bluuebunny/crossref_metadata_2025 huggingface dataset:
A HIDROTERAPIA NAS ALTERAÇÕES FÍSICAS E COGNITIVAS DE CRIANÇAS AUTISTAS: UMA REVISÃO SISTEMÁTICA
Authors: Borges Ana Paula , Martins Vanessa Nazare Silva , Tavares Victoria Brioso
Published: February 2017

Introdução: Através dos efeitos fisiológicos dos princípios físicos da água e do exercício físico a hidroterapia é uma terapia aplicável aos distúrbios motores e cognitivos, trazendo ainda componente lúdico e estimulante, tornando-se viável no processo de reabilitação das crianças autistas. Objetivo: Identificar os benefícios descritos da hidroterapia nos aspectos físicos e cognitivos em crianças com autismo através de revisão sistemática. Métodos: No período de outubro a dezembro de 2015, realizou-se uma revisão bibliográfica nas publicações indexadas nas bases de dados SCIELO, Pubmed e LILACS, priorizando publicações no período de 2005 a 2015. Resultados: Foram encontrados um total de 26 artigos relacionados aos dois distúrbios na pesquisa inicial. A partir dos critérios de inclusão e exclusão foram analisados 4 ensaios clínicos. Conclusão: A hidroterapia é de grande valia para pacientes autistas devido ao melhoramento na flexibilidade, força muscular, funcionalidade, relação social e relação com a água. A combinação destes benefícios se reflete na qualidade de vida destes pacientes.
AMBIENTE E QUALIDADE DE VIDA – PERCEPÇÕES DE PARTICIPANTES DO CENTRO DE TRADIÇÕES GAÚCHAS (CTG) NOVA QUERÊNCIA DE BOA VISTA-RORAIMA
Authors: Matsdorff Silvana Aparecida Mendes , Rempel Claudete , Laroque Luís Fernando da Silva
Published: February 2017

Qualidade de vida é um conceito pessoal e subjetivo. Diz respeito a como a pessoa percebe o mundo e a si própria, tem relação com o bem-estar físico, psicológico e social e também com sua cultura, seus valores, condição econômica, expectativas de vida, relação com o ambiente e políticas públicas. O estudo objetivou identificar as percepções de participantes de uma rede social denominada Centro de Tradições Gaúchas (CTG) Nova Querência de Boa Vista-RR sobre qualidade de vida e a influência deste ambiente nesse contexto. A pesquisa foi qualitativa, utilizando entrevistas como instrumento de coleta de dados. O estudo foi realizado com administradores, instrutores e participantes das diversas atividades físicas e culturais oferecidas no CTG que participam no mínimo três vezes por mês do Centro. A coleta de dados ocorreu em novembro de 2012 e as entrevistas foram analisadas, utilizando-se a técnica de análise de conteúdo. Constatou-se que o conceito de qualidade de vida é multidimensional e que os participantes da pesquisa consideram que o CTG tem influência positiva em sua qualidade de vida, especialmente no aspecto social que repercute positivamente em seu bem-estar geral.
MINERAÇÃO DE DADOS PARA DESCOBERTA DE CONHECIMENTO EM DADOS DE PROMOÇÃO À SAÚDE
Authors: Gregory Guilherme , Pretto Fabrício
Published: February 2017

Atualmente, as corporações se deparam com um problema que são os grandes volumes de informações em seus bancos de dados. Muitas vezes, essas corporações não possuem ferramentas adequadas para extrair essas informações e transformá-las em conhecimento. Sendo assim, esse estudo tem como objetivo auxiliar uma empresa de promoção à saúde na tomada de decisões em relação aos seus clientes. Para que isso fosse possível utilizou-se as técnicas de Data Mining, que por sua vez aborda a sua aplicabilidade, quais áreas de atuação mais comuns da mineração e qual a real importância dessa mineração para a tomada das decisões. Dentre os métodos permitidos de Data Mining, foram utilizados os métodos por regras de associação e clusterização. As informações necessárias para a mineração dos dados foram extraídas do software de gestão de clientes da empresa analisada. Os principais campos que foram analisados e relacionados são, região de atendimento do paciente, gênero, nível de glicose, pressão arterial, tabagismo, consumidores de bebidas alcoólicas, pessoas que praticam atividades físicas, se a alimentação dos mesmos são saudáveis ou não, se participam de programas de acompanhamento na qualidade de vida ou não. Com base no referencial teórico e aplicando as técnicas de Data Mining, foi possível descobrir as relações e correlações da saúde das pessoas dos Vales do Taquari e Rio Pardo.
A AÇÃO ENZIMÁTICA COMO FOCO DO SURGIMENTO DO ALTO ÍNDICE DE CASEINOMACROPEPTÍDEO NO LEITE UHT
Authors: Cavalheiro Robson Wegner , Abrahão Francisco , Bockel Wolmir Jose
Published: February 2017

