bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Going for Income” in Village Tibet: A Longitudinal Analysis of Change and Adaptation, 1997–2007
Authors: Goldstein Melvyn C. , Childs Geoff , Wangdui Puchung 
Published: July 2008

Abstract
Rural Tibet is in the throes of a major paradigm shift from a predominately subsistence agricultural economy to a new mixed economy in which non-farm income plays a dominant role. This paper examines this change, comparing longitudinal data collected through direct fieldwork in rural Tibet in 1997–98 and 2006–07.
Potential effects of perfluorinated compounds in common cormorants from Lake Biwa, Japan: An implication from the hepatic gene expression profiles by microarray
Authors: Nakayama Kei , Iwata Hisato , Tao Lin , Kannan Kurunthachalam , Imoto Mai , Kim Eun-Young , Tashiro Kosuke , Tanabe Shinsuke 
Published: July 2008

Abstract
Contamination levels of perfluorinated compounds (PFCs), including perfluorooctanesulfonate (PFOS), perfluorononanoic acid (PFNA), perfluorooctane sulfonamide (PFOSA), perfluorohexanesulfonate (PFHS), and perfluorooctanoic acid (PFOA), were determined in the livers of wild common cormorants (Phalacrocorax carbo) from Lake Biwa, Japan. Potential effects of PFCs alone and combined effects by complex mixture of PFCs and dioxins and related compounds (DRCs) were also assessed by gene expression profiling using a cormorant oligo array. Perfluorooctanesulfonate, PFNA, and PFOSA were detected in almost all liver samples analyzed, while concentrations of PFHS and PFOA were below the limit of quantification. The microarray data analyses revealed that hepatic PFC levels were correlated with the expression of 74 genes. Real-time reverse-transcript polymerase chain reaction data demonstrated that PFOS concentration was positively correlated with mRNA levels of glutathione peroxidase 1 and glutathione S-transferase alpha 3 and negatively correlated with levels of heat shock 70-kDa protein 8 and tumor rejection antigen 1 mRNAs. These results suggest the induction of antioxidant enzymes in response to oxidative stress caused by PFCs and the suppression of molecular chaperones, leading to reduction in protein stability. Moreover, multiple regression analyses identified seven significant models in which certain genes showed expression levels altered by accumulation of PFCs and DRCs. The regression models explained associations with cytochrome P450 1A mRNA and protein expression levels, and its catalytic activity, ethoxy-resorufin-O-deethylase of both PFNA and the 2,3,7,8-tetrachlorodibenzo-p-dioxin toxic equivalent levels. Thus, the regression models suggested the potential of PFCs to enhance toxicities of DRCs. Since mixture toxicity is an urgent issue, further study is required to understand the effects of mixtures of PFCs and DRCs in wild cormorants.
Development and application of a species sensitivity distribution for temperature-induced mortality in the aquatic environment
Authors: de Vries Pepijn , Tamis Jacqueline E , Murk Albertinka J , Smit Mathijs G. D 
Published: July 2008

Abstract
Current European legislation has static water quality objectives for temperature effects, based on the most sensitive species. In the present study a species sensitivity distribution (SSD) for elevated temperatures is developed on the basis of temperature sensitivity data (mortality) of 50 aquatic species. The SSD applies to risk assessment of heat discharges that are localized in space or time. As collected median lethal temperatures (LT50 values) for different species depend on the acclimation temperature, the SSD is also a function of the acclimation temperature. Data from a thermal discharge in The Netherlands are used to show the applicability of the developed SSD in environmental risk assessment. Although restrictions exist in the application of the developed SSD, it is concluded that the SSD approach can be applied to assess the effects of elevated temperature. Application of the concept of SSD to temperature changes allows harmonization of environmental risk assessment for stressors in the aquatic environment. When a synchronization of the assessment methods is achieved, the steps to integration of risks from toxic and nontoxic stressors can be made.
“Moving Forward”: Success from a Physiotherapist's Point of View
Authors: Takeuchi Rumi , O'Brien Michelle M. , Ormond Keli B. , Brown Steven D.J. , Maly Monica R. 
Published: July 2008

