bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inpatient costs and blood transfusion rates of sarcopenic patients following thoracolumbar spine surgery
Authors: Bokshan Steven L. , Han Alex , DePasse J. Mason , Marcaccio Stephen E. , Eltorai Adam E. M. , Daniels Alan H. 
Published: October 2017

OBJECTIVESarcopenia, the muscle atrophy associated with aging and disease progression, accounts for nearly $18.5 billion in health care expenditures annually. Given the high prevalence of sarcopenia in patients undergoing orthopedic surgery, the goal of this study was to assess the impact of sarcopenia on inpatient costs following thoracolumbar spine surgery.METHODSPatients older than 55 years undergoing thoracolumbar spine surgery from 2003 to 2015 were retrospectively analyzed. Sarcopenia was measured using total psoas area at the L-4 vertebra on perioperative CT scans. Hospital billing data were used to compare inpatient costs, transfusion rate, and rate of advanced imaging utilization.RESULTSOf the 50 patients assessed, 16 were sarcopenic. Mean total hospital costs were 1.75-fold greater for sarcopenic patients compared with nonsarcopenic patients ($53,128 vs $30,292, p = 0.04). Sarcopenic patients were 2.1 times as likely to require a blood transfusion (43.8% vs 20.6%, p = 0.04). Sarcopenic patients had a 2.6-fold greater usage of advanced imaging (68.8% vs 26.5%, p = 0.002) with associated higher diagnostic imaging costs ($2452 vs $801, p = 0.01). Sarcopenic patients also had greater pharmacy, laboratory, respiratory care, and emergency department costs.CONCLUSIONSThis study is the first to show that sarcopenia is associated with higher postoperative costs and rates of blood transfusion following thoracolumbar spine surgery. Measuring the psoas area may represent a strategy for predicting perioperative costs in spine surgery patients.
Isolated optic nerve gliomas: a multicenter historical cohort study
Authors: Shofty Ben , Ben-Sira Liat , Kesler Anat , Jallo George , Groves Mari L. , Iyer Rajiv R. , Lassaletta Alvaro , Tabori Uri , Bouffet Eric , Thomale Ulrich-Wilhelm , Hernáiz Driever Pablo , Constantini Shlomi , _ _ 
Published: October 2017

OBJECTIVEIsolated optic nerve gliomas (IONGs) constitute a rare subgroup of optic pathway gliomas (OPGs). Due to the rarity of this condition and the difficulty in differentiating IONGs from other types of OPGs in most clinical series, little is known about these tumors. Currently, due to lack of evidence, they are managed the same as any other OPG.METHODSThe authors conducted a multicenter retrospective cohort study aimed at determining the natural history of IONGs. Included were patients with clear-cut glioma of the optic nerve without posterior (chiasmatic/hypothalamic) involvement. At least 1 year of follow-up, 2 MRI studies, and 2 neuro-ophthalmological examinations were required for inclusion.RESULTSThirty-six patients with 39 tumors were included in this study. Age at diagnosis ranged between 6 months and 16 years (average 6 years). The mean follow-up time was 5.6 years. Twenty-five patients had neurofibromatosis Type 1. During the follow-up period, 59% of the tumors progressed, 23% remained stable, and 18% (all with neurofibromatosis Type 1) displayed some degree of spontaneous regression. Fifty-one percent of the patients presented with visual decline, of whom 90% experienced further deterioration. Nine patients were treated with chemotherapy, 5 of whom improved visually. Ten patients underwent operation, and no local or distal recurrence was noted.CONCLUSIONSIsolated optic nerve gliomas are highly dynamic tumors. Radiological progression and visual deterioration occur in greater percentages than in the general population of patients with OPGs. Response to chemotherapy may be better in this group, and its use should be considered early in the course of the disease.
Lessons learned from administration of high-dose methylprednisolone sodium succinate for acute pediatric spinal cord injuries
Authors: Caruso Michelle C. , Daugherty Margot C. , Moody Suzanne M. , Falcone Richard A. , Bierbrauer Karin S. , Geis Gary L. 
Published: October 2017

