bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distal Fusion Level Selection in Scheuermann’s Kyphosis: A Comparison of Lordotic Disc Segment Versus the Sagittal Stable Vertebrae
Authors: Kim Han Jo , Nemani Venu , Boachie-Adjei Oheneba , Cunningham Matthew E. , Iorio Justin A. , O’Neill Kevin , Neuman Brian J. , Lenke Lawrence G. 
Published: April 2017

Study Design: Retrospective study. Objective: To compare 2 methods of selecting the lowest instrumented vertebra (LIV) on the rates of revision surgery for distal junctional kyphosis (DJK) following treatment for Scheuermann’s kyphosis (SK). Methods: A retrospective review of patients who have undergone surgical treatment for SK was performed. Forty-four patients were divided into 2 groups based on intervention: Group 1 (n = 26) included patients who had an LIV distal to or at the sagittal stable vertebrae (SSV), and Group 2 (n = 18) included patients who had an LIV proximal to the SSV. For each group, demographic, radiographic, and revision surgery data was analyzed. Results: The average follow-up was 3.1 years. There were no differences among demographic variables between the groups. Preoperative and postoperative thoracic kyphosis, lumbar lordosis, and sagittal balance were not different between groups. Postoperatively, Group 1 demonstrated a significantly greater average lordotic disc angle below the LIV compared with Group 2 (Group 1, −6.2 ± 4.3° vs Group 2, −2.9 ± 5.8°; P = .02). In a subgroup analysis, extending fusions to the sagittal stable vertebra rather than the first lordotic disc resulted in fewer distal LIV complications necessitating revision surgery compared with fusing short of the SSV (5% vs 36.3%, P = .04). Conclusion: The SSV method may reduce complications secondary to distal junctional failure, but at the expense of incorporating additional motion segments in a typically young population.
Radiographic Risk Factors of Reoperation Following Minimally Invasive Decompression for Lumbar Canal Stenosis Associated With Degenerative Scoliosis and Spondylolisthesis
Authors: Kato Minori , Namikawa Takashi , Matsumura Akira , Konishi Sadahiko , Nakamura Hiroaki 
Published: April 2017

Study Design: Prospective cohort study. Objective: Microsurgical bilateral decompression via a unilateral approach (MBDU), a minimally invasive surgical (MIS) decompression method, has been performed for numerous degenerative lumbar diseases, including degenerative lumbar scoliosis (DLS) or degenerative spondylolisthesis (DS), at our institution. In this study, we evaluated the appropriateness of MBDU for DLS or DS patients. Methods: A total of 207 patients treated by MBDU were included (88 women and 119 men; mean age, 70 [40-86] years). Thirty-seven cases were diagnosed as DLS (group A), 51 as DS (group B), and 119 as lumbar canal stenosis (group C). Patient clinical status assessed by JOA score was evaluated preoperatively and 2 years postoperatively. We evaluated the prevalence of cases that required reoperation among the groups and the radiographic risk factors related to reoperation. Results: There was no significant difference in recovery ratios of JOA scores among the groups. Reoperation after MBDU was needed in 13 cases (6.3%); the revision rate did not significantly differ among the groups. Reoperation was associated with poor clinical status, low visual analog scale score for low back pain, and low SF-36 mental component summary score. Reoperation was significantly associated with preoperative scoliotic disc wedging with Cobb’s angle ≥3° in L4-5 (odds ratio = 9.88) and lateral listhesis (odds ratio = 5.22 [total], 12.9 [L4-5]). Conclusions: When we are careful to indicate decompression for patients with these risk factors related to reoperation, MIS decompression alone can successfully improve DLS patients with a Cobb’s angle of ≤20° or DS patients.
Mandatory CSR Spending—Indian Experience
Authors: Kapoor G.K. , Dhamija Sanjay 
Published: April 2017

