bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of revision surgery and adjuvant therapy following subtotal resection of osteosarcoma of the spine: a systematic review with meta-analysis
Authors: Shankar Ganesh M. , Clarke Michelle J. , Ailon Tamir , Rhines Laurence D. , Patel Shreyaskumar R. , Sahgal Arjun , Laufer Ilya , Chou Dean , Bilsky Mark H. , Sciubba Daniel M. , Fehlings Michael G. , Fisher Charles G. , Gokaslan Ziya L. , Shin John H. 
Published: April 2017

OBJECTIVEPrimary osteosarcoma of the spine is a rare osseous neoplasm. While previously reported retrospective studies have demonstrated that overall patient survival is impacted mostly by en bloc resection and chemotherapy, the continued management of residual disease remains to be elucidated. This systematic review was designed to address the role of revision surgery and multimodal adjuvant therapy in cases in which en bloc excision is not initially achieved.METHODSA systematic literature search spanning the years 1966 to 2015 was performed on PubMed, Medline, EMBASE, and Web of Science to identify reports describing outcomes of patients who underwent biopsy alone, neurological decompression, or intralesional resection for osteosarcoma of the spine. Studies were reviewed qualitatively, and the clinical course of individual patients was aggregated for quantitative meta-analysis.RESULTSA total of 16 studies were identified for inclusion in the systematic review, of which 8 case reports were summarized qualitatively. These studies strongly support the role of chemotherapy for overall survival and moderately support adjuvant radiation therapy for local control. The meta-analysis revealed a statistically significant benefit in overall survival for performing revision tumor debulking (p = 0.01) and also for chemotherapy at relapse (p < 0.01). Adjuvant radiation therapy was associated with longer survival, although this did not reach statistical significance (p = 0.06).CONCLUSIONSWhile the initial therapeutic goal in the management of osteosarcoma of the spine is neoadjuvant chemotherapy followed by en bloc marginal resection, this objective is not always achievable given anatomical constraints and other limitations at the time of initial clinical presentation. This systematic review supports the continued aggressive use of revision surgery and multimodal adjuvant therapy when possible to improve outcomes in patients who initially undergo subtotal debulking of osteosarcoma. A limitation of this systematic review is that lesions amenable to subsequent resection or tumors inherently more sensitive to adjuvants would exaggerate a therapeutic effect of these interventions when studied in a retrospective fashion.
Outcomes after hemispherectomy in adult patients with intractable epilepsy: institutional experience and systematic review of the literature
Authors: Schusse Courtney M. , Smith Kris , Drees Cornelia 
Published: April 2017

OBJECTIVEHemispherectomy is a surgical technique that is established as a standard treatment in appropriately selected patients with drug-resistant epilepsy. It has proven to be successful in pediatric patients with unilateral hemispheric lesions but is underutilized in adults. This study retrospectively evaluated the clinical outcomes after hemispherectomy in adult patients with refractory epilepsy.METHODSThis study examined 6 cases of hemispherectomy in adult patients at Barrow Neurological Institute. In addition, all case series of hemispherectomy in adult patients were identified through a literature review using MEDLINE and PubMed. Case series of patients older than 18 years were included; reports of patients without clear follow-up duration or method of validated seizure outcome quantification were excluded. Seizure outcome was based on the Engel classification.RESULTSA total of 90 cases of adult hemispherectomy were identified, including 6 newly added by Barrow Neurological Institute. Sixty-five patients underwent functional hemispherectomy; 25 patients had anatomical hemispherectomy. Length of follow-up ranged from 9 to 456 months. Seizure freedom was achieved in 80% of patients. The overall morbidity rate was low, with 9 patients (10%) having new or additional postoperative speech or language dysfunction, and 19 patients (21%) reporting some worsening of hemiparesis. No patients lost ambulatory or significant functional ability, and 2 patients had objective ambulatory improvement. Among the 41 patients who underwent additional formal neuropsychological testing postoperatively, overall stability or improvement was seen.CONCLUSIONSHemispherectomy is a valuable surgical tool for properly selected adult patients with pre-existing hemiparesis and intractable epilepsy. In published cases, as well as in this series, the procedure has overall been well tolerated without significant morbidity, and the majority of patients have been rendered free of seizures.
Comparison of MRI techniques for detecting microadenomas in Cushing's disease
Authors: Grober Yuval , Grober Hagit , Wintermark Max , Jane John A. , Oldfield Edward H. 
Published: April 2017

