bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series
Authors: Agarwal Nitin , Choi Phillip , Sekula Raymond 
Published: November 2016

Introduction Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation.
Methods Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course.
Results The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification and Severity Scale score was 4 (range 2 to 9). All patients had proper screw placement and uneventful postoperative courses given the severity of their individual traumas. Five of seven patients were reached for long-term follow-up of greater than 28 months. Six of seven patients had excellent pain control and stability at their last follow-up. One patient required revision surgery for noncatastrophic hardware failure.
Conclusion Percutaneous pedicle screw fixation for the treatment of unstable thoracolumbar burst fracture may provide patients with durable benefits and warrants further investigation.
A prospective study of patient safety incidents in gastrointestinal endoscopy
Authors: Matharoo Manmeet , Haycock Adam , Sevdalis Nick , Thomas-Gibson Siwan 
Published: November 2016

Abstract
Background and study aims Medical error occurs frequently with significant morbidity and mortality. This study aime to assess the frequency and type of endoscopy patient safety incidents (PSIs).
Patients and methods A prospective observational study of PSIs in routine diagnostic and therapeutic endoscopy was undertaken in a secondary and tertiary care center. Observations were undertaken within the endoscopy suite across pre-procedure, intra-procedure and post-procedure phases of care. Experienced (Consultant-level) and trainee endoscopists from medical, surgical, and nursing specialities were included. PSIs were defined as any safety issue that had the potential to or directly adversely affected patient care: PSIs included near misses, complications, adverse events and “never events”. PSIs were reviewed by an expert panel and categorized for severity and nature via expert consensus.
Results One hundred and forty procedures (92 diagnostic, 48 therapeutic) over 37 lists (experienced operators n = 25, trainees n = 12) were analyzed. One hundred forty PSIs were identified (median 1 per procedure, range 0 – 7). Eighty-six PSIs (61 %) occurred in 48 therapeutic procedures. Zero PSIs were detected in 13 diagnostic procedures. 21 (15 %) PSIs were categorized as severe and 12 (9 %) had the potential to be “never events,” including patient misidentification and wrong procedure. Forty PSIs (28 %) were of intermediate severity and 78 (56 %) were minor. Oxygen monitoring PSIs occurred most frequently.
Conclusion This is the first study documenting the range and frequency of PSIs in endoscopy. Although many errors are minor without immediate consequence, further work should identify whether prevention of such recurrent errors affects the incidence of severe errors, thus improving safety and quality.
The KINGS of Africa’s Digital Economy
Authors: Osiakwan Eric M.K. 
Published: November 2016

AbstractThe twentieth century saw the economic rise of Asia through the significant economic rise of the “Asian Tiger” countries (Kojima 2000; UNCTAD 1996). But the twenty-first century has been dubbed the African century (Wikipedia 2016). Tech Crunch, renowned technology media company, recently published an article entitled “The Future Is African” (Nash 2015), which aptly described how Africa is unleashing innovation by combining mobile and Web technology to lead the world in the twenty-first century.
Reimagine What You Already Know: Toward New Solutions to Longstanding Problems
Authors: Larson Jay , Munger Michael 
Published: November 2016

AbstractKnowledge and technology can combine to change societies dramatically, creating opportunities that were previously unthinkable. Many African nations now stand at the threshold of revolutionary changes based on information communication technologies (ICTs). Instead of painstakingly developing traditional banking, education, and other sectors—with decades of wasted human lives and opportunities—introducing mobile technology has put completely new solutions into the hands of a new generation. Some of the key elements of these new solutions are in education, the backbone for innovation and economic development. Although innovators are seeking new ways to educate the next generation, the problem of delivering adequate educational services to those without the means to afford expensive private schools is still a critical problem. We suggest that education must be reimagined, very nearly from the ground up. Once people take education out of the four walls of the traditional classroom into homes, libraries, internet cafés, and city streets, a completely new learning experience is imaginable—an experience that innovators need to harness now in order to transform the way in which education is delivered in Africa. Students in the “digital” school will decide what, where, and when to learn. We need these digital models to start reimagining education in Africa. We offer reimaginings of several elements in the education sector, including school management, the classroom, the learning experience, and certification.
Building ICT Entrepreneurship Ecosystems in Resource-Scarce Contexts: Learnings from Kenya’s “Silicon Savannah”
Authors: Bramann Johannes Ulrich 
Published: November 2016

