bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally invasive approach for the treatment of intradural spinal pathology
Authors: Gandhi Ravi H. , German John W. 
Published: August 2013

Object
A wide variety of spinal intradural pathology traditionally has been treated from a midline posterior laminectomy using standard microsurgical techniques. This approach has been successful in treating the pathology; however, it carries a risk of postoperative complications including CSF leakage, wound infection, and spinal instability. The authors describe a minimally invasive surgical (MIS) approach to treating spinal intradural pathology with a low rate of postoperative complications.

Methods
Through a retrospective review of a prospectively collected surgical database, the authors identified 26 patients who underwent 27 surgeries via an MIS approach for intradural pathology of the spine. Using a tubular retractor system and an operative microscope, the authors were able to treat all patients with a unilateral, paramedian, and muscle-splitting technique. They then collected data regarding operative blood loss, length of stay, imaging characteristics, and outcomes.

Results
Eight cervical, 8 thoracic, and 11 lumbar intradural pathological entities, which included 14 oncological lesions, 4 Chiari I malformations, 4 arachnoid cysts, 3 tethered cords, 1 syrinx, and 1 chronic visceral pain, were treated via an MIS approach. The average blood loss was 197 ml and the average hospital stay was 3 days. One patient had to return to the operating room for noninfectious wound dehiscence. One patient required reoperation 18 months after the initial surgery for recurrence of the initial pathology. There was no CSF leak, no infection, and no spinal instability associated with the initial surgery on follow-up.

Conclusions
Intradural spinal pathology can be safely and effectively treated with MIS approaches without an increased risk of neurological injury. This approach may also offer a reduced postoperative length of stay, risk of CSF leak, and risk of future spinal instability.
Outcome following unilateral versus bilateral instrumentation in patients undergoing minimally invasive transforaminal lumbar interbody fusion: a single-center randomized prospective study
Authors: Dahdaleh Nader S. , Nixon Alexander T. , Lawton Cort D. , Wong Albert P. , Smith Zachary A. , Fessler Richard G. 
Published: August 2013

Object
Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is used to treat a wide variety of lumbar degenerative disorders. Although there are some reports showing efficacy of unilateral instrumentation during MIS-TLIF, a controlled randomized prospective study has not been done.

Methods
Forty-one patients were randomly assigned to receive either bilateral or unilateral instrumentation following 1-level unilateral MIS-TLIF. Four patients were lost to follow-up in the unilateral group and 1 patient was lost to follow-up in the bilateral group. Preoperative and postoperative scores on a visual analog scale (VAS) for back pain and leg pain (VAS-BP and VAS-LP, respectively), Oswestry Disability Index (ODI), and 36-Item Short Form Healthy Survey version 2 (SF-36v2) were collected. Additionally, preoperative and postoperative segmental Cobb angles and radiographic evidence of fusion were analyzed.

Results
There was no statistically significant difference in baseline demographic characteristics between the 2 groups. The VAS-BP, VAS-LP, ODI, and SF-36v2 physical component scores improved significantly after surgery in both groups (p < 0.05); there was no statistically significant between-groups difference in the degree of improvement. Blood loss was significantly higher in the bilateral instrumentation group and hospital stay was longer in the unilateral instrumentation group. There was no statistically significant between-groups difference with respect to change in segmental lordosis or fusion rate. The average duration of follow-up was 12.4 months for the bilateral instrumentation group and 11.4 months for the unilateral instrumentation group.

Conclusions
Clinical and radiographic outcomes of unilateral and bilateral instrumentation for unilateral MISTLIF are similar 1 year after surgery.
Flexion-distraction injuries of the thoracolumbar spine: open fusion versus percutaneous pedicle screw fixation
Authors: Grossbach Andrew J. , Dahdaleh Nader S. , Abel Taylor J. , Woods Gregory D. , Dlouhy Brian J. , Hitchon Patrick W. 
Published: August 2013

Object
Flexion-distraction injuries occur due to distractive forces causing disruption of the posterior and middle spinal columns. These fractures classically consist of a fracture line through the posterior bony elements; involvement of the posterior ligamentous complex is, however, common. Surgical treatment is often required for these unstable injuries to avoid neurological deterioration and posttraumatic kyphosis, and the surgery traditionally consists of an open posterior approach with instrumented fusion. Percutaneous pedicle screw fixation for these injuries, with the goal of minimal tissue disruption and preservation of normal anatomy while achieving adequate stabilization, has recently been reported in the literature, but to date, a direct comparative study comparing open and percutaneous fixation has not been reported. The authors report their experience treating these fractures with both techniques and review the available literature.

