bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the unruptured intracranial aneurysm treatment score: comparison with real-world cerebrovascular practice
Authors: Ravindra Vijay M. , de Havenon Adam , Gooldy Timothy C. , Scoville Jonathan , Guan Jian , Couldwell William T. , Taussky Philipp , MacDonald Joel D. , Schmidt Richard H. , Park Min S. 
Published: October 2017

OBJECTIVEThe purpose of this study was to compare the unruptured intracranial aneurysm treatment score (UIATS) recommendations with the real-world experience in a quaternary academic medical center with a high volume of patients with unruptured intracranial aneurysms (UIAs).METHODSAll patients with UIAs evaluated during a 3-year period were included. All factors included in the UIATS were abstracted, and patients were scored using the UIATS. Patients were categorized in a contingency table assessing UIATS recommendation versus real-world treatment decision. The authors calculated the percentage of misclassification, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve.RESULTSA total of 221 consecutive patients with UIAs met the inclusion criteria: 69 (31%) patients underwent treatment and 152 (69%) did not. Fifty-nine (27%) patients had a UIATS between −2 and 2, which does not offer a treatment recommendation, leaving 162 (73%) patients with a UIATS treatment recommendation. The UIATS was significantly associated with treatment (p < 0.001); however, the sensitivity, specificity, and percentage of misclassification were 49%, 80%, and 28%, respectively. Notably, 51% of patients for whom treatment would be recommended by the UIATS did not undergo treatment in the real-world cohort and 20% of patients for whom conservative management would be recommended by UIATS had intervention. The area under the ROC curve was 0.646.CONCLUSIONSCompared with the authors’ experience, the UIATS recommended overtreatment of UIAs. Although the UIATS could be used as a screening tool, individualized treatment recommendations based on consultation with a cerebrovascular specialist are necessary. Further validation with longitudinal data on rupture rates of UIAs is needed before widespread use.
Surgical timing for cervical and upper thoracic injuries in patients with polytrauma
Authors: Lubelski Daniel , Tharin Suzanne , Como John J. , Steinmetz Michael P. , Vallier Heather , Moore Timothy 
Published: October 2017

OBJECTIVEFew studies have investigated the advantages of early spinal stabilization in the patient with polytrauma in terms of reduction of morbidity and mortality. Previous analyses have shown that early stabilization may reduce ICU stay, with no effect on complication rates.METHODSThe authors prospectively observed 340 polytrauma patients with an Injury Severity Score (ISS) of greater than 16 at a single Level 1 trauma center who were treated in accordance with a protocol termed “early appropriate care,” which emphasizes operative treatment of various fractures within 36 hours of injury. Of these patients, 46 had upper thoracic and/or cervical spine injuries. The authors retrospectively compared patients treated according to protocol versus those who were not. Continuous variables were compared using independent t-tests and categorical variables using Fisher’s exact test. Logistic regression analysis was performed to account for baseline confounding factors.RESULTSFourteen of 46 patients (30%) did not undergo surgery within 36 hours. These patients were significantly more likely to be older than those in the protocol group (53 vs 38 years, p = 0.008) and have greater body mass index (BMI; 33 vs 27, p = 0.02), and they were less likely to have a spinal cord injury (SCI) (82% did not have an SCI vs 44% in the protocol group, p = 0.04). In terms of outcomes, patients in the protocol-breach group had significantly more total ventilator days (13 vs 6 days, p = 0.02) and total ICU days (16 vs 9 days, p = 0.03). Infection rates were 14% in the protocol-breach group and 3% in the protocol group (p = 0.2) Total complications trended toward being statistically significantly more common in the protocol-breach group (57% vs 31%). After controlling for potential confounding variables by logistic regression (including age, sex, BMI, race, and SCI), total complications were significantly (p < 0.05) greater in the protocol-breach group (OR 29, 95% CI 1.9–1828). This indicates that the odds of developing “any complication” were 29 times greater if treatment was delayed more than 36 hours.CONCLUSIONSEarly surgical stabilization in the polytrauma patient with a cervical or upper thoracic spine injury is associated with fewer complications and improved outcomes. Hospitals may consider the benefit of protocols that promote early stabilization in this patient population.
Spinal cord injury after traumatic spine fracture in patients with ankylosing spinal disorders
Authors: Teunissen Frederik R. , Verbeek Bianca M. , Cha Thomas D. , Schwab Joseph H. 
Published: October 2017

