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Find video protocols related to scientific articles indexed in Pubmed.
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The National Neurosurgery Quality and Outcomes Database (N2QOD): A Collaborative North American Outcomes Registry to Advance Value-Based Spine Care.
Spine
PUBLISHED: 10-10-2014
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National Prospective Observational Registry OBJECTIVE.: Describe our preliminary experience with the National Neurosurgery Quality and Outcomes Database (NQOD), a national collaborative registry of quality and outcomes reporting after low back surgery.
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Experiences of teen drivers and their advice for the learner license phase.
Traffic Inj Prev
PUBLISHED: 10-08-2014
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Teen drivers remain at considerable risk of injury and fatality during the earliest years of independent driving. Multistage licensing programs, such as graduated driver licensing (GDL), have been implemented in numerous jurisdictions as a form of exposure control, mandating minimum practice periods and driving restrictions such as night driving and passenger limits. However, the teen driver's experiences of GDL during the learner phase, and the driving and other advice they recommend be shared with all learners, remains unknown at this time.
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Long-term outcomes after revision neural decompression and fusion for same-level recurrent lumbar stenosis: defining the effectiveness of surgery.
J Spinal Disord Tech
PUBLISHED: 09-24-2014
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Single-cohort study of patients undergoing revision neural decompression and fusion for same-level recurrent lumbar stenosis.
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EVM005: an ectromelia-encoded protein with dual roles in NF-?B inhibition and virulence.
PLoS Pathog.
PUBLISHED: 08-14-2014
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Poxviruses contain large dsDNA genomes encoding numerous open reading frames that manipulate cellular signalling pathways and interfere with the host immune response. The NF-?B signalling cascade is an important mediator of innate immunity and inflammation, and is tightly regulated by ubiquitination at several key points. A critical step in NF-?B activation is the ubiquitination and degradation of the inhibitor of kappaB (I?B?), by the cellular SCF?-TRCP ubiquitin ligase complex. We show here that upon stimulation with TNF? or IL-1?, Orthopoxvirus-infected cells displayed an accumulation of phosphorylated I?B?, indicating that NF-?B activation was inhibited during poxvirus infection. Ectromelia virus is the causative agent of lethal mousepox, a natural disease that is fatal in mice. Previously, we identified a family of four ectromelia virus genes (EVM002, EVM005, EVM154 and EVM165) that contain N-terminal ankyrin repeats and C-terminal F-box domains that interact with the cellular SCF ubiquitin ligase complex. Since degradation of I?B? is catalyzed by the SCF?-TRCP ubiquitin ligase, we investigated the role of the ectromelia virus ankyrin/F-box protein, EVM005, in the regulation of NF-?B. Expression of Flag-EVM005 inhibited both TNF?- and IL-1?-stimulated I?B? degradation and p65 nuclear translocation. Inhibition of the NF-?B pathway by EVM005 was dependent on the F-box domain, and interaction with the SCF complex. Additionally, ectromelia virus devoid of EVM005 was shown to inhibit NF-?B activation, despite lacking the EVM005 open reading frame. Finally, ectromelia virus devoid of EVM005 was attenuated in both A/NCR and C57BL/6 mouse models, indicating that EVM005 is required for virulence and immune regulation in vivo.
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Co-administration of the broad-spectrum antiviral, brincidofovir (CMX001), with smallpox vaccine does not compromise vaccine protection in mice challenged with ectromelia virus.
Antiviral Res.
PUBLISHED: 08-13-2014
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Natural orthopoxvirus outbreaks such as vaccinia, cowpox, cattlepox and buffalopox continue to cause morbidity in the human population. Monkeypox virus remains a significant agent of morbidity and mortality in Africa. Furthermore, monkeypox virus's broad host-range and expanding environs make it of particular concern as an emerging human pathogen. Monkeypox virus and variola virus (the etiological agent of smallpox) are both potential agents of bioterrorism. The first line response to orthopoxvirus disease is through vaccination with first-generation and second-generation vaccines, such as Dryvax and ACAM2000. Although these vaccines provide excellent protection, their widespread use is impeded by the high level of adverse events associated with vaccination using live, attenuated virus. It is possible that vaccines could be used in combination with antiviral drugs to reduce the incidence and severity of vaccine-associated adverse events, or as a preventive in individuals with uncertain exposure status or contraindication to vaccination. We have used the intranasal mousepox (ectromelia) model to evaluate the efficacy of vaccination with Dryvax or ACAM2000 in conjunction with treatment using the broad spectrum antiviral, brincidofovir (BCV, CMX001). We found that co-treatment with BCV reduced the severity of vaccination-associated lesion development. Although the immune response to vaccination was quantifiably attenuated, vaccination combined with BCV treatment did not alter the development of full protective immunity, even when administered two days following ectromelia challenge. Studies with a non-replicating vaccine, ACAM3000 (MVA), confirmed that BCV's mechanism of attenuating the immune response following vaccination with live virus was, as expected, by limiting viral replication and not through inhibition of the immune system. These studies suggest that, in the setting of post-exposure prophylaxis, co-administration of BCV with vaccination should be considered a first response to a smallpox emergency in subjects of uncertain exposure status or as a means of reduction of the incidence and severity of vaccine-associated adverse events.
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The relative value of postoperative versus preoperative Karnofsky Performance Scale scores as a predictor of survival after surgical resection of glioblastoma multiforme.
J. Neurooncol.
PUBLISHED: 07-23-2014
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The Karnofsky Performance Scale (KPS) score is a widespread metric to stratify patient prognosis and determine appropriate management in glioblastoma multiforme(GBM). Low preoperative KPS values have been associated with shorter overall survival (OS). However, surgical resection can have a dramatic effect on a patient's functional status which subsequently alters their KPS score. To determine the predictive value of preoperative verses postoperative KPS scores in terms of OS in patients with GBM. We conducted a retrospective review of 163 patients who underwent initial surgical intervention for pathologically proven GBM at our institution between 2003 and 2013. Pre and postoperative performance status, demographic, operative, and treatment variables were recorded for each patient. Multivariate regression analysis identified predictors of prolonged OS. The adequacy index was calculated to compare the predictive value of preoperative and postoperative KPS score. Median preoperative and postoperative KPS scores were 70 and 80, respectively. Overall, 92 (57 %) patients experienced an improvement in their KPS score, 40 (25 %) remained stable, and 29 (18 %) declined. Higher postoperative KPS (P = 0.0001), radiation therapy (P < 0.0001), younger age (P = 0.0443) and the absence of diabetes (P = 0.0006) were each independently associated with increased OS in a multivariate regression model. Postoperative KPS score has superior predictive value compared to pre-operative KPS score (A = 0.758 vs. 1.002). Postoperative KPS scores have superior predictive capabilities in terms of OS in GBM and should replace preoperative KPS scores when estimating prognosis in this population.
