bluuebunny/crossref_metadata_2025 huggingface dataset:
Errors in Moral Forecasting
Authors: Teper Rimma , Tullett Alexa M. , Page-Gould Elizabeth , Inzlicht Michael
Published: April 2015

Research in moral decision making has shown that there may not be a one-to-one relationship between peoples’ moral forecasts and behaviors. Although past work suggests that physiological arousal may account for part of the behavior-forecasting discrepancy, whether or not perceptions of affect play an important determinant remains unclear. Here, we investigate whether this discrepancy may arise because people fail to anticipate how they will feel in morally significant situations. In Study 1, forecasters predicted cheating significantly more on a test than participants in a behavior condition actually cheated. Importantly, forecasters who received false somatic feedback, indicative of high arousal, produced forecasts that aligned more closely with behaviors. In Study 2, forecasters who misattributed their arousal to an extraneous source forecasted cheating significantly more. In Study 3, higher dispositional emotional awareness was related to less forecasted cheating. These findings suggest that perceptions of affect play a key role in the behavior-forecasting dissociation.
What a Difference a Pronoun Makes
Authors: Biesen Judith N. , Schooler Deborah E. , Smith David A.
Published: April 2015

Purpose: We investigate the role of pronoun use in people’s perceptions of relationship interaction quality, especially when partners experience worry. Method: Couples ( N = 115) rated their anxiety and interaction quality and participated in a 15-minute problem-solving discussion. Results: Me-focus by actors and You-focus by actors and partners reliably correlated with perceived interaction quality. As well, a person’s own, but not his or her partner’s, worry moderated the association between pronoun use and perceived interaction quality. Pronoun use (actor You- and partner Me-focus) and perceived interaction quality were especially strongly associated for people with relatively lower levels of worry. A principal component analyses uncovered two underlying factors for pronouns: self-focus and other-focus. Actor–partner analyses using underlying factors corroborated the results for individual pronouns. Discussion: These results support previous findings that specific pronouns are related to worse outcomes, and this association may be a function of how worried partners are. Worry may contribute to interpersonal difficulties by overriding otherwise salient interpersonal cues.
How do utterance measures predict raters’ perceptions of fluency in French as a second language?
Authors: Préfontaine Yvonne , Kormos Judit , Johnson Daniel Ezra
Published: April 2015

While the research literature on second language (L2) fluency is replete with descriptions of fluency and its influence with regard to English as an additional language, little is known about what fluency features influence judgments of fluency in L2 French. This study reports the results of an investigation that analyzed the relationship between utterance fluency measures and raters’ perceptions of L2 fluency in French using mixed-effects modeling. Participants were 40 adult learners of French at varying levels of proficiency, studying in a university immersion context. Speech performances were collected on three different types of narrative tasks. Four utterance fluency measures were extracted from each performance. Eleven untrained judges rated the speech performances and we examined which utterance fluency measures are the best predictors of the scores awarded by the raters. The mean length of runs and articulation rate proved to be the most influential factors in raters’ judgments, while the frequency of pauses played a less important role. The length of pauses was positively related to fluency scores, indicating a prominent cross-linguistic variation specific to French. The relative importance of the utterance measures in predicting fluency ratings, however, was found to vary across tasks.
Effects of varied conductor prep movements on singer muscle engagement and voicing behaviors
Authors: Manternach Jeremy N.
Published: April 2015

The purpose of this study was to examine whether certain nonverbal conductor gestures might trigger varied motor behaviors in choristers as indicated by acoustical data and measurement of extrinsic laryngeal muscle activity. Participants ( N = 23) performed a melody while following a prerecorded conductor who displayed the following fully-crossed preparatory gesture conditions: (a) initial upward or downward moving arm, (b) upward moving or neutral head positioning, and (c) fisted hand or open palm. Surface electrodes measured singer posterior neck, upper trapezius, suprahyoid, and sternocleidomastoid muscle region activity during inhalation. Audio recordings provided data for acoustic and perceptual comparisons. Among primary results: (a) suprahyoid mean muscle region activity was significantly greater during upward compared to downward moving gestures; (b) sternocleidomastoid mean muscle region activity was significantly higher during fisted compared to palm open gestures; (c) posterior neck and upper trapezius mean muscle region activity displayed no significant differences during the varied conditions; (d) fisted conditions corresponded to higher mean sung amplitudes than palm open conditions; and (e) expert listeners perceived that singer inhalation was less efficient during upward compared to downward moving gestures. Results were discussed in terms of chorister responses to conductor behaviors, implications for teacher-conductor preparation, and limitations of the study.
Prediction of delamination growth in carbon/epoxy composites using a novel acoustic emission-based approach
Authors: Mohammadi Reza , Saeedifar Milad , Toudeshky Hossein Hosseini , Najafabadi Mehdi Ahmadi , Fotouhi Mohamad
Published: April 2015

Delamination is the most common failure mode in laminated composites and it leads to loss of structural strength and stiffness. In this paper, acoustic emission monitoring was applied on the carbon/epoxy laminated composites when subjected to mode I, mode II, and mixed-mode I and II loading conditions. The main objective is to investigate delamination behavior and to predict propagation curve of the delamination in different GII/GT modal ratio values by the acoustic emission. First, a combination of acoustic emission and mechanical data (sentry function) is used to characterize the propagation stage of the delamination. Next, the crack tip location during propagation of the delamination in the specimens is identified using two methods. In the first method, by determining the velocity of the acoustic emission waves in the specimens, the position of the crack tip can be estimated throughout the tests. In the second method, the cumulative energy of the acoustic emission signals is utilized for localization of the crack tip. Agreement between the predicted crack length and the actual crack length verifies the presented procedures. It can be concluded from the results that the acoustic emission method is a powerful approach to investigate the delamination behavior and to estimate the crack tip position in the composites.
Circadian Clocks in the Immune System
Authors: Labrecque Nathalie , Cermakian Nicolas
Published: April 2015