OBJECTIVESpinal cord injury (SCI) is a major complication of spinal fractures in patients with ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH). Due to the uncommon nature of these conditions, existing literature consists of relatively small case series without detailed neurological data. This study aims to investigate the incidence, predictors, and sequelae of SCI in patients with a traumatic fracture of the ankylosed spine.METHODSThe study included all patients older than 18 years of age with AS or DISH who presented to two affiliated tertiary care centers between January 1, 1990, and January 1, 2016, and had a traumatic fracture of the spine. Factors associated with SCI after traumatic fracture were compared using Fisher’s exact tests. Logistic regression was used for the analysis of predictive factors for SCI. For the comparison of probability of survival between patients with and without SCI, Kaplan-Meier methodology was used.RESULTSOne hundred seventy-two patients with a traumatic fracture of an ankylosed spine were included. Fifty-seven patients (34.1%) had an SCI associated with the fracture. The cervical spine was the most fractured region for patients both with (77.2%) and without (51.4%) SCI. A cervical fracture (odds ratio [OR] 2.70, p = 0.024) and a spinal epidural hematoma (SEH) after fracture (OR 2.69, p = 0.013) were predictive of SCI. Eleven patients (19.3%) with SCI had delayed SCI (range 8–230 days). Of 44 patients with SCI and sufficient follow-up, 20 (45.5%) had neurological improvement after treatment. Early and late complication rates were significantly higher (p = 0.001 and p = 0.004) and hospital stay was significantly longer (p = 0.001) in patients with SCI. The probability of survival was significantly lower in the SCI group compared with the non-SCI group (p = 0.006).CONCLUSIONSThe incidence of SCI was high after fracture of the spine in patients with AS and DISH. Predictive factors for SCI after fracture were a fracture in the cervical spine and an SEH following fracture. One-fifth of the patients with SCI had delayed SCI. Patients with SCI had more complications, a longer hospital stay, and a lower probability of survival. Less than half of the patients with SCI showed neurological improvement.
Evolution of the postoperative sagittal spinal profile in early-onset scoliosis: is there a difference between rib-based and spine-based growth-friendly instrumentation?
Authors: Chen Zhonghui , Li Song , Qiu Yong , Zhu Zezhang , Chen Xi , Xu Liang , Sun Xu 
Published: October 2017

OBJECTIVEAlthough the vertical expandable prosthetic titanium rib (VEPTR) and growing rod instrumentation (GRI) encourage spinal growth via regular lengthening, they can create different results because of their different fixation patterns and mechanisms in correcting scoliosis. Previous studies have focused comparisons on coronal plane deformity with minimal attention to the sagittal profile. In this retrospective study, the authors aimed to compare the evolution of the sagittal spinal profile in early-onset scoliosis (EOS) treated with VEPTR versus GRI.METHODSThe data for 11 patients with VEPTR and 22 with GRI were reviewed. All patients had more than 2 years’ follow-up with more than 2 lengthening procedures. Radiographic measurements were performed before and after the index surgery and at the latest follow-up. The complications in both groups were recorded.RESULTSPatients in both groups had similar diagnoses, age at the index surgery, and number of lengthening procedures. The changes in the major coronal Cobb angle and T1–S1 spinal height were not significantly different between the 2 groups. Compared with the GRI group, the VEPTR group had less correction in thoracic kyphosis (23% ± 12% vs 44% ± 16%, p < 0.001) after the index surgery and experienced a greater correction loss in thoracic kyphosis (46% ± 18% vs 11% ± 8%, p < 0.001) at the latest follow-up. Although the increase in the proximal junctional angle was not significantly different (VEPTR: 7° ± 4° vs GRI: 8° ± 5°, p = 0.569), the incidence of proximal junctional kyphosis was relatively lower in the VEPTR group (VEPTR: 18.2% vs GRI: 22.7%). No significant changes in the spinopelvic parameters were observed, while the sagittal vertical axis showed a tendency toward a neutral position in both groups. The overall complication rate was higher in the VEPTR group than in the GRI group (72.7% vs 54.5%).CONCLUSIONSThe VEPTR had coronal correction and spinal growth results similar to those with GRI. In the sagittal plane, however, the VEPTR was not comparable to the GRI in controlling thoracic kyphosis. Thus, for hyperkyphotic EOS patients, GRI is recommended over VEPTR.
Differences in Parkinson’s Disease Risk with Caffeine Intake and Postmenopausal Hormone Use
Authors: Kim Iris Y. , O’Reilly Éilis J. , Hughes Katherine C. , Gao Xiang , Schwarzschild Michael A. , Ascherio Alberto 
Published: October 2017

