bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Thrombus Sidedness on Presentation and Outcomes of Patients with Proximal Lower Extremity Deep Vein Thrombosis
Authors: Bikdeli Behnood , Sharif-Kashani Babak , Bikdeli Bavand , Valle Reina , Falga Conxita , Riera-Mestre Antoni , Mazzolai Lucia , Verhamme Peter , Wells Philip , Torrero Juan , Lopez-Jiménez Luciano , Monreal Manuel ,   For the RIETE Investigators
Published: January 2018

Small studies have suggested differences in demographics and outcomes between left- and right-sided deep vein thrombosis (DVT), and also unilateral versus bilateral DVT. We investigated the clinical presentation and outcomes of patients with DVT based on thrombus sidedness. The authors used the data from the Registro Informatizado Enfermedad TromboEmbólica (RIETE) database (2001–2016) to identify patients with symptomatic proximal lower-extremity DVT. Main outcomes included cumulative 90-day symptomatic pulmonary embolism (PE) and 1-year mortality. Overall, 30,445 patients were included. The majority of DVTs occurred in the left leg (16,421 left-sided, 12,643 right-sided, and 1,390 bilateral; p < 0.001 for chi-squared test comparing all three groups). Comorbidities were relatively similar in those with left-sided and right-sided DVT. Compared with those with left-sided DVT, patients with right-sided DVT had higher relative frequency of PE (26% versus 23%, p < 0.001) and 1-year mortality (odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.00–1.18). This difference in mortality did not persist after multivariable adjustment (OR: 1.01; 95% CI: 0.93–1.1). Patients with bilateral DVT had a greater burden of comorbidities such as heart failure, and recent surgery compared with those with unilateral DVT (p < 0.001), and higher relative frequency of PE (48%), and 1-year mortality (24.1%). Worse outcomes in patients with bilateral DVT were attenuated but persisted after multivariable adjustment for demographics and risk factors (OR: 1.64; 95% CI: 1.43–1.87). Patients with bilateral DVT had worse outcomes during and after discontinuation of anticoagulation. There is a left-sided preponderance for proximal lower-extremity DVT. Compared with those with left-sided DVT, patients with right-sided DVT have slightly higher rates of PE. Bilateral DVT is associated with markedly worse short-term and 1-year outcomes.
Introdução ao estudo das craniotomias ântero-laterais e osteotomias associadas
Authors: Stávale Joaquim Marcos Augusto , Cabrera Hector Navarro
Published: January 2018

Neste artigo estão integrados conceitos elementares no aprendizado das vias de acesso ântero-laterais do crânio, de acordo com uma sistematização baseada na associação progressiva de osteotomias às craniotomias rotineiras. Um roteiro de estudos sobre estes acessos é exposto com as respectivas recomendações de leitura.
Cavernomas pontinos extraventriculares. Parte I. Acesso transtentorial a cavernoma pontino dorsolateral
Authors: Stávale Joaquim Marcos Augusto , Patriota Gustavo Cartaxo , Bianco André de Macedo
Published: January 2018

Objetivo: Descrever a via transtentorial, por meio de craniotomia têmporo-occipital, para remoção de cavernoma pontino de localização dorsolateral, exemplificado pela apresentação de um caso. Conclusão: O acesso transtentorial demonstra-se útil e seguro para remoção de lesões localizadas nessa região da ponte.
Isquemia encefálica, cascatas vasodilatadoras e alterações bioquímicas
Authors: Stávale Joaquim Marcos Augusto , Patriota Gustavo Cartaxo , Bianco André de Macedo
Published: January 2018

Procede-se a uma revisão das alterações bioquímicas e hemodinâmicas causadas pela isquemia do tecido nervoso. Trata-se de uma visão introdutória que aborda a fisiopatologia e as repercussões da terapêutica sobre a hemodinâmica encefálica.
Tratamento cirúrgico no acidente vascular cerebral hemorrágico: afinal, o que há de evidências?
Authors: Oliveira de Amorim Robson Luis , Paiva Wellingson Silva , Figueiredo Eberval Gadelha , Espírito Santo Marcelo Prudente , de Andrade Almir Ferreira , Teixeira Manoel Jacobsen
Published: January 2018

Mais da metade dos pacientes com hematoma cerebral espontâneo evolui desfavoravelmente. O controle inadequado da pressão arterial sistêmica é uma das principais causas para esse quadro dramático. Várias pesquisas clínicas visando ao controle da expansão do hematoma têm se mostrado satisfatórias, entretanto pouco houve de avanço no tratamento cirúrgico dessas condições. Há inúmeras variáveis que devem ser avaliadas em um paciente com hematoma intraparenquimatoso espontâneo, e esta revisão visa sistematizar o tratamento cirúrgico baseado em evidências.
Prognostic factors in glioblastoma multiforme
Authors: Welling Leonardo , Lynch José Carlos , Pereira Celestino , Andrade Ricardo , Hidalgo Fabiana Polycarpo , Pereira Alessandra G. L. , Escoteguy Claúdia
Published: January 2018

Objective: To study if the prognosis variables such as age, the Karnofsky Performance Status (KPS), extension of tumor removal by surgery, radiotherapy and tumor volume influenced the survival of patients with glioblastoma multiforme (GBM). Method: Retrospective analysis of GBM patients operated at Hospital dos Servidores do Estado between 1998 and 2008. Results: We could observe that age, the KPS and radiotherapy influenced the survival. The other variables did not have any prognosis implications. Conclusions: Despite many researches and many improvements regarding the diagnosis and the surgical techniques, the survival of patients with GBM has not changed in the last 30 years and is a therapeutic challenge. The surgical resection followed by radiotherapy is the standard treatment for patients with GBM. The importance of each variable in the patient's prognosis is still to be established in the multivariate analyzes.
Microvascular decompression of the trigeminal nerve: technical note
Authors: Sfreddo Ericson
Published: January 2018

