bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of infection following posterior instrumented lumbar fusion for degenerative spine disease in 817 consecutive cases
Authors: Chaichana Kaisorn L. , Bydon Mohamad , Santiago-Dieppa David R. , Hwang Lee , McLoughlin Gregory , Sciubba Daniel M. , Wolinsky Jean-Paul , Bydon Ali , Gokaslan Ziya L. , Witham Timothy 
Published: November 2013

Object
Posterior lumbar spinal fusion for degenerative spine disease is a common procedure, and its use is increasing annually. The rate of infection, as well as the factors associated with an increased risk of infection, remains unclear for this patient population. A better understanding of these features may help guide treatment strategies aimed at minimizing infection for this relatively common procedure. The authors' goals were therefore to ascertain the incidence of postoperative spinal infections and identify factors associated with postoperative spinal infections.

Methods
Data obtained in adult patients who underwent instrumented posterior lumbar fusion for degenerative spine disease between 1993 and 2010 were retrospectively reviewed. Stepwise multivariate proportional hazards regression analysis was used to identify factors associated with infection. Variables with p < 0.05 were considered statistically significant.

Results
During the study period, 817 consecutive patients underwent lumbar fusion for degenerative spine disease, and 37 patients (4.5%) developed postoperative spine infection at a median of 0.6 months (IQR 0.3–0.9). The factors independently associated with an increased risk of infection were increasing age (RR 1.004 [95% CI 1.001–1.009], p = 0.049), diabetes (RR 5.583 [95% CI 1.322–19.737], p = 0.02), obesity (RR 6.216 [95% CI 1.832–9.338], p = 0.005), previous spine surgery (RR 2.994 [95% CI 1.263–9.346], p = 0.009), and increasing duration of hospital stay (RR 1.155 [95% CI 1.076–1.230], p = 0.003). Of the 37 patients in whom infection developed, 21 (57%) required operative intervention but only 3 (8%) required instrumentation removal as part of their infection management.

Conclusions
This study identifies that several factors—older age, diabetes, obesity, prior spine surgery, and length of hospital stay—were each independently associated with an increased risk of developing infection among patients undergoing instrumented lumbar fusion for degenerative spine disease. The overwhelming majority of these patients were treated effectively without hardware removal.
Hypoglossal-facial nerve “side”-to-side neurorrhaphy for persistent incomplete facial palsy
Authors: Wan Hong , Zhang Liwei , Li Dezhi , Hao Shuyu , Feng Jie , Oudinet Jean Paul , Schumacher Michael , Liu Song 
Published: November 2013

Object
Hypoglossal-facial nerve neurorrhaphy is a widely used method for treating complete facial palsy. However, the classic surgical procedure using a “side”-to-end neurorrhaphy is not suitable for incomplete facial palsy (IFP), because sectioning of the facial nerve for neurorrhaphy compromises remnant axons and potential spontaneous reinnervation. For the treatment of persistent IFP, the authors investigated in rats a modified method using hypoglossal-facial nerve “side”-to-side neurorrhaphy.

Methods
An IFP model was created by crushing the facial nerve and then ligating the injury site to limit axonal regeneration. After 9 weeks, rats with IFP were submitted to hypoglossal-facial nerve “side”-to-side neurorrhaphy: The gap between the 2 nerves was bridged with a predegenerated peroneal nerve graft, which was sutured to only one-half of the hypoglossal nerve and to the remnant facial nerve through a small window created by removing the epineurium, thus preserving regenerating facial axons.

Results
Four months after repair surgery, double innervation of the target whisker pad by hypoglossal and facial motor neurons was supported by the recording of muscle action potentials and their retrograde labeling. Regenerated hypoglossal and facial motor neurons effectively participated in the reinnervation of the whisker pad, significantly improving facial symmetry without evident synkinesis, compared with rats that underwent IFP without hypoglossal-facial nerve neurorrhaphy.