OBJECTIVEMany centers use conventional and dynamic contrast-enhanced MRI (DMRI) sequences in patients with Cushing's disease. The authors assessed the utility of the 3D volumetric interpolated breath-hold examination, a spoiled-gradient echo 3D T1 sequence (SGE) characterized by superior soft tissue contrast and improved resolution, compared with DMRI and conventional MRI (CMRI) for detecting microadenomas in patients with Cushing's disease.METHODSThis study was a blinded assessment of pituitary MRI in patients with proven Cushing's disease. Fifty-seven patients who had undergone surgery for Cushing's disease (10 male, 47 female; age range 13–69 years), whose surgical findings were considered to represent a microadenoma, and who had been examined with all 3 imaging techniques were included. Thus, selection emphasized patients with prior negative or equivocal MRI on referral. The MRI annotations were anonymized and 4 separate imaging sets were independently read by 3 blinded, experienced clinicians: a neuroradiologist and 2 pituitary surgeons.RESULTSForty-eight surgical specimens contained an adenoma (46 ACTH-staining adenomas, 1 prolactinoma, and 1 nonfunctioning microadenoma). DMRI detected 5 adenomas that were not evident on CMRI, SGE detected 8 adenomas not evident on CMRI, including 3 that were not evident on DMRI. One adenoma was detected on DMRI that was not detected on SGE. McNemar's test for efficacy between the different MRI sets for tumor detection showed that the addition of SGE to CMRI increased the number of tumors detected from 18 to 26 (p = 0.02) based on agreement of at least 2 of 3 readers.CONCLUSIONSSGE shows higher sensitivity than DMRI for detecting and localizing pituitary microadenomas, although rarely an adenoma is detected exclusively by DMRI. SGE should be part of the standard MRI protocol for patients with Cushing's disease.
Reconstruction of 12-lead ECG Using a Single-patch Device
Authors: Lee Hong J. , Lee Dong S. , Kwon Hyun B. , Kim Do Y. , Park Kwang S. 
Published: April 2017

SummaryObjectives: The aim of this study is to develop an optimal electrode system in the form of a small and wearable single-patch ECG monitoring device that allows for the faithful reconstruction of the standard 12-lead ECG.Methods: The optimized universal electrode positions on the chest and the personalized transformation matrix were determined using linear regression as well as artificial neural networks (ANNs). A total of 24 combinations of 4 neighboring electrodes on 35 channels were evaluated on 19 subjects. Moreover, we analyzed combinations of three electrodes within the four-electrode combination with the best performance.Results: The mean correlation coefficients were all higher than 0.95 in the case of the ANN method for the combinations of four neighboring electrodes. The reconstructions obtained using the three and four sensing electrodes showed no significant differences. The reconstructed 12-lead ECG obtained using the ANN method is better than that using the MLR method. Therefore, three sensing electrodes and one ground electrode (forming a square) placed below the clavicle on the left were determined to be suitable for ensuring good reconstruction performance.Conclusions: Since the interelectrode distance was determined to be 5 cm, the suggested approach can be implemented in a single-patch device, which should allow for the continuous monitoring of the standard 12-lead ECG without requiring limb contact, both in daily life and in clinical practice.
Scientific Performance of a Nano-satellite MeV Telescope
Authors: Lucchetta Giulio , Berlato Francesco , Rando Riccardo , Bastieri Denis , Urso Giorgio 
Published: April 2017

Abstract
Over the past two decades, both X-ray and gamma-ray astronomy have experienced great progress. However, the region of the electromagnetic spectrum around ∼1 MeV is not so thoroughly explored. Future medium-sized gamma-ray telescopes will fill this gap in observations. As the timescale for the development and launch of a medium-class mission is ∼10 years, with substantial costs, we propose a different approach for the immediate future. In this paper, we evaluate the viability of a much smaller and cheaper detector: a nano-satellite Compton telescope, based on the CubeSat architecture. The scientific performance of this telescope would be well below that of the instrument expected for the future larger missions; however, via simulations, we estimate that such a compact telescope will achieve a performance similar to that of COMPTEL.
The Canada–France Ecliptic Plane Survey (CFEPS)—High-latitude Component
Authors: Petit J-M. , Kavelaars J. J. , Gladman B. J. , Jones R. L. , Parker J. Wm. , Bieryla A. , Van Laerhoven C. , Pike R. E. , Nicholson P. , Ashby M. L. N. , Lawler S. M. 
Published: April 2017