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Potent neutralization of vaccinia virus by divergent murine antibodies targeting a common site of vulnerability in L1 protein.
J. Virol.
PUBLISHED: 07-16-2014
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Vaccinia virus (VACV) L1 is an important target for viral neutralization and has been included in multicomponent DNA or protein vaccines against orthopoxviruses. To further understand the protective mechanism of the anti-L1 antibodies, we generated five murine anti-L1 monoclonal antibodies (MAbs), which clustered into 3 distinct epitope groups. While two groups of anti-L1 failed to neutralize, one group of 3 MAbs potently neutralized VACV in an isotype- and complement-independent manner. This is in contrast to neutralizing antibodies against major VACV envelope proteins, such as H3, D8, or A27, which failed to completely neutralize VACV unless the antibodies are of complement-fixing isotypes and complement is present. Compared to nonneutralizing anti-L1 MAbs, the neutralization antibodies bound to the recombinant L1 protein with a significantly higher affinity and also could bind to virions. By using a variety of techniques, including the isolation of neutralization escape mutants, hydrogen/deuterium exchange mass spectrometry, and X-ray crystallography, the epitope of the neutralizing antibodies was mapped to a conformational epitope with Asp35 as the key residue. This epitope is similar to the epitope of 7D11, a previously described potent VACV neutralizing antibody. The epitope was recognized mainly by CDR1 and CDR2 of the heavy chain, which are highly conserved among antibodies recognizing the epitope. These antibodies, however, had divergent light-chain and heavy-chain CDR3 sequences. Our study demonstrates that the conformational L1 epitope with Asp35 is a common site of vulnerability for potent neutralization by a divergent group of antibodies.
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Cost per Quality Adjusted Life Year Gained of Revision Fusion for Lumbar Pseudoarthrosis: Defining the Value of Surgery.
J Spinal Disord Tech
PUBLISHED: 07-08-2014
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Single cohort study of patients undergoing revision fusion for lumbar pseudoarthrosis OBJECTIVE:: To assess the two-year comprehensive costs of revision arthrodesis for lumbar pseudoarthrosis at our institution and determine the associated cost per quality adjusted life year gained in this patient population SUMMARY OF BACKGROUND DATA:: The proportion of lumbar spine operations involving a fusion procedure has increased over the past two decades. Similarly, there has been a corresponding increase in the incidence and prevalence of pseudoarthrosis. However, the cost-effectiveness of revision surgery for pseudoarthrosis-associated back pain has yet to be examined.
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Two-year comprehensive medical management of degenerative lumbar spine disease (lumbar spondylolisthesis, stenosis, or disc herniation): a value analysis of cost, pain, disability, and quality of life: clinical article.
J Neurosurg Spine
PUBLISHED: 05-02-2014
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Current health care reform calls for a reduction of procedures and treatments that are less effective, more costly, and of little value (high cost/low quality). The authors assessed the 2-year cost and effectiveness of comprehensive medical management for lumbar spondylolisthesis, stenosis, and herniation by utilizing a prospective single-center multidisciplinary spine center registry in a real-world practice setting.
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Attractiveness difference magnitude affected by context, range, and categorization.
Perception
PUBLISHED: 04-03-2014
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Previous studies have shown that, when subjects view hedonically positive stimuli followed by stimuli oflesser hedonic value, their preference between the stimuli oflesser hedonic value decreases. This is hedonic condensation. In addition, its opposite, hedonic expansion, occurs when subjects view less hedonically positive stimuli followed by more hedonically positive stimuli. Experiment 1 showed both hedonic condensation and expansion in subjects who viewed pictures of unattractive and moderately attractive faces. Experiment 2 showed that, when subjects were instructed to view the stimuli as coming from two different groups, hedonic expansion but not hedonic condensation was eliminated. Experiment 3 showed that increasing the attractiveness difference between the attractive and unattractive faces eliminated all effects of context on subjects' attractiveness difference judgments. Experiment 4 showed that forcing subjects to categorize the extremely attractive and unattractive faces into the same group resulted in hedonic expansion among attractive faces but not condensation among the unattractive faces. These results suggest that, as hedonic contrast changes the hedonic values of stimuli, it also changes the attention paid to those stimuli, thereby altering the degree of preference between them. Manipulations that prevent a shift in hedonic value also block a shift in the magnitude of the preference judgments.
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Canadian nurses launch TV campaign for public support.
Nurs Stand
PUBLISHED: 03-13-2014
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It is good to read that nurses in Ontario, Canada, have set up a campaign under the banner 'More nurses, better care!' (News March 5), urging the public to join the fight for more nurses in the province.
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Patenting personalized medicines in the UK, Europe and USA.
Pharm Pat Anal
PUBLISHED: 03-05-2014
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In this review, we take a look at the patentability issues surrounding personalized medicine patent claims. We examine how the USA and European Patent Office have dealt with such patent claims, and then review the UK 'inherency' and 'selection' decisions to take a view as to how the UK courts will deal with personalized medicine patent claims in the future. We conclude that the UK courts will likely be willing to uphold patent protection for personalized medicines in the right circumstances.
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Evaluation of sex, race, body mass index and pre-vaccination serum progesterone levels and post-vaccination serum anti-anthrax protective immunoglobulin G on injection site adverse events following anthrax vaccine adsorbed (AVA) in the CDC AVA human clinical trial.
Vaccine
PUBLISHED: 02-14-2014
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Anthrax vaccine adsorbed (AVA) administered intramuscularly (IM) results in fewer adverse events (AEs) than subcutaneous (SQ) administration. Women experience more AEs than men. Antibody response, female hormones, race, and body mass index (BMI) may contribute to increased frequency of reported injection site AEs.
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Cost savings associated with antibiotic-impregnated shunt catheters in the treatment of adult and pediatric hydrocephalus.
World Neurosurg
PUBLISHED: 02-10-2014
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CSF shunt infection remains a major cause of morbidity and mortality in the treatment of hydrocephalus and is associated with significant medical cost. Several studies have demonstrated the efficacy of antibiotic impregnated (AI) shunt catheters in reducing CSF shunt infection; however, providers remain reluctant to adopt AI catheters into practice due to the increased upfront cost. We set out to determine if the use of AI catheters provided cost savings in a large nationwide database.
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"I drove after drinking alcohol" and other risky driving behaviours reported by young novice drivers.
