bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional consensus gave birth to the modern public library
Authors: Granda Renny , Machin-Mastromatteo Juan D
Published: April 2015

In 1982, library experts from 30 Latin American and the Caribbean countries met in Venezuela to discuss the current state and development strategies for the region’s public libraries. The result was the first technical-normative document for public libraries in the region, commonly known as the Caracas Declaration. This issue of Developing Latin America comments on the contents of this document, its influence and importance, and suggests the exercise of invoking and reviewing its principles and objectives to once again analyze the current state and project new development strategies.
Primary intracranial angiomatoid fibrous histiocytoma presenting with anaemia and migraine-like headaches and aura as early clinical features
Authors: Hansen Jakob Møller , Larsen Vibeke Andrée , Scheie David , Perry Arie , Skjøth-Rasmussen Jane
Published: April 2015

A 17-year-old female with migraine with aura complained of fatigue and was diagnosed with anemia. Three years later, changes in her headache pattern prompted hospital referral. Brain MRI showed a bi-lobed extra-axial intracerebral tumor encroaching both parieto-occipital regions. The resection specimen yielded a rare diagnosis of primary intracranial angiomatoid fibrous histiocytoma (AFH). Tumor removal resulted in cessation of her migraine and anemia. AFH may cause systemic symptoms – in this case fatigue and anemia – long before focal neurological symptoms are present. This is the first report of an intracranial AFH presenting as migraine with visual aura and anemia.
Epidemiology of Patellofemoral Instability Injuries Among High School Athletes in the United States
Authors: Mitchell Joshua , Magnussen Robert A. , Collins Christy L. , Currie Dustin W. , Best Thomas M. , Comstock R. Dawn , Flanigan David C.
Published: April 2015

Background:

Patellofemoral instability injuries, including dislocations and subluxations, are relatively rare in the general population but are believed to be much more common in young athletic patient populations, such as high school athletes. In spite of the relatively high risk, the epidemiology of such injuries in this population has not been clearly elucidated.

Purpose:

To provide a comprehensive understanding of the epidemiology of patellofemoral instability injuries among high school athletes in the United States.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Data were obtained from the National High School Sports-Related Injury Surveillance System, High School RIO (Reporting Information Online), an Internet-based sports injury surveillance system. Athletic trainers from high schools across the country uploaded data regarding athlete exposures (defined as practice or game participation) and injuries across 22 sports from 2007-2008 through 2012-2013. Data were collected regarding athlete demographics, injury mechanism and details, practice versus competition, return to sport, and the need for surgery.

Results:

A total of 421 patellar instability (143 dislocations and 278 subluxations) injuries occurred during 21,556,515 athlete exposures (AEs) during the study period, for an overall injury rate of 1.95 per 100,000 AEs. The highest injury rates were noted in girls’ gymnastics (6.19 per 100,000 AEs), boys’ football (4.10), and boys’ wrestling (3.45). The overall injury rate was significantly lower for girls than boys (1.66 and 2.15, respectively; rate ratio [RR], 0.77; 95% CI, 0.62-0.94). In contrast, among only the sex-comparable sports, the injury rate was higher for girls than boys (1.47 and 0.88, respectively; RR, 1.67; 95% CI, 1.19-2.34). The rate of injury was higher in competition (3.72) than practice (1.34) (RR, 2.78; 95% CI, 2.29-3.36). A no-contact injury mechanism was the most commonly reported mechanism (37.8% of injuries), followed by player-to-player contact (36.8%). When all contact subcategories are combined, the overall contact mechanism represents 59.3% of injuries. Return to play after a patellofemoral instability injury occurred within 3 weeks for 59.5% of athletes. Return to play in >3 weeks (16.0%) and loss of the remainder of the season (20.0%) were less common outcomes.

Conclusion:

Patellofemoral instability injury rates vary by sport, sex, and type of exposure (competition vs practice). A better understanding of such patterns of patellofemoral instability injury will help drive formulation of new injury prevention strategies and decrease the risk for patellofemoral instability injury among high school athletes.
Concussions in the National Football League
Authors: Yengo-Kahn Aaron M. , Johnson Daniel J. , Zuckerman Scott L. , Solomon Gary S.
Published: April 2015

Background:

Significant attention has been directed toward the immediate and long-term effects of sport-related concussions on athletes participating in contact sports, particularly football. The highest level of football, the National Football League (NFL), has received significant attention and criticism regarding player management and safety after mild traumatic brain injury (mTBI). Several review articles have reported data related to concussion in the NFL, but a succinct review and synthesis of data regarding NFL concussions is currently lacking.

Purpose:

To (1) review systematically the published data regarding concussion in the NFL and assess limitations of the studies, (2) elucidate areas where further research is needed, and (3) identify methods to improve future investigations of concussion in the NFL.

Study Design:

Systematic review of literature.

Methods:

English-language titles and abstracts published between 1900 and September 2014 were searched systematically across electronic databases, and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Peer-reviewed journal articles were included if they contained NFL concussion data with or without additional associated long-term effects. Reviews, editorials, letters to the editor, and comments were not included.

Results:

Of the 344 records screened for review, 88 articles were assessed for eligibility. There were 31 studies that met the inclusion criteria and formed the basis of the evidence synthesis. Included in the current review were 8 case-control studies (Oxford Centre for Evidence-Based Medicine evidence level 3b), 6 descriptive epidemiological studies (level 4), 6 cross-sectional studies (level 4), 6 cohort studies (level 2b), and 5 case series (level 4).