The immune system is a complex set of physiological mechanisms whose general aim is to defend the organism against non-self-bodies, such as pathogens (bacteria, viruses, parasites), as well as cancer cells. Circadian rhythms are endogenous 24-h variations found in virtually all physiological processes. These circadian rhythms are generated by circadian clocks, located in most cell types, including cells of the immune system. This review presents an overview of the clocks in the immune system and of the circadian regulation of the function of immune cells. Most immune cells express circadian clock genes and present a wide array of genes expressed with a 24-h rhythm. This has profound impacts on cellular functions, including a daily rhythm in the synthesis and release of cytokines, chemokines and cytolytic factors, the daily gating of the response occurring through pattern recognition receptors, circadian rhythms of cellular functions such as phagocytosis, migration to inflamed or infected tissue, cytolytic activity, and proliferative response to antigens. Consequently, alterations of circadian rhythms (e.g., clock gene mutation in mice or environmental disruption similar to shift work) lead to disturbed immune responses. We discuss the implications of these data for human health and the areas that future research should aim to address.
Investigation on the unsteady aerodynamics of cycloidal propeller in hovering flight
Authors: Tang Jiwei , Hu Yu , Song Bifeng
Published: April 2015

The aerodynamics of a cycloidal propeller operating in hovering flight is systematically studied using numerical method. By solving the time-dependent incompressible Navier–Stokes equations and using a dynamic mesh technique, the complex unsteady flow field around the cycloidal propeller and the time-varying aerodynamic forces are investigated. The wake flow deflection can be observed in the flow field of the cycloidal propeller, which results in a deflection of the thrust. Strong downwash around cycloidal propeller and unsteady interference between blades are induced by the rotation and pitch motion of the blade. The instantaneous vertical, horizontal and resultant thrusts fluctuate cyclically with the azimuths in a pattern similar to sinusoid, and although the direction of instantaneous resultant thrust varies in a comparatively large region during rotating, the direction of averaged resultant thrust produced in each revolution is almost constant at different rotation speeds. This is beneficial to the flight stability and maneuverability of a cyclogyro. When one blade moves upward, the aerodynamic forces of the blade are much higher than that produced when moving downward. With the increase of the blade number, the unsteady interference between blades and the wakes of other blades tend to be stronger, producing great effects on aerodynamic forces of the blades as well as the aerodynamic performance of cycloidal propeller.
Time, temporality and cultural rhythmics: An anthropological case study
Authors: Iparraguirre Gonzalo
Published: April 2015

This article presents the introduction and the update of an ethnographic research on temporality among indigenous groups, published in 2011 in its full version as a book in Spanish. It seeks to prove the usefulness of the conceptual distinction between time, defined as the phenomenon of becoming in itself, and temporality, defined as the human apprehension of becoming in a cultural context. Furthermore, the existence of non-hegemonic temporalities is exemplified by a case study of originary temporality with Mocoví indigenous societies in Argentina’s Chaco region. The methodology built for studying temporality in different social groups, termed here as cultural rhythmics, is also introduced. By studying different rhythmic experiences integrated in the participant observation, the rhythmic method enables us to interpret social facts that are implicit in the everyday practices of organisation, in the economic–political relations, and in the group’s worldviews.
Ethical problems in nursing management
Authors: Aitamaa Elina , Leino-Kilpi Helena , Iltanen Silja , Suhonen Riitta
Published: April 2015

Background:

Nurse managers have responsibilities relating to the quality of care, the welfare of the staff and running of the organization. Ethics plays significant role in these responsibilities. Ethical problems are part of daily management, but research in this area is limited.

Objective:

The aim of this study was to identify and describe ethical problems nurse managers encounter in their work to get more detailed and extensive view of these problems.

Methods:

The data consisted of nine interviews with nurse managers at different management levels in primary healthcare and specialized healthcare organizations, and it was analysed by inductive content analysis.

Ethical considerations:

Permission to conduct the interviews including ethical approval was given at all participating organizations according to national standards. The respondents were informed about the aim of the study, and voluntary participation, anonymous response and confidentiality were explained to them.

Findings:

Four main categories were found: conflicts in practical situations, lack of appreciation, disregard of problems and experienced inadequacy. Problems could also be divided to patient-related, staff-related, organization-related and other problems.

Discussion:

The findings correspond with results from earlier studies but add knowledge of the nature and details of nurse managers’ ethical problems. New information is produced related to the ethical problems with nurse managers’ own courage, motivation and values.