Accid Anal Prev
PUBLISHED: 02-03-2014
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Volitional risky driving behaviours such as drink- and drug-driving (i.e. substance-impaired driving) and speeding contribute to the overrepresentation of young novice drivers in road crash fatalities, and crash risk is greatest during the first year of independent driving in particular. Aims: To explore the: (1) self-reported compliance of drivers with road rules regarding substance-impaired driving and other risky driving behaviours (e.g., speeding, driving while tired), one year after progression from a Learner to a Provisional (intermediate) licence; and (2) interrelationships between substance-impaired driving and other risky driving behaviours (e.g., crashes, offences, and Police avoidance).
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The driver, the road, the rules … and the rest? A systems-based approach to young driver road safety.
Accid Anal Prev
PUBLISHED: 01-23-2014
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The persistent overrepresentation of young drivers in road crashes is universally recognised. A multitude of factors influencing their behaviour and safety have been identified through methods including crash analyses, simulated and naturalistic driving studies, and self-report measures. Across the globe numerous, diverse, countermeasures have been implemented; the design of the vast majority of these has been informed by a driver-centric approach. An alternative approach gaining popularity in transport safety is the systems approach which considers not only the characteristics of the individual, but also the decisions and actions of other actors within the road transport system, along with the interactions amongst them. This paper argues that for substantial improvements to be made in young driver road safety, what has been learnt from driver-centric research needs to be integrated into a systems approach, thus providing a holistic appraisal of the young driver road safety problem. Only then will more effective opportunities and avenues for intervention be realised.
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Accurately measuring the quality and effectiveness of lumbar surgery in registry efforts: determining the most valid and responsive instruments.
Spine J
PUBLISHED: 01-15-2014
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Prospective registries have emerged as a feasible way to capture real-world care across large patient populations. However, the proven validity of more robust and cumbersome patient-reported outcomes instruments (PROis) must be balanced with what is feasible to apply in large-scale registry efforts.
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Unorthodox bubbles when boiling in cold water.
Phys Rev E Stat Nonlin Soft Matter Phys
PUBLISHED: 01-15-2014
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High-speed movies are taken when bubbles grow at gold surfaces heated spotwise with a near-infrared laser beam heating water below the boiling point (60-70?°C) with heating powers spanning the range from very low to so high that water fails to rewet the surface after bubbles detach. Roughly half the bubbles are conventional: They grow symmetrically through evaporation until buoyancy lifts them away. Others have unorthodox shapes and appear to contribute disproportionately to heat transfer efficiency: mushroom cloud shapes, violently explosive bubbles, and cavitation events, probably stimulated by a combination of superheating, convection, turbulence, and surface dewetting during the initial bubble growth. Moreover, bubbles often follow one another in complex sequences, often beginning with an unorthodox bubble that stirs the water, followed by several conventional bubbles. This large dataset is analyzed and discussed with emphasis on how explosive phenomena such as cavitation induce discrepancies from classical expectations about boiling.
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Young novice drivers and the risky behaviours of parents and friends during the Provisional (intermediate) licence phase: a brief report.
Accid Anal Prev
PUBLISHED: 01-11-2014
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While there is research indicating that many factors influence the young novice driver's increased risk of road crash injury during the earliest stages of their independent driving, there is a need to further understand the relationship between the perceived risky driving behaviour of parents and friends and the risky behaviour of drivers with a Provisional (intermediate) licence.
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Ultrasonic BoneScalpel for osteoplastic laminoplasty in the resection of intradural spinal pathology: case series and technical note.
Neurosurgery
PUBLISHED: 12-19-2013
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Osteoplastic laminoplasty is a well-described technique that may decrease the incidence of progressive kyphosis when used in the setting of intradural spinal cord tumor resection.
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Effect of symptomatic pseudomeningocele on improvement in pain, disability, and quality of life following suboccipital decompression for adult Chiari malformation Type I.
J. Neurosurg.
PUBLISHED: 09-06-2013
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Suboccipital decompression is a common procedure for patients with Chiari malformation Type I (CMI). Published studies have reported complication rates ranging from 3% to 40%, with pseudomeningocele being one of the most common complications. To date, there are no studies assessing the effect of this complication on long-term outcome. Therefore, the authors set out to assess the effect of symptomatic pseudomeningocele on patient outcomes following suboccipital decompression for CM-I.
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Cost-utility analysis of minimally invasive versus open multilevel hemilaminectomy for lumbar stenosis.
J Spinal Disord Tech
PUBLISHED: 08-02-2013
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Two-year cost-utility study comparing minimally invasive (MIS) versus open multilevel hemilaminectomy in patients with degenerative lumbar spinal stenosis.
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Effect of reduced dose schedules and intramuscular injection of anthrax vaccine adsorbed on immunological response and safety profile: A randomized trial.
Vaccine
PUBLISHED: 07-18-2013
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We evaluated an alternative administration route, reduced schedule priming series, and increased intervals between booster doses for anthrax vaccine adsorbed (AVA). AVAs originally licensed schedule was 6 subcutaneous (SQ) priming injections administered at months (m) 0, 0.5, 1, 6, 12 and 18 with annual boosters; a simpler schedule is desired.
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Comparative effectiveness and cost-benefit analysis of local application of vancomycin powder in posterior spinal fusion for spine trauma: clinical article.
J Neurosurg Spine
PUBLISHED: 07-12-2013
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Surgical site infection (SSI) is a morbid complication with high cost in spine surgery. In this era of health care reforms, adjuvant therapies that not only improve quality but also decrease cost are considered of highest value. The authors introduced local application of vancomycin powder into their practice of posterior spinal fusion for spine trauma and undertook this study to determine the value and cost benefit of using vancomycin powder in surgical sites to prevent postoperative infections.
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Comprehensive assessment of 1-year outcomes and determination of minimum clinically important difference in pain, disability, and quality of life after suboccipital decompression for Chiari malformation I in adults.
Neurosurgery
PUBLISHED: 06-22-2013
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To date, there has been no study to comprehensively assess the effectiveness of suboccipital craniectomy (SOC) for Chiari malformation I (CMI) using validated patient-reported outcome measures.
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Cost savings associated with prevention of recurrent lumbar disc herniation with a novel annular closure device: a multicenter prospective cohort study.
J Neurol Surg A Cent Eur Neurosurg
PUBLISHED: 05-13-2013
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Same-level recurrent disc herniation is a well-defined complication following lumbar discectomy. Reherniation results in increased morbidity and health care costs. Techniques to reduce these consequences may improve outcomes and reduce cost after lumbar discectomy. In a prospective cohort study, we set out to evaluate the cost associated with surgical management of recurrent, same-level lumbar disc herniation following primary discectomy.