Abstract
The High Ecliptic Latitude (HiLat) extension of the Canada–France Ecliptic Plane Survey (CFEPS), conducted from 2006 June to 2009 July, discovered a set of Trans-Neptunian objects (TNOs) that we report here. The HiLat component was designed to address one of the shortcomings of ecliptic surveys (like CFEPS), their low sensitivity to high-inclination objects. We searched 701 deg2 of sky ranging from 12° to 85° ecliptic latitude and discovered 24 TNOs, with inclinations between 15° and 104°. This survey places a very strong constraint on the inclination distribution of the hot component of the classical Kuiper Belt, ruling out any possibility of a large intrinsic fraction of highly inclined orbits. Using the parameterization of Brown, the HiLat sample combined with CFEPS imposes a width 14° ≤ σ ≤ 15.°5, with a best match for σ = 14.°5. HiLat discovered the first retrograde TNO, 2008 KV42, with an almost polar orbit with inclination 104°, and (418993) = 2009 MS9, a scattering object with perihelion in the region of Saturn’s influence, with a ∼ 400 au and i = 68°.
Devenir le plus bel athlète du monde
Authors: Hamousin Frantz , Louis-Marie Raphaël , Bourgeois Mickaël 
Published: April 2017

Êtes-vous prêt à soulever des montagnes, boire des océans, vous infliger un régime alimentaire d’acier et vivre des semaines en enfer, sans perspective de profit ni de gloire ? Si oui, vous pourrez être champion du monde de culturisme naturel...
Society , l’audacieuse création du trublion de la presse papier
Authors: Karnbauer Éric , Férot Brieux 
Published: April 2017

À l’ère du numérique, un titre papier, Society , est lancé en fanfare par le groupe So Press. L’aventure d’une bande de copains autour de Franck Annese a constitué un savoir-faire et une philosophie, résumée par la règle des 3 H : humour, humain, histoire.
Accès aux marchés urbains et variation des revenus des agriculteurs ruraux du secteur informel au Cameroun
Authors: Mpabe Bodjongo Mathieu Juliot , Sikod Fondo 
Published: April 2017

L’objectif de cette note de recherche est d’examiner l’effet de l’accès aux marchés urbains sur la variation des revenus des agriculteurs ruraux du secteur informel au Cameroun. L’analyse porte sur un échantillon de 6526 agriculteurs ruraux travaillant dans le secteur informel, issu de la troisième enquête camerounaise auprès des ménages ECAM3 ( Ins , 2007). En s’inspirant du modèle théorique des biens publics et du modèle de Todaro , les résultats économétriques, obtenus à l'aide d'un modèle logit, révèlent que : les contrôles de la police routière dépourvus de corruption et la bonne qualité des routes raccordant les exploitations agricoles rurales aux marchés urbains favorisent l’accroissement des revenus des agriculteurs ruraux.
Nasopharyngeal aspirate & blood cytokine profile in infants hospitalized for respiratory syncytial virus bronchiolitis
Authors: Natarajan Suresh , Ramasamy Ganesh , Kumar N. Pavan , Babu S. Subash , Janakiraman Lalitha 
Published: April 2017

Background & objectives:
Following a respiratory syncytial virus (RSV) bronchiolitis, only some infants develop serious illness, and a proportion of them develop recurrent wheeze subsequently. Studies have revealed that cytokine expression following RSV infection may influence the severity and also the risk for subsequent reactive airway disease. This present study was conducted to determine the blood, and nasopharyngeal aspirate (NPA) cytokine profile among infants admitted for RSV bronchiolitis.

Methods:
In this prospective pilot study, a sample size of 15 cases and 15 controls was included. Detailed history, physical examination, blood sample and NPA collection were done. Cytokines (IFNγ and IL-4) estimation was done in the blood and NPA samples of cases and blood samples of controls.

Results:
The mean levels of interferon gamma in controls (blood) and cases (NPA and blood) were 5.95, 9.54 and 32.02 pg/ml, respectively. The mean levels of interleukin-4 in controls (blood), and cases (NPA and blood) were 1280.77, 956.08 and 692.37 pg/ml, respectively (P<0.05).