Conclusion:

The study of concussions in the NFL has been limited by lack of recent empirical data, reliance on self-reported concussion history, and ascertainment bias of brains donated for autopsy studies. The scientific community as well as the public should be cautious in interpreting the current literature surrounding concussion.
From modeling to remodeling of upper airways: Centrality of hyaluronan (hyaluronic acid)
Authors: Castelnuovo P , Tajana G , Terranova P , Digilio E , Bignami M , Macchi Alberto
Published: April 2015

After traumatic events (accidental or surgical), the respiratory tract activates specific and prolix repairing mechanisms which tend to claw back the primitive differentiated state. The attempt of reactivation of the normal tissue functions is called ‘remodeling’ and its aim is to reinstate the modeling mechanisms that existed before the damaging event or the pathology’s establishment. Endoscopic sinus surgery represents the gold standard treatment for inflammatory, malformative, benign, and, in selected cases, malignant diseases. The surgical technique is commonly described as minimally invasive as the nostrils are used as an access route and therefore does not leave any external scars. Currently, the surgical procedures, even though minimally invasive regarding the way in, are in fact widely destructive towards the surgical target. The healing process and re-epithelialization will depend on the amount of bony tissue that has been exposed and it will be important to stratify the different surgical typologies in order to foresee the increasing difficulty of mucosal healing process. As far as upper inflammatory diseases are concerned, recent studies demonstrated how intranasal hyaluronic acid can positively regulate mucosal glands secretion and modulate inflammatory response, being a useful tool for the improvement of remodeling after endoscopic sinus surgery. Acid has shown to be able to regulate mucosal glands secretion and modulate the inflammatory response.
Different coupling agents in wood-polypropylene composites containing recycled mineral wool: A comparison of the effects
Authors: Väntsi Olli , Kärki Timo
Published: April 2015

Coupling agents can have a major effect on the various properties of wood-plastic composites. In this study, the effects of maleated polypropylene and γ-methacryloxypropyl trimethoxy silane as coupling agents on the mechanical and moisture resistance properties of wood-polypropylene composites containing recycled mineral wool are investigated. The spraying method was used to apply γ-methacryloxypropyl trimethoxy silane on the wood fibers and recycled mineral wool fibers. According to the findings, the utilization of maleated polypropylene as a coupling agent led generally to better mechanical and moisture resistance properties, but treatment with γ-methacryloxypropyl trimethoxy silane provided comparable properties on certain filler loadings and treatment solution concentrations.
Adding Insult to Injury
Authors: Greiner Mary V. , Greiner Hansel M. , Caré Marguerite M. , Owens Deanna , Shapiro Robert , Holland Katherine
Published: April 2015

The primary objectives of this study were to determine the prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in patients with abusive head trauma who underwent electroencephalography (EEG) monitoring and to describe predictive factors for this population. Children with a diagnosis of abusive head trauma were studied retrospectively to determine the rate of EEG monitoring, the rate of nonconvulsive seizures and nonconvulsive status epilepticus, and the associated neuroimaging findings. Over 11 years, 73 of 199 (36.8%) children with abusive head trauma had electroencephalography monitoring performed. Of these, 20 (27.4%) had nonconvulsive seizures and 3 (4.1%) had nonconvulsive status epilepticus. The presence of subarachnoid hemorrhage and cortical T2 / fluid-attenuated inversion recovery signal abnormalities were both significantly associated with the presence of nonconvulsive seizures / nonconvulsive status epilepticus. Nonconvulsive seizures are relatively common in abusive head trauma and may go unrecognized. Specific neuroimaging characteristics increase the likelihood of nonconvulsive seizures on EEG.
Direct-Breastfeeding Premature Infants in the Neonatal Intensive Care Unit
Authors: Briere Carrie-Ellen , McGrath Jacqueline M. , Cong Xiaomei , Brownell Elizabeth , Cusson Regina
Published: April 2015

Background:

The neonatal intensive care unit (NICU) presents challenges for breastfeeding, especially with feeding directly at the breast (direct-breastfeeding).

Objectives:

The objectives of this study were to describe the characteristics of direct-breastfeeding and identify factors that are associated with direct-breastfeeding in the NICU.

Methods:

A retrospective chart review of 88 infants born < 34 weeks gestational age whose mothers provided human milk was conducted. Analyses included chi-square and logistic regression models.

Results:

Of infants who received human milk at the time of their first oral feeding, 59% received their first oral feeding at breast and 33% of mothers had a specific breastfeeding goal. Mothers who breastfed ≥ 1 direct-breastfeed per day were more likely to have a breastfeeding goal (odds ratio [OR] = 11.13; 95% confidence interval [CI], 1.43-86.88) and be older (OR = 1.33; 95% CI, 1.03-1.72). Their infants had more days between the first breastfeed and introduction of a bottle (OR = 1.56; 95% CI, 1.11-2.17) and had shorter lengths of stay (OR = 0.9; 95% CI, 0.9-0.97). Mothers were more likely to provide direct-breastfeeding at discharge if they were non-Hispanic (OR = 0.05; 95% CI, < 0.01-0.60), were primiparous (OR = 0.06; 95% CI, 0.01-0.45), had a specific breastfeeding goal (OR = 13.79; 95% CI, 1.99-95.80), and their infant had a shorter length of stay (OR = 0.94; 95% CI, 0.90-0.98).