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Revisiting the concept of the problem young driver within the context of the young driver problem: who are they?
Accid Anal Prev
PUBLISHED: 05-10-2013
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For decades there have been two young driver concepts: the young driver problem where the driver cohort represents a key problem for road safety; and the problem young driver where a sub-sample of drivers represents the greatest road safety problem. Given difficulties associated with identifying and then modifying the behaviour of the latter group, broad countermeasures such as graduated driver licensing (GDL) have generally been relied upon to address the young driver problem. GDL evaluations reveal general road safety benefits for young drivers, yet they continue to be overrepresented in fatality and injury statistics. Therefore it is timely for researchers to revisit the problem young driver concept to assess its potential countermeasure implications. This is particularly relevant within the context of broader countermeasures that have been designed to address the young driver problem Personal characteristics, behaviours and attitudes of 378 Queensland novice drivers aged 17-25 years were explored during their pre-, Learner and Provisional 1 (intermediate) licence as part of a larger longitudinal project. Self-reported risky driving was measured by the Behaviour of Young Novice Drivers Scale (BYNDS), and five subscale scores were used to cluster the drivers into three groups (high risk n=49, medium risk n=163, low risk n=166). High risk problem young drivers were characterised by greater self-reported pre-Licence driving, unsupervised Learner driving, and speeding, driving errors, risky driving exposure, crash involvement, and offence detection during the Provisional period. Medium risk drivers were also characterised by more risky road use than the low risk group. Interestingly problem young drivers appear to have some insight into their high-risk driving, since they report significantly greater intentions to bend road rules in future driving. The results suggest that tailored intervention efforts may need to target problem young drivers within the context of broad countermeasures such as GDL which address the young driver problem in general. Experiences such as crash-involvement could be used to identify these drivers as a preintervention screening measure.
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Five-level sub-axial cervical vertebrectomy and reconstruction: technical report.
Eur Spine J
PUBLISHED: 05-08-2013
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PURPOSE: Regardless of the etiology, severe cervical deformities can be extremely debilitating and are a challenge to correct. Often a multi-modality team approach is required to safely and effectively reduce the deformity, provide adequate decompression, and ensure solid fixation and fusion. In cases of iatrogenic cervical deformity necessitating five-level corpectomy and fixation, the feasibility, safety, and durability of this procedure remains unknown. RESULTS: We describe a patient who presented with debilitating pain and inability to eat due to an iatrogenic chin-on-chest cervical kyphotic deformity. The patient underwent a back-front-back staged procedure requiring five-level cervical vertebrectomy, C3-T1 anterior fixation, and occipital to T5 posterior fusion, resulting in successful reduction of cervical kyphosis from 75 to 0 degrees. At 6 months post-operatively, the patient demonstrated marked improvement in neurologic function and reported substantial improvements in neck pain-specific disability (NDI) and quality of life (SF-12 and EQ-5D). CONCLUSION: The feasibility and safety of five-level vertebrectomy and reconstruction for chin-on-chest deformity remains poorly described. The current case suggests that thoughtful planning that involves maximizing the patients health status, judicious use of traction under direct neurological examination, staged circumferential release, and design of a construct that provides anterior and posterior column support with several points of fixation beyond the axis of rotation will attenuate the risk of peri-operative morbidity and potentiate the durability of deformity correction.
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A review of experimental and natural infections of animals with monkeypox virus between 1958 and 2012.
Future Virol
PUBLISHED: 04-30-2013
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Monkeypox virus (MPXV) was discovered in 1958 during an outbreak in an animal facility in Copenhagen, Denmark. Since its discovery, MPXV has revealed a propensity to infect and induce disease in a large number of animals within the mammalia class from pan-geographical locations. This finding has impeded the elucidation of the natural host, although the strongest candidates are African squirrels and/or other rodents. Experimentally, MPXV can infect animals via a variety of multiple different inoculation routes; however, the natural route of transmission is unknown and is likely to be somewhat species specific. In this review we have attempted to compile and discuss all published articles that describe experimental or natural infections with MPXV, dating from the initial discovery of the virus through to the year 2012. We further discuss the comparative disease courses and pathologies of the host species.
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Accurately measuring the quality and effectiveness of cervical spine surgery in registry efforts: determining the most valid and responsive instruments.
Spine J
PUBLISHED: 04-25-2013
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There is a growing demand to measure the real-world effectiveness and value of care across all specialties and disease states. Prospective registries have emerged as a feasible way to capture real-world care across large patient populations. However, the proven validity of more robust and cumbersome patient-reported outcome instruments (PROi) must be balanced with what is feasible to apply in large-scale registry efforts. Hence, commercial registry efforts that measure quality and effectiveness of care in an attempt to guide quality improvement, pay for performance, or value-based purchasing should incorporate measures that most accurately represent patient-centered improvement.
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Human risky choice in a repeated-gambles procedure: an up-linkage replication of Lakshminarayanan, Chen and Santos (2011).
Anim Cogn
PUBLISHED: 03-10-2013
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Lakshminarayanan et al. (J Exp Soc Psychol 47: 689-693, 2011) showed that when choice is between variable (risky) and fixed (safe) food amounts with the same expected values, capuchins prefer the safe alternative if choice is framed as a gain, but the risky alternative if it is framed as a loss. These results seem similar to those seen in human prospect-theory tests in choice between variable and fixed gains or losses. Based on this similarity, they interpreted their results as identifying a between-species commonality in cognitive function. In this report, we repeat their experiment with humans as subjects (an up-linkage replication). Whether choices were rewarded with candy or nickels, choice approximated indifference whether framed as gains or losses. Our data mirror those of others who found that when humans make risky choices within a repeated-trials procedure without verbal instruction about outcome likelihoods, preference biases seen in one-shot, language-guided, prospect-theory tests such as Tversky and Kahnemans (Science 211:453-458, 1981) reflection effect may not appear. The disparity between our findings and those of Lakshminarayanan et al. suggests their study does not evidence a cognitive process shared by humans and capuchins.
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Determining the quality and effectiveness of surgical spine care: patient satisfaction is not a valid proxy.
Spine J
PUBLISHED: 02-11-2013
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Given the unsustainable costs of the US health-care system, health-care purchasers, payers, and hospital systems are adopting the concept of value-based purchasing by shifting care away from low-quality providers or hospitals. Legislation now allows public reporting of these quality rankings. True measures of quality, such as surgical morbidity and validated questionnaires of effectiveness, are burdensome and costly to collect. Hence, patients satisfaction with care has emerged as a commonly used metric as a proxy for quality because of its feasibility of collection. However, patient satisfaction metrics have yet to be validated as a measure of overall quality of surgical spine care.