OBJECTIVEMethylprednisolone sodium succinate (MPSS) has been studied as a pharmacological adjunct that may be given to patients with acute spinal cord injury (ASCI) to improve neurological recovery. MPSS treatment became the standard of care in adults despite a lack of evidence supporting clinical benefit. More recently, new guidelines from neurological surgeon groups recommended no longer using MPSS for ASCI, due to questionable clinical benefit and known complications. However, little information exists in the pediatric population regarding MPSS use in the setting of ASCI. The aim of this paper was to describe steroid use and side effects in patients with ASCI at the authors’ Level 1 pediatric trauma center in order to inform other hospitals that may still use this therapy.METHODSA retrospective chart review was conducted to determine adherence in ordering and delivery according to the guideline of the authors’ institution and to determine types and frequency of complications. Inclusion criteria included age < 17 years, blunt trauma, physician concern for ASCI, and admission for ≥ 24 hours or treatment with high-dose intravenous MPSS. Exclusion criteria included penetrating trauma, no documentation of ASCI, and incomplete medical records. Charts were reviewed for a predetermined list of complications.RESULTSA total of 602 patient charts were reviewed; 354 patients were included in the study. MPSS was administered in 59 cases. In 34 (57.5%) the order was placed correctly. In 13 (38.2%) of these 34 cases, MPSS was administered according to the recommended timeline protocol. Overall, only 13 (22%) of 59 patients received the therapy according to protocol with regard to accurate ordering and administration.Among the patients with ASCI, 20 (55.6%) of the 36 who received steroids had complications, which was a significantly higher rate than in those who did not receive steroids (8 [24.2%] of 33, p = 0.008). Among the patients without ASCI, 10 (43.5%) of the 23 who received steroids also experienced significantly more complications than patients who did not receive steroids (50 [19.1%] of 262, p = 0.006).CONCLUSIONSHigh-dose MPSS for ASCI was not delivered to pediatric patients according to protocol with a high degree of reliability. Patients receiving steroids for pediatric ASCI were significantly more likely to experience complications than patients not receiving steroids. The findings presented, including complications of steroid use, support removal of high-dose MPSS as a treatment option for pediatric ASCI.
Progression of Duchenne Cardiomyopathy Presenting with Chest Pain and Troponin Elevation
Authors: Hor Kan N. , Johnston Pace , Kinnett Kathi , Mah May Ling , Stiver Corey , Markham Larry , Cripe Linda 
Published: October 2017

Background: Improved neuromuscular and respiratory therapies have altered the natural history of Duchenne muscular dystrophy (DMD) such that the most common cause of mortality is progressive cardiomyopathy. Despite imaging evidence of progressive cardiomyopathy, troponin I (cTn) is not significantly elevated in asymptomatic DMD patients. Results: We describe eight boys with DMD evaluated for acute chest pain (ACP) and found to have acute cTn elevation with depressed left ventricular ejection fraction (LVEF). Of our eight patients, five presented with a primary complaint of ACP, while three presented with secondary myocardial injury in the context of systemic illness requiring hospitalization. Electrocardiograms showed diffuse ST changes and mean peak cTn level was 44±15.4 ng/mL (reference range <0.03 ng/mL). cTn levels normalized with only supportive care. Cardiac magnetic resonance imaging (CMR) was performed during the event on all but one patient, demonstrating increased late gadolinium enhancement (LGE) from 12.4±11.4% to 36.5±10.3% with associated deterioration of LVEF from 61±4.4% to 47.6±6.6% which remained depressed on follow-up CMR study (49.1±7.8%). All viral studies were negative. Additional investigations varied among patients, but no causative findings were demonstrated. Conclusions: ACP with cTn elevation occurs in DMD boys and may be indicative of cardiomyopathy progression as evidenced by acute left ventricular dysfunction and development or progression of myocardial fibrosis. This clinical presentation is under recognized. These events may represent an important pathophysiological mechanism in cardiomyopathy progression.
Initiation of Levodopa-Carbidopa Intestinal Gel Infusion Using Telemedicine (Video Communication System) Facilitates Efficient and Well-Accepted Home Titration in Patients with Advanced Parkinson’s Disease
Authors: Willows Thomas , Dizdar Nil , Nyholm Dag , Widner Håkan , Grenholm Peter , Schmiauke Ursula , Urbom Anna , Groth Kristina , Larsson Jörgen , Permert Johan , Kjellander Susanna 
Published: October 2017