Conclusion:

Nurse managers identified a variety of different ethical problems in their work. This information is useful in the development of ethics in nursing management. Further research about the frequency and intensity of nurse managers’ ethical problems is needed as well as possible differences in different levels of management.
A novel pathogenic mechanism for cerebellar lesions produced by Solanum bonariense in cattle
Authors: Verdes José Manuel , Márquez Mercedes , Calliari Aldo , Battes Daniel , Moraña José Antonio , Gimeno Eduardo Juan , Odriozola Ernesto , Giannitti Federico , Guerrero Florentina , Fidalgo Luis Eusebio , Pumarola Martí
Published: April 2015

Intoxication with Solanum bonariense in cattle causes cerebellar cortical degeneration with perikaryal vacuolation, axonal swelling, and death primarily of Purkinje cells, with accumulation of electron-dense residual storage bodies in membrane-bound vesicles. The pathogenesis of this disease is not fully understood. Previously, we proposed that inhibition of protein synthesis in Purkinje cells among other altered metabolic pathways could lead to cytoskeletal alterations, subsequently altering cell-specific axonal transport. In the present study, immunohistochemical and histochemical methods were used to identify neuronal cytoskeletal alterations and axonal loss, demyelination, and astrogliosis in the cerebellum of intoxicated bovines. Samples of cerebellum from 3 natural and 4 experimental cases and 2 control bovines were studied. Immunoreactivity against neurofilament (NF)-200KDa confirmed marked loss of Purkinje neurons, and phospho-NF protein, β-tubulin, and affinity reaction against phalloidin revealed an altered perikaryal distribution of neuronal cytoskeletal proteins in the remaining Purkinje cells in intoxicated cattle. Reactive astrogliosis in every layer of the cerebellar cortex was also observed with anti–glial fibrillary acidic protein immunohistochemistry. In affected cattle, demyelination and axonal loss in the cerebellar white matter, as well as basket cell loss were demonstrated with Klüver–Barrera and Bielschowsky stains, respectively. Based on these results, we propose that neuronal cytoskeletal alterations with subsequent interference of the axonal transport in Purkinje cells may play a relevant role in the pathogenesis of this neurodegenerative disorder, and also that demyelination and axonal loss in the cerebellar white matter, as well as astrogliosis in the gray matter, likely occur secondarily to Purkinje cell degeneration and death.
Climatologists’ Communication of Climate Science to the Agricultural Sector
Authors: Wilke Adam K. , Morton Lois Wright
Published: April 2015

Farming is a risky business. Climate science information can assist agriculture in formulating management decisions that hedge against uncertainty and risks. Climatologists are key actors in communicating historical trends and forecast information. Interviews and surveys of climatologists in the North Central Region reveal that they are providing accurate and objective information but are likely to let the science speak for itself. This suggests missed opportunities to communicate climate science in ways that make science relevant to decision maker beliefs, values, and practical applications. Furthermore, more active engagement with agriculture could increase colearning necessary for effective adaptive management under increasingly variable climate conditions.
Rheological, physical and sensorial evaluation of cookies supplemented with dairy powders
Authors: Sert Durmuş , Demir M Kürşat , Ertaş Nilgün
Published: April 2015

The effect of dairy powders (skim milk powder, butter milk powder, sodium caseinate, yoghurt powder, milk powder and colostrum powder) on cookie quality was studied. Cookies were tested for aw, calorimetric energy, diameter, thickness, spread ratio, breaking strength, colour, dough consistency and sensory evaluation. The lowest aw values were obtained for cookies containing colostrum powder; also the highest calorimetric energy values were obtained from the colostrum powder-added cookies. Diameter values of cookies with the addition of skim milk powder, butter milk powder, yoghurt powder and milk powder were higher than that of sodium caseinate and colostrum powder. The lowest spread ratio was measured in the cookie samples with added skim milk powder. The addition of yoghurt powder gave the highest breaking strength of cookies. Cookies with sodium caseinate addition exhibited the highest lightness (L*) values than the other cookies with different dairy powders. Cookies prepared with butter milk powder received the highest scores for colour, appearance, texture, crispness and overall acceptability.
High Familial Correlation in Methylphenidate Response and Side Effect Profile
Authors: Gazer-Snitovsky Michal , Brand-Gothelf Ayelet , Dubnov-Raz Gal , Weizman Abraham , Gothelf Doron
Published: April 2015

Objective: To examine whether a familial tendency exists in clinical response to methylphenidate. Method: Nineteen pairs of siblings or parent–child stimulant-naive individuals with ADHD were prescribed methylphenidate–immediate release, and were comprehensively evaluated at baseline, Week 2, and Week 4, using the ADHD Rating Scale IV, Clinical Global Impression Scale, and the Barkley Side Effects Rating Scale. Results: We found significant intraclass correlations in family member response to methylphenidate–immediate release and side effect profile, including emotional symptoms and loss of appetite and weight. Conclusion: Family history of response to methylphenidate should be taken into account when treating ADHD.
Development of a framework for prospective payment for child mental health services
Authors: Vostanis Panos , Martin Peter , Davies Roger , De Francesco Davide , Jones Melanie , Sweeting Ruth , Ritchie Benjamin , Allen Pauline , Wolpert Miranda
Published: April 2015

Objectives

There is a need to develop a payment system for services for children with mental health problems that allows more targeted commissioning based on fairness and need. This is currently constrained by lack of clinical consensus on the best way forward, wide variation in practice, and lack of data about activity and outcomes. In the context of a national initiative in England our aim was to develop a basis for an improved payment system.

Methods

Three inter-related studies: a qualitative consultation with child and adolescent mental health services (CAMHS) stakeholders on what the key principles for establishing a payment system should be, via online survey ( n = 180) and two participatory workshops ( n = 91); review of relevant national clinical guidelines ( n = 15); and a quantitative study of the relationship between disorders and resource use ( n = 1774 children from 23 teams).