Conclusion:

Mothers should be supported to breastfeed before using bottles in the NICU. In addition, goal setting is important for prenatal care providers to discuss with all mothers early in pregnancy, especially those at high risk for premature delivery.
The Restructured Landscape of Economic Development
Authors: Meléndez Edwin , Borges-Mendez Ramon , Visser M. Anne , Rosofsky Anna
Published: April 2015

Regional workforce development collaborations have emerged as a notable approach to tackle complex problems within workforce development systems. While much of the existing research on workforce development documents the importance of promoting regional workforce development collaborations, little research exists that adequately identifies the specific barriers that organizations encounter in establishing and maintaining these collaborations. Through several sets of interviews over a 10-year period, this article examines the experiences of three detailed case studies of regions—Greater North Bay area, CA; Greater Fort Wayne/Northeastern IN; and Greater Pittsburgh/Southwestern PA—to identify the barriers and emerging strategies for creating regional workforce development systems. The authors identify three primary barriers: high initial upfront costs, competition, and fragmentation. They also find that an effective regional workforce development system is promoted primarily through an anchor organization that possesses programmatic and jurisdictional authority throughout a region.
Why migrants earn less: in search of the factors producing the ethno-migrant pay gap in a Dutch public organization
Authors: Siebers Hans , van Gastel Jilles
Published: April 2015

In many countries, migrant/ethnic minority workers earn less than non-migrant/ethnic majority employees. This pay gap is not only attributable to migrant/ethnic minority employees having acquired less human capital or social capital, to the impact of government policies and to discrimination. Based on both qualitative and quantitative data collected in 2010, this case study of the job segregation component of the wage disadvantages of migrant employees in a Dutch public organization identifies several other factors. Migrant workers’/ethnic minority employees’ lower levels of participation in work-related communication and the application of socio-ideological labour control also widen this earnings gap. Moreover, migrant workers’/ethnic minority employees’ institutional and relational uncertainties, due to their subordinated position in Dutch society, help to explain their lower levels of participation in work-related communication and how socio-ideological labour control works out negatively for them.
Neglecting the 19th century
Authors: Miralles Carles Sirera
Published: April 2015

The present article examines the historical narrative proposed by modernization theory about the recent Spanish past. Its assumptions and consequences for historical research focused on the 19th century are described in order to understand the lack of intellectual exchange among historians and sociologists in the Spanish academic world. Modernization theory has justified the political consensus that allowed the Spanish transition to democracy and its academic authority has narrowed the scope of historical research about previous democratization processes. Although the paradigm of Spanish backwardness has been refuted by specialists on 19th-century Spain, sociologists, economists and historians of the 20th century still propose a teleological interpretation of the democratization process that assumes the validity of the paradigm of secular Spanish backwardness. The scientific and political authority of modernization theory has made impossible an open academic debate and consequently the work of historians that refute teleological interpretations of development has been neglected, since modernization theory provides a political interpretation of the Spanish Second Republic and the Spanish Civil War as historically determined failures in order to legitimize the present democratic monarchy and constitution.
A swarm intelligent approach for multi-objective optimization of compact heat exchangers
Authors: Yousefi Milad , Yousefi Moslem , Martins Ferreira Ricardo Poley , Darus Amer Nordin
Published: April 2015

Design optimization of heat exchangers is a very complicated task that has been traditionally carried out based on a trial-and-error procedure. To overcome the difficulties of the conventional design approaches especially when a large number of variables, constraints and objectives are involved, a new method based on a well-established evolutionary algorithm, particle swarm optimization, weighted sum approach and a novel constraint handling strategy is presented in this study. Since the conventional constraint handling strategies are not effective and easy-to-implement in multi-objective algorithms, a novel feasibility-based ranking strategy is introduced which is both extremely user-friendly and effective. A case study from industry has been investigated to illustrate the performance of the presented approach. The results show that the proposed algorithm can find the near pareto-optimal with higher accuracy when it is compared to conventional non-dominated sorting genetic algorithm II. Moreover, the difficulties of a trial-and-error process for setting the penalty parameters are solved in this algorithm.
Leaders’ Use of Moral Justifications Increases Policy Support
Authors: Van Zant Alex B. , Moore Don A.
Published: April 2015

Leaders must choose how to justify their organization’s actions to stakeholders. We differentiate moral frames, or justifications based on moral values, from pragmatic frames, or justifications based on practical costs and benefits. In Experiments 1a and 1b, we found that moral policy frames elicited more support than pragmatic frames across a variety of scenarios. This effect was mediated by the perception that leaders who offer moral justifications possess relatively greater moral character. In Experiment 2, we found that perceptions of a leader’s private motives had a stronger influence on policy support than did the leader’s public stance. Experiment 3 demonstrated that, irrespective of how a policy was framed, people were most supportive of a policy championed by a leader high in moral character. In Experiment 4, we documented an additional benefit of moral policy frames: They allow leaders to mitigate the moral outrage generated by reneging on a policy.
Alternative standardization approaches to improving streamflow reconstructions with ring-width indices of riparian trees
Authors: Meko David M , Friedman Jonathan M , Touchan Ramzi , Edmondson Jesse R , Griffin Eleanor R , Scott Julian A
Published: April 2015