Corporate Social Responsibility (CSR) has received increased attention in the recent past as a means for sustainable development. CSR has largely been viewed as a voluntary exercise. However, the Companies Act, 2013 has made it mandatory for a certain category of companies to spend 2 percent of their average net profit in the past 3 years on CSR activities. If a company fails to spend the mandated amount on CSR activities, it is required to explain the reasons for the same in the Board’s report. India thereby became the first and the only country in the world to have mandatory CSR spending. The Act also prescribes the activities that would be eligible for this purpose. The year 2014–2015 was the first year of operations for these provisions. The article aims to critically review the requirements of the Companies Act, 2013 in this regard and assess the implementation of CSR spending requirements in the maiden year of operations.
Engage, participate, empower: Modelling power transfer in disadvantaged rural communities
Authors: Steiner Artur Adam , Farmer Jane 
Published: April 2017

Abstract This article explores a process meant to empower disadvantaged communities that have not previously engaged in government-instigated civic projects. Drawing on a large exploratory study of an empowerment project in seven Scottish rural communities, findings include that empowering communities should harness community development techniques that use both external actors and sources of support (i.e. exogenous practices), and those that utilise assets from within the community (i.e. endogenous practices). The paper presents the Engagement-Participation-Empowerment Model showing stages in transferring power from external actors to local communities. The paper highlights that the process of community empowerment starts with engagement and follows with participation – both representing a precondition of community empowerment. The paper indicates that there are limits to which community members are capable of embracing current community empowerment policies and showing that even targeted ‘well-tailored’ community empowerment programmes might fail. Implications of the study for further research and policy are identified.
A functional DC cross talk promotes human ILC homeostasis in humanized mice
Authors: Lopez-Lastra Silvia , Masse-Ranson Guillemette , Fiquet Oriane , Darche Sylvie , Serafini Nicolas , Li Yan , Dusséaux Mathilde , Strick-Marchand Helene , Di Santo James P. 
Published: April 2017

Key PointsA novel humanized mouse model to study human ILC biology. Human DC cross talk with ILCs in vivo.
Borderline intellectual functioning and psychosis: Adult Psychiatric Morbidity Survey evidence
Authors: Hassiotis A. , Noor M. , Bebbington P. , Afia A. , Wieland J. , Qassem T. 
Published: April 2017

SummaryBorderline intellectual functioning (BIF) is associated with several neuropsychological deficits. We used national data to establish the prevalence of psychosis and psychotic symptoms, and the role of potential mediators. The BIF group were more than twice as likely to have probable psychosis (adjusted odds ratio (OR) = 2.3, 95% CI 14−4.0) and to report hallucinations (adjusted OR = 2.9, 95% CI 1.9−44) but not persecutory ideation. Salient mediators were depressive symptoms and the cumulative total of life events. Our findings suggest mechanisms other than drug use that are contributing to the strong relationship between BIF and severe mental illness and that may be amenable to treatment.
Phase 1 Dose-Escalation Study of Pegylated Arginine Deiminase, Cisplatin, and Pemetrexed in Patients With Argininosuccinate Synthetase 1–Deficient Thoracic Cancers
Authors: Beddowes Emma , Spicer James , Chan Pui Ying , Khadeir Ramsay , Corbacho Javier Garcia , Repana Dimitra , Steele Jeremy P. , Schmid Peter , Szyszko Teresa , Cook Gary , Diaz Monica , Feng Xiaoxing , Johnston Amanda , Thomson Jim , Sheaff Michael , Wu Bor-Wen , Bomalaski John , Pacey Simon , Szlosarek Peter W. 
Published: April 2017