Results

CAMHS stakeholders stressed the need for a broader definition of need than only diagnosis, including the measurement of indirect service activities and appropriate outcome measurement. National clinical guidance suggested key aspects of best practice for care packages but did not include consideration of contextual factors such as complexity. Modelling data on cases found that problem type and degree of impairment independently predicted resource use, alongside evidence for substantial service variation in the allocation of resources for similar problems.

Conclusions

A framework for an episode-based payment system for CAMHS should include consideration of: complexity and indirect service activities; evidence-based care packages; different needs in terms of impairment and symptoms; and outcome measurement as a core component.
A new perspective on the Plog psychographic system
Authors: Litvin Stephen W , Smith Wayne W
Published: April 2015

This research evaluates Plog’s model of allocentricity and psychocentricity in order to test its effectiveness as a predictor of travel behavior. While some of Plog’s psychographic system’s behavioral characteristics were confirmed, the major finding related to the actual visitation patterns of the tested sample’s travel, with the vast majority of the sample’s travel, regardless of the traveler’s Plog classification, to destinations classified as psychocentric. Practical marketing and destination management implications are discussed.
Hope matters to the glycemic control of adolescents and young adults with type 1 diabetes
Authors: Santos Fábio RM , Sigulem Daniel , Areco Kelsy CN , Gabbay Monica AL , Dib Sergio A , Bernardo Viviane
Published: April 2015

This study investigated the association of hope and its factors with depression and glycemic control in adolescents and young adults with type 1 diabetes. A total of 113 patients were invited to participate. Significant negative correlations were found between hope and HbA1c and also between hope and depression. Hope showed a significant association with HbA1c and depression in the stepwise regression model. Among the hope factors, “inner positive expectancy” was significantly associated with HbA1c and depression. This study supports that hope matters to glycemic control and depression. Intervention strategies focusing on hope should be further explored.
Positioning Microbicides for HIV Prevention in Kenya
Authors: Ryan Elizabeth , Bockh Emily , Tolley Elizabeth E. , Pack Allison P. , Mackenzie Caroline , Olawo Alice , Githuka George
Published: April 2015

This case study describes the experience of developing communication messages and materials to position microbicide gel—a product still in clinical trials—for HIV prevention in Kenya. A robust development process included stakeholder and audience consultations, a national message development workshop, two rounds of pretesting, and an evaluation study to evaluate the impact of the materials on intentions and attitudes related to microbicide use. Awareness-raising and in-depth educational materials for both potential microbicide users and health care providers were developed. The project team tested two different ways of positioning microbicides—one focused primarily on the HIV prevention benefits of the product and the other focused on other benefits, such as increased sexual pleasure and intimacy. This experience presented a number of unique social marketing and communication challenges related to the inherent characteristics of microbicides, the fact that they are not yet licensed for use, and the potential for inadvertently stigmatizing the product and encouraging condom migration. The project confirmed that marketing microbicides to women in a wide variety of sexual contexts—and gaining support of male partners—will be critical for avoiding stigmatization of the product. It also confirmed that the positioning of the product can impact interest in using microbicides and that in-depth counseling of users will be critical for ensuring correct use.
Modeling and experiments of a laminated magnetostrictive cantilever beam
Authors: Cao Qinghua , Chen Dingfang , Lu Quanguo , Tang Gang , Yan Jianwu , Zhu Zhifang , Xu Bin , Zhao Ran , Zhang Xiaoxing
Published: April 2015

A nonlinear modeling of magnetostrictive cantilever beam actuators is proposed by integrating an energy-based constitutive magnetostrictive model with the classical laminated beam theory in this article. The composite stiffness and the magnetic field are identified as the critical parameters which significantly influence the performance of the cantilever beam. Detailed experimental studies are carried out with different applied magnetic fields and various cantilever beam thicknesses. The experimental results verified the nonlinearity of the magnetomechanical response of the structure.
A refined element-based Lagrangian shell element for geometrically nonlinear analysis of shell structures
Authors: Jung Woo-Young , Han Sung-Cheon
Published: April 2015

For the solution of geometrically nonlinear analysis of plates and shells, the formulation of a nonlinear nine-node refined first-order shear deformable element-based Lagrangian shell element is presented. Natural co-ordinate-based higher order transverse shear strains are used in present shell element. Using the assumed natural strain method with proper interpolation functions, the present shell element generates neither membrane nor shear locking behavior even when full integration is used in the formulation. Furthermore, a refined first-order shear deformation theory for thin and thick shells, which results in parabolic through-thickness distribution of the transverse shear strains from the formulation based on the third-order shear deformation theory, is proposed. This formulation eliminates the need for shear correction factors in the first-order theory. To avoid difficulties resulting from large increments of the rotations, a scheme of attached reference system is used for the expression of rotations of shell normal. Numerical examples demonstrate that the present element behaves reasonably satisfactorily either for the linear or for geometrically nonlinear analysis of thin and thick plates and shells with large displacement but small strain. Especially, the nonlinear results of slit annular plates with various loads provided the benchmark to test the accuracy of related numerical solutions.
Integrating Visual Dietary Documentation in Mobile-Phone-Based Self-Management Application for Adolescents With Type 1 Diabetes
Authors: Frøisland Dag Helge , Årsand Eirik
Published: April 2015