Old, multi-aged populations of riparian trees provide an opportunity to improve reconstructions of streamflow. Here, ring widths of 394 plains cottonwood ( Populus deltoides, ssp. monilifera) trees in the North Unit of Theodore Roosevelt National Park, North Dakota, are used to reconstruct streamflow along the Little Missouri River (LMR), North Dakota, US. Different versions of the cottonwood chronology are developed by (1) age-curve standardization (ACS), using age-stratified samples and a single estimated curve of ring width against estimated ring age, and (2) time-curve standardization (TCS), using a subset of longer ring-width series individually detrended with cubic smoothing splines of width against year. The cottonwood chronologies are combined with the first principal component of four upland conifer chronologies developed by conventional methods to investigate the possible value of riparian tree-ring chronologies for streamflow reconstruction of the LMR. Regression modeling indicates that the statistical signal for flow is stronger in the riparian cottonwood than in the upland chronologies. The flow signal from cottonwood complements rather than repeats the signal from upland conifers and is especially strong in young trees (e.g. 5–35 years). Reconstructions using a combination of cottonwoods and upland conifers are found to explain more than 50% of the variance of LMR flow over a 1935–1990 calibration period and to yield reconstruction of flow to 1658. The low-frequency component of reconstructed flow is sensitive to the choice of standardization method for the cottonwood. In contrast to the TCS version, the ACS reconstruction features persistent low flows in the 19th century. Results demonstrate the value to streamflow reconstruction of riparian cottonwood and suggest that more studies are needed to exploit the low-frequency streamflow signal in densely sampled age-stratified stands of riparian trees.
Serum aldosterone and cortisol concentrations before and after suppression with fludrocortisone in cats
Authors: Matsuda Mayu , Behrend Ellen N. , Kemppainen Robert , Refsal Kent , Johnson Aime , Lee Hollie
Published: April 2015

Primary hyperaldosteronism is an increasingly recognized syndrome in cats, and diagnosis can be difficult. A potential diagnostic method has been reported, utilizing oral fludrocortisone administered twice daily for 4 days followed by collection of urine. In the current study, we sought to determine if blood sampling and a shorter dosing period would provide a possible means to test for primary hyperaldosteronism. Also, cortisol concentrations were measured to assess the potential of fludrocortisone to act as a glucocorticoid in cats. In phase I, 8 healthy laboratory cats were studied in a placebo-controlled, crossover design. Serum aldosterone and cortisol concentrations were measured before and on the second, third, and fourth day of treatment and compared within groups. In phase II, based on the results obtained in phase I, 8 healthy client-owned cats were administered 3 doses of fludrocortisone or placebo. Serum aldosterone and cortisol concentrations were compared before and after treatment within groups. In both phases, serum aldosterone and cortisol concentrations were significantly suppressed in fludrocortisone-treated cats. Thus, it was determined that oral administration of fludrocortisone causes suppression of serum aldosterone in healthy adult cats after only 3 doses. Further research is needed to determine the effects of oral fludrocortisone in cats with primary hyperaldosteronism and cats with other disorders causing hypertension and/or hypokalemia to determine if this protocol can be used as a tool for the definitive diagnosis of primary hyperaldosteronism.
Trends in Engagement in Advance Care Planning Behaviors and the Role of Socioeconomic Status
Authors: Khosla Nidhi , Curl Angela L. , Washington Karla T.
Published: April 2015

We investigated the trends in advance care planning (ACP) between 2002 and 2010 and whether socioeconomic status explained such trends. We conducted a pooled regression analysis of Health and Retirement Study data from 6052 proxies of deceased individuals. We studied 3 ACP behaviors, discussing end-of-life (EOL) care preferences, providing written EOL care instructions, and appointing a durable power of attorney for health care (DPAHC). ACP increased by 12% to 23% every 2 years from 2002 to 2010. Higher household income increased the odds of having a DPAHC. Education was not associated with ACP. Socioeconomic status alone appears to play a very limited role in predicting ACP. Engagement in ACP likely depends on a constellation of many social and contextual factors.
Effect of Coronal and Sagittal Alignment on Outcome After Mobile-Bearing Total Ankle Replacement
Authors: Braito Matthias , Dammerer Dietmar , Reinthaler Andrea , Kaufmann Gerhard , Huber Dennis , Biedermann Rainer
Published: April 2015

Background:

Comparably high revision rates are reported after total ankle replacement (TAR). Therefore, further critical analysis of the influence of implant position on clinical outcome is necessary.

Methods:

We analyzed the reliability and predictive value of previously published pre- and postoperative coronal and sagittal parameters in routine ankle radiographs on the clinical outcome of 84 HINTEGRA total ankle replacements (Newdeal, Lyon, France; Integra, Plainsboro, New Jersey). Mean follow-up was 4.0 years, and 15.5% of the TARs had revision surgery.

Results:

Mean postoperative American Orthopaedic Foot & Ankle Society ankle-hindfoot score was 71.3; mean postoperative verbal rating scale for pain was 3.1; and mean postoperative ankle range of motion was 26.4 degrees. Most tested radiologic parameters showed moderate or high intra- and interobserver reliability. With the numbers available, no significant difference in clinical outcome for all tested radiologic parameters could be detected.

Conclusion:

Our results indicate that mild malalignment of TAR, as assessed on routine ankle radiographs, did not affect midterm clinical outcome after TAR. Further multicenter studies with longer follow-up are needed to support our findings.