Background: Caffeine intake has been associated with a lower risk of Parkinson’s disease (PD). This association is robust in men, but inconsistent in women due to a possible interaction with post-menopausal hormone (PMH) use. Objective: To (1) evaluate the association between caffeine intake and PD risk and (2) assess potential effect modification of the association by PMH use among women. Methods: We examined associations between caffeine intake and incident PD risk in the Nurses’ Health Study (NHS) (N = 121,701 women) and the Health Professionals Follow-up Study (HPFS) (N = 51,529 men). Dietary data on coffee and caffeine from other sources were collected every four years using a validated semi-quantitative food frequency questionnaire for both cohorts. Information on lifestyle and incident PD diagnosis was updated biennially and PD diagnoses were confirmed by medical record review. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards models. Results: We documented a total of 1,219 PD cases over the follow-up period. The multivariable-adjusted HR comparing the highest to lowest quintile of caffeine intake was 0.50 (95% CI: 0.37, 0.68; Ptrend<0.0001) in the HPFS. Among women, there was a suggestion of an interaction between coffee intake and PMH use ( P = 0.08). In the pooled analyses combining men and women who have never used PMH, the risk of PD was lower as coffee intake increased ( Ptrend<0.001). Conclusions: Our results support previous findings that increased caffeine intake may be associated with a decreased PD risk in men and women who have never used PMH.
The effects of exercise on cognitive function and brain plasticity – a feasibility trial
Authors: Gomes-Osman Joyce , Cabral Danylo F. , Hinchman Carrie , Jannati Ali , Morris Timothy P. , Pascual-Leone Alvaro 
Published: October 2017

Background: Exercise-mediated cognitive improvements can be at least partly attributed to neuroplastic changes in the nervous system, and may be influenced by the Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene. Transcranial magnetic stimulation (TMS) can be used to assess mechanisms of plasticity in humans noninvasively. Objectives: To assess the feasibility of evaluating the effects of short-term regular exercise on cognitive performance, and to evaluate the relationship between these effects, TMS measures of plasticity, and BDNF Met carrier status in young healthy sedentary adults. Methods: Of the 19 participants who enrolled in the study, 14 sedentary adults (12 females, age mean± SD, 27±12.3 yr), with less than two sessions of physical exercise in the preceding 2 months, completed an aerobic exercise regimen including four 30-min daily sessions per week for 4 weeks (for a total of 16 sessions) delivered at 55–64% of age-predicted maximal heart rate. Prior to and following the exercise regimen, participants performed a neuropsychological test battery and an intermittent theta-burst TMS plasticity protocol. Results: All participants completed the various measures and adhered to the exercise regimen. There were no complications and the results obtained were reliable. The feasibility of the approach is thus well established. Between-group comparisons of pre-post change revealed trends toward increased performance on the Stroop and faster reaction times in the CPT detectability in the Val66Val subgroup ( p = 0.07 and p = 0.08), and a reduction in TBS-induced modulation of TMS responses in Met carriers ( p = 0.07). Conclusion: Acute exercise interventions in sedentary adults can be meaningfully conducted along with cognitive and neurophysiologic measures to assess behavioral and neurobiological effects and assessment of BDNF polymorphism. TMS measures of plasticity can be used to evaluate the effects of exercise on brain plasticity, and relate them to neuropsychological measures of cognition.
L’idiotie ou la subversion par les marges dans Molloy
Authors: Clément Sarah 
Published: October 2017