The goal of modern diabetes treatment is to a large extent focused on self-management to achieve and maintain a healthy, low HbA1c. Despite all new technical diabetes tools and support, including advanced blood glucose meters and insulin delivery systems, diabetes patients still struggle to achieve international treatment goals, that is, HbA1c < 7.5 in children and adolescents. In this study we developed and tested a mobile-phone-based tool to capture and visualize adolescents’ food intake. Our aim was to affect understanding of carbohydrate counting and also to facilitate doctor–adolescent communication with regard to daily treatment. Furthermore, we wanted to evaluate the effect of the designed tool with regard to empowerment, self-efficacy, and self-treatment. The study concludes that implementing a visualization tool is an important contribution for young people to understand the basics of diabetes and to empower young people to define their treatment challenges. By capturing a picture of their own food, the person’s own feeling of being in charge can be affected and better self-treatment achieved.
Attivazione delle aree corticali motorie nel morbo di Parkinson Studio funzionale con risonanza magnetica
Authors: Tambasco N. , Lalli F. , Rossi A. , Gallai V. , Guercini G. , Pelliccioli G.P.
Published: April 2015

I pazienti affetti da morbo di Parkinson (MP) sperimentano nella bradicinesia uno dei sintomi più disabilitanti, verosimilmente determinato da una deafferentazione dai nuclei della base di alcune aree corticali motorie. Scopo di questo studio è stato quello di evidenziare mediante risonanza magnetica funzionale (fMRI) differenze nell'attivazione delle aree corticali motorie primarie e secondarie in risposta a compiti motori specifici tra un gruppo di pazienti affetti da MP iniziale e un gruppo di soggetti di controllo di pari età. Abbiamo inoltre studiato l'effetto dell'apomorfina, farmaco dopaminoagonista efficace nella bradicinesia, per verificare se al miglioramento clinico corrispondesse una variazione di attivazione delle aree corticali motorie. I pazienti hanno mostrato una riduzione significativa del numero di sequenze motorie effettuate con la mano destra, lato più affetto, rispetto al controlato ed ai controlli. Dopo somministrazione di apomorfina si è verificato un incremento della media delle sequenze motorie, senza però raggiungere i valori dei controlli.

L'esame con fMRI ha fatto evidenziare che il numero totale di pixel non differiva tra i vari gruppi. Nei pazienti si è osservata una attivazione statisticamente inferiore dell'area corticale motoria primaria (M1) controlaterale al lato più affetto e una maggior attivazione, statisticamente significativa, dell'area corticale premotoria laterale (PML) nell'emisfero più affetto.

La riduzione di attivazione nella Ml è in relazione principalmente con il rallentamento motorio, mentre l'iperattivazione della PML potrebbe essere il correlato neuroradiologico delle alterazioni che sottendono una disfunzione delle afferenze dai nuclei della base.
Ossigeno-ozono terapia vs infiltrazioni epidurali cortisoniche
Authors: Bonetti M. , Cotticelli B. , Raimondi G. , Valdenassi L. , Richelmi P. , Bertè E
Published: April 2015

L'approccio terapeutico tramite iniezioni epidurali di steroidi nel trattamento della sintomatologia dolorosa da ernia del disco è praticato da molti anni. Più recenti sono i riscontri sull'efficacia clinica dell'ossigeno-ozono terapia nel trattamento dei conflitti disco-radicolari da ernia discale. Nelle diverse casistiche riportate in letteratura vengono segnalate percentuali di successo terapeutico con ossigeno-ozono variabili fra il 75 e 1′85%. È descritto il caso di una paziente trattata inizialmente con infiltrazioni epidurali di cortisone con beneficio clinico scarso e di breve durata, successivamente risolto grazie all'utilizzo dell'ossigeno-ozono terapia. I risultati ottenuti sono stati documentati con indagini TC prima e dopo il trattamento.
Ematoma sub-periostale dell'orbita conseguente ad immersione subacquea Aspetti TC ed RM
Authors: Crasto S. Greco , Giordano F. , Ragazzi P. , Daniele D. , Zeme S. , Bradač GB
Published: April 2015

L'ematoma sub-periostale dell'orbita è una patologia rara. Benchè la maggior parte dei casi siano conseguenza di un trauma facciale diretto o una complicanza chirurgica, sono stati descritte cause non traumatiche. Riportiamo un caso di ematoma sub-periostale orbitario spontaneo comparso durante un'immersione subacquea in una giovane donna. In questo lavoro vengono discussi i reperti di risonanza magnetica, di tomografia computerizzata e viene effettuata una revisione della letteratura.
Varianti anatomiche del complesso ostiomeatale
Authors: Scaroni R. , Molini E. , Ciorba E. , Ricci G. , Simoncelli C. , Pelliccioli G.P.
Published: April 2015

Alcune varianti anatomiche del complesso ostiomeatale (COM) possono contribuire al blocco del meato medio ed essere responsabili di sindromi cefalalgiche associate o meno a sinusopatia.

Allo scopo di stabilire l'incidenza delle varianti anatomiche del COM in pazienti sottoposti a tomografia computerizzata (TC) del massiccio facciale per cefalea di presunta origine sinusale, abbiamo riesaminato 316 studi TC effettuati in oltre un anno di attività, escludendo la patologia traumatica e neoplastica, le poliposi massive, i papillomi invertiti, gli esiti di pregressi interventi chirurgici.