Level of Evidence:

Level III, comparative series.
Preoperative Physiology, Imaging, and Management of Transposition of the Great Arteries
Authors: Files Matthew D. , Arya Bhawna
Published: April 2015

Transposition of the great arteries (TGA) refers to hearts with concordant atrioventricular connections but discordant ventriculoarterial connections. In this lesion, the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. As such, the pulmonary and aortic circulations run in parallel as opposed to in series, and this lesion is not compatible with survival without adequate mixing of these circulations. The management and outcomes of TGA parallels the field of pediatric cardiac surgery itself. Uniformly fatal in childhood, palliative procedures from the 1950s to 1970s offered survival, albeit at a high early and late cost. In the 1970s, the arterial switch operation (ASO) provided an anatomical “cure,” with survival to adulthood in the current era of around 90%. Detailed perioperative imaging, attention to associated lesions, and comprehension of the physiology are critical to medical and surgical management.
Cross-behavior associations and multiple health behavior change: A longitudinal study on physical activity and fruit and vegetable intake
Authors: Fleig Lena , Küper Carina , Lippke Sonia , Schwarzer Ralf , Wiedemann Amelie U
Published: April 2015

This study aimed to examine the interrelation of physical activity and fruit and vegetable intake. The influence of stage congruence between physical activity and fruit and vegetable intake on multiple behavior change was also investigated. Health behaviors, social-cognitions, and stages of change were assessed in 2693 adults at two points in time. Physical activity and fruit and vegetable intake were assessed 4 weeks after the baseline.

Social-cognitions, stages as well as stage transitions across behavior domains were positively interrelated. Stage congruence was not related to changes in physical activity and fruit and vegetable intake. Physical activity and nutrition appear to facilitate rather than hinder each other. Having intentions to change both behaviors simultaneously does not seem to overburden individuals.
Eating in groups: Do multiple social influences affect intake in a fast-food restaurant?
Authors: Brindal Emily , Wilson Carlene , Mohr Philip , Wittert Gary
Published: April 2015

This study investigated multiple social influences to determine whether they affect amount eaten at a fast-food environment. Using observational methods, data on meal duration, foods eaten and personal characteristics were collected for 157 McDonald’s patrons. Analysis of covariance revealed that female diners ate less kilojoules when eating in mixed- versus same-sex groups (adjusted difference = 967 kJ, p < .05), while male diners eating in mixed-sex company ate more in groups compared to pairs (adjusted difference = 1067 kJ, p = .019). Influences to increase and restrict the amount eaten can operate simultaneously in an eating environment with gender a critical factor for consideration.
Lifestyle Medicine Education
Authors: Polak Rani , Pojednic Rachele M. , Phillips Edward M.
Published: April 2015

The actual causes of premature adult deaths, the preponderance of noncommunicable chronic diseases, and their associated costs are related to unhealthy behaviors, such as poor nutrition, physical inactivity, and tobacco use. Although recommended as the first line of prevention and management, providers often do not provide behavioral change counseling in their care. Medical education in lifestyle medicine is, therefore, proposed as a necessary intervention to allow all health providers to learn how to effectively and efficiently counsel their patients toward adopting and sustaining healthier behaviors. Lifestyle medicine curricula, including exercise, nutrition, behavioral change, and self-care, have recently evolved in all levels of medical education, together with implementation initiatives like Exercise is Medicine and the Lifestyle Medicine Education (LMEd) Collaborative. The goal of this review is to summarize the existing literature and to provide knowledge and tools to deans, administrators, faculty members, and students interested in pursuing lifestyle medicine training or establishing and improving an LMEd program within their institution.
Study on the damage mechanism of articular cartilage based on the fluid–solid coupled particle model
Authors: Hong Jun , Evans T Matthew , Mente Peter L
Published: April 2015

Articular cartilage damage is the primary cause of osteoarthritis. Very little literature work focuses on the microstructural damage mechanism of articular cartilage. In this article, a new numerical method that characterizes fluid coupling in particle model is proposed to study the damage mechanism of articular cartilage. Numerical results show that the damage mechanism of articular cartilage is related to the microstructure of collagen. The damage mechanism of superficial articular cartilage is tangential damage. On the other hand, horizontal separation is the damage mechanism of deep articular cartilage. The new numerical method shows the capability to effectively reveal the damage mechanism of superficial articular cartilage.
“Truthiness” and Second-Level Agenda Setting
Authors: Littau Jeremy , Stewart Daxton R. “Chip”
Published: April 2015

This study examined the impact of satire news programs on perceptions of media credibility. Using second-level agenda setting as a theoretical framework, the results of this mixed-methods study show that negative portrayals of television news on these satire news shows make salient certain negative attributes that match viewers’ perceptions of credibility. A survey ( N = 650) found that Daily Show/ Colbert Report viewers had less positive views about the credibility of television news programs, while content analysis ( N = 401) of 4 weeks of episodes of The Daily Show and The Colbert Report reflected the results of the survey, showing that television news programs, particularly those on cable, were more frequently portrayed negatively and made the target of jokes. The analysis shows television news is a frequent target of these satire shows’ criticisms and these shows’ negative attributes are made salient, which is reflected in the survey respondents’ low credibility scores for this medium.
Single Voxel Proton MR Spectroscopy Methods and Applications in Neuropediatrics
Authors: Frahm J. , Hanefeld F.
Published: April 2015

The purpose of this contribution is to introduce quantitative single voxel proton MR spectroscopy of the human brain as an easy-to-use method for a noninvasive assessment of cellular composition and metabolism and to demonstrate its clinical potential in the field of neuropediatrics.