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Identification of a therapeutic dose of continuously delivered erythropoietin in the eye using an inducible promoter system.
Curr Gene Ther
PUBLISHED: 02-10-2013
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Erythropoietin (EPO) can protect the retina from acute damage, but long-term systemic treatment induces polycythemia. Intraocular gene delivery of EPO is not protective despite producing high levels of EPO likely due to its bellshaped dose curve. The goal of this study was to identify a therapeutic dose of continuously produced EPO in the eye. We packaged a mutated form of EPO (EPOR76E) that has equivalent neuroprotective activity as wild-type EPO and attenuated erythropoietic activity into a recombinant adeno-associated viral vector under the control of the tetracycline inducible promoter. This vector was injected into the subretinal space of homozygous postnatal 5-7 day retinal degeneration slow mice, that express the tetracycline transactivators from a retinal pigment epithelium specific promoter. At weaning, mice received a single intraperitoneal injection of doxycycline and were then maintained on water with or without doxycycline until postnatal day 60. Intraocular EPO levels and outer nuclear layer thickness were quantified and correlated. Control eyes contained 6.1 ± 0.1 (SEM) mU/ml EPO. The eyes of mice that received an intraperitoneal injection of doxycycline contained 11.8 ± 2.0 (SEM) mU/ml EPO-R76E. Treatment with doxycycline water induced production of 35.9 ± 2.4 (SEM) mU/ml EPO-R76E in the eye. The outer nuclear layer was approximately 8 ?m thicker in eyes of mice that received doxycycline water as compared to the control groups. Our data indicates that drug delivery systems should be optimized to deliver at least 36 mU/ml EPO into the eye since this dose was effective for the treatment of a progressive retinal degeneration.
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Accurately measuring outcomes after surgery for adult Chiari I malformation: determining the most valid and responsive instruments.
Neurosurgery
PUBLISHED: 02-06-2013
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There has been a transition to using patient-reported outcome instruments (PROi) to assess surgical effectiveness. However, none of these instruments have been validated for outcomes of adult Chiari I malformation (CMI).
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Microvascular decompression for classic trigeminal neuralgia: determination of minimum clinically important difference in pain improvement for patient reported outcomes.
Neurosurgery
PUBLISHED: 01-19-2013
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Outcomes studies use patient-reported outcome (PRO) measurements to assess treatment effectiveness, but can lack direct clinical meaning. Minimum clinically important difference (MCID) calculation provides a point estimate of the critical threshold needed to achieve clinically relevant treatment effectiveness. MCID remains uninvestigated for microvascular decompression (MVD), a common surgical procedure for trigeminal neuralgia.
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Preoperative Zung depression scale predicts patient satisfaction independent of the extent of improvement after revision lumbar surgery.
Spine J
PUBLISHED: 01-14-2013
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Patient satisfaction ratings are increasingly being used in health care as a proxy for quality and are becoming the focal point for several quality improvement initiatives. Affective disorders, such as depression, have been shown to influence patient-reported outcomes and self-interpretation of health status. We hypothesize that patient psychiatric profiles influence reported satisfaction with care, independent of surgical effectiveness.
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Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis: Comparative Effectiveness and Cost-Utility Analysis.
World Neurosurg
PUBLISHED: 01-04-2013
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Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) for lumbar spondylolisthesis allows for the surgical treatment of back/leg pain while minimizing tissue injury and accelerating the patients recovery. Although previous results have shown shorter hospital stays and decreased intraoperative blood loss for MIS versus open TLIF, short- and long-term outcomes have been similar. Therefore, we performed comparative effectiveness and cost-utility analysis for MIS versus open TLIF.
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Mileage, car ownership, experience of punishment avoidance, and the risky driving of young drivers.
Traffic Inj Prev
PUBLISHED: 12-03-2011
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Young drivers are at greatest risk of injury or death from a car crash in the first 6 months of independent driving. In Queensland, the graduated driver licensing (GDL) program was extensively modified in July 2007 in order to reduce this risk. Increased mileage and car ownership have been found to play a role in risky driving, offenses, and crashes; however, GDL programs typically do not consider these variables. In addition, young novice drivers experiences of punishment avoidance have not previously been examined. This article explores the mileage (duration and distance), car ownership, and punishment avoidance behaviors of young newly licensed intermediate (provisional) drivers and their relationship to risky driving, crashes, and offenses.
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Cost per quality-adjusted life year gained of revision neural decompression and instrumented fusion for same-level recurrent lumbar stenosis: defining the value of surgical intervention.
J Neurosurg Spine
PUBLISHED: 11-04-2011
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Despite advances in technology and understanding in spinal physiology, reoperation for symptomatic same-level recurrent stenosis continues to occur. Although revision lumbar surgery is effective, attention has turned to the question of the utility and value of revision decompression and fusion procedures. To date, an analysis of cost and heath state gain associated with revision lumbar surgery for recurrent same-level lumbar stenosis has yet to be described. The authors set out to assess the 2-year comprehensive cost of revision surgery and determine its value in the treatment of same-level recurrent stenosis.
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Cost per quality-adjusted life year gained of laminectomy and extension of instrumented fusion for adjacent-segment disease: defining the value of surgical intervention.
J Neurosurg Spine
PUBLISHED: 11-04-2011
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Over the past decade, there has been a dramatic increase in the number of spinal fusions performed in the US and a corresponding increase in the incidence of adjacent-segment disease (ASD). Surgical management of symptomatic ASD consists of decompression of neural elements and extension of fusion. It has been shown to have favorable long-term outcomes, but the cost-effectiveness remains unclear. In this study, the authors set out to assess the cost-effectiveness of revision surgery in the treatment of ASD over a 2-year period.
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Laminectomy and extension of instrumented fusion improves 2-year pain, disability, and quality of life in patients with adjacent segment disease: defining the long-term effectiveness of surgery.
World Neurosurg
PUBLISHED: 10-11-2011
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Adjacent segment disease (ASD) may occur as a long-term consequence of spinal fusion and is associated with significant back and leg pain. Surgical management of symptomatic ASD consists of neural decompression and extension of fusion. However, conflicting results have been reported with respect to the long-term clinical effectiveness of revision surgery in this setting. We set out to comprehensively assess the long-term clinical outcome after revision surgery and determine its effectiveness in the treatment of adjacent segment disease.
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Determination of minimum clinically important difference in pain, disability, and quality of life after extension of fusion for adjacent-segment disease.