Methods
Patients with flexion-distraction injury who were treated between May 2003 and March 2013 were prospectively followed. American Spinal Injury Association scores and degree of kyphotic angulation were recorded at admission, discharge, and follow-up. Data regarding intraoperative blood loss and operative time were obtained from a chart review. Patients treated with open versus minimally invasive procedures were compared.

Results
The authors identified 39 patients who suffered flexion-distraction injuries and were treated at their institution during the specified period; one of these patients declined surgery. All had injury to the posterior ligamentous complex. Open surgical procedures with pedicle screw fixation and posterolateral fusion were performed in 27 patients, while 11 patients underwent minimally invasive pedicle screw placement. Overall, there was improvement in kyphotic angulation at the time of discharge as well as most recent follow-up in both the open surgery and minimally invasive surgery (MIS) groups. The authors found no significant difference in American Spinal Injury Association score or the degree of kyphotic angulation between the MIS and open surgery groups. There was a trend toward shorter operative time for the MIS group, and patients who underwent minimally invasive procedures had significantly less blood loss.

Conclusions
Minimally invasive percutaneous pedicle screw fixation appears to have similar efficacy in the treatment of flexion-distraction injuries and it allows for reduced blood loss and tissue damage compared with open surgical techniques. Therefore it should be considered as an option for the treatment of this type of injury.
Plädoyer für die Rückbesinnung auf den Kern der Nachhaltigkeit (Essay)
Authors: Denzler Lukas 
Published: August 2013

We must return to the core principles of sustainability (essay)
Three hundred years ago, Hans Carl von Carlowitz, building on earlier work, made a major new contribution to the definition of sustainable forest management. Since the 1970s, it has been generally acknowledged that our planet is dependent on limited resources: many observers have acknowledged parallels with forestry. The concept of sustainable development has been discussed for 25 years, based on the notion of three dimensions or pillars of equal importance: “economic”, “ecological” and “social”. However, Nature is not a “pillar”, but rather the foundation of all human activity. To survive, we must put Nature to good use. With a growing human population and sharper global competition between different land-uses, high priority must be given to the use of our own domestic resources, in particular Swiss wood.
Urner Wald – Grundlage für eine nachhaltige Entwicklung (Essay)
Authors: Annen Beat 
Published: August 2013

The forests of the canton of Uri: the foundation of sustainable development (essay)
The canton of Uri is characterised by extreme topography: steep slopes and narrow valleys. Limited space is a major challenge for the development of the canton. Prudent management of this mountainous area is necessary to ensure a safe and attractive environment. In this situation, the forest, or to be more precise, the management of the forest, plays a key role. Most of the forest area is classified as protection forest, which is an essential condition to guarantee safety. The overriding management objective for the protective forest is sustainability. The existence of the forest in all its forms is the necessary condition also for biodiversity and landscape beauty. There is strong demand for land on the valley floor, where the main challenge is to protect the few remaining forest areas. Elsewhere however, the forest is expanding and measures must be taken to stop it taking over completely. Forest operations have consequences beyond the forest borders. For these reasons, sustainable management of the forest resource is the foundation of sustainable development of the mountainous canton of Uri.
Comprendre la durabilité et la multifonctionalité à l'exemple de la forêt (essai)
Authors: Locatelli Gloria , Pellaud Francine 
Published: August 2013

Understanding sustainability and multifunctionality through the forest (essai)
“Learn from yesterday, act today, think of tomorrow.”. For a long time now forest management in Switzerland has been based on the concept of sustainability. Nevertheless, not all forest visitors see things in the same way as foresters. Often the foresters' work is criticized because the meaning and goals of forest interventions are not well understood and consequently not accepted by the population. Real-world examples show that direct contact between foresters and forest visitors improves the population's awareness of forest management. They also show that forests are an ideal place for education on sustainable development (ESD). ESD projects offer the participants the opportunity for hands-on involvement, fieldwork experience and cooperation with professionals. These issues breed understanding and tolerance among the different stakeholders. The SILVIVA project “World of the forester” and the project weeks of the organization “Bildungswerkstatt Bergwald” are practical examples of this concept.
Reflet de l'occupation sur le plateau de Saint-André-de-l'Eure (Eure) du Ier siècle avant J.-C. au III è siècle après J.-C. (R.N. 154 - section nord)
Authors: Lepert Thierry , Paez-Rezende Laurent , Adrian Yves-Marie , Boivin Agnès 
Published: August 2013