The chosen approach transforms fully relaxed (TR = 6000 ms) short echo time (TE = 20 ms) proton MR spectra (STEAM localization sequence) into absolute metabolite concentrations by automatically fitting the raw data with a library of model spectra comprising all metabolites at known concentration (LCModel). The procedure includes total N-acetylaspartyl compounds as a marker for viable neuroaxonal tissue and myo-inositol as a purely glial constituent as well as total creatine, choline-containing compounds, glutamate and glutamine, and lactate.

Extensive studies of brain disorders in childhood suggest the use of proton MRS as a promising tool for an in vivo histopathologic characterization of brain tissue. Typical metabolite patterns are observed for pathologic processes such as lactic acidosis, loss of functioning neurons, astrocytosis, myelin breakdown, or loss of oligodendrocytes. Examples deal with the diagnostic workup of enzyme deficiencies, demyelinating white matter diseases, and focal brain lesions.
Quantificazione assoluta in 1HMRS
Authors: Tarducci R.
Published: April 2015

In questo lavoro si affronta il problema della quantificazione assoluta del segnale preveniente dal tessuto cerebrale in un esame 1HMRS. Viene proposto un metodo di quantificazione basato sull'uso di un riferimento esterno costituito da una provetta di acqua pura e sulla compartimentazione del contenuto di acqua nel volume di interesse. Viene discussa la formulazione generale e, brevemente, un protocollo di assicurazione della qualità.
Uso della risonanza magnetica spettroscopica del protone nello studio delle malattie della sostanza bianca cerebrale
Authors: Mortilla M. , Federico A. , De Stefano N.
Published: April 2015

La risonanza magnetica spettroscopica (MRS) è una tecnica non invasiva per la misura della concentrazione relativa di alcuni composti cerebrali. L'uso di questa tecnica nello studio delle malattie della materia bianca cerebrale ha apportato miglioramenti nella classificazione diagnostica e nelle misure relative all'andamento delle malattie.

Un uso più estensivo delle tecniche di risonanza multimodale, comprendenti tomografia RM, spettroscopia ed altre modalità non convenzionali, dovrebbe quindi essere incoraggiato. Ciò permetterà una miglior comprensione della complessa dinamica dei cambiamenti patologici nelle malattie della sostanza bianca ed una più accurata valutazione della progressione e della risposta alla terapia della malattia stessa.
Studio RMf della dominanza emisferica in destrimani e non destrimani
Authors: Vitali P. , Mavilio N. , Capello D. , Rosa M. , Ferrari A. , Levrero F. , Pilot A. , Nobili F. , Rodriguez G.
Published: April 2015

La valutazione non invasiva della dominanza emisferica per il linguaggio è una delle più promettenti applicazioni cliniche della risonanza magnetica funzionale, specie nei pazienti destinati alla neurochirurgia. In questo studio sono state eseguite due prove linguistiche in un gruppo di giovani volontari sani (8 destrimani, 12 non destrimani): una di fluenza fonemica ed una di associazione semantica. Tra i voxels statisticamente attivati nei due emisferi sono stati calcolati tre indici di asimmetria (emisferico, frontale e temporoparietale) in ogni soggetto e per ogni prova.

Nel complesso, la prova di fluenza fonemica attivava fortemente il lobo frontale, mentre la prova di associazione semantica determinava un pattern di attivazione piu distribuito, che comprendeva anche il giro temporale medio ed il giro angolare.

Per quanto riguarda gli indici di asimmetria, nei destrimani quello emisferico e quello frontale indicavano sempre l'attivazione prevalente dell'emisfero sinistro. Un solo soggetto ambidestro ha presentato nella prova di fluenza fonemica indici di asimmetria emisferico e frontale espressivi di lateralizzazione destra. D'altra parte, l'indice di asimmetria temporoparietale deponeva per una lieve revalenza dell'emisfero destro in un destrimane ed per una chiara lateralizzazione destra in un non destrimane.

La risonanza magnetica funzionale appare dunque metodica sensibile ed appropriata nella valutazione della dominanza emisferica per il linguaggio.

L'impiego di indici di asimmetria lobari può meglio evidenziare il differente contributo alla dominanza emisferica delle aree frontali rispetto a quelle temporoparietali. Infine, l'individuazione delle aree corticali correlate con la funzione linguistica è uno strumento potenzialmente utile per il neurochirurgo nel programmare resezioni di aree limitrofe.
Pharyngeal Abscess Resulting in a Fusion of the Skullbase-Cl-C2
Authors: Birch-Iensen M.
Published: April 2015

A 46-year-old white male drug addict presented with a retropharyngeal space mass. Clinical examination was suggestive of an abscess which was confirmed by radiological examination which also showed contrast enhancement in the prevertebral and epidural space from the skullbase to the C5 level. The abscess was incised and antibiotics administered. The following year, atlantoaxial instability and a rotatory dislocation of C1 on C2 was found and two years after treatment a rotatory dislocation of C1 on C2 with a fusion between the skullbase, C1 and C2 was found, a complication not previously reported. His complaints at this stage consisted of L'Hermitte symptoms and severe limitation on head rotation.
Giunzione occipito-cervicale
Authors: Cirillo S. , Caranci F. , D'Amico A. , Briganti F. , Tortora F. , Greco M. , Elefante R.
Published: April 2015

La giunzione occipito-cervicale, regione di transizione tra cranio e colonna vertebrale, possiede caratteristiche uniche per la struttura osteo-ligamentosa di cui è costituita e per le importanti formazioni neuro-vascolari con cui contrae rapporti di contiguità. Questa particolare regione può essere interessata da una serie di differenti entità patologiche: essa è infatti sede di particolari anomalie congenite, di patologie infiammatorie o degenerative, di gravi lesioni traumatiche e di lesioni espansive di differente natura.