The technique described by Jannetta uses Teflon “turfs” (polytetrafluoroethylene). With the technological advancement of materials it is increasingly harder to find Teflon in the market. The author describes a technique which uses a portion of a vascular prosthesis made of polyester (FlowNit Bioseal®) manufactured by JOTEC® Gmbh reference 35BI1206. The use of this vascular prosthesis seems to be an effective alternative for intracranial neurovascular decompression. One of its advantages is having a circumferential format, which provides greater stability and safety to possible displacement.
Síndrome de malformação vascular retinocefálica congênita unilateral (síndrome de Wyburn-Mason ou síndrome de Bonnet-Dechaume-Blanc) – Relato de caso raro e revisão de literatura
Authors: Sousa Parreira Johnathan de , Giovanetti Pontes Fabio Teixeira , Antonucci Adriano Torres , Santiago Natally Marques , Neto Roberto Parente , Azevedo Oliveira Bruno de , Garcia Lopes Luis Henrique , Ferreira Adelmo , Lopes Pedro Garcia
Published: January 2018

A síndrome de Wyburn-Mason ou Bonnet-Dechaume-Blanc representa uma doença neurocutânea congênita rara, não hereditária, do grupo das facomatoses, caracterizada por anormalidades vasculares ipsilaterais comprometendo a face, as vias da visão e o encéfalo, não sendo obrigatória a existência concomitante dos três locais para a confirmação diagnóstica. Acredita-se que tal distúrbio seja atribuído a um defeito de desenvolvimento do mesoderma primitivo vascular. Em 1937 e 1943, foram relatados na literatura os primeiros casos de pacientes com malformações vasculares unilaterais afetando o olho, o cérebro e a face, com tamanha riqueza de detalhes, que tal quadro sindrômico passou a receber o nome dos autores responsáveis pelas publicações. A denominação de malformações vasculares retinocefálicas unilaterais (MVR) foi utilizada primeiramente em 1974. A síndrome de Wyburn-Mason tipicamente se apresenta após a terceira década de vida e se manifesta de várias formas. As manifestações oculares são as mais comuns, enquanto as manifestações cutâneas faciais podem não ser encontradas. No presente trabalho, apresentamos um caso raro da síndrome de malformação vascular retinocefálica unilateral em paciente adulta-jovem, do sexo feminino, submetida a ressecções cirúrgicas de lesões retiniana e encefálica supratentoriais, ipsilaterais, em tempos diferentes, com outra lesão infratentorial, assintomática, submetida a tratamento conservador até o momento. O anatomopatológico das lesões confirmou tratar-se de hemangioma cavernoso.
Análise pós-operatória tardia da artrodese por via posterior em pacientes ASIA/Frankel e com trauma raquimedular toracolombar em serviço universitário
Authors: Cavalcante Tiago de Paiva , Kuehnitzsch Siegfried Pimenta , Barbosa Emerson Oliveira , Guimarães Otacilio Moreira , Lages Gustavo Veloso , dos Passos George Santos
Published: January 2018

Objetivo: O propósito deste estudo foi avaliar retrospectivamente o tratamento cirúrgico de pacientes vítimas de trauma raquimedular desse segmento sem déficit neurológico, quanto à evolução da dor local e à deformidade cifótica local e regional do segmento acometido, em um serviço universitário. Método: Foram utilizados dados de prontuário e avaliações clínicas e radiológicas de 16 pacientes submetidos à artrodese pedicular por via posterior, no período de maio de 2003 a dezembro de 2006, operados há pelo menos dois anos. Resultados: A média de idade foi de 43,43 ± 11,44 anos e o nível mais acometido L1. O mecanismo principal do trauma foi queda de altura. Após realização de raios X em perfil e cálculo dos ângulos local sagital (ALS) e regional sagital (ARS), de pós-operatório precoce e tardio, não houve diferença estatisticamente significativa entre os dados obtidos, apesar da diminuição de -15,3° para -10,7° nas cifoses locais e do aumento de -13,7° para 15,9° nas cifoses regionais. Houve diferença estatística na avaliação de dor pela Escala Analógica de Dor (EAD), entre o pré-operatório e o pós-operatório tardio (maior que dois anos), com redução de quatro vezes da intensidade da dor entre os pacientes analisados (p < 0,05). Conclusão: A artrodese pela via posterior é uma proposta alternativa de tratamento quando se discute a dor desses pacientes. Fica a necessidade de abranger um número maior de pacientes com essa patologia, a fim de dispor dados mais fidedignos, respaldando o tratamento como uma alternativa viável no manejo de pacientes com fraturas toracolombares e neurologicamente intactos.
Considerações sobre a síndrome da disfunção autonômica pós-traumatismo cranioencefálico: fisiopatologia e tratamento
Authors: Magalhães Francisco Neuton , Paiva Wellingson Silva , de Andrade Almir Ferreira , Bor-Seng-Shu Edson , Faleiro Rodrigo Moreira , Figueiredo Eberval Gadelha , Teixeira Manoel Jacobsen
Published: January 2018

O termo síndrome da disautonomia pós-traumática é usado para identificar uma síndrome de hiperatividade simpática e muscular paroxística após TCE. Essa síndrome representa uma afecção grave, frequentemente subestimada na assistência ao paciente com neurotrauma e que resulta em piora da recuperação funcional e elevação dos custos hospitalares por aumento do tempo de internação. Neste artigo, realizamos uma revisão crítica da literatura sobre os princípios fisiopatológicos e abordagem terapêutica na síndrome da disautonomia no paciente com traumatismo cranioencefálico.
Granuloma eosinofílico da coluna vertebral cervical em criança
Authors: Faleiro Rodrigo Moreira , Vieira Martins Luanna Rocha , Cardoso Bicalho Geraldo Vítor
Published: January 2018