PurposePegylated arginine deiminase (ADI-PEG 20) depletes essential amino acid levels in argininosuccinate synthetase 1 (ASS1) –negative tumors by converting arginine to citrulline and ammonia. The main aim of this study was to determine the recommended dose, safety, and tolerability of ADI-PEG 20, cisplatin, and pemetrexed in patients with ASS1-deficient malignant pleural mesothelioma (MPM) or non–small-cell lung cancer (NSCLC).Patients and MethodsUsing a 3 + 3 + 3 dose-escalation study, nine chemotherapy-naïve patients (five MPM, four NSCLC) received weekly ADI-PEG 20 doses of 18 mg/m2, 27 mg/m2, or 36 mg/m2, together with pemetrexed 500 mg/m2and cisplatin 75 mg/m2which were given every three weeks (maximum of six cycles). Patients achieving stable disease or better could continue ADI-PEG 20 monotherapy until disease progression or withdrawal. Adverse events were assessed by Common Terminology Criteria for Adverse Events version 4.03, and pharmacodynamics and immunogenicity were also evaluated. Tumor response was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 for NSCLC and by modified RECIST criteria for MPM.ResultsNo dose-limiting toxicities were reported; nine of 38 reported adverse events (all grade 1 or 2) were related to ADI-PEG 20. Circulating arginine concentrations declined rapidly, and citrulline levels increased; both changes persisted at 18 weeks. Partial responses were observed in seven of nine patients (78%), including three with either sarcomatoid or biphasic MPM.ConclusionTarget engagement with depletion of arginine was maintained throughout treatment with no dose-limiting toxicities. In this biomarker-selected group of patients with ASS1-deficient cancers, clinical activity was observed in patients with poor-prognosis tumors. Therefore, we recommend a dose for future studies of weekly ADI-PEG 20 36 mg/m2plus three-weekly cisplatin 75 mg/m2and pemetrexed 500 mg/m2.
The Association of Frailty With Outcomes and Resource Use After Emergency General Surgery: A Population-Based Cohort Study
Authors: McIsaac Daniel I. , Moloo Husein , Bryson Gregory L. , van Walraven Carl 
Published: April 2017

BACKGROUND:
Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty is an important predictor of adverse outcomes in older surgical patients. The population-level effect of frailty on EGS is poorly described. Therefore, our objective was to measure the association of preoperative frailty with outcomes in a population of older patients undergoing EGS.

METHODS:
We created a population-based cohort study using linked administrative data in Ontario, Canada, that included community-dwelling individuals aged >65 years having EGS. Our main exposure was preoperative frailty, as defined by the Johns Hopkins Adjusted Clinical Groups frailty–defining diagnoses indicator. The Adjusted Clinical Groups frailty–defining diagnoses indicator is a binary variable that uses 12 clusters of frailty-defining diagnoses. Our main outcome measures were 1-year all-cause mortality (primary), intensive care unit admission, length of stay, institutional discharge, and costs of care (secondary).

RESULTS:
Of 77,184 patients, 19,779 (25.6%) were frail. Death within 1 year occurred in 6626 (33.5%) frail patients compared with 11,366 (19.8%) nonfrail patients. After adjustment for sociodemographic and surgical confounders, this resulted in a hazard ratio of 1.29 (95% confidence interval [CI] 1.25–1.33). The risk of death for frail patients varied significantly across the postoperative period and was particularly high immediately after surgery (hazard ratio on postoperative day 1 = 23.1, 95% CI 22.3–24.1). Frailty was adversely associated with all secondary outcomes, including a 5.82-fold increase in the adjusted odds of institutional discharge (95% CI 5.53–6.12).

CONCLUSIONS:
After EGS, frailty is associated with increased rates of mortality, institutional discharge, and resource use. Strategies that might improve perioperative outcomes in frail EGS patients need to be developed and tested.
Generative Retrieval Improves Learning and Retention of Cardiac Anatomy Using Transesophageal Echocardiography
Authors: Kleiman Amanda M. , Forkin Katherine T. , Bechtel Allison J. , Collins Stephen R. , Ma Jennie Z. , Nemergut Edward C. , Huffmyer Julie L. 
Published: April 2017

BACKGROUND:
Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy.

METHODS:
Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups. GR participants were required to verbally identify each unlabeled cardiac anatomical structure within 10 seconds of the TEE video appearing on the screen. Then a correctly labeled TEE video clip was shown to the GR participant for 5 more seconds. SP participants viewed the same TEE video clips as GR but there was no requirement for SP participants to generate an answer; for the SP group, each TEE video image was labeled with the correctly identified anatomical structure for the 15 second period. All participants were tested for intermediate (1 week) and late (1 month) retention of normal TEE cardiovascular anatomy. Improvement of intermediate and late retention of TEE cardiovascular anatomy was evaluated using a linear mixed effects model with random intercepts and random slopes.