J Neurosurg Spine
PUBLISHED: 09-30-2011
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Spinal surgical outcome studies rely on patient-reported outcome (PRO) measurements to assess treatment effect. A shortcoming of these questionnaires is that the extent of improvement in their numerical scores lack a direct clinical meaning. As a result, the concept of minimum clinical important difference (MCID) has been used to measure the critical threshold needed to achieve clinically relevant treatment effectiveness. As utilization of spinal fusion has increased over the past decade, so has the incidence of adjacent-segment degeneration following index lumbar fusion, which commonly requires revision laminectomy and extension of fusion. The MCID remains uninvestigated for any PROs in the setting of revision lumbar surgery for adjacent-segment disease (ASD).
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The influence of sensitivity to reward and punishment, propensity for sensation seeking, depression, and anxiety on the risky behaviour of novice drivers: a path model.
Br J Psychol
PUBLISHED: 09-07-2011
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Young novice drivers are significantly more likely to be killed or injured in car crashes than older, experienced drivers. Graduated driver licensing (GDL), which allows the novice to gain driving experience under less-risky circumstances, has resulted in reduced crash incidence; however, the drivers psychological traits are ignored. This paper explores the relationships between gender, age, anxiety, depression, sensitivity to reward and punishment, sensation-seeking propensity, and risky driving. Participants were 761 young drivers aged 17-24 (M=19.00, SD=1.56) with a Provisional (intermediate) drivers licence who completed an online survey comprising socio-demographic questions, the Impulsive Sensation Seeking Scale, Kesslers Psychological Distress Scale, the Sensitivity to Punishment and Sensitivity to Reward Questionnaire, and the Behaviour of Young Novice Drivers Scale. Path analysis revealed depression, reward sensitivity, and sensation-seeking propensity predicted the self-reported risky behaviour of the young novice drivers. Gender was a moderator; and the anxiety level of female drivers also influenced their risky driving. Interventions do not directly consider the role of rewards and sensation seeking, or the young persons mental health. An approach that does take these variables into account may contribute to improved road safety outcomes for both young and older road users.
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Cerebrospinal shunt infection in patients receiving antibiotic-impregnated versus standard shunts.
J Neurosurg Pediatr
PUBLISHED: 09-03-2011
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Cerebrospinal fluid shunt infections are associated with significant morbidity and mortality in the treatment of adult and pediatric hydrocephalus. Antibiotic-impregnated shunt (AIS) catheters have been used with the aim of reducing shunt infection. While many studies have demonstrated a reduction in shunt infection with AIS, this reported efficacy has varied within the literature.
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Long-term outcomes of revision fusion for lumbar pseudarthrosis: clinical article.
J Neurosurg Spine
PUBLISHED: 06-24-2011
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The number of low-back fusion procedures for the treatment of spine disorders has increased steadily over the past 10 years. Lumbar pseudarthrosis is a potential complication of lumbar arthrodesis and can be associated with significant pain and disability. The aim of this study was to assess, using validated patient-reported outcomes measures, the long-term effectiveness of revision arthrodesis in the treatment of symptomatic pseudarthrosis.
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The psychological distress of the young driver: a brief report.
Inj. Prev.
PUBLISHED: 05-16-2011
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The objective of the research was to explore the role of psychological distress in the self-reported risky driving of young novice drivers. A cross-sectional online survey incorporating Kesslers Psychological Distress Scale and the Behaviour of Young Novice Drivers Scale was completed by 761 tertiary students aged 17-25 years with an intermediate (Provisional) driving licence in Queensland, Australia, between August and October 2009. Regression analyses revealed that psychological distress uniquely explained 8.5% of the variance in young novices risky driving, with adolescents experiencing psychological distress also reporting higher levels of risky driving. Psychological distress uniquely explained a significant 6.7% and 9.5% of variance in risky driving for males and females respectively. Medical practitioners treating adolescents who have been injured through risky behaviour need to be aware of the potential contribution of psychological distress, while mental health professionals working with adolescents experiencing psychological distress need to be aware of this additional source of potential harm. The nature of the causal relationships linking psychological distress and risky driving behaviour are not yet fully understood, indicating a need for further research so that strategies such as screening can be investigated.
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The attenuated NYCBH vaccinia virus deleted for the immune evasion gene, E3L, completely protects mice against heterologous challenge with ectromelia virus.
Vaccine
PUBLISHED: 05-13-2011
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The New York City Board of Health (NYCBH) vaccinia virus (VACV) vaccine strain was deleted for the immune evasion gene, E3L, and tested for its pathogenicity and ability to protect mice from heterologous challenge with ectromelia virus (ECTV). NYCBH?E3L was found to be highly attenuated for pathogenicity in a newborn mouse model and showed a similar attenuated phenotype as the NYVAC strain of vaccinia virus. Scarification with one or two doses of the attenuated NYCBH?E3L was able to protect mice equally as well as NYCBH from death, weight loss, and viral spread to visceral organs. A single dose of NYCBH?E3L resulted in low poxvirus-specific antibodies, and a second dose increased levels of poxvirus-specific antibodies to a level similar to that seen in animals vaccinated with a single dose of NYCBH. However, similar neutralizing antibody titers were observed following one or two doses of NYCBH?E3L or NYCBH. Thus, NYCBH?E3L shows potential as a candidate for a safer human smallpox vaccine since it protects mice from challenge with a heterologous poxvirus.
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Cost-effectiveness of transforaminal lumbar interbody fusion for Grade I degenerative spondylolisthesis.
J Neurosurg Spine
PUBLISHED: 05-06-2011
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Transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis-associated back and leg pain is associated with improvement in pain, disability, and quality of life. However, given the rising health care costs associated with spinal fusion procedures and varying results of recent cost-utility studies, the cost-effectiveness of TLIF remains unclear. The authors set out to assess the comprehensive costs of TLIF at their institution and to determine its cost-effectiveness in the treatment of degenerative spondylolisthesis.
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Ability of electromyographic monitoring to determine the presence of malpositioned pedicle screws in the lumbosacral spine: analysis of 2450 consecutively placed screws.
J Neurosurg Spine
PUBLISHED: 05-03-2011
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Pedicle screws provide efficient stabilization along all 3 columns of the spine, but they can be technically demanding to place, with malposition rates ranging from 5% to 10%. Intraoperative electromyographic (EMG) monitoring has the capacity to objectively identify a screw breaching the medial pedicle cortex that is in proximity to a nerve root. The purpose of this study is to describe and evaluate the authors 7-year institutional experience with intraoperative EMG monitoring during placement of lumbar pedicle screws and to determine the clinical utility of intraoperative EMG monitoring.
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Effect of antibiotic-impregnated shunts on infection rate in adult hydrocephalus: a single institutions experience.
