bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraosseous Sacral Paraganglioma with Extradural Extension
Authors: Falavigna Asdrubal , Righesso Orlando , Teles Alisson Roberto , Conzatti Lucas Piccoli , Rizkalla Elisa Braun 
Published: May 2015

Introduction Paragangliomas are tumors that arise from the paraganglion system, which is a component of the neuroendocrine system. Approximately, 10% are located in the extra-adrenal paraganglion system. Paragangliomas of the spine, however, are rare. They usually present as an intradural tumor in the cauda equina. There are only three reports of primary intraosseous paragangliomas of the sacrum. Patient and Methods: A 69-year-old man presented with low back pain and urinary incontinence. Imaging revealed a large intraosseous mass at S2, S3, and S4. Surgical resection was accomplished through a posterior midline incision exposing the spine from L5 to the coccyx. The tumor was located in the extradural space. It was friable, grayish, and bleeding. Total tumor removal was performed, with normal bone margins. Follow-up at 2 years showed complete resolution of the preoperative symptoms and no evidence of local recurrence. Results Extra-adrenal paragangliomas have been found in locations where paraganglia are not normally located, such as the stomach, duodenum, uterus, and lungs. In the central nervous system, a few cases in the cerebellopontine angle and cerebellum have been described. A spinal location is also rare; tumors have been found in the intradural, extramedullary compartment, predominantly in the lumbar region and, rarely, in the cervical or thoracic regions. Only three cases of paraganglioma originating primarily within sacral bone have been reported. In 1998, Coles reported the first case of a primary intraosseous tumor, located at S3. This was followed by a report from Sundgern in 1999 of another case located at the S1 vertebral body. Recently, in 2007, Laufer reported the third case of primary sacral paraganglioma, located at the S1 vertebral body. Conclusion Although rare, the possibility of paraganglioma should be included in the differential diagnosis of sacral tumors. The majority of the spinal paragangliomas are benign, slowly growing tumors with low proliferative activity. Despite these characteristics, local recurrence has been reported in cases of both macroscopically total and subtotal resection. Postoperative radiation therapy for patients with incomplete excision may not prevent recurrence, so gross tumor removal should be the goal of surgery.
Sacrococcygeal Teratoma in Children
Authors: Falavigna Asdrubal , Gandara Carlos , Radaelli Lucas , Merlin Luiz Henrique , Wurzius Francine , Bassanesi Francisco 
Published: May 2015

Introduction Germ cell tumors originate in the primary stem cell located either inside or outside the gonadal system. Teratomas are the major group, with the sacrococcygeal location being the most common extragonadal site, independent of their being benign or malignant. We describe five cases of sacrococcygeal teratoma and emphasize aspects of diagnosis, surgical techniques, and complementary approaches. Patients and Methods A total of five cases of sacrococcygeal teratoma were reported and a literature review was performed using an online database, Pubmed.gov. The authors emphasize aspects of diagnosis, classification, prognosis, and the therapeutic options. Results The five cases were females and the age range from 38 weeks intrauterine (ultrasonography diagnosis) to 1.5 years. The clinical presentation usually was a sacral mass or fecal constipation. The Altman classification was type 1 in three cases and type 4 in two cases. The serum levels of α-fetoprotein was normal in three cases. Preoperative high serum α-fetoprotein levels returned to normal levels 10 days after surgery. The radical surgical resection of the tumor and the coccyx was done in all cases through a posterior sacral approach and midline incision. The surgery did not compromise the neurological function. No tumor recurrence was seen in by radiologic and α-fetoprotein examinations after a medium follow-up of 15.3 years. Conclusion The sacrococcygeal region is the most frequent site of teratomas in children. Complete tumor resection and removal of the coccyx are the main objective in curative treatment of the teratoma. Diagnosis and treatment as early as possible is essential to prevent it from becoming malignant.
Restoring the Spino-Pelvic Parameters Correlates with Better Outcome in Adult Deformity Surgical Correction?
Authors: Barbanti Brodano Giovanni , Babbi Lisa , Colangeli Simone , Girolami Marco , Gasbarrini Alessandro 
Published: May 2015