Granuloma eosinofílico (GE) refere-se à forma benigna e mais frequente de histiocitose de células de Langerhans. Trata-se de uma doença que acomete principalmente crianças e adolescentes, sendo rara a sua ocorrência em adultos. Constitui a forma localizada de proliferação de histiócitos em crânio e ossos longos. O acometimento vertebral é incomum, sendo a localização cervical a menos descrita. Neste artigo, é descrito um caso de uma criança de 7 anos de idade com GE na coluna vertebral cervical com compressão medular. A criança evoluiu com regressão dos sintomas após tratamento conservador, tendo permanecido assintomática ao longo de seguimento de dois anos.
Hematoma subdural agudo infratentorial: relato de caso
Authors: Araújo Leonardo Barnsley , de Barros Raul Starling , de Castro Bruno Freire
Published: January 2018

Os autores relatam o caso de um paciente adulto vítima de traumatismo cranioencefálico e que apresentou uma lesão considerada rara na literatura, o hematoma subdural agudo da fossa posterior. O paciente foi submetido à craniectomia suboccipital com drenagem do hematoma e recebeu alta com escore de 3 pontos na Glasgow Outcome Scale; um bom resultado, pois essa lesão atinge 71% de mortalidade em algumas séries.
Hidrocefalia: relação entre o conhecimento do cuidador e sequelas motoras
Authors: Oliveira Débora Moura da Paixão , Pereira Carlos Umberto , Freitas Záira Moura da Paixão , Costa Aida Carla Santana de Melo
Published: January 2018

Objetivo: Verificar se o conhecimento do cuidador está relacionado ou não à presença de sequelas motoras na criança. Métodos: Estudo descritivo, exploratório, sob abordagem quantitativa, utilizando a técnica da entrevista padronizada, com cuidadores atendidos no ambulatório de um hospital universitário da cidade de Aracaju. Resultados: A amostra foi composta por 54 crianças e seus cuidadores. A média da idade do cuidador foi de 27,3 ± 7 anos, com predomínio absoluto do gênero feminino. O conhecimento foi significativamente maior em cuidadores de crianças com sequelas (P = 0,003). Conclusão: A escolaridade do cuidador foi significativa para maior conhecimento. Cuidadoras de crianças com sequelas motoras apresentam maior conhecimento sobre aspectos importantes da hidrocefalia.
Terapia endovascular no vasoespasmo cerebral secundário à hemorragia subaracnóidea
Authors: Teixeira Saulo Araújo , Figueiredo Eberval Gadelha , Pereira Caldas Jose Guilherme Mendes , Rodrigues Daniella Brito , Carvalho Viegas Maria Luana , Teixeira Manoel Jacobsen
Published: January 2018

O vasoespasmo cerebral é uma complicação relativamente frequente após episódios de hemorragia subaracnóidea de etiologia aneurismática. É responsável pela mortalidade de aproximadamente 30% dos pacientes e por sequelas neurológicas em 50% dos sobreviventes. Revisão de literatura realizada em julho de 2012. Foram pesquisadas as bases de dados PubMed e BVS e selecionados 37 artigos em português e inglês. A terapia do triplo H, largamente utilizada, diminui complicações isquêmicas, mas pode piorar comorbidades. A nimodipina ainda é a única droga que melhora comprovadamente o prognóstico do paciente. O tratamento endovascular pode ser baseado em angioplastia por balão, que dilata mecanicamente os vasos estreitados, ou em administração intra-arterial de agentes vasodilatadores, como a papaverina. Angioplastia profilática em determinados segmentos arteriais pode reduzir em até 10,4% as complicações isquêmicas. A angioplastia terapêutica tem melhores resultados quando realizada nas duas primeiras horas após a instalação do vasoespasmo sintomático. A papaverina induz melhora angiográfica em até 66% dos pacientes, mas pode estar relacionada à neurotoxicidade. A terapia endovascular parece ter resultados muito positivos para o tratamento do vasoespasmo cerebral. Pela falta de evidências, no entanto, deve ainda ser reservada para pacientes refratários ao tratamento clínico ou com complicações que o impeçam.
Ocorrência de adenomas pituitários correlacionados a idade e sexo em centros de referências para tratamento neurocirúrgico de patologia selar
Authors: Vieira da Cunha Marcelo Lemos , Vieira da Cunha Matheus Lemos , Amaral Veríssimo Denildo César , Rehder Roberta , Biurrum Borba Luis Alencar , Boguszewski Cesar Luiz
Published: January 2018

Objetivo: Avaliar a incidência dos adenomas pituitários (AP) em centros de referência no tratamento da patologia selar, em uma área geográfica bem delimitada, analisando-os de acordo com o sexo e a idade dos pacientes no momento do ato neurocirúrgico. Métodos: Realizado estudo retrospectivo dos pacientes submetidos a tratamento neurocirúrgico via transesfenoidal realizado pelo neurocirurgião sênior (LABB), com imunoistoquímica compatível com adenoma hipofisário. Resultados: Entre os 231 casos selecionados, os adenomas pituitários não funcionantes foram os mais comuns. Em relação às lesões ditas funcionantes, houve predomínio dos produtores do hormônio do crescimento (GH). A superioridade dos não funcionantes em números absolutos e do GH no subgrupo das lesões produtoras é válida tanto na análise geral dos dados quanto na estratificação da população estudada por sexo. Os pacientes foram agrupados, conforme a idade, em décadas de vida, com predomínio de doentes tratados cirurgicamente entre 30 e 40 anos. A relação masculino:feminino foi de 1:1,69. Conclusão: A escassez de dados não permite uma análise global mais fidedigna da distribuição dos adenomas pituitários com referência ao subgrupo, idade e sexo. Nossos dados são destoantes dos de outras publicações em alguns dos aspectos analisados, o que pode conotar diferenças epidemiológicas regionais dos AP.
Rizotomia dorsal seletiva (RDS) para espasticidade: técnica minimamente invasiva no cone medular
Authors: Kiss Andre , Pato Salles Tamara Rodrigues , Freitas de Morais Haydee Cristina , Junior Julio Aguiar , Kiss Rafael Morais
Published: January 2018