After ten years of development in the south of the Eure, preparatory works of archaeology hâve resulted in the constitution of a documentation collected in relatively homogenous conditions over almost 300 hectares (500 by the end of 2001). The areas concemed are located at random within a chosen study zone, for analysis of land occupation, because of its geographical and topographical cohérence. The representativity of data produced by this documentation is a known parameter. Thus, they come increasingly to constitute an objective sample illustrating the archaeological potential of their acquisition area. Such a sample provides a first interprétation of the data on the archaeological map. As far as the plateau of Saint- André-de-1' Eure is concemed, the number of sites recorded goes over one thousand, half of which resuit from aerial research.
The exploitation of this mass of information concerns ail the protohistorical and historical eras. Indeed, a reasoned and quantified survey of the importance of the sites of the second Iron Age and Early Empire cannot be envisaged without taking into account the continuities and discordances preceding and following the era in question.
This case study leads to surprising results at first sight, the most outstanding being the extremely late évolution of the development of territory concemed. The intégration of the results of study into a reflexion on wider geographical areas provides a first explanation. The acceptable hypothesis of a very late rise of the rural exploitation of the plateau is after ail quite simple. The whole area was very scarcely occupied before the foundation and the development of the city of Evreux. The development of the urban centre together with the rural sites could therefore be accounted for almost exclusively by the satisfaction of the needs of the local urban market. As to the implantation of Evreux, it could simply be resuit of the administrative and économie organization on a large scale, subséquent to the Augustan reforms'1'.
Vertebral Erosions Associated with Spinal Inflammation in Patients with Ankylosing Spondylitis Identified by Magnetic Resonance Imaging: Changes After 2 Years of Tumor Necrosis Factor Inhibitor Therapy
Authors: Baraliakos Xenofon , Listing Joachim , Haibel Hildrun , Sieper Joachim , Braun Jurgen 
Published: August 2013

Objective.Spinal inflammation and erosions have been described in magnetic resonance imaging (MRI) examinations of patients with ankylosing spondylitis (AS). MRI scoring systems have implemented these observations.Methods.MRI scans (T1 or short-tau inversion recovery) from tumor necrosis factor-α blocker (anti-TNF) trials with patients with active AS (n = 22) were analyzed at baseline and after 2 years based on vertebral units (VU). The analysis was based on the prevalence of spinal erosions in relation to inflammation (active erosions) or without it (inactive erosions) as an outcome measure on MRI and their course under anti-TNF therapy. The results of MRI scoring systems that include (ASspiMRI) or exclude (Berlin score) erosions were also compared.Results.At baseline, there were more VU with inflammation (33.7%) than with erosions irrespective of activity (10.6%). After 2 years, active erosions decreased to 3.7% while inflammation was seen in a total of 12% of VU — a reduction of 58.9% and 64.5%, respectively (both p < 0.02). The overall extent of erosions decreased from 10.6% at baseline to 5.6% at 2 years. At the patient level, 73% and 32% of patients showed active erosions (p = 0.002), while 100% and 64% of patients showed inflammation (p = 0.029) at baseline and 2 years, respectively. Both scoring systems showed similar improvement, independent of inclusion or exclusion of erosions.Conclusion.Inflammation with erosions was observed in the spine of most patients with AS but their contribution to changes observed upon anti-TNF therapy was small, indicating that erosions do not need to be included in quantitative scoring systems of inflammation. Spinal inflammation was still present after 2 years of anti-TNF therapy in two-thirds of patients.
Parents’ Responses to Stress in the Neonatal Intensive Care Unit
Authors: Busse Morgan , Stromgren Kayleigh , Thorngate Lauren , Thomas Karen A. 
Published: August 2013

Background
Parents’ stress resulting from hospitalization of their infant in the neonatal intensive care unit (NICU) produces emotional and behavioral responses. The National Institutes of Health–sponsored Patient Reported Outcomes Measurement Information System (PROMIS) offers a valid and efficient means of assessing parents’ responses.