Background: Levodopa-carbidopa intestinal gel (LCIG; Duodopa®) is used for continuous infusion in advanced Parkinson’s disease. To achieve optimal effect, the LCIG dose is individually titrated, traditionally conducted during hospitalization in Sweden. However, dose adjustment depends on surrounding conditions, physical activity, and emotional stress, which is why titration at home could be beneficial. Telemedicine (TM) using a video communication system offers alternative titration procedures, allowing LCIG initiation at home. Objective: Study objectives were to show the feasibility of TM for LCIG home titration, evaluate resource use, and assess patient, neurologist, and nurse satisfaction. Methods: Four clinics enrolled 15 patients to observe efficiency and feasibility of TM-based monitoring. Results: Patient median (range) age was 67 (52–73) years and time since diagnosis was 10 (7–23) years. Median time between LCIG initiation and end of TM-assisted titration was 2.8 (2.0–13.8) days. Median time required for home titration by neurologists, nurses, and patients was (hours:minutes) 1 : 14 (0 : 29–1 : 52), 5 : 49 (2 : 46–10 : 3), and 8 : 53 (4 : 11–14 : 11), respectively. Neurologists and nurses considered this to be less time than required for hospital titration. TM allowed patients 92% free time from start to end of titration. Technical problems associated with TM contacts were rare, mostly related to digital link, and quickly resolved. Patients, neurologists, and nurses were satisfied using TM. No serious adverse events were reported; there was one device complaint (tube occlusion). Conclusions: In this study, TM-assisted LCIG titration at home was resource-efficient, technically feasible, well-accepted and was deemed satisfactory by patients, neurologists, and nurses.
The Role of Vitamin D in Disease Progression in Early Parkinson’s Disease
Authors: Sleeman Isobel , Aspray Terry , Lawson Rachael , Coleman Shirley , Duncan Gordon , Khoo Tien K. , Schoenmakers Inez , Rochester Lynn , Burn David , Yarnall Alison 
Published: October 2017

Background: Previous cross-sectional studies have shown that Parkinson’s disease (PD) patients have lower serum 25-hydroxy vitamin D (25(OH)D) concentrations than controls. Vitamin D deficiency was associated with increased disease severity and cognitive impairment in prevalent PD patients. Objective: The aim of the study was to determine 25(OH)D in newly diagnosed PD and age-matched controls and to assess if there was an association with clinical outcomes (disease severity, cognition and falls) over the 36-month follow up period. Methods: A prospective observational study of newly diagnosed PD patients in the North East of England with age-matched controls (PD, n = 145; control, n = 94). Serum 25(OH)D was assessed at baseline and 18 months. Participants underwent clinical assessment at baseline, 18 and 36 months. One hundred and ten participants with PD also took part in a prospective falls study. Results: Mean serum 25(OH)D concentrations were lower in PD than control participants at baseline (44.1±21.7 vs. 52.2±22.1 nmol/L, p < 0.05) and 18 months (44.2±23.6 vs. 55.7±28.8 nmol/L, p < 0.05). Baseline serum 25(OH)D concentration, age, motor score and dosage of dopaminergic medication were significant predictors of variance of motor severity at 36 months (( ΔR2 = 0.039, F = 6.6, p < 0.01). Serum 25(OH)D was not associated with cognition or falls during the follow up period. Conclusions: Patients with incident PD had significantly lower serum 25(OH)D concentrations than age-matched controls, which may have implications in terms of bone health and fracture risk. There was a small but significant association between vitamin D status at baseline and disease motor severity at 36 months.
The therapeutic use of non-invasive brain stimulation in multiple sclerosis – a review
Authors: Iodice Rosa , Manganelli Fiore , Dubbioso Raffaele 
Published: October 2017