AbstractEstablishing information and communications technology (ICT) entrepreneurship ecosystems in resource-scarce contexts is difficult because these contexts lack important preconditions, such as financial resources, established ICT sectors, and relevant human capital. Current theoretical perspectives and policy prescriptions about them stem mainly from the Global North and provide little insight into how to establish these conditions “from scratch.” In 2016, numerous African countries are looking toward the continent’s ICT vanguard, Kenya, and its gradually maturing “Silicon Savannah,” asking themselves, “How did they do it?”This chapter will shed light on the evolution of Kenya’s ICT ecosystem and explore the barriers and subsequent enabling processes encountered when growing an ICT ecosystem in a resource-scarce context. The insights offered here were developed over three years of doctoral research and especially through four months of qualitative research in Nairobi in 2013. The chapter provides a holistic perspective on the barriers and enablers encountered in the areas of culture, human capital, finance, policy, entrepreneurial support systems, and markets. Together with relevant theory on how ecosystems emerge and develop, these insights will be used to propose a model that explains how ICT ecosystems can emerge in resource-scarce contexts. The model shows how locally available enabling processes can be drawn on to substitute and establish the missing condition factors. Entrepreneurship support institutions, for example, emerged as pivotal enablers that can kick-start industry emergence processes, train human capital, and help establish conducive sociocultural norms. Further, the creation of initial market demand through developmental stakeholders and the inflow of expatriate entrepreneurs also emerged as enablers. The chapter ends with a call for critically needed research and specific recommendations for development stakeholders, governments, and practitioners in tackling current barriers in order to help develop ecosystems in resource-scarce countries beyond their nascent phase.
Preferential interactions promote blind cooperation and informed defection
Authors: Pérez-Escudero Alfonso , Friedman Jonathan , Gore Jeff 
Published: November 2016

Significance
Humans often behave in seemingly irrational ways. A common instance of such perplexing behavior is that we typically care about how and why people chose their actions, rather than caring only about the actions themselves. For example, when people agree to do us a favor, we prefer them to do so directly, rather than to first gather all the relevant information. Using game theory, we show that this preference may in fact be rational: The decision-making process often reveals hidden preferences of the decision maker, which can become relevant in a future interaction. This work elucidates the conditions that make caring about motivations beneficial and makes predictions regarding the real-world situations in which it is expected to occur.
Molecular mechanisms of substrate-controlled ring dynamics and substepping in a nucleic acid-dependent hexameric motor
Authors: Thomsen Nathan D. , Lawson Michael R. , Witkowsky Lea B. , Qu Song , Berger James M. 
Published: November 2016

Significance
Hexameric, ring-shaped translocases are molecular motors that convert the chemical energy of ATP hydrolysis into the physical movement of protein and nucleic acid substrates. Structural studies of several distinct hexameric translocases have provided insights into how substrates are loaded and translocated; however, the range of structural changes required for coupling ATP turnover to a full cycle of substrate loading and translocation has not been visualized for any one system. Here, we combine low- and high-resolution structural studies of the Rho transcription termination factor, defining a set of conformational transitions that accompany substrate binding and translocations by a processive hexameric helicase.
Remediation of Flow-Through Trout Raceway Effluent via Aquaponics
Authors: Buzby Karen M , West Todd P , Waterland Nicole L , Lin Lian-Shin 
Published: November 2016