RESULTS:
There was no statistically significant difference in baseline score between GR (49% ± 11) and SP (50% ± 12), with mean difference (95% CI) -1.1% (-9.5, 7.3%). At 1 week following the educational intervention, GR (90% ± 5) performed significantly better than SP (82% ± 11), with mean difference (95% CI) 8.1% (1.9, 14.2%); P = .012. This significant increase in scores persisted in the late posttest session at one month (GR: 83% ± 12; SP: 72% ± 12), with mean difference (95% CI) 10.2% (1.3 to 19.1%); P = .026. Mixed effects analysis showed significant improvements in TEE cardiovascular anatomy over time, at 5.9% and 3.5% per week for GR and SP groups respectively (P = .0003), and GR improved marginally faster than SP (P = .065).

CONCLUSIONS:
Medical students and anesthesiology residents inexperienced in the use of TEE showed both improved learning and retention of basic cardiovascular ultrasound anatomy with the incorporation of GR into the educational experience.
Change Amid Continuity, Innovation within Tradition: Wampum Diplomacy at the Treaty of Greenville, 1795
Authors: Harrison Daniel F. 
Published: April 2017

Abstract
The Treaty of Greenville (1795) was noteworthy for the extensive use of wampum by both Western Confederacy leaders and the American negotiator, Anthony Wayne. Analysis of the rhetoric of the negotiations and the wampum article used reveals structural correspondences with traditional Iroquoian diplomacy. Evidence suggests that the Six Nations of the Iroquois Confederacy, while not officially in attendance, exerted significant influence on the treaty process. Amid this continuity, however, the Native negotiators put wampum to innovative uses. Examination of specific wampum presentations offers an interpretation of a surviving belt and insight into a design now known as the Two-Row Wampum.
Ethnohistory in the Making: Guido Marlière and the Circulation of Knowledge About Jê Peoples of Minas Gerais, Brazil, 1760–1840
Authors: Bieber Judy 
Published: April 2017

Abstract
This article analyzes the evolution of ethnographic texts written about Jê-speaking peoples of the interior of Minas Gerais, Brazil, from the 1760s through the 1830s. It interprets both the timing and content of these sources with reference to the emergence of Enlightenment thought, the development of a transatlantic community of letters, and the intervention of an idiosyncratic French military officer, Guido Marlière, who participated in Brazil’s Botocudo War of 1808–31. Marlière’s writing, informed by his long association with Jê peoples, mastery of their languages, and advocacy for more humane indigenous policy, was unprecedented in its cultural specificity. Marlière also contributed directly and indirectly to the production of canonical texts authored by European scientists. In this article, Bieber recovers Marlière’s vivid, humanizing observations about Jê peoples and uses him as an example of how local actors contributed to the circulation of ideas and production of ethnographic knowledge.
MRSA decolonisation using polyhexanide 0.1 % with application where necessary of systemic antibiotics
Authors: Lorenz M. B. , Gkogkolou P. , Köck R. , Goerge T. 
Published: April 2017

SummaryBackground: Increasing infections and drug resistances lead to new treatment concepts in terms of MRSA decolonisation. An antibiotic-free decolonisation treatment with topical antiseptics is of great clinical interest. We investigated the effectiveness of MRSA decolonisation therapy using the topical antiseptic agent polyhexanide 0.1 %. If needed, a systemic antibiotic was added in case of hospitalisation, abscess formation, chronic wounds and others.Patients and methods: 63 patients were introduced to our outpatient clinic within a period of record of 15 months. 42 (66.7 %) of them were confirmed MRSA-positive and 27 (64.3 %) of these colonised patients were included to the protocol of decolonisation. Patients who followed the protocol of decolonisation (n=27) were investigated in terms of the site of MRSA-colonisation, parameters that minimize the effect of decolonisation, spa types as well as the effectiveness of the topical antiseptic agent polyhexanide 0.1 %.Results: 22 patients (81.5 %) were successfully decolonised within the group that followed the decolonisation protocol (n=27). Using polyhexanide 0.1 % as single treatment regime seven people (31.8 %) were successfully decolonised, whereas 15 patients (68.2 %) were in need of an additional systemic treatment with antibiotics in order to be decolonised. The implementation of one topical eradication cycle with polyhexanide 0.1 % was effective in case of an exclusive colonisation of the nose (n=3). At maximum, three decolonisation runs were necessary. Within six months of post-eradication investigations no relapses of MRSA were registered.Conclusions: One third of the decolonised patients were successfully treated with the topical antiseptic polyhexanide 0.1 %, whereas two thirds of the patients that followed the decolonisation protocol were in need of an additional systemic antibiotic.
Operative and postoperative risks of combined interventions by phlebectomy and foam sclerotherapy
Authors: Frendel A. , Kahle B. , Recke A. L. 
Published: April 2017