Objective
To examine the relationship of stress to anxiety, depression, fatigue, and sleep disruption among parents of infants hospitalized in the NICU.

Methods
Thirty parents completed the Parental Stressor Scale (PSS:NICU) containing subscales for NICU Sights and Sounds, Infant Behavior and Appearance, and Parental Role Alteration, and the PROMIS anxiety, depression, fatigue, and sleep disturbance short-form instruments.

Results
PSS total score was significantly correlated with anxiety (r = 0.61), depression (r = 0.36), and sleep disturbance (r = 0.60). Scores for NICU Sights and Sounds were not significantly correlated with parents’ outcomes; however, scores for Alteration in Parenting Role were correlated with all 4 outcomes, and scores for Infant Appearance were correlated with all except fatigue.

Conclusion
Stress experienced by parents of NICU infants is associated with a concerning constellation of physical and emotional outcomes comprising anxiety, depression, fatigue, and sleep disruption.
Diet-Induced Obese Mice Exhibit Altered Heterologous Immunity during a Secondary 2009 Pandemic H1N1 Infection
Authors: Milner J. Justin , Sheridan Patricia A. , Karlsson Erik A. , Schultz-Cherry Stacey , Shi Qing , Beck Melinda A. 
Published: August 2013

Abstract
During the 2009 pandemic H1N1 influenza A virus (pH1N1) outbreak, obese individuals were at greater risk for morbidity and mortality from pandemic infection. However, the mechanisms contributing to greater infection severity in obese individuals remain unclear. Although most individuals lacked pre-existing, neutralizing Ab protection to the novel pH1N1 virus, heterologous defenses conferred from exposure to circulating strains or vaccination have been shown to impart protection against pH1N1 infection in humans and mice. Because obese humans and mice have impaired memory T cell and Ab responses following influenza vaccination or infection, we investigated the impact of obesity on heterologous protection from pH1N1 infection using a mouse model of diet-induced obesity. Lean and obese mice were infected with influenza A/Puerto Rico/8/34 (PR8) and 5 wk later challenged with a lethal dose of heterologous pH1N1. Cross-neutralizing Ab protection was absent in this model, but obese mice exhibited a significantly lower level of nonneutralizing, cross-reactive pH1N1 nucleoprotein Abs following the primary PR8 infection. Further, obese mice had elevated viral titers, greater lung inflammation and lung damage, and more cytotoxic memory CD8+ T cells in the lung airways. Although obese mice had more regulatory T cells (Tregs) in the lung airways than did lean controls during the pH1N1 challenge, Tregs isolated from obese mice were 40% less suppressive than Tregs isolated from lean mice. In sum, excessive inflammatory responses to pH1N1 infection, potentially owing to greater viral burden and impaired Treg function, may be a novel mechanism by which obesity contributes to greater pH1N1 severity.
Functional KCa3.1 Channels Regulate Steroid Insensitivity in Bronchial Smooth Muscle Cells
Authors: Chachi Latifa , Shikotra Aarti , Duffy S. Mark , Tliba Omar , Brightling Christopher , Bradding Peter , Amrani Yassine 
Published: August 2013