Abstract
Production and nutrient removal were assessed for three vegetable crops (kohlrabi, lettuce, and Swiss chard) and two edible flowers (calendula and nasturtium) grown entirely on effluent from a flow-through trout raceway. Soluble nutrient concentrations in the effluent averaged 0.56 and 0.19 mg/L for total nitrogen and soluble reactive phosphate, respectively. Seeds were sown into Styrofoam trays filled with vermiculite and placed directly into the plant growing channels. Lettuce was harvested at 6, 9, and 12 weeks for a total mean harvest biomass of 4.5 kg/m2. Kohlrabi and Swiss chard were harvested at 12 weeks, with a mean harvest biomass of 15.4 and 7.5 kg/m2, respectively. Harvest biomass of kohlrabi was significantly greater than that of lettuce or Swiss chard. Nasturtium flowers were harvested at 9 and 12 weeks, while calendula did not begin to produce flowers until 12 weeks. There were no significant differences in percent removal of total ammonia nitrogen (TAN), nitrate, or phosphate at 6 weeks. However, at 9 weeks, kohlrabi, Swiss chard, and nasturtium removed significantly more TAN and nitrate than lettuce and calendula. Total ammonia nitrogen removal decreased at 12 weeks while nitrate removal increased for kohlrabi, Swiss chard, and calendula. Phosphate removal was low for all cultivars and may be the result of high phosphate concentrations in the source water. Careful crop selection will be necessary to maximize the benefits of aquaponics as crops varied in growth rates, overall nutrient removal capacity, and timing of nutrient removal.
Human Immunodeficiency Virus (HIV) Quality Indicators Are Similar Across HIV Care Delivery Models
Authors: Rhodes Corinne M. , Chang Yuchiao , Regan Susan , Singer Daniel E. , Triant Virginia A. 
Published: November 2016

Abstract

Background
There are limited data on human immunodeficiency virus (HIV) quality indicators according to model of HIV care delivery. Comparing HIV quality indicators by HIV care model could help inform best practices because patients achieving higher levels of quality indicators may have a mortality benefit.

Methods
Using the Partners HIV Cohort, we categorized 1565 patients into 3 HIV care models: infectious disease provider only (ID), generalist only (generalist), or infectious disease provider and generalist (ID plus generalist). We examined 12 HIV quality indicators used by 5 major medical and quality associations and grouped them into 4 domains: process, screening, immunization, and HIV management. We used generalized estimating equations to account for most common provider and multivariable analyses adjusted for prespecified covariates to compare composite rates of HIV quality indicator completion.

Results
We found significant differences between HIV care models, with the ID plus generalists group achieving significantly higher quality measures than the ID group in HIV management (94.4% vs 91.7%, P = .03) and higher quality measures than generalists in immunization (87.8% vs 80.6%, P = .03) in multivariable adjusted analyses. All models achieved rates that equaled or surpassed previously reported quality indicator rates. The absolute differences between groups were small and ranged from 2% to 7%.

Conclusions
Our results suggest that multiple HIV care models are effective with respect to HIV quality metrics. Factors to consider when determining HIV care model include healthcare setting, feasibility, and physician and patient preference.
Cervical Length at Mid-gestation in Screening for Preterm Birth in Twin Pregnancy
Authors: Pagani G. , Stagnati V. , Fichera A. , Prefumo F. 
Published: November 2016

(Abstracted from Ultrasound Obstet Gynecol 2016;48:56–60)
Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality, and the increased proportion of twin births is one factor that contributes to PTB. A short cervical length (CL) in midgestation is one among the various risk factors that is considered predictive for spontaneous PTB of less than 32 weeks in twin gestations.
Snakes and Hypertension
Authors: Miller Edward D. 
Published: November 2016