SummaryBackground: Insufficiency of anterior accessory great saphenous vein (AASV) with a competent great saphenous vein (GSV) is frequently encountered in patients referred for phlebological evaluation. The classic therapeutic approach to treat AASV insufficiency consists of crossectomy and stripping of GSV and all tributaries. In isolated AASV insufficiency, stripping of the AASV combined with foam sclerotherapy of the proximal AASV section is a useful alternative to preserve the GSV. Historically, the combination of phlebectomy and sclerotherapy in a single session was avoided given the perceived and reported risk of complicationsAim: A retrospective analysis of the side effects and complications following phlebectomy of the AASV combined with foam sclerotherapy in one session.Patients and method: Case records of all patients with isolated AASV insufficiency, who underwent a combined procedure (phlebectomy of the AASV and foam sclerotherapy) between 01.01.2013 and 30.11.2016, were evaluated.Results: 28 patients (29 legs) were included. There were no severe side effects or complications in any case. Complete occlusion of the proximal AASV could be demonstrated sono-graphically.Conclusion: The combination of phlebectomy and foam sclerotherapy in one session is an effective and safe treatment option in cases of isolated AASV insufficiency.
Foam sclerotherapy of segments of the saphenous vein with adjuvant hyaluronan compression
Authors: Despa O. R. , Brüggemann U. , El-Chamali S. , Stoyanova K. , Ragg J. C. 
Published: April 2017

SummaryBackground: Thermal, mechano-chemical and chemical methods of vein closure are increasingly less effective in saphenous veins with diameters above 10 mm. Furthermore, increasing vein size is associated with unpleasant inflammatory reactions, in particular in locations close to sensitive structures like the skin. External compression media are not able to prevent these unwanted sequela in a tolerable way. As a possible solution, perivenous hyaluronan compression was evaluated combined with microfoam sclero-therapy.Methods: 34 patients (25 f, 9 m, 43–71 yr/o) with saphenous insufficiency (GSV), dia -meters 10.1–23.1 mm (M: 14.1 mm), distance to skin: >10 mm, received a vein lumen compression oft thigh- or calf segments by perivenous injection of a NASHA gel mediated by a coaxial paravenous catheter prior to catheter-applied microfoam sclerotherapy (aethoxysklerol 1 %). Injection of both, hyaluronan and microfoam, were performed during catheter withdrawal. The aim of hyaluronan compression was a 2/3 reduction oft the native vein cross section. For comparison, adjacent segments were compressed with common tumescent fluid. Segments for both modalities had similar diameter and were randomized. Due to department rules, the junction segment was closed with endovenous lasers to warrant elimination of reflux. No textile compression media were applied. Clinical controls including ultrasound were performed after 2, 8, 26 and 54 weeks.Results: All treated vein segments showed total occlusion after 2 weeks (first visit). The lumen reduction was 54–81 % (M: 68.4 %) in segments with hyaluronan compression and 8–29 % (M: 19.2 %) in segments with tumes-cent fluid. Time needed for hyaluronan compression was 1.1–3.5 min (M: 2.2 min) and for tumescence 0.8–2.7 min (M: 1.8 min) per 10 cm-segment. Clinical investigations up to 8 weeks did not reveal any symptoms, visible inflammations or stainings in segments covered with hyaluronan, while tumescent-compressed segments had such findings in 20/34 cases (58.8 %). Perivenous hyaluronan did not induce any discomfort or side effects during follow-up.Conclusions: Even large saphenous veins can be effectively and safely treated by microfoam sclerotherapy without any postinterventional symptoms when the vein lumen is reduced by perivenous injection of hyaluronan gel. However, it takes additional interventional effort to achieve this goal. Future applications could also include combinations with thermal or gluing device or support novel foams like Varithena or biomatrix sclerofoam when treating very large veins or venous aneurysms, and furthermore serve in vein shaping fort the purpose of establishing laminar flow or modifying pressure relations (venoplasty).