Conclusions
This study demonstrates that hypoglossal-facial nerve “side”-to-side neurorrhaphy with a predegenerated nerve graft can lead to rapid functional benefits for persistent IFP without compromising the remnants of facial axons, thus providing a proof-of-feasibility for further studies in humans.
Cilostazol, a selective Type III phosphodiesterase inhibitor: prevention of cervical myelopathy in a rat chronic compression model
Authors: Yamamoto Shinji , Kurokawa Ryu , Kim Phyo 
Published: November 2013

ObjectRegional blood flow is decreased in experimental models of chronic spinal cord compression, and the alteration presumably contributes to the development of myelopathy. Cilostazol (Otsuka Pharmaceuticals Co.), a selective Type III phosphodiesterase inhibitor, has been shown to be neuroprotective in cerebral hypoperfusion animal models and clinically effective in preventing the recurrence of cerebral infarction. To investigate the neuroprotective effect of cilostazol on cervical spondylotic myelopathy, the preventive effect against progressive motor dysfunction and the loss of anterior horn motor neurons were assessed using a chronic cord compression model in rats.MethodsTo produce chronic cervical cord compression in male Wistar rats, thin polyurethane sheets (3 × 5 × 0.7 mm) that gradually expand over 48–72 hours by absorbing water were implanted under the C5–6 laminae. In sham operations, the sheets were momentarily placed and then immediately removed. This model has been shown to reproduce characteristic features of clinical cervical myelopathy, with progressive motor disturbances after a latency period and insidious neuronal loss preceding the onset of symptoms. In the treatment group, cilostazol (30 mg/kg/day) was orally administered to the rats once a day, starting the day after surgery and continuing through the entire observation period of 25 weeks. In the control group, vehicle solution was administered under the same protocol. Changes in motor function were monitored by measuring bilateral forepaw grip strength and the duration of forced running on a treadmill. Twenty-five weeks after surgery, cervical spinal cords were examined histopathologically.ResultsCilostazol preserved both forepaw grip strength and forced running capability. The drug also preserved anterior horn motor neurons in the C5–6 spinal cord segment, which diminished in number in the untreated chronic compression group. The drug decreased the number of TUNEL-positive apoptotic cells.ConclusionsThese results indicate that cilostazol is neuroprotective in the chronically compressed cervical cord and is potentially useful in the treatment of cervical spondylotic myelopathy.
Predictive value of E-PASS and POSSUM systems for postoperative risk assessment of spinal surgery
Authors: Hirose Jun , Taniwaki Takuya , Fujimoto Toru , Okada Tatsuya , Nakamura Takayuki , Okamoto Nobukazu , Usuku Koichiro , Mizuta Hiroshi 
Published: November 2013

Object
The Estimation of Physiological Ability and Surgical Stress (E-PASS) and Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) systems are surgical risk scoring systems that take into account both the patient's preoperative condition and intraoperative variables. While they predict postoperative morbidity and mortality rates for several types of surgery, spinal surgeries are currently not included. The authors assessed the usefulness of E-PASS and POSSUM algorithms and compared the predictive ability of both systems in patients with spinal disorders considered for surgery.

Methods
The E-PASS system includes a preoperative risk score, a surgical stress score, and a comprehensive risk score that is determined by both the preoperative risk score and surgical stress score. The POSSUM system is composed of a physiological score and an operative severity score; its total score is based on both the physiological score and operative severity score. The authors calculated the E-PASS and POSSUM scores for 601 consecutive patients who had undergone spinal surgery and investigated the relationship between the individual scores of both systems and the incidence of postoperative complications. They also assessed the correctness of the predicted morbidity rate of both systems.

Results
Postoperative complications developed in 64 patients (10.6%); there were no in-hospital deaths. All EPASS scores (p ≤ 0.001) and the operative severity score and total score of the POSSUM (p < 0.03) were significantly higher in patients with postoperative complications than in those without postoperative complications. The morbidity rates correlated linearly and significantly with all E-PASS scores (p ≤ 0.001); their coefficients (preoperative risk score, ρ = 0.179; surgical stress score, ρ = 0.131; and comprehensive risk score, ρ = 0.198) were higher than those for the POSSUM scores (physiological score, ρ = 0.059; operative severity score, ρ = 0.111; and total score, ρ = 0.091). The area under the receiver operating characteristic curve for the predicted morbidity rate was 0.668 for the E-PASS and 0.588 for the POSSUM system.

