, tout comme le sont les guérisseurs qui les mobilisent. Nous prendrons deux exemples ethnographiques : celui de la reine et guérisseuse Rabolobolo qui aurait régné sur le Betsileo au xixe siècle, et celui de Rainisoalambo, devin-guérisseur repenti et fondateur du mouvement de Réveil protestant en 1894. Nous analyserons ces figures qui apparaissent dans les récits de vie stéréotypés des guérisseuses « descendantes » de la reine Rabolobolo et dans ceux des exorcistes laïcs du mouvement de Réveil. Ces récits sont élaborés en miroir de ceux des personnages historiques qui se manifestent dans les étapes d’apparition du don ou les pratiques de guérison. La souffrance et le renoncement s’entrecroisent dans ces récits de vie extraordinaires.
On a Property of Real Plane Curves of Even Degree
Authors: Reichstein Zinovy B. 
Published: October 2017

AbstractF. Cukierman asked whether or not for every smooth real plane curve$X\subset \mathbb{P}^{2}$of even degree$d\geqslant 2$there exists a real line$L\subset \mathbb{P}^{2}$such$X\cap L$has no real points. We show that the answer is yes if$d=2$or 4 and no if$n\geqslant 6$.