Interpretation & conclusions:
Our study showed that infants with RSV bronchiolitis evoked a Th1 response in both blood and NPA. Large multicentre studies are needed to validate our findings.
Number of decidual natural killer cells & macrophages in pre-eclampsia
Authors: Milosevic-Stevanovic Jelena , Krstic Miljan , Radovic-Janosevic Dragana , Popovic Jasmina , Tasic Marija , Stojnev Slavica 
Published: April 2017

Background & objectives:
The process of human placentation is complex and still not well understood. This study was aimed to examine the relationship between clinical features of pre-eclampsia and degree of trophoblastic invasion after its immunohistochemical visualization in the context of possible alterations in the number of natural killer (NK) cells and macrophages in the decidua.

Methods:
This prospective study included a study group comprising 30 pregnant women with pre-eclampsia delivered by caesarean section and a control group comprising 20 healthy pregnant women also delivered by caesarean section. Samples of placental bed obtained during caesarean section were analyzed after immunohistochemical labelling CD56+ NK cells, CD68+ macrophages and cytokeratin 7 trophoblastic cells.

Results:
In pre-eclampsia, there was a significantly lower number of CD56+ NK cells in the decidua (P<0.001) and a higher number of CD68+ macrophages (P<0.001) compared to control group. In the subgroup of pre-eclampsia with intrauterine growth retardation (IUGR), a significantly greater number of NK cells (P<0.05) was recorded, as well as an increased number of macrophages, but not significantly compared to pre-eclampsia without IUGR. There was no significant difference in the distribution of these cells in the decidua in relation to the severity of pre-eclampsia. CD56+ NK cells were significantly less (P<0.05) and macrophages were more (P<0.05) in the group with poor trophoblastic invasion.

Interpretation & conclusions:
Alterations in the number of immune cells in relation to the degree of trophoblastic invasion indicated their role in aetiopathogenesis of pre-eclampsia, while the direct association between their number and severity of pre-eclampsia was not confirmed.
Feasibility of intravitreal injections and ophthalmic safety assessment in marmoset (Callithrix jacchus) monkeys
Authors: Korbmacher Birgit , Atorf Jenny , Fridrichs-Gromoll Stephanie , Hill Marilyn , Korte Sven , Kremers Jan , Mansfield Keith , Mecklenburg Lars , Pilling Andrew , Wiederhold Andreas 
Published: April 2017

Abstract. To safeguard patients, regulatory authorities require that new drugs that are to be given by the intravitreal (IVT) route are assessed for their safety in a laboratory species using the same route of administration. Due to the high similarity of ocular morphology and physiology between humans and nonhuman primates (NHPs) and due to the species specificity of many biotherapeutics, the monkey is often the only appropriate model. To this end, intravitreal administration and assessment of ocular toxicity are well established in cynomolgus monkeys (Macaca fascicularis). In contrast, the common marmoset monkey (Callithrix jacchus) is not a standard model for ocular toxicity studies due to its general sensitivity to laboratory investigations and small eye size. It was the purpose of the present work to study whether the marmoset is a useful alternative to the cynomolgus monkey for use in intravitreal toxicological studies. Six marmoset monkeys received repeated (every 2 weeks for a total of four doses) intravitreal injections of 10 or 20 µL of a placebo. The animals were assessed for measurements of intraocular pressure (IOP), standard ophthalmological investigations and electroretinography (ERG). At the end of the dosing period, the animals were sacrificed and the eyes were evaluated histologically. ERG revealed similar results when comparing predose to end-of-study data, and there was no difference between the two dose volumes. A transient increase in the IOP was seen immediately after dosing, which was more pronounced after dosing of 20 µL compared to 10 µL. Ophthalmologic and microscopic observations did not show any significant changes. Therefore, it can be concluded that 10 µL as well as 20 µL intravitreal injections of a placebo are well tolerated in the marmoset. These results demonstrate that the common marmoset is an alternative to the cynomolgus monkey for intravitreal toxicity testing.
A Cross-sectional Analysis of Minimum USMLE Step 1 and 2 Criteria Used by Orthopaedic Surgery Residency Programs in Screening Residency Applications
Authors: Schrock John B. , Kraeutler Matthew J. , Dayton Michael R. , McCarty Eric C. 
Published: April 2017

Introduction:
The purpose of this study was to analyze how program directors (PDs) of orthopaedic surgery residency programs use United States Medical Licensing Examination (USMLE) Step 1 and 2 scores in screening residency applicants.

Methods:
A survey was sent to each allopathic orthopaedic surgery residency PD. PDs were asked if they currently use minimum Step 1 and/or 2 scores in screening residency applicants and if these criteria have changed in recent years.