La figure de l'idiot beckettien remplit une triple fonction : critique, philosophique, et poétique. Cet article montre que l’indétermination de Molloy porte en germe une puissance de subversion qui remet en cause les lois de la communauté. En inversant la hiérarchie des valeurs, l'idiot se pose comme une conscience interrogeante qui remet en cause tous les emblèmes du savoir docte, institué, académique. Il oppose également une résistance au langage dont il renouvelle les règles en faisant entendre une voix autre, la voix sensible d’une humanité dérisoire, des oubliés, des sans-voix, une voix universelle et épuisée.
La lecture comme événement
Authors: Minzetanu Andrei 
Published: October 2017

La notion d'« événement » occupe dans l'épistémologie des sciences humaines contemporaines une place considérable. En mobilisant des définitions empruntées à l'histoire, à l'anthropologie et à la philosophie, cet article essaie de reprendre et de consolider une distinction proposée par Barthes dans ses derniers cours au Collège de France entre l' « incident » et le « moment de vérité ». Étant donné que les conséquences existentielles, éthiques et épistémologiques de ces deux notions sont très différentes, il convient de ne pas enfermer le « moment de vérité », comme le souhaitait Barthes, dans une « critique pathétique », c'est-à-dire dans une critique qui s'intéresse principalement aux moments intenses d'une lecture.
Un modèle calibré de l’effet du CICE sur l’emploi
Authors: Breda Thomas , Haywood Luke , Wang Haomin 
Published: October 2017

Dans cet article, nous tentons de comparer les effets potentiels sur l’emploi et la structure des salaires du crédit d’impôt pour la compétitivité et l’emploi (CICE) et sur les d’allégements de cotisation ciblés supplémentaires, similaires dans leur format à ceux en vigueur aujourd’hui. À cette fin, nous construisons un modèle de recherche et d’appariement sur le marché du travail, avec salariés et entreprises hétérogènes, complémentarités productives, et négociations salariales. Les individus peuvent être inactifs, en recherche d’emploi ou salariés. Ils peuvent rechercher un emploi et recevoir des offres lorsqu’ils travaillent déjà. Notre contribution théorique, s’inscrivant dans un agenda de recherche plus large, est d’inclure à la fois un salaire minimum et de la fiscalité sur les salaires dans un modèle de ce type. Le modèle est calibré de différentes manières possibles à l’état stationnaire à partir de statistiques sur l’emploi fournies par l’Insee et de statistiques sur les salaires calculées à partir des déclarations annuelles de données sociales (DADS). Il est ensuite utilisé pour réaliser des simulations contrefactuelles. Ces simulations indiquent que, à coût équivalent, l’effet du CICE sur l’emploi est systématiquement plus limité que l’effet d’allégements de cotisation ciblés. Nous concluons qu’un modèle prenant uniquement en compte le marché du travail mais « aussi riche que possible » ne permet pas d’estimer des effets conséquents du CICE sur l’emploi.
La place des emplois atypiques dans les trajectoires d’entrée dans la vie active
Authors: Couprie Hélène , Joutard Xavier 
Published: October 2017

Des « formes atypiques d’emploi », déviant de la norme de l’emploi salarié en contrat à durée indéterminée et à temps complet, se développent sur le marché du travail français depuis plusieurs décennies. Ces formes atypiques d’emploi concernent en premier lieu la jeunesse et peuvent constituer un préalable à une insertion durable ou laisser des cicatrices sur leurs chances d’emploi à moyen terme. Nous comparons les trajectoires d’entrée sur le marché du travail de cohortes de primo -sortants du système éducatif de 1998, 2004 et 2010 à l’aide d’un modèle dynamique markovien de transitions hétérogènes sur le marché du travail. Nos analyses montrent que la norme d’emploi est de plus en plus difficile à atteindre. Les évolutions récentes des dynamiques de transitions sur le marché du travail, en lien avec la crise de 2008, apparaissent fortement hétérogènes. Elles ont contribué à compenser la dégradation tendancielle des effets tremplin de l’emploi à temps complet en CDD vers le CDI à temps complet.
La fabrique pragmatique des politiques publiques
Authors: Zittoun Philippe 
Published: October 2017