Conclusions
As E-PASS predicted morbidity more correctly than POSSUM, it is useful for estimating the postoperative risk of patients considered for spinal surgery.
Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma
Authors: Tatsui Claudio E. , Suki Dima , Rao Ganesh , Kim Stefan S. , Salaskar Abhijit , Hatiboglu Mustafa Aziz , Gokaslan Ziya L. , McCutcheon Ian E. , Rhines Laurence D. 
Published: November 2013

Object
Renal cell carcinoma (RCC) frequently metastasizes to the spine, and the prognosis can be quite variable. Surgical removal of the tumor with spinal reconstruction has been a mainstay of palliative treatment. The ability to predict prognosis is valuable when determining the role and magnitude of surgical intervention in cancer patients. To better identify factors affecting survival in patients undergoing surgery for spinal metastasis from RCC, the authors undertook a retrospective analysis of a large patient cohort at a tertiary care cancer center.

Methods
Relevant clinical data on a consecutive series of patients who had undergone surgery for spinal metastasis of RCC between 1993 and 2007 at The University of Texas MD Anderson Cancer Center were retrospectively reviewed. Demographic data, histopathological grade of primary tumor, timing of spinal surgery relative to diagnosis, treatment history prior to surgery, neurological status, and systemic disease burden were analyzed to determine the impact of these factors on survival outcome.

Results
The authors identified 267 patients who met the study criteria. Five-year overall survival (OS) after spine tumor resection was 7.8%, with a median OS of 11.3 months (95% CI 9.5–13.0 months). Patients with Fuhrman Grade 4 RCC had a median OS of 6.1 months (95% CI 3.5–8.7 months), which was significantly lower than the 14.3 months (95% CI 9.1–19.4 months) observed in patients with Fuhrman Grade 3 or less RCC (p < 0.001). Patients with preoperative neurological deficits had a median survival of 5.9 months (95% CI 4.1–7.7 months), which was significantly lower than the 13.5 months (95% CI 10.4–16.6 months) observed in patients with a normal neurological examination (p < 0.001). Patients whose spine was the only site of metastasis had a median OS of 19 months (95% CI 9.8–28.2 months) after surgery, significantly longer than the 9.7 months (95% CI 8.1–11.3 months) observed in patients with additional extraspinal metastasis sites (p < 0.001). Patients with nonprogressing extraspinal metastasis (no metastasis, stable, or concurrent) had a median survival of 20.6 months (95% CI 15.1–26.1 months), compared with 5.6 months (95% CI 4.4–6.8 months) in patients with progressing metastasis (p < 0.001).

Conclusions
The authors identified several factors influencing survival after spine surgery for metastatic spinal RCC, including grade of the original nephrectomy specimen, activity of the systemic disease, and neurological status at the time of surgery. These clinical features may help to identify patients who may benefit from aggressive surgical intervention.
Surgical manifestations of thoracic arachnoid pathology: series of 28 cases
Authors: Griessenauer Christoph J. , Bauer David F. , Moore Thomas A. , Pritchard Patrick R. , Hadley Mark N. 
Published: November 2013

Object
Various pathologies involving the thoracic arachnoid mater uniformly manifest as thoracic myelopathy and may present a significant management dilemma. The authors undertook this study to assess outcome in cases of thoracic myelopathy due to thoracic arachnoid pathology.

Methods
The authors have cared for and followed 28 patients with thoracic myelopathy from thoracic arachnoid pathology over the last 17 years. A chart review and contemporary follow-up of these patients was performed and outcomes were reported.

Results
Patients with thoracic myelopathy from thoracic arachnoid pathology often have improvement in their condition after surgical decompression/detethering procedures. While not universal, patients in this series had improvement in mJOA scores at 1 year after surgery (p = 0.0001) and at last follow-up (p = 0.04). Results indicated that across a wide variety of pathologies the extent of thoracic spinal cord involvement is a predictor of the disease course and outcome. Comparison of the group of patients with cord involvement limited to 2 vertebral segments (short-segment pathology) versus the group with cord tethering of more than 2 segments (long-segment pathology) showed that patients in the short-segment group more frequently had ventral or dorsal arachnoid bands (p = 0.003), more frequently had signal change in the cord on MRI (p = 0.02), and less frequently presented with a syrinx (p = 0.02), and a smaller percentage of patients in this group underwent reoperation (p = 0.02). While patients with short-segment pathology typically improved after a single operative intervention, patients with long-segment pathology typically improved after multiple operations, frequently for CSF diversion.