I pazienti con sinusopatia evidente alla TC non hanno complessivamente mostrato una incidenza significativamente superiore di anomalie del COM. Tuttavia alcune di esse, come la pneumatizzazione della lamella verticale, la curvatura paradossa del cornetto medio, la presenza di cellule di Haller e la pneumatizzazione del processo uncinato, sono risultate più comuni nei pazienti affetti da malattia mucosa.

I nostri risultati confermano che le anomalie del COM, pur non essendo l'unico fattore patogenetico, possono essere considerate predisponenti alla malattia sinusale.
Tumore a cellule giganti del basicranio
Authors: Scuotto A. , D'Avanzo R. , Accardo C. , Iscaro F.M. , Barbato R. , Lippiello A.
Published: April 2015

I tumori a cellule giganti sono neoplasie primitive ossee a bassa incidenza percentuale, che coinvolgono tipicamente le ossa lunghe e solo raramente il distretto cranio-facciale, ove prediligono la regione mandibolare e mascellare. L'interessamento del cranio è stato descritto solo raramente in letteratura, in circa una decina di casi, prevalentemente a sede temporale e sfenoidale. È presentato un ulteriore caso di localizzazione al basicranio di questa neoplasia, studiata con TC e RM, la cui diagnosi è stata posta istologicamente. Sono discussi gli aspetti neuroradiologici e valutati gli elementi di diagnosi differenziale.
MRI nella valutazione della barriera aracnoido-piale nei Meningiomi
Authors: Pero G. , Albanese V. , Pero G.
Published: April 2015

La previsione del tipo di clivaggio chirurgico dei meningiomi dal cervello è sicuramente un importante fattore per formulare la prognosi e per programmare la strategia operatoria. Ci siamo chiesti quali sono le possibilità di predire il tipo di clivaggio chirurgico dei meningiomi attraverso lo studio con risonanza magnetica. Abbiamo studiato retrospettivamente 28 casi di meningiomi che sono stati sottoposti ad exeresi microchirurgica presso il nostro Istituto, prendendo in considerazione varie informazioni che si possono dedurre dalle indagini RM e cercando di capire quali di esse possono, in effetti, avere un ruolo predittivo del clivaggio. L'estensione dell'edema peritumorale, l'interfaccia encefalotumore (intesa come una rima che circonda il tumore) ed il tipo di superficie del meningioma, in RM, si sono rivelati essere fattori predittivi del tipo di clivaggio del meningioma dal cervello.

In particolare, abbiamo riscontrato che nel caso in cui l'edema peritumorale sia assente, la superficie del tumore sia liscia e sia possibile individuare in RM l'interfaccia tra meningioma ed parenchima cerebrale, il clivaggio chirurgico del meningioma dal piano aracnoido-piale sarà facilmente ottenibile; nel caso in cui, invece, l'edema peritumorale sia esteso per più di 1 cm, la superficie del meningioma sia frastagliata e non sia possibile individuare in RM l'interfaccia tra tumore ed parenchima cerebrale, allora il clivaggio chirurgico sarà ottenuto con difficoltà o non sarà possibile ottenerlo.
The Proteus Syndrome: Cerebral, Cranial, Facial and Neck Manifestations
Authors: Shah J. , Parmar H. , Patkar D.
Published: April 2015

The Proteus syndrome is a rare hamartoneoplastic disorder with multiple somatic manifestations. Involvement of the brain, calvarium and soft tissues of the face and neck is not a constant feature of this syndrome, but frequently reported. We present a case with some striking abnormalities. Brain anomalies seen in our case included marked hemimegalencephaly of the right hemisphere, dilated right ventricle, areas of pachygyria and white matter abnormalities. Marked asymmetry of the calvarium was seen with areas of hyperostosis, causing proptosis. Maxillary and mandibular dysmorphism with exostosis formation and unilateral condylar hyperplasia were also seen. Subcutaneous fatty and lymphangiomatous masses were seen in neck and face, accentuating the facial disfigurement.
Lo studio neuroradiologico dell'idrocefalo Valutazione pre- e post-chirurgica con particolare riguardo all'approccio endoscopico
Authors: Simonetti L. , Agati R. , Bacci A. , Leonardi M.
Published: April 2015

La studio neuroradiologico dell'idrocefalo nell'epoca dei trattamenti chirurgici endoscopici si arricchisce di nuovi quesiti e di nuovi segni.

Se la TC mantiene la sua validità nella prima diagnosi di idrocefalo e nello studio delle complicanze immediate dei trattamenti endoscopici, perde il ruolo preminente che aveva nei controlli post-operatori a medio e lungo termine.

La RM è l'esame di scelta in fase prechirurgica, per la pianificazione dell'intervento endoscopico, con lo studio dell'anatomia della regione del III ventricolo. Lo stesso discorso vale per i controlli post-chirurgici delle terzoventricolostomie, vista la maggiore importanza del dato funzionale della pervietà della stomia rispetto al semplice dato morfologico della variazione della volumetria ventricolare.

Gli studi quantitativi con sequenze specifiche per il flusso e con sincronizzazione cardiaca, eventualmente abbinati alla funzione cine, sono indubbiamente accurati, raffinati ed eleganti, ma non indispensabili, nella pratica clinica, per lo studio del flusso liquorale; infatti non si è ancora dimostrata una loro significativa maggiore sensibilità rispetto ai dati qualitativi (flusso si/flusso no) ottenibili con normali sequenze FSE e TSE T2 w.
Trattamento endoscopico dell'idrocefalo complesso
Authors: Donati P.A.
Published: April 2015

II termine di idrocefalo complesso comprende un gruppo di patologie come l'idrocefalo multiloculato e quello associato a cisti della linea mediana o ependimali ad origine dai plessi corioidei, con esclusione delle intere cavità ventricolari dal flusso del liquido cerebrospinale (LCS). In queste condizioni il LCS è intrappolato nei comparti formati all'interno del sistema ventricolare.