Purpose: The purpose of this study was to capture the meaning of professional success to experienced physiotherapists practising in the Greater Toronto Area (GTA).Methods: Using a qualitative, phenomenological approach, 10 physiotherapists from the GTA each participated in a 60-minute, semistructured, face-to-face interview. Interviews were transcribed verbatim and analyzed using the vanKaam method, modified by Moustakas.Results: Participants described success as “moving forward,” a dynamic and evolving experience that extends throughout an entire career. Study participants identified three markers of professional success: positive patient outcome, career advancement, and advancement of the physiotherapy profession. The experience of moving forward toward success applied to all of these markers and was driven by making choices. Choices made throughout a career were influenced by mentorship and self-reflection.Conclusions: The physiotherapists in this study described different indicators of success than have been described by other health care or corporate professionals in the literature. Success in the physiotherapy profession is experienced as a circular rather than linear process. Physiotherapists, professional organizations, and employers have a role in fostering professional success. We suggest the introduction of mentorship and self-reflection programmes early in one's career, focusing on the three markers of success: patient outcomes, career advancement, and advancement of the profession.
Convergent Validity of the Constant-Murley Outcome Measure in Patients with Rotator Cuff Disease
Authors: Razmjou Helen , Bean Andrea , MacDermid Joy C. , van Osnabrugge Varda , Travers Niki , Holtby Richard 
Published: July 2008

Purpose: Despite the popularity of the Constant-Murley score (CMS), a combined patient-report and objective (health professional administered) shoulder outcome measure, minimal information exists on its reliability or validity. The purpose of this study was to examine (1) internal consistency and convergent validity of the CMS and (2) the degree to which other shoulder measures explain variation in range of motion and strength components of the CMS. Methods: In this cross-sectional study of outcome measures, 45 patients undergoing conservative or surgical treatment for rotator cuff disease participated. Two disease-specific outcome measures, one shoulder-specific measure, and one upper extremity outcome measure were compared to the CMS. Results: Correlations between competing measures and relative total CMS were moderate (0.56 to 0.75). The American Shoulder & Elbow Score, the Upper Extremity Functional Index, the Western Ontario Rotator Cuff Index, and the Rotator Cuff Quality of Life index explained 38%, 28%, 26%, and 10% of variance of the objective component of the CMS respectively. Conclusions: The patient-report component of the CMS measures a multidimensional concept. The strength component had moderate correlations with isometric strength measures of the shoulder external rotators and abductors. The total CMS appears to measure a construct that is not totally captured by competing measures. The unexplained variance may be due, in part, to the lack of importance of the patient's physical impairment to symptoms or activity limitations as measured by other instruments.
Same-segment and adjacent-segment disease following posterior cervical foraminotomy
Authors: Clarke Michelle J. , Ecker Robert D. , Krauss William E. , McClelland Robyn L. , Dekutoski Mark B. 
Published: July 2008

Object
The cervical foraminotomy was pioneered in the 1940s to address radicular symptoms via a posterior approach, but the long-term outcome has not been adequately studied.

Methods
The authors retrospectively analyzed data obtained from 303 patients (188 male and 115 female, mean age 49.2 years) who had consecutively undergone a single-level posterior foraminotomy for cervical radiculopathy between 1972 and 1992. The median follow-up duration was 7.1 years. The major end point studied was the development of symptomatic adjacent- or same-segment disease. Incidence rates per 1000 person-years were calculated, and the natural history of the disease was predicted using Kaplan–Meier survivorship analysis.
In 15 (4.9%) of 303 patients, symptomatic adjacent-segment disease developed, yielding a rate of 6.4/1000 person-years at risk. This included nine (2.9%) of 303 patients requiring reoperation, yielding a rate of 3.8/1000 person-years. Kaplan–Meier survivorship analysis suggested a relatively stable annual 0.7% rate for developing adjacent-segment disease, with a 10-year rate of 6.7%. Ten patients developed same-segment disease, yielding a risk rate of 3.9/1000 person-years.
Kaplan–Meier survivorship analysis demonstrated a 5- and 10-year risk rate of developing same-segment disease of 3.2 and 5.0%, respectively.