Conclusions
Thoracic arachnoid pathology causing thoracic cord dysfunction and myelopathy is varied, has multiple etiologies, and can be difficult to treat over the long term. Surgical management, when indicated, is case specific. Serial long-term follow-up is essential to document enduring clinical and radiographic success.
Why are there different versions of the Oswestry Disability Index?
Authors: Fairbank Jeremy C. T. 
Published: November 2013

This article updates readers on the current state of the Oswestry Disability Index (ODI) and the impact of unvalidated versions. The ODI is now licensed to the Mapi Research Trust in order to preserve a standard version in English and in validated translations. A proposed threshold of “normality” is potentially helpful as an outcome for both audit and research. There is an application of the sex section as a quality measure in Germany.
The ODI is an important international shared resource for clinicians and investigators and should not be abused. Its current status will not be enhanced by further modification. It is now registered with the International Consortium for Health Outcomes Measurement as a standard outcome measure.
Les désordres conjugaux comme risque pour l’enfant [Adultère, maternité et paternité dans les procédures de divorce]
Authors: Nagy Véronika 
Published: November 2013

Marital disruptions as a risk for the child. Adultery, maternity and paternity in divorce proceedings.
Can there be any relationship between marital infidelity, which appears to be an amorous and/ or sexual disruption perceived as a personal matter between the two members in a couple, and the issue of their children’s well-being ? Since the reform dated 11 July 1975 French family law has clearly stated that this is not the case ; they decide on the fate of under-aged children in a separating couple, the divorce judge must be guided only by the child’s interest and is therefore required to overlook everything affecting the relationship between the adults. However, a review of 47 divorce cases involving a fault claim indicates that the divorcing parents present the partner’s infidelity as a threat to the children’s well-being, using differentiated male and female representations. Such results raise the question of the distinction between ‘ marital couple’ and ‘ parental couple’ whilst casting a whole new light on the issue of contemporary re-compositions of male and female representations.
Inflexions des trajectoires professionnelles des hommes et des femmes après la naissance d’enfants
Authors: Pailhé Ariane , Solaz Anne 
Published: November 2013

Career changes for men and women after childbirth.
Although it seems clear that childbirth does not affect the careers of men and women symmetrically, quantitative data measuring such effects are few and far between. One of the objectives of the Families and Employers survey conducted by INED and INSEE in 2004-2005 is to assess the impact of childbirth on the career of both parents. To do so, the survey combines statements about careers in the year following childbirth and a calendar of professional and family activities. For men, childbirth may on occasion lead to a modification in professional activity, but such changes concern a position or job change or an increase in activity or responsibility. The advent of a child more often leads to career interruptions for women. The effect is amplified with successive births. Changes are quite varied after the first birth : resignation or exit of activity ; full-time parental leave ; change in jobs, parttime and unemployment. After a second or third birth, a greater proportion of women take parental leave or part-time work. The divide between men and women widens as the number of births rises.
L’assistance, un mode paradoxal d’acquittement de la dette collective
Authors: Bec Colette 
Published: November 2013

Assistance has been severely criticised throughout its secular history. Assistance is accused of contributing to what it is supposed to fight and is blamed for many social ills and considered the vector of many policy dangers. At a time when
criticism is at its most virulent, political use of assistance reaches its height. The purpose of this article is to explain this paradox based on an analysis of three historically and politically significant moments.
Flowering phenology and its implications for management of big‐leaf mahogany Swietenia macrophylla in Brazilian Amazonia
Authors: Grogan James , Loveless Marilyn D. 
Published: November 2013