Il trattamento tradizionale di queste patologie consiste nell'inserimento di multipli shunt o multipli cateteri ventricolari, nella chirurgia stereotassica o in craniotomie a cielo aperto. La neuro-endoscopia è una metodica alternativa con un importante ruolo nell'idrocefalo complesso, semplificando o addirittura eliminando l'utilizzo dello shunt.

Dal Luglio 1997 al Marzo 1999 16 pazienti con diagnosi di Idrocefalo complesso sono stati trattati presso il Dipartimento di Neurochirurgia dell'Ospedale Anna Meyer di Firenze.

I pazienti comprendono sei casi di idrocefalo multiloculato, cinque casi di cisti intraventricolari, due casi di ventricoli laterali esclusi e tre casi di quarto ventricolo escluso. Dopo uno studio con risonanza magnetica per stabilire la traiettoria dell'approccio al sistema ventricolare, la procedura è stata realizzata con endoscopi flessibili Storz di diametro esterno di 3,7 e 2,5 mm e con un canale di lavoro di rispettivamente 1,5 e 1,2 mm.

La neurochirurgia endoscopica nel trattamento dell'idrocefalo complesso rappresenta una valida alternativa al trattamento tradizionale più invasivo, il quale comporta maggiori rischi di complicanze.
La terzoventricolostomia nell'idrocefalo normoteso e tetraventricolare
Authors: Delitala A. , Brunori A. , Chiappetta F.
Published: April 2015

La terzo-ventricolostomia (TVS) endoscopica è procedura di provata efficacia nella risoluzione definitiva dell'idrocefalo ostruttivo-ipertensivo, per il quale costituisce oggi il trattamento di scelta. La letteratura indica una incidenza di complicanze correlate alla tecnica del 5–7% con una mortalità trascurabile limitata a reports sporadici. Al contrario nessuno studio ha indagato in maniera sistematica il possibile ruolo della TVS nell'idrocefalo non-ipertensivo (comunicante e non), ovvero nell'entità clinica nota come idrocefalo “normoteso” e negli idrocefali cronici cosiddetti “compensati” oltre che negli idrocefali “tetraventricolari” di altra etiopatogenesi. La creazione di vie di deflusso alternative, l'esposizione delle cisterne all'effetto Behring ed il lavaggio ventricolare intraoperatorio sono fattori potenzialmente in grado di rimettere in moto la circolazione liquorale, ammettendo l'integrità delle capacità resorptive. Gli Autori analizzano retrospettivamente un gruppo di 17 pazienti con indicazione “atipica” alla TVS: il miglioramento clinico stabile ottenuto in 6 di questi induce a non trascurare questa opzione, non preclusiva di un eventuale successivo shunt extracranico, negli idrocefali normotesi ostruttivi “chirurgici”, nell'idrocefalo compensato del bambino e nei rari casi di idrocefalo tetraventricolare da stenosi dell'egresso del IV ventricolo. È tuttavia auspicabile la promozione di uno studio clinico randomizzato per poter finalmente trarre delle conclusioni in una materia tanto controversa.
La ventricolocisternostomia nell'idrocefalo normoteso dell'anziano
Authors: Cramaro A. , Skrap M.
Published: April 2015

La ventricolocisternostomia (VCS) può essere risolutiva in alcuni casi di idrocefalo con pervietà dell'acquedotto di Silvio, probabilmente grazie alla rapida trasmissione dell'onda pulsatile negli spazi subaracnoidei. Vengono descritti 17 casi di idrocefalo normoteso con prevalente dilatazione triventricolare dell'anziano, trattati con VCS. Sette pazienti sono migliorati, sette sono rimasti invariati e tre sono peggiorati, per cui è stato applicato uno shunt ventricoloperitoneale. Il miglioramento clinico nel 45% dei casi è un dato incoraggiante, che permette di proporre l'intervento endoscopico in casi selezionati.
Trattamento endoscopico delle cisti colloidi Razionale e tecnica
Authors: Longatti P.L. , Martinuzzi A. , Fiorindi A. , Di Paola F. , Moro M. , Carteri A.
Published: April 2015

Le cisti colloidi sono lesioni del III ventricolo, che possono essere trattate chirurgicamente in tre modi: resezione microchirurgica, aspirazione stereotattica e trattamento endoscopico. L'endoscopia offre la possibilità di un'ampia apertura della cisti con aspirazione di tutto il suo contenuto seguita dalla coagulazione della membrana interna secernente la colloide. L'aspirazione stereotattica è l'approccio meno invasivo nel trattamento delle cisti colloidi, ma il successo di questa metodica dipende dalla densità della cisti. La tecnica microchirurgica permette la resezione della lesione ma con una maggiore invasività e con maggiori rischi di morbidità chirurgica.