Neurosurgery
PUBLISHED: 04-19-2011
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Cerebrospinal fluid (CSF) shunt infection remains a major cause of morbidity and mortality in the treatment of hydrocephalus. Studies have demonstrated the efficacy of antibiotic-impregnated shunt (AIS) systems in reducing CSF shunt infections in pediatric patients. Fewer studies evaluate the efficacy of AIS systems in adult hydrocephalus.
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A model of top-down gain control in the auditory system.
Atten Percept Psychophys
PUBLISHED: 04-14-2011
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To evaluate a model of top-down gain control in the auditory system, 6 participants were asked to identify 1-kHz pure tones differing only in intensity. There were three 20-session conditions: (1) four soft tones (25, 30, 35, and 40 dB SPL) in the set; (2) those four soft tones plus a 50-dB SPL tone; and (3) the four soft tones plus an 80-dB SPL tone. The results were well described by a top-down, nonlinear gain-control system in which the amplifiers gain depended on the highest intensity in the stimulus set. Individual participants identification judgments were generally compatible with an equal-variance signal-detection model in which the mean locations of the distribution of effects along the decision axis were determined by the operation of this nonlinear amplification system.
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Accuracy of free-hand pedicle screws in the thoracic and lumbar spine: analysis of 6816 consecutive screws.
Neurosurgery
PUBLISHED: 04-14-2011
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Pedicle screws are used to stabilize all 3 columns of the spine, but can be technically demanding to place. Although intraoperative fluoroscopy and stereotactic-guided techniques slightly increase placement accuracy, they are also associated with increased radiation exposure to patient and surgeon as well as increased operative time.
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Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high-grade glioma.
J. Neurooncol.
PUBLISHED: 04-06-2011
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Type 2 diabetes mellitus (DM) and obesity are known risk factors for poor outcomes in patients with systemic malignancies but are not well-studied in the brain tumor population. In this study we asked if type 2 DM and elevated body mass index (BMI) are independent risk factors for poor prognosis in patients with high-grade glioma (HGG.). We conducted a retrospective cohort study of 171 patients surgically treated for HGG at a single institution. BMI and records of pre-existing type 2 DM were obtained from medical histories. Variables associated with survival in a univariate analysis were included in the multivariate Cox model if P < 0.10. Variables with probability values >0.05 were then removed from the multivariate model in a step-wise fashion. Mean age at diagnosis was 55.0 ± 17.3 years. Fifteen (8.8%) patients had a history of type 2 DM. Fifty-eight (35.8%) patients had a BMI < 25, 55 (34.0%) BMI 25-30, and 49(30.2%) BMI > 30. Radiation therapy, temozolomide, and higher KPS score were independently associated with prolonged survival while increasing age was associated with decreased survival. DM (P = 0.001) and increasing BMI (P = 0.003) were found to be independently associated with decreased survival. Diabetics had a decreased median overall survival (312 vs. 470 days, P = 0.003) and PFS (106 vs. 166 days, P = 0.04) compared to non-diabetics. Increasing BMI (<25, 25-30, and >30) was also associated with decreased median PFS: 195 vs. 165 vs. 143 days, respectively. Pre-existing DM and elevated BMI are independent risk factors for poor outcome in patients with HGG.
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Placentation in the eastern water skink (Eulamprus quoyii): a placentome-like structure in a lecithotrophic lizard.
J. Anat.
PUBLISHED: 03-24-2011
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The eastern water skink (Eulamprus quoyii) has lecithotrophic embryos and was previously described as having a simple Type I chorioallantoic placenta. Indeed, it was the species upon which the definition of a Type I placenta was thought to be based, although we had cause to question that assumption. Hence we have described the morphology of the uterus of E. quoyii and found it to be more complex than previously supposed. The mesometrial pole of the uterus in E. quoyii displays a vessel-dense elliptical structure (the VDE) with columnar uterine epithelial cells. As pregnancy proceeds, the uterine epithelium near the mesometrial pole becomes folded and glands become hypertrophied, so that the morphology of VDE resembles that of a placentome, characteristic of Type III placentae. Unlike species with a Type III placenta, the apposing chorioallantoic membrane of E. quoyii is lined with squamous cells and interdigitates with the folded uterine epithelium. The remainder of the uterus is thin with a squamous uterine epithelium throughout pregnancy. Immunohistochemical localisation of blood vessels reveals a dense network of small capillaries directly beneath the folded epithelium of the VDE, while blood vessels are larger and sparser at the abembryonic pole of the uterus. Alkaline phosphatase (AP) activity is present in the uterine epithelium and sub-epithelial blood vessels in newly ovulated females. AP activity disappears from the epithelium between stages 27 and 29 of embryonic development and from the blood vessels after stage 34, but appears in the uterine glands at stage 35, where it remains until the end of pregnancy. Although the VDE is structurally similar to the placentomes found in other viviparous lizards, different distributions of AP activity in the uterus of E. quoyii and Pseudemoia spenceri suggest that the VDE may be functionally different from the placentome of the latter species. Our description of uterine morphology in E. quoyii provides evidence that, at least in some lineages, the evolution of a placentome may not occur in concert with the evolution of microlecithal eggs and obligate placentotrophy.
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Uterine and chorioallantoic angiogenesis and changes in the uterine epithelium during gestation in the viviparous lizard, niveoscincus conventryi (Squamata: Scincidae).
J. Morphol.
PUBLISHED: 03-20-2011
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We used immunofluorescent confocal microscopy and scanning electron microscopy to quantify uterine vascularity and to describe uterine surface morphology during gestation in pregnant females of the lecithotrophic lizard Niveoscincus coventryi. As uterine angiogenesis and epithelial cell morphology are thought to be under progesterone control, we studied the effect of a progesterone receptor antagonist (mifepristone) on uterine and chorioallantoic microvasculature and features of the uterine epithelial surfaces. Although intussuceptive angiogenesis was observed in both, uterine and chorioallantoic, vascular beds during gestation, the only significant increases were in the diameters of the uterine vessels. An ellipsoid vessel-dense area grows in the mesometrial hemisphere of the developing conceptus, which parallels the expansion of the allantois to form the chorioallantoic placenta. Uterine surface topography changed during gestation. In particular, uterine blood vessels bulge over the luminal surface to form marked ridges on the uterine embryonic hemisphere, especially during the last stage of pregnancy, and ciliated cells are maintained in the embryonic and abembryonic hemispheres but disappear in both the mesometrial and antimesometrial poles. This distinct regionalization of uterine ridges and ciliated cells in the uterine surface and in the shape of the epithelial component of the chorion might be related to the function of both chorioallantoic and yolk sac placentae during gestation. There was no significant difference between females treated with or without mifepristone, which may be related to the partial function of mifepristone as a progestin antagonist and/or with the function and time of action of progesterone in the uterus during gestation in N. coventryi. Differences in the pattern of angiogenesis and uterine surface morphology during gestation among squamates may be related to the functional diversity of the uterine component of the different placentae and probably reflect its diverse evolutionary history.