A rizotomia dorsal seletiva é um procedimento cirúrgico bem aceito no manejo da espasticidade e tem como objetivo o alívio desse sintoma em pacientes cuidadosamente selecionados. Neste estudo, apresentamos o método que utilizamos em nosso serviço para indicação de pacientes, bem como a técnica cirúrgica e o método de monitorização neurofisiológica intraoperatória utilizado para otimizar os resultados. Realizamos também uma revisão bibliográfica utilizando os sites de busca da PubMed/ MedLine e Lilacs, com artigos publicados entre os anos de 1965 e 2013. Os descritores utilizados foram: “rizotomia”, “espasticidade”, “paralisia cerebral” e “monitorização intraoperatória”. Foram selecionados 17 artigos para este estudo.
Protótipo para realização de cranioplastia de baixo custo
Authors: Alvim Jair Pimentel , de Carvalho Leandro Ururahy , de Oliveira Claudio Russio , Kossak Carlos , Maior Paolo Souto , Teles Gustavo , Clair Igor Saint
Published: January 2018

Objetivo: O presente trabalho propõe uma técnica para realização de cranioplastia com metilmetacrilato em formas pré-moldadas e esterilizadas visando evitar cranioplastia com prototipagem pré-moldada. Método: Conforme rotina apresentada, o flap ósseo realizado para craniotomia descompressiva é armazenado em recipientes com formol e enviado para o serviço de patologia do hospital. Quando realizamos a cranioplastia, utilizamos o flap ósseo armazenado para realização dos moldes que serão utilizados na cranioplastia. Resultado: O resultado estético é muito bom e os índices de complicação e infecção são baixos. Conclusão: Apresenta resultados estéticos semelhantes aos casos de prototipagem com baixo custo na confecção.
Cisto ósseo aneurismático do osso parietal: Relato de caso
Authors: Pereira Carlos Umberto , Carneiro Leão João Domingos Barbosa , Silva Santos Egmond Alves
Published: January 2018

O cisto ósseo aneurismático é uma tumoração óssea vascular benigna de crescimento rápido e destruição extensa do osso. Sua localização craniana ocorre entre 1% e 6% dos casos.

Os autores relatam um caso de cisto ósseo aneurismático na região parietal esquerda, em uma criança de 4 anos de idade, sem história de traumatismo craniano e doenças sistêmicas associadas. Foi submetida á ressecção total da lesão, com evolução excelente. Discutem sua etiopatogenia, diagnóstico, tratamento e prognóstico.
Cirsoid aneurysm of the scalp: case report
Authors: Romero Flávio Ramalho , Haddad Gabriela Roncada , Figueiredo Eberval Gadelha , Teixeira Manoel Jacobsen
Published: January 2018

We report a case of a 23-year-old man presented with a painful swelling over his right occipital region. Selective right carotid angiogram demonstrated a markedly tortuous and dilated right occipital artery feeding into a circular or cirsoid aneurysm in the right occipital scalp. Percutaneous occlusion of the cirsoid aneurysm was not attempted and the patient underwent a successful resection of the fistula with good outcome after three months followed up.
Ellenbogenfraktur im Alter – Erhalt oder Ersatz?
Authors: Plath Johannes , Förch Stefan , Haufe Thomas , Mayr Edgar
Published: January 2018

Distale Humerusfrakturen zeigen im geriatrischen Patientenkollektiv eine zunehmende Inzidenz. Aufgrund der häufig vorbestehenden osteoporotischen Knochenverhältnisse ist der Chirurg regelhaft mit komplexen intraartikulären mehrfragmentären Frakturen konfrontiert.

Der Erhalt der Selbstständigkeit und das Vermeiden von Pflegebedürftigkeit ist ein Dogma in der Versorgung geriatrischer Patienten. Gerade beim betagten Patienten ist folglich eine stabile postoperative Situation und eine frühfunktionelle Nachbehandlung anzustreben. Die offene anatomische Reposition und stabile Retention mittels Doppelplattenosteosynthese ist der osteosynthetische Versorgungsstandard. Moderne anatomische, winkelstabile Implantate sollen die stabile Retention erleichtern und die Operationsdauer verkürzen. Die wenigen zur Verfügung stehenden Daten mit modernen Plattensystemen zeigen beim geriatrischen Patienten zwar gute funktionelle Ergebnisse, jedoch auch hohe Komplikationsraten.

Wie an anderen großen Gelenken hat sich auch am Ellenbogen die Frakturendoprothetik aufgrund der direkten Primärstabilität als wertvolle therapeutische Alternative beim älteren Patienten etabliert. So zeigen die Register in den letzten Jahrzehnten eine Vervielfachung der Implantationszahlen.

Das Standardimplantat in der Frakturendoprothetik des geriatrischen Patienten ist die zementierte „semi-constrained“ Prothese. Als Nachteile einer primär endoprothetischen Versorgung werden die lebenslange Belastungsrestriktion sowie potenzielle prothesenassoziierte Langzeitkomplikationen wie aseptische Lockerung und periprothetische Frakturen genannt.