• Premise of the study: Flowering phenology is a crucial determinant of reproductive success and offspring genetic diversity in plants. We measure the flowering phenology of big‐leaf mahogany (Swietenia macrophylla, Meliaceae), a widely distributed neotropical tree, and explore how disturbance from logging impacts its reproductive biology.• Methods: We use a crown scoring system to estimate the timing and duration of population‐level flowering at three forest sites in the Brazilian Amazon over a five‐year period. We combine this information with data on population structure and spatial distribution to consider the implications of logging for population flowering patterns and reproductive success.• Key results: Mahogany trees as small as 14 cm diam flowered, but only trees > 30 cm diam flowered annually or supra‐annually. Mean observed flowering periods by focal trees ranged from 18–34 d, and trees flowered sequentially during 3–4 mo beginning in the dry season. Focal trees demonstrated significant interannual correlation in flowering order. Estimated population‐level flowering schedules resembled that of the focal trees, with temporal isolation between early and late flowering trees. At the principal study site, conventional logging practices eliminated 87% of mahogany trees > 30 cm diam and an estimated 94% of annual pre‐logging floral effort.• Conclusions: Consistent interannual patterns of sequential flowering among trees create incompletely isolated subpopulations, constraining pollen flow. After harvests, surviving subcommercial trees will have fewer, more distant, and smaller potential partners, with probable consequences for post‐logging regeneration. These results have important implications for the sustainability of harvesting systems for tropical timber species.
Les expérimentations « article 34 de la loi de 2005 ». Bilan et discussion d'une recherche sur des pratiques scolaires « innovantes »
Authors: Reuter Yves , Condette Sylvie , Boulanger Liliane 
Published: November 2013

Cet article rend compte d’une recherche sur les expérimentations prévues par l’article 34 de la loi de 2005 sur l’école. Après avoir proposé une formalisation des différents niveaux d’actualisation de ce dispositif, il expose les principaux résultats : diversité des fonctionnements, grandes tendances (types d’établissements caractéristiques des équipes et des projets, motivations avancées, difficultés rencontrées...), incertitude évaluative...
Répondre à une demande institutionnelle d'évaluation : quelques problèmes de méthodologie de recherche
Authors: Bart Daniel , Lahanier-Reuter Dominique , Reuter Yves 
Published: November 2013

Cet article rend compte d’une recherche commanditée par le Haut Conseil de l’Éducation concernant l’évaluation des effets de la promulgation de l’article 34 sur les innovations et expérimentations dans les écoles, collèges et lycées. Tandis qu’un autre article de ce numéro expose les principaux résultats de cette recherche réalisée en 2010-2011, celui-ci est plus particulièrement centré sur les méthodologies élaborées pour répondre à cette commande institutionnelle. En évoquant les tensions entre les modes de communication des différentes institutions partenaires et commanditaires, en posant clairement les problèmes rencontrés, il permet de contribuer à la réflexion sur les conditions des recherches en éducation, sur les obstacles avec lesquels elles ont à composer, sur les diffusions des résultats qu’elles établissent.
De l'initiative à l'expérimentation : la longue vie du soutien à l'innovation
Authors: Cros Françoise 
Published: November 2013

Depuis les années 1960, la mise en place de dispositifs nationaux d’aide au développement des innovations scolaires a posé fondamentalement la question de la représentation politique du processus de réforme du système éducatif. Plusieurs dispositifs ont été installés par des textes législatifs et des déclinaisons locales. À l’occasion de la demande d’évaluation du dispositif issu de la loi de 2005, plus précisément l’article 34, par le Haut Conseil à l’Évaluation, cette contribution interroge les dispositifs antérieurs et leurs effets ou contre-effets au regard du développement de ce dispositif et sur son évaluation.
La musique dans le Dictionnaire de pédagogie et d'instruction primaire de Ferdinand Buisson : une discipline scolaire pour moraliser et éduquer le peuple
Authors: Grivet Bonzon Catherine 
Published: November 2013

Texte majeur et fondateur, le Dictionnaire de Pédagogie et d’instruction primaire de Ferdinand Buisson (deux éditions : 1887 et 1911) est une œuvre dont nous proposons une lecture des articles liés au chant et à la musique comme objets d’enseignement. Nous tenterons de comprendre à travers les articles consacrés à l’édification d’une discipline scolaire singulière, quelques-unes des enjeux, des luttes et des rapprochements inhérents aux changements et aux bouillonnements de la fin d’un siècle, celui de l’invention de l’École Républicaine. Au-delà des dissensions et dans leur volonté d’insérer la musique dans la nouvelle culture scolaire primaire tant pour socialiser que pour émanciper le futur citoyen, les différents auteurs ouvrent la voie déjà pressentie par Schiller de la contribution essentielle des pratiques artistiques dans la construction du sujet, dans son épanouissement autant que dans ses rapports sociaux.