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Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior/transforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients.
J Neurosurg Spine
PUBLISHED: 03-18-2011
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Surgical site infection (SSI) after lumbar fusion results in significant patient morbidity and associated medical resource utilization. Minimally invasive (MI) techniques for posterior/transforaminal lumbar interbody fusion (P/TLIF) were introduced with the goals of smaller wounds, less tissue trauma, reduced blood loss, and quicker postoperative recovery, while maintaining comparable surgical results. Studies with sufficient power to directly compare the incidence of SSI following MI versus open P/TLIF procedures have been lacking. Furthermore, the direct medical cost associated with the treatment of SSI following the P/TLIF procedure is poorly understood and has not been adequately assessed. Thus, the aim in the present study was to determine the incidence of perioperative SSI in patients undergoing MI versus open P/TLIF and the direct hospital cost associated with the diagnosis and management of SSI after P/TLIF as reported in a large administrative database.
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Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life.
J Spinal Disord Tech
PUBLISHED: 02-22-2011
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Retrospective cohort comparison between minimally invasive (MIS) and open transforaminal lumbar interbody fusion (TLIF).
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Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis.
J Neurosurg Spine
PUBLISHED: 02-18-2011
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Outcome studies for spine surgery rely on patient-reported outcomes (PROs) to assess treatment effects. Commonly used health-related quality-of-life questionnaires include the following scales: back pain and leg pain visual analog scale (BP-VAS and LP-VAS); the Oswestry Disability Index (ODI); and the EuroQol-5D health survey (EQ-5D). A shortcoming of these questionnaires is that their numerical scores lack a direct meaning or clinical significance. Because of this, the concept of the minimum clinically important difference (MCID) has been put forth as a measure for the critical threshold needed to achieve treatment effectiveness. By this measure, treatment effects reaching the MCID threshold value imply clinical significance and justification for implementation into clinical practice.
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Preoperative Zung Depression Scale predicts outcome after revision lumbar surgery for adjacent segment disease, recurrent stenosis, and pseudarthrosis.
Spine J
PUBLISHED: 02-16-2011
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Persistent back pain and leg pain after index surgery is distressing to patients and spinal surgeons. Revision surgical treatment is technically challenging and has been reported to yield unpredictable outcomes. Recently, affective disorders, such as depression and anxiety, have been considered potential predictors of surgical outcomes across many disease states of chronic pain. There remains a paucity of studies assessing the predictive value of baseline depression on outcomes in the setting of revision spine surgery.
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Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years.
World Neurosurg
PUBLISHED: 02-13-2011
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Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spondylolisthesis allows for surgical treatment of back and leg pain while theoretically minimizing tissue injury and accelerating overall recovery. Although the authors of previous studies have demonstrated shorter length of hospital stay and reduced blood loss with MIS versus open-TLIF, short- and long-term outcomes have been similar. No studies to date have evaluated the comprehensive health care costs associated with TLIF procedures or assessed the cost-utility of MIS- versus open-TLIF. As such, we set out to assess previously unstudied end points of health care cost and cost-utility associated with MIS- versus open-TLIF.
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The impact of changes to the graduated driver licensing program in Queensland, Australia on the experiences of Learner drivers.
Accid Anal Prev
PUBLISHED: 01-20-2011
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Graduated driver licensing (GDL) has been introduced in numerous jurisdictions in Australia and internationally in an attempt to ameliorate the significantly greater risk of death and injury for young novice drivers arising from road crashes. The GDL program in Queensland, Australia, was extensively modified in July 2007. This paper reports the driving and licensing experiences of Learner drivers progressing through the current-GDL program, and compares them to the experiences of Learners who progressed through the former-GDL program.
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Cost-effectiveness of multilevel hemilaminectomy for lumbar stenosis-associated radiculopathy.
Spine J
PUBLISHED: 01-14-2011
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Laminectomy for lumbar stenosis-associated radiculopathy is associated with improvement in pain, disability, and quality of life. However, given rising health-care costs, attention has been turned to question the cost-effectiveness of lumbar decompressive procedures. The cost-effectiveness of multilevel hemilaminectomy for radiculopathy remains unclear.
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Body shape and size depictions of African American women in JET magazine, 1953-2006.
Body Image
PUBLISHED: 09-20-2010
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Depictions of Caucasian women in the mainstream media have become increasingly thinner in size and straighter in shape. These changes may be inconsistent with the growing influence of African American beauty ideals, which research has established as more accepting of larger body sizes and more curvaceous body types than Caucasians. The present study looked at trends in the portrayal of African American women featured in JET magazine from 1953 to 2006. Beauty of the Week (BOW) images were collected and analyzed to examine body size (estimated by independent judges) and body shape (estimated by waist-to-hip ratio). We expected body sizes to increase and body shapes to become more curvaceous. Results revealed a rise in models body size consistent with expectations, but an increase in waist-to-hip ratio, contrary to prediction. Our findings suggest that the African American feminine beauty ideal reflects both consistencies with and departures from mainstream cultural ideals.
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Angiogenesis of the uterus and chorioallantois in the eastern water skink Eulamprus quoyii.
J. Exp. Biol.
PUBLISHED: 09-14-2010
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We have discovered a modification of the uterus that appears to facilitate maternal-fetal communication during pregnancy in the scincid lizard Eulamprus quoyii. A vessel-dense elliptical area (VDE) on the mesometrial side of the uterus expands as the embryo grows, providing a large vascular area for physiological exchange between mother and embryo. The VDE is already developed in females with newly ovulated eggs, and is situated directly adjacent to the chorioallantois of the embryo when it develops. It is likely that signals from the early developing embryo determine the position of the VDE, as the VDE is off-centre in cases where the embryo sits obliquely in the uterus. The VDE is not a modification of the uterus over the entire chorioallantoic placenta, as the VDE is smaller than the chorioallantois after embryonic stage 33, but expansion of the VDE and growth of the chorioallantois during pregnancy are strongly correlated. The expansion of the VDE is also strongly correlated with embryonic growth and increasing embryonic oxygen demand (Vo2). We propose that angiogenic stimuli are exchanged between the VDE and the chorioallantois in E. quoyii, allowing the simultaneous growth of both tissues.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.