Introduction The surgical approach to adult deformities is challenging both in terms of surgical planning and of amount of complications. Current literature shows potential benefits in surgical correction of adult deformities; recovery of both frontal and sagittal balance seems to be the key for satisfactory outcomes. Patients and Methods In this retrospective study, from an initial pattern of 30 patients, 12 selected patients were considered. All patients, average age 57 years, underwent adult scoliosis surgical correction. We evaluated the clinical outcomes in correlation with restoring of the sagittal balance and the rate of complications and mechanical failure. Previous surgery was not an exclusion criteria. Average follow-up was 8.2 months (range, 3–20 months). Clinical evaluation was performed by using Visual Analog Score test, Oswestry Disability Index, and Quality of Life test. Radiological measures were performed by software Surgimap Spine. Results In 10 cases (83% of patients), we observed agreement between clinical and radiological outcomes (we focused in particular on sagittal balance). To a satisfactory recovery of sagittal balance, in eight cases we found improvement at clinical tests while in two cases to a poor balance correction, the patients' quality of life did not improve. In only two cases (16% of patients), we found disagreement between the two parameters indicated (sagittal balance and quality of life). In our series, five patients had mechanical failures: four of them did not improve their sagittal balance at postoperative X-ray. Conclusion The purpose of this study was to validate the hypothesis that good clinical results in adult deformities correction are better achieved when restoration of sagittal balance is obtained. The large agreement among quality of life evaluation and recovery of sagittal balance we observed in this preliminary series of selected patients seems to hold it up. Moreover, the respect of physiological pelvic parameters seems to reduce the number of adverse events in terms of mechanical failures and consequently the number of reoperations; its indeed necessary to underline how 100% of patients whose sagittal balance did not improve with surgery had mechanical failure of instrumentation. Only one patient with acceptable sagittal parameters needed reoperation because of breaking of the rods.
Microscopically Assisted versus Standard Laparotomy L5–S1 Circumferential Fusion
Authors: Buric Josip , Bombardieri Domenico 
Published: May 2015

Introduction Microscopically assisted retroperitoneal laparotomy is a minimally invasive modification of a standard approach for anterior lumbar interbody fusion (ALIF). In this study, we compare the peri- and immediate postoperative results of standard versus microscopically assisted L5–S1 interbody fusion. Patients and Methods A total of 20 patients with low back pain because of the degenerative disc disease and/or spondylolisthesis were included in the study. Overall, 10 patients were submitted to a single-stage microscopically assisted left-retroperitoneal interbody fusion and 10 patients were submitted to a single-stage standard left-retroperitoneal interbody fusion. All patients were instrumented posteriorly with screw and rod system. Data were collected for vascular and visceral injuries, blood loss, operating time, walk-out-of-bed time, peristalsis recovery, and initial 48 hours pain levels. Results Significant differences were found for vascular lesion and blood loss between the two groups with the standard laparotomy group being on the worse side. Furthermore, patients subjected to a microscopically assisted approach showed a more rapid recovery of intestinal peristalsis, a reduced walk-out-of-bed time, and a lower intensity of perceived pain in the first 48 hours after the surgery. Conclusion The results of this study indicate the minimally invasive approach for ALIF as an equally efficient but much safer approach as compared with the standard laparotomy approach. Reduction of complications and a shorter in-hospital stay contribute on lowering the costs of the treatment making it not only clinically, but also economically more suitable surgical choice.
Clinical and Surgical Predictors of Specific Complications following Surgery for the Treatment of Degenerative Cervical Myelopathy: Results from the Multicenter, Prospective AOSpine International Study on 479 Patients
Authors: Fehlings Michael , Tetreault Lindsay , Kopjar Branko , Arnold Paul , Defino Helton , Kale Shashank , Barbagallo Giuseppe , Zileili Mehmet , Tan Gamiel , Yukawa Yasutsugu , Moraes Osmar , Scerrati Massimo , Tanaka Masato , Toyone Tomoaki , Bolger Ciaran , Cote Pierre 
Published: May 2015