Dall'agosto 1995 all'ottobre 1997 abbiamo eseguito 10 procedure endoscopiche per trattare nove pazienti con cisti colloidi del III ventricolo (6 maschi e 3 femmine). Gli interventi sono stati eseguiti usando un fibro-endoscopio Codman in 9 casi ed un endoscopio rigido Aesculap in 1. Il trattamento è stato eseguito sotto guida stereotattica in 1 caso con un controllo in neuro-navigazione in 2 e a mano libera in 7 casi.

Non sono state osservate recidive sia dal punto di vista clinico che radiologico.

Il confronto fra l'aspirazione stereotattica e l'endoscopia risulta a favore di quest'ultimo tipo di tecnica. La rimozione della sostanza colloide è infatti completa e controllabile con l'endoscopia mentre è parziale e non controllabile visivamente con la stereotassi.

I nostri risultati relativi al trattamento endoscopico delle cisti colloidi sono senz'altro incoraggianti. L'intervento presenta una percentuale accettabile di complicanze e, nella nostra esperienza, non sono stati osservati deficit neurologici dovuti alla procedura. Al contrario, la resezione microchirurgica può spesso dare esito a complicanze postoperatorie, in particolare all'insorgenza di epilessia o disturbi mnestici causati da lesione dei fornici.

Colloid cysts are third ventricle lesions which can be treated surgically in three ways: microsurgical resection, stereotactic aspiration and endoscopic treatment. Endoscopy offers the possibility of opening the cyst widly with aspiration of all its content followed by coagulation of the internal colloid-secreting wall. Stereotactic aspiration is the least invasive approach in the treatment of colloid cysts, but the success of this method depends on cyst density. The microsurgical technique allows resection of the lesion at the cost of being more invasive and carrying a much greater risk of morbidity.
Microdiscectomia videoassistita con endoscopia
Authors: Parenti G.
Published: April 2015

Numerose sono le tecniche mini-invasive proposte per il trattamento delle ernie discali lombari. La microdiscectomia artroscopica consente una diretta visione del tessuto discale da asportare. Foley ha sviluppato una nuova metodica extradiscale conosciuta come Microdiscectomia Endoscopica. Essa implica l'uso di un divaricatore tubulare posizionato nello spazio discale interessato tramite una serie di dilatatori. Il divaricatore tubulare ha un diametro di 15 mm e la massima lunghezza utile è di 65 mm. 21 pazienti costituiscono la nostra esperienza con tale tecnica, meno invasiva rispetto alla microdiscectomia di Caspar e più vantaggiosa rispetto alle tecniche intradiscali, consentendo il trattamento di protrusioni discali erniate.
Chirurgia endoscopica endonasale trans-sfenoidale della regione sellare: Valutazione pre-operatoria con TC spirale ed endoscopia virtuale
Authors: Cirillo S. , Caranci F. , Briganti F. , D'Amico A. , Volpe A. , Elefante A. , Cappabianca P. , Elefante R.
Published: April 2015

La chirurgia endoscopica trans-sfenoidale consente in maniera non invasiva l'accesso alle lesioni della regione sellare.

La TC spirale, grazie anche alla possibilità di ottenere ricostruzioni bidimensionali e tridimensionali di elevata qualità, consente una accurata valutazione dell'anatomia delle cavità nasali e dei seni paranasali e delle loro modificazioni patologiche, presupposto indispensabile per l'approccio chirurgico endoscopico funzionale.

Oltre ad una accurata definizione del percorso anatomico da intraprendere endoscopicamente e dell'eventuale patologia associata, la TC consente di identificare le varianti costituzionali rino-sinusali, alcune delle quali abbastanza comuni (concha bullosa, curvatura paradossa del turbinato medio, deviazione del setto nasale, deviazione del processo uncinato, curvatura mediale del processo uncinato, bulging del canale ottico).

Sebbene l'analisi delle immagini ottenute sui piani coronale ed assiale fornisca già una accurata e fedele rappresentazione dell'anatomia rino-sinusale nello spazio, la rappresentazione tridimensionale con endoscopia virtuale consente di ottenere immagini simili a quelle endoscopiche tradizionali. Nell'ambito delle cavità nasali e paranasali vengono visualizzati spazi ed orifizi anatomici, anche quelli inaccessibili al-endoscopia classica, facilitando la comprensione della realtà anatomica delle strutture rino-sinusali e prefigurando al chirurgo l'aspetto delle cavità prima dell'intervento.
T1-Hypersignal Foci in Cerebral Toxoplasmosis after Stem Cell Transplantation
Authors: Terada H. , Kamata N. , Yokoyama Y. , Ohashp K. , Akiyama H. , Sakamaki H.
Published: April 2015

We present here the unique image of toxoplasma encephalitis in a transplant recipient, characterized by the finding of T1-hypersignal foci. It is emphasized that cerebral toxoplasmosis after stem cell transplantation may show a high signal on T1-weighted images even without any hemorrhagic or calcified lesions.
Effetti dell'ozono sul nucleo polposo: Reperti anatomo-patologici su un caso operato
Authors: Leonardi M. , Simonetti L. , Barbara C.
Published: April 2015

Il meccanismo di azione dell'ozono sul nucleo polposo è stato variamente ipotizzato su basi teoriche e sperimentali.

Gli autori descrivono un caso di intervento chirurgico su disco sottoposto a ozonoterapia intradiscale, in cui il materiale discale asportato è stato giudicato dal chirurgo macroscopicamente diverso dal solito ed è stato inviato all'anatomo-patologo per una valutazione istologica.

Si riportano i risultati di tale analisi istologica.