Background: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system and a leading cause of disability in young adults. Many disabling symptoms in MS, such as spasticity, pain, depression and cognitive deficits are not fully controlled by drug treatment. Non-invasive brain stimulation (NIBS) techniques can be used as tools for modulating altered cortical excitability and plasticity MS patients, providing an improvement in disabling symptoms affecting such patients. Objective: This review reported and summarized some of the most interesting and promising recent achievements regarding the therapeutic use of NIBS in MS patients. Methods: We reviewed the clinical application of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), emphasizing their effect on clinical symptoms and signs that are commonly involved in MS patients. In addition, we shortly described new NIBS protocols, such as transcranial alternating current stimulation and transcranial focused ultrasound stimulation as potential and innovative therapeutic options to be applied in future studies in MS patients. Results: We reviewed twenty-one studies covering six main clinical domains. Most of such studies focused on fatigues (33.3%), motor performance (19%) and spasticity (19%), sparse results were about pain (9.5%), cognitive abilities (9.5%), sensory deficit (4.8%) and bladder function (4.8%). The most promising results have been published for the improvement of motor (i.e. hand dexterity) and cognitive performances (i.e. attention and working memory) by applying rTMS or tDCS alone or in association with motor/cognitive training, for pain’s treatment by using tDCS. Conclusion: There are still no official recommendations for the therapeutic use of tDCS or rTMS in MS. The huge inter-individual variability of NIBS efficacy is still a big challenge which needs to be solved. However, well-designed studies, deeper knowledge about pathomechanisms underlying MS, and the combination of such techniques with motor and cognitive rehabilitation might results in higher effectiveness of NIBS.
Making if-then plans counteracts learned non-use in stroke patients: A proof-of-principle study
Authors: Marquardt Michael K. , Cohen Anna-Lisa , Gollwitzer Peter M. , Gilbert Sam J. , Dettmers Christian 
Published: October 2017

Background: After stroke, the learned non-use of a paretic arm is a major obstacle to the improvement of hand function. Objective: We examined whether patients with a central paresis could profit from applying the self-regulation strategy of making if-then plans that specify situational triggers to using the paretic arm. Method: Seventeen stroke patients with a mild to moderate hand paresis were asked to perform a Simon task which is commonly used to study the enhanced executive control needed when there is a mismatch between stimulus (e.g., color) and response (e.g., location) features. We examined whether patients with hemiparesis would be able to reduce the Simon effect (i.e., responding slower to mismatched as compared to matched stimulus and response features) by creating new stimulus-response associations via if-then plans. Results: A significant Simon effect was observed in both the affected and the non-affected arm for control trials. However, there was no longer a significant Simon effect for the critical trials prepared by forming if-then plans. This led to a significant stimulus×compatibility interaction effect for the affected arm and a marginally significant interaction effect for the non-affected arm. Making if-then plans was effective for eliminating or at least reducing the Simon effect for the affected and the non-affected arm, respectively. Conclusion: This observation opens a potential new route to improving stroke rehabilitation. If-then plans may qualify as a viable strategy to overcome the learned non-use of the affected arm. Further research is now required to develop and test therapeutic measures based on this proof-of-principle.
Pour une socio-anthropologie de l’action publique dans les pays ‘sous régime d’aide’
Authors: Lavigne Delville Philippe 
Published: October 2017

Interroger les projets – objets anciens de la socio-anthropologie du développement – et les politiques de développement – objets nouveaux – en termes d’action publique élargit et renouvelle les questionnements de la socio-anthropologie du développement, et offre de nouveaux regards sur l’État, l’aide et les modalités spécifiques de gouvernance internationalisée que celle-ci produit. Après un bref état des lieux des rapports entre anthropologie et politiques publiques, cet article pose les jalons d’une socio-anthropologie de l’action publique dans les pays « sous régime d’aide », propose des pistes de recherche et plaide pour un dialogue constructif avec la sociologie politique de l’action publique.
Coproduction de la sécurité publique dans le Nord-Bénin
Authors: Abou Moumouni Issifou 
Published: October 2017