Results:
Responses were received from 113 of 151 PDs (75%). One program did not have the requested information and five declined participation, leaving 107 responses analyzed. Eighty-nine programs used a minimum USMLE Step 1 score (83%). Eighty-three programs (78%) required a Step 1 score ≥210, 80 (75%) required a score ≥220, 57 (53%) required a score ≥230, and 22 (21%) required a score ≥240. Multiple PDs mentioned the high volume of applications as a reason for using a minimum score and for increasing the minimum score in recent years.

Discussion:
A large proportion of orthopaedic surgery residency PDs use a USMLE Step 1 minimum score when screening applications in an effort to reduce the number of applications to be reviewed.
Association Between Deep Sedation from Continuous Intravenous Sedatives and Extubation Failures in Mechanically Ventilated Patients in the Pediatric Intensive Care Unit
Authors: Schultheis Jennifer M. , Heath Travis S. , Turner David A. 
Published: April 2017

OBJECTIVE The primary objective of this study was to determine whether an association exists between deep sedation from continuous infusion sedatives and extubation failures in mechanically ventilated children. Secondary outcomes evaluated risk factors associated with deep sedation.
METHODS This was a retrospective cohort study conducted between January 1, 2009, and October 31, 2012, in the pediatric intensive care unit (PICU) at Duke Children's Hospital. Patients were included in the study if they had been admitted to the PICU, had been mechanically ventilated for ≥48 hours, and had received at least one continuous infusion benzodiazepine and/or opioid infusion for ≥24 hours. Patients were separated into 2 groups: those deeply sedated and those not deeply sedated. Deep sedation was defined as having at least one documented State Behavioral Scale (SBS) of −3 or −2 within 72 hours prior to planned extubation.
RESULTS A total of 108 patients were included in the analysis. Both groups were well matched with regard to baseline characteristics. For the primary outcome, there was no difference in extubation failures in those who were deeply sedated compared to those not deeply sedated (14 patients [22.6%] versus 7 patients [15.2%], respectively; p = 0.33). After adjusting for potential risk factors, patients with a higher weight percentile for age (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00–1.03), lower Glasgow Coma Score (GCS) score prior to intubation (OR 0.85; 95% CI 0.74–0.97), and larger maximum benzodiazepine dose (OR 1.93; 95% CI 1.01–3.71) were associated with greater odds of deep sedation. A higher GCS prior to intubation was significantly associated with increased odds of extubation failure (OR 1.19; 95% CI 1.02–1.39).
CONCLUSIONS While there was no statistically significant difference in extubation failures between the 2 groups included in this study, considering the severe consequences of extubation failure, the numerical difference reported may be clinically important.
Pensionnats autochtones : impact intergénérationnel
Authors: Jacinthe Dion  , Jennifer Hains  , Amélie Ross  , Delphine Collin-Vézina  
Published: April 2017

Les pensionnats autochtones sont des institutions ayant été en activité de la fin du 19e siècle à la fin du 20e siècle, que des enfants autochtones ont été forcés de fréquenter au Canada. Des enquêtes ont démontré que plusieurs jeunes fréquentant ces institutions y ont été victimes de négligence et de mauvais traitements. Les conséquences négatives découlant des mauvais traitements durant l’enfance ont été amplement documentées, notamment à travers les travaux de la Commission de vérité et réconciliation du Canada. Néanmoins, très peu d’études quantitatives ont été réalisées à ce sujet. L’objectif de cette recherche est de documenter, chez une population autochtone du Québec, les impacts associés à la fréquentation des pensionnats chez les survivants, mais également chez leurs enfants devenus adultes. Au total, 301 participants autochtones ont été rencontrés. Parmi les participants, 26,9 % ont fréquenté les pensionnats et 45,5 % ont un parent qui les a fréquentés. Les résultats indiquent que la fréquentation des pensionnats est associée à une probabilité plus élevée d’avoir vécu des traumas (agression sexuelle, agression physique, violence conjugale, etc.) dans l’enfance ou à l’âge adulte. Les résultats révèlent également que la fréquentation des pensionnats est associée à plusieurs difficultés, notamment à la consommation problématique d’alcool ou de drogues, au jeu problématique et à la détresse psychologique. Les résultats de cette étude soulignent l’importance de tenir compte des conséquences des traumatismes historiques et intergénérationnels liés aux pensionnats dans notre compréhension de la situation actuelle des peuples autochtones du Canada.