Abstract
Inhibition of Angiotensin Conversion in Experimental Renovascular Hypertension. By Miller ED Jr, Samuels A, Haber E, and Barger AC. Science 1972; 177:1108–9. Reprinted with permission from AAAS.
Constriction of the renal artery and controlled reduction of renal perfusion pressure is followed by a prompt increase in systemic renin activity and a concomitant rise in blood pressure in trained, unanesthetized dogs. The elevated blood pressure induced by the renal artery stenosis can be prevented by prior treatment with the nonapeptide Pyr-Trp-Pro-Arg-Pro-Gln-Ile-Pro-Pro, which blocks conversion of angiotensin I to angiotensin II. Further, the nonapeptide can restore systemic pressure to normal in the early phase of renovascular hypertension. These results offer strong evidence that the renin– angiotensin system is responsible for the initiation of hypertension in the unilaterally nephrectomized dog with renal artery constriction.
The Interobserver and Intraobserver Reliability of the Sanders Classification Versus the Risser Stage
Authors: Vira Shaleen , Husain Qasim , Jalai Cyrus , Paul Justin , Poorman Gregory W. , Poorman Caroline , Yoon Richard S. , Looze Christopher , Lonner Baron , Passias Peter G. 
Published: November 2016

Background:
Estimation of skeletal maturity, classically performed using Risser sign, plays a crucial role in the treatment of AIS. Recent data, however, has shown the simplified Tanner-Whitehouse (Sanders) classification, based on an anteriorposterior (AP) hand radiographs, to correlate more closely to the rapid growth phase and thus curve progression. This study evaluated the interobserver and intraobserver reliability of the Sanders and Risser classifications among clinicians at different levels of training.

Methods:
Twenty AP scoliosis radiographs and 20 AP hand radiographs were randomized and distributed to 11 graders. The graders consisted of 3 orthopaedic residents, 3 spine fellows, 3 spine surgeons, and 1 radiologist. The graders were then asked to classify the radiographs according to the Sanders and Risser classifications. There were 3 rounds of grading, each done 3 weeks apart. The overall κ coefficient was then calculated for each system to evaluate the interobserver and intraobserver reliability.

Results:
For all graders the average κ coefficient for the interobserver and intraobserver reliability of the Sanders classification was 0.54 and 0.62, respectively, and 0.46 and 0.49 for the Risser classification. With respect to spine attendings alone, the average κ coefficient for the interobserver and intraobserver reliability of Sanders classification was 0.72 and 0.77, respectively, and 0.46 and 0.67 for the Risser classification.

Conclusions:
Our study demonstrated that the Sanders classification had moderate reliability with respect to physicians at various levels of training and had good reliability with respect to attending spine surgeons. Interestingly, the Risser staging was found to have less interobserver and intraobserver reliability overall. The Sanders classification is a reliable and reproducible system and should be in the armamentarium of surgeons who treat adolescent idiopathic scoliosis.

Level of evidence:
Level III.
Body Mass Hides the Curve: Thoracic Scoliometer Readings Vary by Body Mass Index Value
Authors: Margalit Adam , McKean Greg , Constantine Adam , Thompson Carol B. , Lee Rushyuan Jay , Sponseller Paul D. 
Published: November 2016

Background:
Guidelines suggest referral for scoliosis when rib slope (scoliometer measurement, angle of trunk rotation) is ≥7 degrees. We hypothesized that overweight and obese patients would have lower scoliometer measurements compared with normal-weight and underweight patients for a given spinal curvature, causing overweight and obese patients with adolescent idiopathic scoliosis to present for treatment later and with larger curves. Our goal was to determine the association between scoliometer readings and major curve magnitudes in relation to body mass index (BMI).

Methods:
This retrospective cohort study at a tertiary referral center included 483 patients (420 girls) aged 10 to 18 years (mean age, 14±1.6 y) with thoracic adolescent idiopathic scoliosis who presented to 1 orthopaedic surgeon for initial evaluation of spinal deformity from 2010 to 2015. Records were reviewed for BMI percentile for age and sex (underweight, ≤fourth percentile; normal weight, fifth to 84th percentile; overweight, 85th to 94th percentile; obese, ≥95th percentile), patient characteristics, thoracic scoliometer measurements, and thoracic major curves.