Introduction This study aimed to identify important clinical and surgical predictors of perioperative complications in patients with CSM. This knowledge will help clinicians recognize their high-risk patients and allow them to institute appropriate prevention plans. Material and Methods This study aimed to identify important clinical and surgical predictors of perioperative complications in patients with CSM. This knowledge will help clinicians recognize their high-risk patients and allow them to institute appropriate prevention plans. Results A total of 80 patients experienced 92 perioperative complications (16.7%). Univariately, the major clinical risk factors were OPLL ( p = 0.022), the number of comorbidities ( p = 0.020), diabetes ( p = 0.004), and coexisting gastrointestinal disorders ( p = 0.045). Patients undergoing a two-stage surgery and those with a longer operative duration were also at a greater risk of perioperative complications. A final model consisted of diabetes (OR = 2.35, p = 0.039), age (OR = 1.02, 0.25), operative duration (OR = 1.003, p = 0.17), two-stage surgery (OR = 20.37, p = 0.012), OPLL (OR = 1.82, p = 0.064), gastrointestinal comorbidities (OR = 2.53, p = 0.020), and BMI (OR = 1.06, p = 0.10). Conclusion Patients are at a higher risk of perioperative complications if they are older; have OPLL, a higher BMI, diabetes or gastrointestinal disorders; and if they undergo a two-stage surgery and a long operation.
Management of Combined Atlas–Axis Fractures with Anterior Transarticular Fixation in Elderly Patients
Authors: Kocis Jan 
Published: May 2015

Introduction Posterior techniques of treatment in atlas–axis combined injury are reported less prone to failure of osteosynthesis. At the same time, however, more frequent occurrence of complications is presented, mainly consisting of higher blood loss, reduced wound healing, chronic pain, and possibility of injury of a. vertebralis. In addition, prone position is not suitable for elderly patients from the anesthesiologist perspective. On the contrary, the frequent failure of anterior osteosynthesis of dens axis because of osteoporosis calls for finding alternative solutions. Patients and Methods Between 2009 and 2013, 10 consecutive patients with combined C1/C2 fractures underwent triple anterior screw fixation in our hospital. The group consisted of 10 women. The age ranged between 67 and 90 years. The patients follow-up was 1 year. Results The operation was performed without complications in all patients. Early postoperative failure of screws in C1 was observed in one patient. Reoperation was required. The bone was healed in fracture of dens axis in eight patients according to CT examination. Pseudoarthrosis without clinical sequelae was found in two patients. None of the patients had neurological disorder and we had no patient deaths during the period under review. Conclusion This method allows simple and safe treatment of combined atlas–axis fractures.
Genetic Population Structure of Black Drum in U.S. Waters
Authors: Leidig Jacqueline M. , Shervette Virginia R. , McDonough Christopher J. , Darden Tanya L. 
Published: May 2015