Conclusions
Although additional study is needed, analysis of the present data suggests that posterior foraminotomy is associated with a low rate of same- and adjacent-segment disease.
A comparison of changes over time in cervical foraminal height after tricortical iliac graft or polyetheretherketone cage placement following anterior discectomy
Authors: Çelik Suat E. , Kara Ayhan , Çelik Sevinç 
Published: July 2008

Object
The authors prospectively evaluated cervical foraminal height changes after anterior cervical discectomy and fusion. To their knowledge, this prospective study is the first in which foraminal height changes over time are compared following the placement of a tricortical graft or a polyetheretherketone (PEEK) cage.

Methods
The patients were randomly divided in two groups. In one group, 30 patients underwent anterior cervical microdiscectomy and free bone graft (FBG) insertion at 46 levels via the Smith–Robinson technique. The FBG was harvested from the right iliac crest. Another 35 patients underwent the same operation, but fusion was provided by the insertion of PEEK intervertebral cages at 41 levels. Fusion status and the C2–7 Cobb angle, interspace height, and foraminal height changes were observed on anterior, lateral, and oblique radiographs obtained at the 18-month follow-up examination.
There were no differences between the groups with regard to clinical recovery, fusion status, and Cobb angle. A significant interspace height reduction was observed in the FBG group during the 1st postoperative month. In the FBG group, the mean heights (± standard deviation) of the foramina were 8.2 ± 2.7 mm preoperatively, 10.8 ± 2.6 mm on postoperative Day 2, and 8.1 ± 1.5 mm after 18 months of follow up. In the PEEK cage group, the mean heights were 8.4 ± 2.8 mm preoperatively, 10.3 ± 1.1 mm on postoperative Day 2, and 9.6 ± 1.2 mm after 18 months of follow up. The increase in foraminal height was significantly preserved at the 6th, 12th, and 18th months in the cage group.

Conclusions
In both groups the foraminal height increased sufficiently and the nerve root was decompressed postoperatively. The PEEK cages may provide sufficient preservation of foraminal height even 1.5 years after the operation.
Cervical neurapraxia in elite athletes: evaluation and surgical treatment
Authors: Maroon Joseph C. , El-Kadi Hikmat , Abla Adnan A. , Wecht Daniel A. , Bost Jeffrey , Norwig John , Bream Tim 
Published: July 2008

Object
Neurapraxia, transient posttraumatic paralysis of the motor and/or sensory tracts in the spinal cord, may be a career-ending event in an athlete. Management, rehabilitation, and return-to-play decisions remain controversial.

Methods
Five elite football players were evaluated after experiencing episodes of neurapraxia. All patients experienced bilateral paresthesias—three in all four extremities and two in the upper extremities—lasting a few minutes to more than 24 hours. Transient motor deficits occurred in two individuals but caused no permanent sequelae. Neuroimaging confirmed the presence of herniated discs, focal cord compression, and no parenchymal changes in all cases.
All patients underwent anterior cervical microdiscectomy and fusion, and cervical plates were placed in four. After aggressive rehabilitation and confirmation of fusion ranging from 9 weeks to 8 months postoperatively, the players were allowed to return to active play. Two of the players developed recurrent career-ending disc herniations, one above and the other below the fusion level. One player required repeated spinal cord decompression.