Cet article expose les principaux principes, concepts et hypothèses d’une approche pragmatique des politiques publiques. Inspirée par la philosophie pragmatique américaine de Peirce, James et Dewey du début du 20e siècle, par le linguistic turn de la philosophie des années 1970 et par la sociologie pragmatique française de Boltanski et Latour, cette nouvelle perspective privilégie la description concrète des activités que conduisent les acteurs pour maintenir ou transformer les politiques publiques. Elle privilégie un regard micro décrivant précieusement les phénomènes empiriques dans leur complexité à un regard macro rendu possible par des théories causales dont la force explicative a tendance à trop fortement simplifier la réalité. Prenant au sérieux les capacités cognitives et discursives des individus, elle propose de suivre la carrière des propositions d’action publique en s’intéressant aux stratégies définitionnelles, argumentatives et conflictuelles que ces derniers conduisent dans les jeux de langage, d’enrôlement et de pouvoir dans lesquels ils sont engagés. S’appuyant sur une méthode d’enquête qualitative, cette approche compréhensive accorde une importance majeure au sens qu’élaborent les acteurs pour définir les contraintes et les opportunités dans leurs interactions au cours du processus décisionnel.
Impacts of the agricultural transformation of the Canadian Prairies on grassland arthropods
Authors: Vankosky M.A. , Cárcamo H.A. , Catton H.A. , Costamagna A.C. , De Clerck-Floate R. 
Published: October 2017

AbstractThe prairie grasslands have been transformed to become the primary source of agricultural production in Canada. Soon after its establishment, the Biological Survey of Canada recognised the urgent need to document the arthropods of the prairie grasslands, especially in the few pristine remnants. Although this initiative has yielded considerable progress in documenting the species present in the Prairies Ecozone, comprehensive ecological studies are sparse. Landscape effects on arthropods are well studied elsewhere, but no equivalent studies have been published for the Canadian Prairies. Crop rotation varies landscape composition annually, changes host plant resources in fields, and interacts with other agricultural inputs to disturb pest and beneficial arthropods. Despite only a handful of studies on grazing, there is an emerging pattern: moderate grazing increases arthropod diversity and benefits certain arthropod guilds. Abiotic inputs elicit variable responses from different arthropod taxa; Carabidae (Coleoptera) are best studied, with some information available for ants (Hymenoptera: Formicidae) and aquatic arthropods. Biotic inputs include arthropods released for biocontrol of weed and insect pests; evidence indicates that biocontrol agents of insects have a greater potential for impact on native communities of arthropods. The studies reviewed here reveal important trends and research gaps to be addressed in the future.
Contribution of DNA barcoding to the study of the bees (Hymenoptera: Apoidea) of Canada: progress to date
Authors: Sheffield Cory S. , Heron Jennifer , Gibbs Jason , Onuferko Thomas M. , Oram Ryan , Best Lincoln , deSilva Nicholai , Dumesh Sheila , Pindar Alana , Rowe Genevieve 
Published: October 2017

AbstractBees (Hymenoptera: Apoidea, Apiformes) are taxonomically and ecologically diverse, with a wide range of social complexity, nesting preferences, floral associations, and biogeographic restrictions. A Canadian bee checklist, greatly assisted by the gene-assisted approach of DNA barcoding, is nearing completion. Previous evaluation of bee diversity in Canada, assisted by DNA barcoding, was restricted to Nova Scotia, which contains about 25% of the bee species in the country. Here, we summarise efforts to date to build a comprehensive DNA barcode library supporting bee taxonomic studies in Canada, consisting of more than 12 500 barcode-compliant sequences yielding 811 distinct barcode index numbers (BINs). This appears to represent ~95% of the 856 bee species presently recorded from Canada, but comparison with known morphological species in each genus shows that some genera are still under-sampled or may contain cryptic taxa, with much taxonomic work still to be done on bees in Canada. This is particularly true within the taxonomically difficult generaAndrenaFabricius (Andrenidae), HylaeusFabricius (Colletidae),MelissodesLatreille (Apidae),NomadaScopoli (Apidae),OsmiaPanzer (Megachilidae), andSphecodesLatreille (Halictidae). DNA analysis will likely be a key asset in resolving bee taxonomic issues in Canada in the future, and to date has even assisted studies of well-known bee taxa. Here we present summaries of our results, and discuss the use of DNA barcoding to assist future taxonomic work, faunal lists, and ecological studies.