Vergleichende Studien mit kurz- und mittelfristigen Nachuntersuchungszeiträumen zeigen gegenüber der Osteosynthese vergleichbare funktionelle Ergebnisse, jedoch weniger Komplikationen und Revisionen sowie eine verkürzte Operationsdauer. Langzeitergebnisse, die potenzielle prothesenassoziierte Komplikationen suffizient erfassen, fehlen jedoch.

In der rekonstruierbaren und für eine frühfunktionelle Beübung stabil retinierbaren Fraktursituation des distalen Humerus bleibt die Osteosynthese folglich auch beim geriatrischen Patienten das Verfahren der ersten Wahl.
Magnetostructural transitions and magnetocaloric effects in Ni50Mn35In14.25B0.75 ribbons
Authors: Pandey Sudip , Quetz Abdiel , Ibarra-Gaytan P. J. , Sánchez-Valdés C. F. , Aryal Anil , Dubenko Igor , Sanchez Llamazares Jose Luis , Stadler Shane , Ali Naushad
Published: January 2018

The structural, thermal, and magnetic behaviors, as well as the martensitic phase transformation and related magnetocaloric response of Ni50Mn35In14.25B0.75 annealed ribbons have been investigated using room-temperature X-ray diffraction (XRD), differential scanning calorimetry (DSC), and magnetization measurements. Ni50Mn35In14.25B0.75 annealed ribbons show a sharper change in magnetization at the martensitic transition, resulting in larger magnetic entropy changes in comparison to bulk Ni50Mn35In14.25B0.75. A drastic shift in the martensitic transformation temperature (TM) of 70 K to higher temperature was observed for the annealed ribbons relative to that of the bulk (TM = 240 K). The results obtained for magnetic, thermal, structural, and magnetocaloric properties of annealed ribbons have been compared to those of the corresponding bulk alloys.
A novel vibration assisted polishing device based on the flexural mechanism driven by the piezoelectric actuators
Authors: Wang Guilian , Zhou Xiaoqin , Ma Peiqun , Wang Rongqi , Meng Guangwei , Yang Xu
Published: January 2018

The vibration assisted polishing has widely application fields because of higher machining frequency and better polishing quality, especially the polishing with the non-resonant mode that is regarded as a kind of promising polishing method. This paper reports a novel vibration assisted polishing device, consisting of the flexible hinge mechanism driven by the piezoelectric actuators, which is suitable for polishing planes or curve surfaces with slow curvature. Firstly, the generation methods of vibration trajectory are investigated for the same frequency and different frequency signals’ inputs, respectively, and then the types of elliptic and Lissajous’s vibration trajectories are generated respectively. Secondly, a flexural mechanism consisting of the right circular flexible hinges and the leaf springs is developed to produce two-dimensional vibration trajectory. Statics and dynamics investigating of this flexible mechanism are finished in detail. The analytical models about input and output compliances of the flexural mechanism are established according to the matrix-based compliance modeling, and the dynamic model of the flexural mechanism based on the Euler-Lagrange equation is also presented. The finite element model of the flexural mechanism was established to carry out the numerical simulation in order to testify the rationality of device design. Finally, the polishing experiment is carried out to prove the effectiveness of the vibration device. The experimental results show that this novel vibration assisted polishing device developed in this study can remove more effectively the cutting marks left by last process and obviously reduce the workpiece surface roughness.
Stochastic modeling for neural spiking events based on fractional superstatistical Poisson process
Authors: Konno Hidetoshi , Tamura Yoshiyasu
Published: January 2018

In neural spike counting experiments, it is known that there are two main features: (i) the counting number has a fractional power-law growth with time and (ii) the waiting time (i.e., the inter-spike-interval) distribution has a heavy tail. The method of superstatistical Poisson processes (SSPPs) is examined whether these main features are properly modeled. Although various mixed/compound Poisson processes are generated with selecting a suitable distribution of the birth-rate of spiking neurons, only the second feature (ii) can be modeled by the method of SSPPs. Namely, the first one (i) associated with the effect of long-memory cannot be modeled properly. Then, it is shown that the two main features can be modeled successfully by a class of fractional SSPP (FSSPP).
Effects of adipokinetic hormone and its related peptide on maintaining hemolymph carbohydrate and lipid levels in the two-spotted cricket, Gryllus bimaculatus
Authors: Zhou Yi Jun , Fukumura Keisuke , Nagata Shinji
Published: January 2018

Adipokinetic hormone (AKH) regulates energy homeostasis in insects by mobilizing lipid and carbohydrate from the fat body. Here, using RNA sequencing data, we identified cDNAs encoding AKH (GbAKH) and its highly homologous hormone AKH/corazonin-related peptide (GbACP) in the corpora cardiaca of the two-spotted cricket, Gryllus bimaculatus. RT-PCR revealed that GbAKH and GbACP are predominantly expressed in the corpora cardiaca and corpora allata, respectively. Phylogenetic analysis confirmed that the identified GbAKH and GbACP belong to the clades containing other AKHs and ACPs, respectively. Injection of synthetic GbAKH and GbACP elevated hemolymph carbohydrate and lipid levels and reduced food intake significantly. In contrast, knockdown of GbAKH and GbACP by RNA interference increased the food intake, although hemolymph lipid level was not altered. Collectively, this study provides evidence that ACP regulates hemolymph carbohydrate and lipid levels in cricket, possibly collaborative contribution with AKH to the maintenance of energy homeostasis.
Guidelines vs Actual Management of Skin and Soft Tissue Infections in the Emergency Department
Authors: Kamath Rahul S , Sudhakar Deepthi , Gardner Julianna G , Hemmige Vagish , Safar Hossam , Musher Daniel M
Published: January 2018

Background

Infections of skin and soft tissue (SSTI) commonly cause visits to hospital emergency departments (EDs). The Infectious Diseases Society of America (IDSA) has published guidelines for the management of SSTI, but it is unclear how closely these guidelines are followed in practice.