AbstractIdentifying the factors responsible for relative glucocorticosteroid (GC) resistance present in patients with severe asthma and finding tools to reverse it are of paramount importance. In asthma we see in vivo evidence of GC-resistant pathways in airway smooth muscle (ASM) bundles that can be modeled in vitro by exposing cultured ASM cells to TNF-α/IFN-γ. This action drives GC insensitivity via protein phosphatase 5–dependent impairment of GC receptor phosphorylation. In this study, we investigated whether KCa3.1 ion channels modulate the activity of GC-resistant pathways using our ASM model of GC insensitivity. Immunohistochemical staining of endobronchial biopsies revealed that KCa3.1 channels are localized to the plasma membrane and nucleus of ASM in both healthy controls and asthmatic patients, irrespective of disease severity. Western blot assays and immunofluorescence staining confirmed the nuclear localization of KCa3.1 channels in ASM cells. The functional importance of KCa3.1 channels in the regulation of GC-resistant chemokines induced by TNF-α/IFN-γ was assessed using complementary inhibitory strategies, including KCa3.1 blockers (TRAM-34 and ICA-17043) or KCa3.1-specific small hairpin RNA delivered by adenoviruses. KCa3.1 channel blockade led to a significant reduction of fluticasone-resistant CX3CL1, CCL5, and CCL11 gene and protein expression. KCa3.1 channel blockade also restored fluticasone-induced GC receptor-α phosphorylation at Ser211 and transactivation properties via the suppression of cytokine-induced protein phosphatase 5 expression. The effect of KCa3.1 blockade was evident in ASM cells from both healthy controls and asthmatic subjects. In summary, KCa3.1 channels contribute to the regulation of GC-resistant inflammatory pathways in ASM cells: blocking KCa3.1 channels may enhance corticosteroid activity in severe asthma.
Macrophage Clearance of Neutrophil Extracellular Traps Is a Silent Process
Authors: Farrera Consol , Fadeel Bengt 
Published: August 2013

Abstract
Neutrophil extracellular traps (NETs) facilitate the extracellular killing of pathogens. However, in recent years, excessive NET formation has been implicated in several pathological conditions. Indeed, NETs that are not removed from tissues or from the circulation might serve to trigger autoimmune responses. We observed that physiological amounts of DNase I do not suffice to completely degrade NETs in vitro, suggesting that additional mechanisms are required for the removal of these extracellular structures. We show in this article that human monocyte–derived macrophages are able to engulf NETs in a cytochalasin D–dependent manner, indicating that this is an active, endocytic process. Furthermore, preprocessing of NETs by DNase I facilitated their clearance by macrophages. In addition, both recombinant C1q and endogenous C1q derived from human serum were found to opsonize NETs, and this facilitated NET clearance. Upon internalization, NETs were apparently degraded in lysosomes, as treatment with chloroquine led to accumulation of extranuclear DNA in human monocyte–derived macrophages. Finally, uptake of NETs alone did not induce proinflammatory cytokine secretion, whereas LPS-induced production of IL-1β, IL-6, and TNF-α was promoted by the uptake of NETs. In summary, we show that macrophages are capable of clearance of NETs and that this occurs in an immunologically silent manner.
Phenotype and Function of T Cells Infiltrating Visceral Metastases from Gastrointestinal Cancers and Melanoma: Implications for Adoptive Cell Transfer Therapy
Authors: Turcotte Simon , Gros Alena , Hogan Katherine , Tran Eric , Hinrichs Christian S. , Wunderlich John R. , Dudley Mark E. , Rosenberg Steven A. 
Published: August 2013

Abstract
Adoptive cell transfer of tumor-infiltrating lymphocytes (TILs) can mediate cancer regression in patients with metastatic melanoma, but whether this approach can be applied to common epithelial malignancies remains unclear. In this study, we compared the phenotype and function of TILs derived from liver and lung metastases from patients with gastrointestinal (GI) cancers (n = 14) or melanoma (n = 42). Fewer CD3+ T cells were found to infiltrate GI compared with melanoma metastases, but the proportions of CD8+ cells, T cell differentiation stage, and expression of costimulatory molecules were similar for both tumor types. Clinical-scale expansion up to ∼50 × 109 T cells on average was obtained for all patients with GI cancer and melanoma. From GI tumors, however, TIL outgrowth in high-dose IL-2 yielded 22 ± 1.4% CD3+CD8+ cells compared with 63 ± 2.4% from melanoma (p &lt; 0.001). IFN-γ ELISA demonstrated MHC class I–mediated reactivity of TIL against autologous tumor in 5 of 7 GI cancer patients tested (9% of 188 distinct TIL cultures) and in 9 of 10 melanoma patients (43% of 246 distinct TIL cultures). In these assays, MHC class I–mediated up-regulation of CD137 (4-1BB) expression on CD8+ cells suggested that 0–3% of TILs expanded from GI cancer metastases were tumor-reactive. This study implies that the main challenge to the development of TIL adoptive cell transfer for metastatic GI cancers may not be the in vitro expansion of bulk TILs, but the ability to select and enrich for tumor-reactive T cells.