Conclusions
Neurologically intact athletes with focal cord compression due to a single-level herniated disc may safely return to football after undergoing decompressive surgery and confirmation of fusion. It appears, however, that there may be an increased chance of repeated herniation above or below a fused level.
Clinical outcomes and complications after pedicle subtraction osteotomy for correction of thoracolumbar kyphosis
Authors: Ikenaga Minoru , Shikata Jitsuhiko , Takemoto Mitsuru , Tanaka Chiaki 
Published: July 2008

ObjectMany patient complications have been reported after the use of the pedicle subtraction osteotomy (PSO) technique. To the authors' knowledge, no previous reseachers have reported on the causes of complications after using the single-stage PSO technique with a posterior approach. The purpose of this study was to investigate complications after the procedure, to clarify the factors influencing the complications, and to identify ways to minimize complications.MethodsRecords for 67 patients treated with the PSO technique were examined retrospectively. All complications were recorded and analyzed in relation to the radiological and clinical outcomes.No patient died or became paraplegic as a result of surgery. There were 48 surgery-related complications in 27 patients (40%): six intraoperative, four perioperative, and 38 late-onset postoperative complications. As the study progressed and more patients were treated, the rate of intraoperative complications decreased significantly. The incidence of late-onset complications associated with an adjacent-segment progression of kyphosis was lower in patients with a long fusion from a midthoracic vertebra to the sacrum or pelvis than in patients treated with a shorter fusion. The C-7 plumb line values and postoperative complications were closely correlated with clinical results.ConclusionsIntraoperative complications can be prevented or the risks minimized with adequate surgical training. Most of the late-onset complications in these patients were related to the progression of kyphosis. The frequency of complications was closely correlated with patient satisfaction at follow up. Correcting the C-7 plumb line value with minimal complications appeared to lead to better clinical results.
Inhibition of x-irradiation–enhanced locomotor recovery after spinal cord injury by hyperbaric oxygen or the antioxidant nitroxide tempol
Authors: Hillard Virany H. , Peng Hong , Das Kaushik , Murali Raj , Moorthy Chitti R. , Etlinger Joseph D. , Zeman Richard J. 
Published: July 2008

Object
Hyperbaric oxygen (HBO), the nitroxide antioxidant tempol, and x-irradiation have been used to promote locomotor recovery in experimental models of spinal cord injury. The authors used x-irradiation of the injury site together with either HBO or tempol to determine whether combined therapy offers greater benefit to rats.

Methods
Contusion injury was produced with a weight-drop device in rats at the T-10 level, and recovery was determined using the 21-point Basso-Beattie-Bresnahan (BBB) locomotor scale. Locomotor function recovered progressively during the 6-week postinjury observation period and was significantly greater after x-irradiation (20 Gy) of the injury site or treatment with tempol (275 mg/kg intraperitoneally) than in untreated rats (final BBB Scores 10.6 [x-irradiation treated] and 9.1 [tempol treated] compared with 6.4 [untreated], p < 0.05). Recovery was not significantly improved by HBO (2 atm for 1 hour [BBB Score 8.2, p > 0.05]). Interestingly, the improved recovery of locomotor function after x-irradiation, in contrast with antiproliferative radiotherapy for neoplasia, was inhibited when used together with either HBO or tempol (BBB Scores 8.2 and 8.3, respectively). The ability of tempol to block enhanced locomotor recovery by x-irradiation was accompanied by prevention of alopecia at the irradiation site. The extent of locomotor recovery following treatment with tempol, HBO, and x-irradiation correlated with measurements of spared spinal cord tissue at the contusion epicenter.

Conclusions
These results suggest that these treatments, when used alone, can activate neuroprotective mechanisms but, in combination, may result in neurotoxicity.
Single-stage total C-2 intralesional spondylectomy for chordoma with three-column reconstruction
Authors: Suchomel Petr , Buchvald Pavel , Barsa Pavel , Froehlich Robert , Choutka Ondrej , Krejzar Zdenek , Sourkova Petra , Endrych Ladislav , Dzan Ladislav 
Published: July 2008