Methods

We reviewed records of patients seen in the ED at a large tertiary care hospital to determine guidelines adherence in 4 important areas: the decision to hospitalize, choice of antibiotics, incision and drainage (I&D) of abscesses, and submission of specimens for culture.

Results

The decision to hospitalize did not comply with guidelines in 19.6% of cases. Nonrecommended antibiotics were begun in the ED in 71% of patients with nonpurulent infections and 68.4% of patients with purulent infections. Abscesses of mild severity were almost always treated with antibiotics, and I&D was often not done (both against recommendations). Blood cultures were done (against recommendations) in 29% of patients with mild-severity cellulitis. Abscess drainage was almost always sent for culture (recommendations neither favor nor oppose). Overall, treatment fully complied with guidelines in 20.1% of cases.

Conclusions

Our results show a striking lack of concordance with IDSA guidelines in the ED management of SSTI. Social factors may account for discordant decisions regarding site of care. Use of trimethoprim/sulfamethoxazole (TMP/SMX) in cellulitis was the most common source of discordance; this practice is supported by some medical literature. Excess antibiotics were often used in cellulitis and after I&D of simple abscesses, opposing antibiotic stewardship. Ongoing education of ED doctors and continued review of published guidelines are needed.
U.S. Nuclear Strategy
Authors: Nichols Thomas M.
Published: January 2018

Because of their awesome destructive capability, nuclear weapons require national security policymakers to carefully evaluate how they fit within a country’s national security posture. No consensus exists as to whether the use of such weapons is in fact an option for decision makers to consider or whether the goal is to ensure that they can never be used. The different strategies that have been developed since 1945 for U.S. nuclear strategy—massive retaliation, flexible response, a fatalistic acceptance of the logic of mutually assured destruction, and the search for the most effective ways of stemming nuclear proliferation in unstable or unpredictable actors—all reflect attempts to provide guidance for policymakers as to the strategic purpose of these weapons.
International Rivalry and National Security
Authors: DiCicco Jonathan M. , Valeriano Brandon
Published: January 2018

International rivalries are discussed with an emphasis on their relevance to U.S. national security. Social-scientific research on these protracted, antagonistic, and often violent relationships serves as a wellspring of insight into national security challenges. A primary focus on rivalries between sovereign states is supplemented with discussion of rivalries involving nonstate actors, including armed groups associated with insurgency and terrorism. To anchor these discussions, the chapter briefly denotes definitional, conceptual, and operational aspects of rivalry research. Rivalries are linked to U.S. national security concerns through first-, second-, and third-order effects. The challenge of overcoming histories of hostility to achieve peaceful resolution of rivalries is examined. Future directions in rivalry research, including the imperative to incorporate contemporary policy concerns (such as cybersecurity and emerging technologies and techniques associated with international conflict), are discussed in a forward-looking manner that emphasizes the complementarity of scholarship and policy arenas.
The Political Economy of Security
Authors: Ripsman Norrin M. , Zielinski Rosella Cappella , Schilde Kaija E.
Published: January 2018

National security has typically been studied as analytically separate and distinct from political economy. This chapter explores the economic underpinnings of national security and, in particular, the key economic dimensions of contemporary U.S. security policy dilemmas. It offers an overview of the problems associated with security policy in an era of austerity, the economic dimensions of power transition from unipolarity to multipolarity, and the security consequences of U.S. and global populist discontent. We then move beyond the traditional relationship between economics and security to discuss several important contemporary political economy dilemmas that face the U.S. security establishment. Finally, it discusses the economic dimensions of counterterrorism, counterproliferation strategies, and war mobilization.
Tornadoes and Their Parent Convective Storms
Authors: Bluestein Howard B.
Published: January 2018

In the past four decades much has been discovered about tornado formation and structure from observations, laboratory models, and numerical-simulation experiments. Observations include nearby movies and photographs of tornadoes, fixed-site, airborne, and ground-based mobile Doppler radar remote measurements, and in situ measurements using instrumented probes. Laboratory models are vortex chambers and numerical-simulations are based on the governing fluid dynamical equations. However, questions remain: How and why do tornadoes form? and How does the wind field associated with them vary in space and time? Recent studies of tornadoes based on observations, particularly by radar, are detailed. The major aspects of numerically simulating a tornado and its formation are reviewed, and the dynamics of tornado formation and structure based on both observations and laboratory and numerical-simulation experiments are described. Finally, future avenues of research and suggested instrument development for furthering our knowledge are discussed.
Coastal Hazards, Risks, and Marine Extreme Events
Authors: Marone Eduardo , de Camargo Ricardo , Salcedo Castro Julio
Published: January 2018

This article describes the threat costal hazards pose to existing life in light of climate change and natural disaster. It includes an overview of flooding, extreme waves, and other water-related stressors. The article discusses how human-induced risks in the coastal zone, resulting from mismanaged urbanization, persistent pollution, and overexploitation of resources, exacerbate matters and pose extra pressure on the environment, science, and society. Ways of measurement and reaction to these events, as well as best practices for preparedness, are discussed. Businesses, individuals, and ecosystems are under threat of destruction from these circumstances. The article also emphasizes the need to make scientific work in this field accessible and understandable to society and decisión makers.
Multi-Issue Food Activism
Authors: Sebo Jeff
Published: January 2018