Abstract
The Black Drum Pogonias cromis is an estuarine-dependent fish that supports recreational and commercial fisheries throughout its range along the U.S. Atlantic coast and Gulf of Mexico (GOM) coast. We used nuclear microsatellite markers and samples collected from multiple locations along both the U.S. Atlantic and GOM coasts to evaluate the stock structure of Black Drum and to examine small-scale spatial genetic population structure along the U.S. Atlantic coast. As no microsatellite primers had been developed for Black Drum, primers for Spotted Seatrout Cynoscion nebulosus and Red Drum Sciaenops ocellatus were screened, selected, and optimized for use with Black Drum DNA. Six polymorphic loci were identified and used to genotype samples. Results suggested (1) significant genetic divergence between Black Drum populations from the U.S. Atlantic coast and the GOM coast; and (2) either recent or current gene flow between the two regions. Along the U.S. Atlantic coast, there appeared to be weak but significant genetic divergence among Black Drum from southern states, specifically between individuals from the Carolinas and Florida. An isolation-by-distance pattern was also observed for Black Drum from North Carolina to Florida. On a larger scale, results suggested a lack of genetic divergence between individuals from Delaware and Virginia and those from the southern Atlantic states, which may be attributable to the life history patterns of Black Drum. Our results support the management of Black Drum in U.S. waters as two separate stocks: Atlantic and GOM. The results also support the management of Black Drum along the U.S. Atlantic coast as a single unified stock and indicate the need for common management regulations among the Atlantic states.
Received August 26, 2014; accepted February 4, 2015
Effects of Lake Surface Elevation on Shoreline-Spawning Lost River Suckers
Authors: Burdick Summer M. , Hewitt David A. , Rasmussen Josh E. , Hayes Brian S. , Janney Eric C. , Harris Alta C. 
Published: May 2015

Abstract
We analyzed remote detection data from PIT-tagged Lost River Suckers Deltistes luxatus at four shoreline spawning areas in Upper Klamath Lake, Oregon, to determine whether spawning of this endangered species was affected by low water levels. Our investigation was motivated by the observation that the surface elevation of the lake during the 2010 spawning season was the lowest in 38 years. Irrigation withdrawals in 2009 that were not replenished by subsequent winter–spring inflows caused a reduction in available shoreline spawning habitat in 2010. We compared metrics of skipped spawning, movement among spawning areas, and spawning duration across 8 years (2006–2013) that had contrasting spring water levels. Some aspects of sucker spawning were similar in all years, including few individuals straying from the shoreline areas to spawning locations in lake tributaries and consistent effects of increasing water temperatures on the accumulation of fish at the spawning areas. During the extreme low water year of 2010, 14% fewer female and 8% fewer male suckers joined the shoreline spawning aggregation than in the other years. Both males and females visited fewer spawning areas within Upper Klamath Lake in 2010 than in other years, and the median duration at spawning areas in 2010 was at least 36% shorter for females and 20% shorter for males relative to other years. Given the imperiled status of the species and the declining abundance of the population in Upper Klamath Lake, any reduction in spawning success and egg production could negatively impact recovery efforts. Our results indicate that lake surface elevations above 1,262.3–1,262.5 m would be unlikely to limit the number of spawning fish and overall egg production.
Received May 16, 2014; accepted January 29, 2015
Direct and Indirect Evidence Suggests Continuous Presence of Viral Hemorrhagic Septicemia Virus (Genotype IVb) in Budd Lake, Michigan: Management Implications
Authors: Throckmorton Elizabeth , Peters Amber , Brenden Travis , Faisal Mohamed 
Published: May 2015

Abstract
In May 2007, viral hemorrhagic septicemia virus genotype IVb (VHSV IVb) was isolated from several fish species in Budd Lake, a 71-ha inland lake in central Michigan. Because of the virulence and pathogenicity of VHSV IVb, follow-up testing was conducted between 2007 and 2010. This testing found no further evidence of VHSV IVb presence. Similar patterns (i.e., initial mortality events followed by no evidence of additional infections) have been observed in other waterbodies, which leads to questions regarding the implications that these patterns could have for fisheries management (e.g., could stocking naive fish lead to additional epizootic occurrences?). This study was conducted to determine whether VHSV IVb was still present in Budd Lake by intensively sampling across multiple seasons, locations, and size-groups of Muskellunge Esox masquinongy, Northern Pike Esox lucius, and Largemouth Bass Micropterus salmoides. Individuals were tested for both active VHSV IVb infection and antibody production. We found that VHSV IVb was still present in Budd Lake, as active infections were detected from samples in spring, summer, and fall 2011, with highest infection prevalence in spring 2011. Spring 2011 infection prevalence was 17% for esocids and 33% for Largemouth Bass. Between 74% and 80% of collected esocids produced antibodies, depending on the sampling season. Antibody production in Largemouth Bass ranged from 12% in spring and fall 2011 to 20% in spring 2012. Based on these results, we recommend sustained vigilance in the management of VHSV IVb–positive systems to limit the risk of virus spread as it is perhaps questionable whether systems that have experienced an outbreak will ever be virus-free.
Received September 16, 2014; accepted February 7, 2015
The effect of entrepreneurial context on the performance of new ventures
Authors: Lin Song , Rogoff Edward G. , Foo Check-Teck , Liu Xiaoyuan 
Published: May 2015