L'instabilità della giunzione conseguente a tali patologie o le diverse lesioni espansive determinano come conseguenza fondamentale la compressione del midollo cervicale superiore; altri effetti secondari sono rappresentati dalla compressione delle strutture vascolari e dall'ostacolo alla circolazione liquorale.

La tomografia computerizzata e la risonanza magnetica rappresentano le metodiche neuroradiologiche di elezione per lo studio della giunzione occipito-cervicale. La TC è in grado di definire con maggiore accuratezza le alterazioni osteo-strutturali e le fini calcificazioni. Malgrado tali prerogative, la RM è la metodica di scelta grazie alla possibilità di uno studio multiplanare, dell'elevata risoluzione di contrasto e dell'assenza di artefatti legati alla vicinanza di strutture ossee; un ulteriore vantaggio è costituito dalla possibilità di studio delle strutture vascolari del basicranio mediante angio-RM.

La radiologia tradizionale conserva un ruolo complementare, utile soprattutto in fase di screening nello studio della patologia ossea malformativa o traumatica.

Un'accurata conoscenza delle caratteristiche anatomiche e della semeiotica neuroradiologica è essenziale per affrontare uno studio corretto delle patologie della cerniera occipito-cervicale.
La loggia cavernosa: Anatomia neuroradiologica normale
Authors: Gallucci M. , Gagliardo O. , Splendiani A. , De Amicis R.
Published: April 2015

Il termine “loggia cavernosa”, sinonimo di “regione parasellare” indica l'insieme di strutture latero-sellari, differenziabili embriologicamente in almeno tre comparti: il seno cavernoso propriamente detto, di origine vascolare, la regione dell'apice orbitario, di derivazione orbitaria, e, infine, la regione del cavo di Meckel, di derivazione pterigo-mascellare. Viene riportata una revisione di anatomia normale ottenuta in vivo con tecniche di moderna neuroradiologia, per lo più derivate da ricostruzioni tridimensionali con algoritmi Shaded Surface Display (SSD) di acquisizioni TC, ottenute con tecnica elicoidale, e RM con sequenze 3D.
Patologia dell'articolazione temporo-mandibolare
Authors: Michelozzi G. , Mourou M.Y. , Schiavoni S. , Gandolfo N. , Calabrò F.
Published: April 2015

RM e TC permettono la valutazione di tutta la patologia dell'articolazione temporo-mandibolare (ATM) e in particolare delle dislocazioni discali senza e con riduzione, delle osteopatie necrotiche (specie osteocondrite dissecante e necrosi vascolare asettica), della patologia sinoviale e delle artriti (artrite reumatoide, condromatosi sinoviale, sinovite villonodulare, cisti sinoviali), dei corpi liberi intra-articolari, della patologia neoplastica primitiva e secondaria, dei traumi e naturalmente delle malformazioni. Le affezioni patologiche intra- e extracapsulari della ATM sono per lo più responsabili di una limitata apertura della bocca associata in genere a dolore locale.

Anche la rara patologia del processo coronoideo (iperplasia coronoidea, osteocondroma e esiti traumatici) rappresenta un'altra causa di alterata funzionalità della ATM che è caratterizzata da una limitata apertura della bocca in genere non dolorosa: lo studio sistematico del coronoide deve pertanto essere considerato estensione obbligatoria di quello dell'ATM.
Aspetti neurologici della patologia del basicranio
Authors: Tartaglione A. , Mazzella L. , Capellini C.
Published: April 2015

Questa presentazione si propone di definire il basicranio, identificarne i diversi compartimenti e sottolinearne i rapporti con le strutture neurali adiacenti. Ciò offre la possibilità di riassumere schematicamente i quadri clinici di interesse più specificamente neurologico, secondari a patologia del basicranio, tra i quali spiccano le sindromi da interessamento multiplo dei nervi cranici. Si sottolinea, in particolare, la rilevanza che esse hanno nella diagnostica delle lesioni del basicranio, soprattutto quando la neuroradiologia è muta, considerato che la compromissione dei nervi cranici è strettamente correlata con la sede della lesione. A questo proposito viene riportato un caso di sindrome di Vernet giunto di recente alla nostra osservazione.

Infine vengono considerate le possibili alternative diagnostico-differenziali che si propongono in caso di compromissione multipla dei nervi cranici, con particolare riferimento alla carcinomatosi meningea. Di quest'ultimo quadro vengono riassunte le caratteristiche fondamentali, attraverso l'esame di un caso clinico che permette di sottolineare la differenza tra patologia leptomeningea e del basicranio.
Malformazione focale oculo-encefalica
Authors: Lupo F.A. , Perfetto S.C. , Sticchi G.
Published: April 2015

Viene descritto un caso clinico, giunto alla nostra osservazione, relativo ad un neonato a termine portatore di una complessa malformazione oculo encefalica omolaterale.