Food activism sits at the intersection of many different social movements. For example, one might engage in food activism because one wants to combat racism, sexism, classism, speciesism, and more. The pluralistic nature of food activism has risks and benefits. For instance, it can lead to conflict across movements, but it can also lead to the building of alliances across movements. This chapter examines the debate between multi-issue food activism, which spans multiple movements and addresses multiple issues, and single-issue food activism, which does not. It begins by reviewing the kinds of connections across issues that are relevant here. It then presents and evaluates two arguments for multi-issue food activism—one principled and one pragmatic—and three approaches to multi-issue food activism—unity, solidarity, and mutual understanding. Finally, the chapter closes with a few preliminary conclusions about how food activism can be done in a thoughtful and strategic way.
Afrina sporoboliae sp. n. (Nematoda: Anguinidae) Associated with Sporobolus cryptandrus from Idaho, United States: Phylogenetic Relationships and Population Structure
Authors: Barrantes-Infante Bianca L. , Schroeder Brenda K. , Subbotin Sergei A. , Murray Timothy D.
Published: January 2018

The dropseed gall-forming nematode, Afrina sporoboliae sp. n., is described from seed galls of Sporobolus cryptandrus (Poaceae: Chloridoideae: Sporobolinae) collected in Idaho, USA. This is the third report of an Afrina species in North America and the first report of this genus in a natural plant population on this continent. Morphological, morphometric, and molecular analyses placed this nematode in genus Afrina and demonstrated that it differs from Afrina hyparrheniae and Afrina spermophaga by having longer body and stylet lengths for females and males, and from Afrina wevelli by the absence of tip irregularities on the tails of female and presence of lips noticeably protruding beyond the body contour. The new species has several characters that overlap with Afrina tumefaciens, but differs from this species by inducing seed galls, whereas Afrina tumefaciens induces ovoid galls on stems, leaves, and in flower heads. Evolutionary relationships of Afrina sporoboliae sp. n. with other representatives of the family Anguinidae are presented based on analysis of the internal transcribed spacer (ITS)1-5.8S-ITS2 rRNA and the D2-D3 regions of the rRNA genes. Analysis of 270 sequences of the cox1 gene from 25 populations of Afrina sporoboliae sp. n. revealed seven haplotypes with sequence divergence up to 5%. This study did not demonstrate a significant positive relationship between genetic difference and geographic distance. Seed gall nematodes are important quarantine pests in many countries. The association of this and other seed gall nematodes with Rathayibacter species and their ability to serve as vectors, especially of R. toxicus, is of concern for U.S. agriculture.
Hyperbaric Oxygen for Ischemia due to Injection of Cosmetic Fillers: Case Report and Issues
Authors: Henderson Raven , Reilly Debra A. , Cooper Jeffrey S.
Published: January 2018

Natural and synthetic fillers have revolutionized aesthetic facial rejuvenation and soft-tissue augmentation. We present a case highlighting the dangers of filler self-injection. A 37-year-old woman self-injected a dermal filler around both temples. She immediately experienced left--side hearing loss, blanching over the left face, and pain. Prompt treatment with hyaluronidase, topical nitro paste, and warm compresses ensued. An emergency computed tomography angiogram showed occlusion of a superficial temporal artery branch. We treated her with enoxaparin, aspirin, dexamethasone, piperacillin-tazobactam, and intradermal lidocaine. After 6 hyperbaric oxygen therapy (HBO2) treatments in 3 days, the patient showed improvement in appearance with markedly decreased ischemic discoloration and her hearing returned to baseline. Algorithms for treating such injuries generally neglect HBO2. HBO2 is thought to be efficacious in these situations by a variety of mechanisms: oxygenation of ischemic tissues, reduction of edema, amelioration of ischemic/reperfusion injury, promotion of angiogenesis and collagen maturation. Her resolved hearing highlights the utility of HBO2 in sudden hearing loss as well. Injectors should have guidelines for using product, not only on patients but staff as well. Filler courses should include handling complications and include HBO2 in their guidelines. Clinicians should remind patients to seek treatment from qualified clinicians. The goal of a bargain price using self-injection may quickly become expensive and disfiguring.
Effects of the Humanized Anti-Adrenomedullin Antibody Adrecizumab (HAM8101) on Vascular Barrier Function and Survival in Rodent Models of Systemic Inflammation and Sepsis
Authors: Geven Christopher , Peters Esther , Schroedter Mathias , Struck Joachim , Bergmann Andreas , McCook Oscar , Radermacher Peter , Kox Matthijs , Pickkers Peter
Published: January 2018

Purpose:

Adrenomedullin (ADM) is an important regulator of endothelial barrier function during sepsis. Administration of a murine antibody targeted against the N-terminus of ADM (HAM1101) resulted in improved outcome in models of murine sepsis. We studied the effects of a humanized form of this antibody (HAM8101, also known as Adrecizumab) on vascular barrier dysfunction and survival in rodent models of systemic inflammation and sepsis.

Methods:

Rats (n=48) received different dosages of HAM8101 or placebo (n = 8 per group), directly followed by administration of lipopolysaccharide (5 mg/kg). Twenty-four hours later, Evans Blue dye was administered to assess vascular leakage in kidney and liver tissue. Furthermore, mice (n = 24) were administered different dosages of HAM8101 or placebo (n = 6 per group), immediately followed by cecal ligation and puncture (CLP). Eighteen hours later, albumin, vascular endothelial growth factor (VEGF), and angiopoietin-1 were analyzed in the kidney. Finally, effects of single and repeated dose administration of HAM1101, HAM8101 and placebo on survival were assessed in CLP-induced murine sepsis (n = 60, n = 10 per group).

Results:

Dosages of 0.1 and 2.5 mg/kg HAM8101 attenuated renal albumin leakage in endotoxemic rats. Dosages of 0.1, 2.0, and 20 mg/kg HAM8101 reduced renal concentrations of albumin and the detrimental protein VEGF in septic mice, whereas concentrations of the protective protein angiopoietin-1 were augmented. Both single and repeated administration of both HAM1101 and HAM8101 resulted in improved survival during murine sepsis.