Purpose– This empirical study aims to test the impact of four types of entrepreneurial context on the growth and success rates of new ventures in China and related the findings to the theory and practice of entrepreneurship dating back 2,500 years to ancient China.Design/methodology/approach– After describing the business guidelines given by Fan Li, an entrepreneurial merchant selling Chinese medicines in ancient times, a conceptual framework was extracted as the basis for a discussion of the relationship between entrepreneurial context and entrepreneurial activity. Entrepreneurial context was conceptualized as being composed of family, social, business and institutional components. Five hypotheses about the influence of these different context variables on entrepreneurial activities were developed. From data compiled from the sampling of 239 business entrepreneurs in Beijing, a hierarchical regression was formed and the hypotheses tested.Findings– The impact of entrepreneurial context on entrepreneurial activity can be divided into two layers, internal factors (e.g. family context) which are similar to “yin” (?) in the traditional Chinese philosophy while external factors (e.g. business, social and institutional contexts) were like “yang” (?). The two factors play different roles in entrepreneurial activities, while different contexts mediate and moderate each other in complex ways.Research limitations/implications– Research limitations pertain to the size and locale of the sample. A larger sample that involved subjects from different regions would facilitate a wider understanding of the effects of entrepreneurial context upon the entrepreneurial process.Originality/value– The theory of entrepreneurial context is in its beginning stages, and the paper completed a systematic study of entrepreneurial context through theoretical model building using large-sample empirical research. In addition, the paper is the first ever to relate the theory and practice of entrepreneurship back 2,500 years. Through a multi-research methodology, the study clearly shows the critical importance of integrating Chinese history into the development of management theory.
Unraveling legitimation strategies of Chinese Internet start-ups
Authors: Su Xiaohua , Peng Haidong , Zhang Shujun , Rong Yun 
Published: May 2015

Purpose– The purpose of this paper is to explore the legitimacy needs and legitimation strategies of Internet start-ups in the context of industry dynamism.Design/methodology/approach– The purpose of this paper is to explore the legitimacy needs and legitimation strategies of Internet start-ups in the context of industry dynamism.Findings– The authors found that Internet start-ups are in great need of acquiring market and relational legitimacy at their nascent stages. Conformance to the environment is widely adopted by them as a legitimacy-enhancing strategy. There is an inverted “U” relationship between the maturity of the industry and the proactivity of any legitimation strategy in the sector. In the face of high- and low-level industry maturity, start-ups tend to employ prudent strategies to build up legitimacy. While in medium-mature industries, ventures are more likely to adopt proactive and aggressive strategies.Research limitations/implications– Due to the very nature of case methodology, this study is based on a small number of observations and it is set in the context of the Internet industry. The generalizability of its findings needs to be reinforced by further concrete studies.Practical implications– This paper suggests that industry dynamism should be taken into account carefully when implementing a choice of legitimation strategies.Originality/value– This study makes an attempt to further our understanding of how industry dynamism influences firms’ choices of legitimation strategies.
Service quality framework for clinical laboratories
Authors: Ramessur Vinaysing , Hurreeram Dinesh Kumar , Maistry Kaylasson 
Published: May 2015

Purpose– The purpose of this paper is to illustrate a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement.Design/methodology/approach– The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework.Findings– The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour.Practical implications– The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners.Originality/value– This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.