I reperti iconografici mostrano in sede encefalica: displasia corticale focale ds con dismorfismo e dilatazione del corno frontale del ventricolo laterale corrispondente; a livello oculare: ipoplasia del globo oculare ds, cisti nello spazio extraconico supero-mediale, coloboma, alterazione del vitreo e persistenza del canale del Cloquet con residuo dell'arteria ialoidea.

Gli Autori ipotizzano che questo singolare quadro malformativo possa rappresentare una variante, presumibilmente non ereditaria, su genesi vascolare, della Sindrome di Warburg, in una forma compatibile con la vita, in considerazione anche del fatto che, al momento, non sono state rilevate altre anomalie nei restanti distretti corporei.
Steno-occlusive Carotid Pathology: Comparative Study between MRA (2D TOF vs C.E. 3D FGE) and Selective Catheter Angiography
Authors: Sabatini M. , Gallucci M. , Marsili L. , Barile A. , Splendiani A. , Di Cesare E. , Masciocchi C.
Published: April 2015

Magnetic resonance angiography offers many techniques for study of the carotid district. Time of flight (TOF) is the most widely used technique and can be employed to obtain single slice (2D) or volumetric (3D) images. Our study compared a widely used technique like 2D TOF with the relatively new technique of 3D FGE with bolus administration of contrast medium. From our experience in 20 patients, we conclude that MR angiography with the contrast enhanced 3D FGE offers more detailed information than the 2D TOF technique, thereby justifying its minimum invasiveness and the costs linked to contrast administration. The new technique is a valid alternative to DSA in solving doubtful cases and establishing appropriate treatment strategies.
Duplicazione dell'ipofisi: Descrizione di due casi diagnosticati con RM e revisione della letteratura
Authors: Duca S. , Crasto S. , Salzedo E. , Liboni W.
Published: April 2015

La duplicazione dell'ipofisi è una malformazione molto rara, che può essere associata ad altre anomalie della linea mediana, del corpo calloso, dei vasi, dei bulbi oculari, delle ossa craniche e del midollo spinale.

L'eziopatogenesi di questa malformazione è da ricercare all'interno delle anomalie di sviluppo embrionale che compaiono tra la 3° e 6° settimana di gestazione, quando lo sviluppo si trova compreso fra il 10° ed il 17° stadio embrionale.

Vengono descritti due casi di duplicazione ipofisaria, uno associato ad agenesia dell'arteria carotide interna di destra, a meningocele sfenoidale e a coloboma dell'occhio di destra, l'altro, associato a meningocele sfenoidale, agenesia del corpo calloso e ad ispessimento della lamina terminalis.
Cisti idatidea intracranica extradurale con segno patognomonico di “colpo d'unghia” sulla teca interna Descrizione di un caso
Authors: Andreula C. , Vreto G. , Santini E. , Podda P. , Osmanlli A. , Alimehmeti R. , Petrela M.
Published: April 2015

Il coinvolgimento del sistema nervoso centrale in corso di echinococcosi ha una incidenza stimata intorno al 2%-4%.

L'echinococcosi intracranica rappresenta il 2–4% di tutti i casi di patologia idatidea e può avere sedi intracerebrale ed extracerebrale. La forma intracranica extracerebrale può manifestarsi in tre localizzazioni:

– ossea con compromissione iniziale della spongiosa. Solo il 2% delle cisti si localizza nello scheletro e di questo solo il 3%-4% nel cranio; – extradurale: lo spazio può essere infettato da embolizzazione di scolici o embrioni attraverso vasi sanguigni; per estrinsecazione di una cisti cerebrale attraverso la dura madre integra o per erosione di una cisti ossea idatidea nello spazio extradurale; – combinata: con cisti contemporanee intracerebrali, extradurali ed ossee.

Delle tre forme la cisti idatidea extradurale è la più rara.

Dalla revisione della letteratura emergono solo 16 precedenti casi di cisti idatidea intracranica extracerebrale; di questi solo 7 con reperti TC. Infatti più della metà di questi casi risale agli anni Sessantacin-que-Settanta e per la diagnosi (peraltro solo di processo espansivo), gli autori si sono avvalsi della sola radiologia tradizionale: Radiografia diretta (che in alcuni casi documentava una asimmetria del cranio con assottigliamento del tavolato interno o la presenza di una parete calcifica) ed angiografia.

Attualmente La TC svolge un ruolo estremamente importante, potendo suggerire preoperatoriamente l'ipotesi idatidea, con notevole utilità per l'approccio neurochirurgico, oltre che definire dimensioni e sede della lesione cistica. La semeiotica TCè piuttosto caratteristica rivelando la cisti a contenuto simil-liquorale e margine convesso verso il parenchima cerebrale. Non si osserva impregnazione della parete della lesione dopo mdc né significativo edema perilesionale. Molto rare le calcificazioni. Il tavolato interno a contatto con la lesione appare di solito assottigliato.

Nel caso da noi riportato, diagnosticato e trattato chirurgicamente in Albania, l'esame TC documentava inoltre circoscritte erosioni del tavolato interno adiacente alla lesione, con aspetto a colpo d'unghia. Tale elemento semeiologico ha suggerito insieme agli altri rilievi TC la diagnosi di cisti idatidea extradurale.

Tale segno può pertanto indirizzare una diagnosi eziologica e va ricercato con estrema accuratezza e con “finestre adeguate”.