Conclusions:

Pretreatment with the humanized anti-ADM antibody HAM8101 improved vascular barrier function and survival in rodent models of systemic inflammation and sepsis.
Data-driven approaches for Tau-PET imaging biomarkers in Alzheimer’s disease
Authors: Vogel Jacob W. , Mattsson Niklas , Iturria-Medina Yasser , Strandberg T. Olof , Schöll Michael , Dansereau Christian , Villeneuve Sylvia , van der Flier Wiesje M. , Scheltens Philip , Bellec Pierre , Evans Alan C. , Hansson Oskar , Ossenkoppele Rik ,   the Alzheimer’s Disease Neuroimaging Initiative,   the Swedish BioFINDER study
Published: January 2018

Previous positron emission tomography (PET) studies have quantified filamentous tau pathology using regions-of-interest (ROIs) based on observations of the topographical distribution of neurofibrillary tangles in post-mortem tissue. However, such approaches may not take full advantage of information contained in neuroimaging data. The present study employs an unsupervised data-driven method to identify spatial patterns of tau-PET distribution, and to compare these patterns to previously published “pathology-driven” ROIs. Tau-PET patterns were identified from a discovery sample comprised of 123 normal controls and patients with mild cognitive impairment or Alzheimer’s disease (AD) dementia from the Swedish BioFINDER cohort, who underwent [18F]AV1451 PET scanning. Associations with cognition were tested in a separate sample of 90 individuals from ADNI. BioFINDER [18F]AV1451 images were entered into a robust voxelwise stable clustering algorithm, which resulted in five clusters. Mean [18F]AV1451 uptake in the data-driven clusters, and in 35 previously published pathology-driven ROIs, was extracted from ADNI [18F]AV1451 scans. We performed linear models comparing [18F]AV1451 signal across all 40 ROIs to several tests of global cognition, adjusting for age, sex and education. Two data-driven ROIs consistently demonstrated the strongest or near-strongest effect sizes across all cognitive tests. Inputting all regions plus demographics into a feature selection routine resulted in selection of two ROIs (one data-driven, one pathology-driven) and education, which together explained 28% of the variance of a global cognitive composite score. Our findings suggest that [18F]AV1451-PET data naturally clusters into spatial patterns that are biologically meaningful and that may offer advantages as clinical tools.
Vascular risk factors for male and female urgency urinary incontinence at age 68 from a British birth cohort study
Authors: Tsui Alex , Kuh Diana , Cardozo Linda , Davis Daniel
Published: January 2018

Objective

To investigate the prevalence of UUI at age 68 and the contribution of vascular risk factors to male and female UUI pathogenesis in addition to the associations with raised BMI

Subjects and methods

1762 participants were from the MRC National Survey for Health and Development (NSHD) birth cohort, who answered the International Consultation on Incontinence Questionnaire short form (ICIQ-SF) at age 68. Logistic regression was used to estimate associations between UUI and earlier life vascular risk factors including: lipid status, diabetes, hypertension, body mass index (BMI), previous stroke or transient ischaemic attack (TIA) diagnosis; adjusting for smoking status, physical activity, co-presentation of SUI symptoms, educational attainment and in women only, type of menopause, age at period cessation and use of hormone replacement therapy.

Results

UUI was reported by 12% of men and 19% of women at 68. Female sex, previous stroke or TIA diagnosis, increased BMI and hypertension (in men only) at age 60-64 were independent risk factors for UUI. Female sex, increased BMI and a previous diagnosis of stroke/ TIA increased the relative risk of more severe UUI symptoms. Type and timing of menopause and HRT use did not alter the estimated associations between UUI and vascular risk factors in women.

Conclusion

Multifactorial mechanisms lead to UUI and vascular risk factors may contribute to pathogenesis of bladder overactivity in addition to higher BMI. Severe UUI appears to be a distinct presentation with more specific contributory mechanisms than milder UUI.
Factor Structure and Heritability of Obsessive-Compulsive Traits in Children and Adolescents in the General Population
Authors: Burton C.L. , Park L. S. , Corfield E. C. , Forget-Dubois N. , Dupuis A. , Sinopoli V. M. , Shan J. , Goodale T. , Shaheen S-M , Crosbie J. , Schachar R.J. , Arnold P.D
Published: January 2018

Background

Obsessive-compulsive disorder (OCD) is a heritable childhood-onset psychiatric disorder that may represent the extreme of obsessive-compulsive (OC) traits that are widespread in the general population. We studied the factor structure and heritability of the Toronto Obsessive Compulsive Scale (TOCS), a new measure designed to assess traits associated with OCD in children and adolescents. We also examined the degree to which genetic effects are unique and shared between dimensions.

Methods

OC traits were measured using the TOCS in 16,718 children and adolescents (6 to 18 years) at a local science museum. Factor analysis was conducted to identify OC trait dimensions. Univariate and multivariate twin modeling was performed to estimate the heritability of OC trait dimensions in a subset of twins (220 pairs).

Results

Six OC dimensions were identified: Cleaning/Contamination, Hoarding, Rumination, Superstition, Counting/Checking, and Symmetry/Ordering. The TOCS total score (74%) and OC trait dimensions were heritable (30-77%). Hoarding was phenotypically distinct but shared genetic effects with other OC dimensions. Most of the genetic effects were shared between dimensions while unique environment accounted for the majority of dimension-specific variance, except for hoarding which had considerable unique genetic factors. A latent trait did not account for the shared variance between dimensions.

Conclusions

OC traits and individual OC dimensions were heritable, although the degree of shared and dimension-specific etiological factors varied by dimension. The TOCS is useful for genetic research of OC traits and OC dimensions should be examined individually and together along with total trait scores to characterize OC genetic architecture.