Results:
Of the 483 patients, 23 were underweight, 372 were normal weight, 52 were overweight, and 36 were obese. Obese patients had a larger mean major curve (44 degrees) than normal-weight patients (34 degrees) (P=0.004). The odds of presenting with a major curve ≥20 degrees were 4.9 (95% confidence interval, 1.1-22; P=0.037) times higher for obese versus normal-weight patients. Receiver operating characteristic analysis of major curves (≥20 vs. <20 degrees) estimated the scoliometer values with the greatest sensitivity and specificity to be 8 degrees for underweight patients, 7 degrees for normal-weight patients, 6 degrees for overweight patients, and 5 degrees for obese patients.

Conclusions:
Obese patients presented with larger thoracic curves versus normal-weight patients. Differences in chest-wall thickness in patients with different BMI values may alter scoliometer measurements for a given rotational deformity. Our data suggest new referral criteria for the scoliometer test based on BMI values. Specifically, obese patients should be referred at an angle of trunk rotation of 5 degrees.

Level of Evidence:
Level II.
What’s New in the Management of Foot Deformities in Children With Cerebral Palsy
Authors: Heydemann John A. , Abousamra Oussama , Franzone Jeanne M. , Kaufman Brian E. , Sees Julieanne P. 
Published: November 2016

Background:
Foot deformities have been frequently reported in cerebral palsy (CP), and numerous diagnostic modalities and treatment options have recently been developed to achieve a better level of management for children with CP.

Methods:
A thorough search of the English literature, published between January 2013 and March 2016, was performed. A summary of the new findings that had not previously described was reported. The review included recent advances regarding clinical and gait evaluation, orthotic management, botulinum toxin A treatment, and surgical correction.

Results:
The review summarized new findings reported in 46 articles and abstracts that were published between January 2013 and March 2016. Older articles were included and cited when an original description was mentioned, or when a change or development of some findings was discussed.

Conclusions:
Foot deformity forms an essential part of evaluating children with CP. Dramatic advances have been achieved in gait assessment, conservative management, and surgical correction. Promising results have been reported with the goal to reach a higher level of orthopaedic care and optimize the functional potentials for children with CP.

Level of Evidence:
Level IV—literature review.
Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals: Implementing PAD Guidelines Via the ABCDEF Bundle in 6,064 Patients*
Authors: Barnes-Daly Mary Ann , Phillips Gary , Ely E. Wesley 
Published: November 2016

Objectives:
To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals.

Design:
A prospective cohort quality improvement initiative involving ICU patients.

Setting:
Seven community hospitals within California’s Sutter Health System.

Patients:
Ventilated and nonventilated general medical and surgical ICU patients enrolled between January 1, 2014, and December 31, 2014.

Measurements and Main Results:
Total and partial bundle compliance were measured daily. Random effects regression was used to determine the association between ABCDEF bundle compliance accounting for total compliance (all or none) or for partial compliance (“dose” or number of bundle elements used) and outcomes of hospital survival and delirium-free and coma-free days, after adjusting for age, severity of illness, and presence of mechanical ventilation. Of 6,064 patients, a total of 586 (9.7%) died before hospital discharge. For every 10% increase in total bundle compliance, patients had a 7% higher odds of hospital survival (odds ratio, 1.07; 95% CI, 1.04–1.11; p < 0.001). Likewise, for every 10% increase in partial bundle compliance, patients had a 15% higher hospital survival (odds ratio, 1.15; 95% CI, 1.09–1.22; p < 0.001). These results were even more striking (12% and 23% higher odds of survival per 10% increase in bundle compliance, respectively, p < 0.001) in a sensitivity analysis removing ICU patients identified as receiving palliative care. Patients experienced more days alive and free of delirium and coma with both total bundle compliance (incident rate ratio, 1.02; 95% CI, 1.01–1.04; p = 0.004) and partial bundle compliance (incident rate ratio, 1.15; 95% CI, 1.09–1.22; p < 0.001).

Conclusions:
The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance was independently associated with improved survival and more days free of delirium and coma after adjusting for age, severity of illness, and presence of mechanical ventilation.