✓Chordomas are locally invasive, malignant bone tumors that rarely occur in the cervical spine. En bloc resection or even fully resecting the tumor along its margin offers improved patient survival and a potential disease cure. Complete resection of tumors involving the upper cervical vertebrae requires a combined anterior–posterior approach but is complicated by the presence of vertebral arteries (VAs). In addition, reconstruction of the postresection defect may be prone to failure.The authors present a case of a chordoma involving the axis that was treated using a single-stage total intralesional C-2 spondylectomy with preservation of both VAs because the patient did not tolerate a preoperative occlusion test. A three-column reconstruction technique is also presented.
Use of newly developed instruments and endoscopes: full-endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach
Authors: Ruetten Sebastian , Komp Martin , Merk Harry , Godolias Georgios 
Published: July 2008

ObjectEven with good results, conventional disc operations may result in subsequent damage due to trauma. Endoscopic techniques have become the standard in many areas because of the advantages they offer intraoperatively and postoperatively in rehabilitation. The goal of this prospective study was to examine the expanded technical possibilities of full-endoscopic transforaminal and interlaminar resection of herniated lumbar discs in which the authors used newly developed optics and instruments. The focus was on questions of achieving sufficient decompression, as well as the advantages and disadvantages of the minimally invasive procedure.MethodsTwo hundred thirty-two patients underwent follow up for 2 years after undergoing surgery. In addition to general and specific parameters, the following measuring instruments were used: a visual analog scale, the German version of the North American Spine Society instrument, and the Oswestry Disability Index of low-back pain disability.Postoperatively 84% of the patients no longer had leg pain, and 12% had only occasional pain. The results of decompression were equivalent to those of conventional procedures. The incidence of traumatization was reduced. Epidural scarring was minimized. The recurrence rate was 6.0%. No serious surgical complications were observed. Resection of the herniated disc was technically possible in all cases in which the new instruments were used.ConclusionsThe authors view the aforedescribed techniques, which offer the advantages of a truly minimally invasive procedure, as a sufficient and safe supplementation and alternative to conventional procedures, when the appropriate indication criteria are heeded. The new endoscope with its 4.2-mm working channel and corresponding instruments significantly reduced the technical problems.
Cortical reorganization in patients with cervical spondylotic myelopathy
Authors: Holly Langston T. , Dong Yun , Albistegui-Dubois Richard , Marehbian Jonathan , Dobkin Bruce 
Published: July 2008

Object
Recent investigations have demonstrated that the cerebral cortex can reorganize as a result of spinal cord injury and may play a role in preserving neurological function. Reorganization of cortical representational maps in patients with cervical spondylotic myelopathy (CSM) has not been previously described. The authors sought to determine the feasibility of using functional magnetic resonance (fMR) imaging in patients with CSM to investigate changes in the cortical representation of the wrist and ankle before and after surgical intervention.

Methods
Four patients with clinical and imaging evidence of CSM were prospectively enrolled in this study. The patients underwent preoperative neurological examination, functional assessment, cervical imaging, and brain fMR imaging. The fMR imaging activation task undertaken was either wrist extension or ankle dorsiflexion, depending on whether the patient's primary impairment was hand dysfunction or gait difficulty. The cohort then underwent further evaluations at 6 weeks and 3 and 6 months postoperatively. In addition, five healthy volunteers underwent fMR imaging at two different time points and served as controls.
In the healthy volunteers fMR imaging demonstrated areas of focal cortical activation limited to the contralateral primary motor area for the assigned motor tasks; the activation patterns were stable throughout repeated imaging. In comparison, in patients with CSM fMR imaging demonstrated expansion of the cortical representation of the affected extremity. Surgical decompression resulted in improvements in neurological function and reorganization of the representational map.

Conclusions
The findings of this preliminary study demonstrate the potential of fMR imaging to assess changes in cortical representation before and after surgical intervention in patients with CSM. A future study involving a larger cohort of patients as well as the stratification of patients with CSM, based on the aforementioned factors that influence cortical adaptation, will allow a more detailed quantitative analysis.