Cet article explore les mécanismes de collaboration entre les forces de l’ordre et les associations de chasseurs (Dambanga) dans la lutte contre la délinquance au Bénin et cherche à comprendre la tolérance affichée par les forces de sécurité publique envers les pratiques violentes des Dambanga. Il met en exergue les facteurs qui favorisent le recours aux chasseurs par les forces de l’ordre et les arrangements qui se développent quotidiennement entre ces deux types d’acteurs dans la lutte contre les coupeurs de route. Les forces de l’ordre trouvent dans leur collaboration avec les Dambanga un moyen de contourner les normes officielles qui entravent leur efficacité dans la lutte contre la délinquance. La délégation tacite de leur pouvoir répressif aux Dambanga, leur permet de se soustraire aux accusations de violation des normes de droit tout en produisant un bien public important : la sécurité des personnes. Loin de caractériser une perte d’hégémonie de l’État dans le domaine du maintien de l’ordre, cette implication informelle des chasseurs néo-traditionnels est plutôt une stratégie locale de construction de l’État contemporain.
Las relaciones al pasado en la fotografía latinoamericana: por un acercamiento estético y antropológico de la fotografía
Authors: Corp Mathieu 
Published: October 2017

L’approche de la « photographie latino-américaine » a longtemps été dominée par la question de la valeur critique et contextuelle des œuvres, au détriment d’une mise en évidence de leurs qualités artistiques. Depuis les années 1990, commissaires et critiques ont voulu rompre avec cette approche pour célébrer l’hétérogénéité et les qualités formelles des pratiques photographiques. Pour continuer de légitimer l’échelle « Amérique latine » des expositions, ils ont réuni des œuvres différentes dans certaines catégories thématiques qui reviennent de manière récurrente et qu’identifient les termes : histoire, mémoire et identité. Dans la thèse d’où sont issues les réflexions qui composent cet article, je propose une analyse des problématiques et des rapports au passé dont ces termes sont l’indice, à partir d’une approche des images articulant la valeur critique et contextuelle des œuvres à leurs qualités artistiques.
Kau. Los toldos tehuelches en los dibujos, grabados y fotografías de viajeros por la Patagonia (Argentina y Chile)
Authors: Butto Ana , Saletta María José , Fiore Dánae 
Published: October 2017

En este trabajo analizaremos un corpus de veintidós dibujos, grabados y fotografías de toldos tehuelches producidos por diversos viajeros que recorrieron la Patagonia desde comienzos del siglo XIX hasta comienzos del siglo XX, con el objetivo de rastrear las semejanzas y diferencias en las representaciones de dichas estructuras de habitación generadas mediante estos diferentes sistemas de representación. Para ello, centramos el estudio en la comparación de la estructura del toldo, su tamaño, apertura, orientación, paisaje circundante, cultura material, personas y fauna asociada. Los resultados del análisis muestran la existencia de sesgos en cada sistema de representación, a pesar de los cuales las imágenes muestran una continuidad en las formas de documentar visualmente una parte de la realidad pasada ; que permite rescatar elementos relativos a la agencia de los sujetos productores y usuarios de los toldos y a la pregnancia de los objetos representados, que a su vez se transmite a las imágenes que los documentan.
L’anthropologique et l’artistique, et vice-versa
Authors: Aguiar Carneiro Martins Fernanda 
Published: October 2017

Entre 2012 et 2014, lors de différents voyages, la photographe et anthropologue brésilienne Andrea Eichenberger a parcouru les 4 542 km de BR-101, autoroute qui longe le littoral du Brésil du nord au sud, et croise différents états et régions. Son objectif était de rendre compte de la vie le long de cette voie, par la photographie, en favorisant les rencontres avec les habitants et usagers. Lors de son passage par Bahia, l’artiste a été invitée à présenter son travail photographique et les enjeux de sa pratique artistique aux étudiants en Cinéma et Audiovisuel de l’Universidade Federal do Recôncavo da Bahia (UFRB), à Cachoeira. Cet article intègre les débats avec ces derniers. Les droits de publication des images photographiques, trouvées dans cet article et dans Artelogie Expo-Revue, ont été cédés par l´artiste.