A busca incondicional pela qualidade alimentícia tem projetado vários estudos ligados à qualidade e controle de fraudes no leite. O trabalho proposto buscou avaliar a ação das enzimas proteases, produzidas por microrganismos psicrotróficos, no alto índice de caseinomacropeptídeo (CMP) no leite UHT ao longo do tempo de estocagem e também comparando com amostras fraudadas propositalmente com soro de queijo. Foram analisadas amostras de um lote de leite UHT, sua respectiva matéria-prima, e após o processo de pasteurização e padronização, e o produto pronto ao longo de seu shelf life. Neste estudo foi utilizado a Cromatografia Líquida de Alta Eficiência (CLAE) para a determinação do CMP, este é um método internacionalmente reconhecido e oficializado no Brasil pela Instrução Normativa IN nº 68 de 2006 do Ministério da Agricultura, Pecuária e Abastecimento (MAPA). A análise do índice de CMP é avaliada pela porção da molécula de proteína k-caseína solúvel no soro, como indicador da ocorrência da fraude da adição de soro de queijo. No entanto, a ação de proteases pode interferir neste teste levando a resultados falso-positivos, situação que passou a ter maior importância desde a implementação da IN nº 51 de 2002 e, posteriormente, da IN nº 62 de 2011 que exige que o leite deve ser refrigerado.
La capacitación como forma de prevención del bullying
Authors: Villalobos Torres Gabriela
Published: February 2017

El bullying es una problemática social que afecta al alumnado de las diferentes instancias educativas: públicas o privadas, de primaria o secundaria, diurna o nocturna. La reiteración de las acciones y la premeditación de los hechos son elementos clave, a los cuales debe estar atento el personal docente y administrativo para determinar si algún estudiante está siendo víctima de este tipo de violencia. Sin embargo, la prevención es la mejor arma para combatir el bullying, ya que con ella se evitan dolorosas situaciones, tanto para las posibles víctimas como para quien es testigo de estos hechos. El grupo docente no actúa con la pericia debida en algunas situaciones, pues carece de conocimientos que lo faculten para un adecuado abordaje del bullying, ya sea en los niveles de prevención y atención o de seguimiento. De ahí que los procesos de capacitación se convierten en elementos necesarios para subsanar esas debilidades, sobre todo en la sociedad de la tecnología y la información donde los avances en aplicaciones, celulares, móviles, portátiles, juegos por computadoras y otros, se mueven más rápido cada vez.
Aspectos relevantes para la transversalización de la perspectiva de género en el proceso de desarrollo curricular universitario
Authors: Chaves Jiménez Rocío
Published: February 2017

La transversalidad de género representa la acción de integrar la perspectiva de género en las ideas, prácticas y políticas institucionales, orientándolas hacia el propósito específico de lograr la igualdad entre mujeres y hombres, teniendo en cuenta, en todo momento, la necesidad de identificar los posibles impactos diferenciados sobre unas y otros. Estos impactos pueden conducir a cambiar los roles tradicionales, así como a eliminar las desigualdades de género, o bien, al reforzamiento o perpetuación de aquellas estructuras patriarcales que producen brechas entre mujeres y hombres. Las universidades tienen la responsabilidad de contrarrestar estos efectos de la cultura patriarcal y de evitar cualquier forma de exclusión que se produzca a partir de conclusiones basadas en los estereotipos de género, ya que los currículos que rigen nuestro sistema educativo son de carácter androcéntrico, el cual sitúa a las mujeres en una posición de subordinación y desventaja. Por ende, el trabajo de incorporar la visión de género radicará al menos en considerar los contenidos temáticos de los cursos, los diferentes medios didácticos, el uso de lenguaje inclusivo y no sexista, los diversos procesos de aprendizaje y la política y gestión institucional, con la intención de promover la capacidad crítica y una cultura de igualdad de género, que se origine desde la cotidianidad de la vida universitaria, transformando los sistemas discriminatorios en espacios de igualdad. En fin, la transversalidad de género sería tanto una estrategia metodológica como una estrategia política.
Martín Heidegger: crítica al concepto hegeliano de experiencia (segunda parte)
Authors: García Aguilar Rodolfo
Published: February 2017

El presente trabajo tiene como objetivo retomar la temática expuesta por Martín Heidegger, en su artículo “El concepto hegeliano de experiencia”, para rescatar sus reflexiones en el campo de la ontología. Se busca abrir nuevamente la discusión en un mundo metafísico donde se consolida lo que el autor llama “la imagen del mundo”, y donde se considera esta, erróneamente, como la única forma de enfrentarse y apoderarse de la realidad.
Avaliação de equipamentos de proteção individual: um estudo sobre os coletores de lixo domiciliar
Authors: Medeiros Ivan Luiz de , Facione Giovana Lorena , Merino Eugenio Andrés Díaz , Braviano Gilson
Published: February 2017

Este artigo analisa o trabalho do profissional responsável pela coleta de resíduo sólido acondicionado e descartado pela população residencial das cidades. Essa atividade é realizada por meio de um esforço físico considerável do indivíduo. Além do esforço físico, existem situações de intempéries, mau acondicionamento dos produtos no lixo causando diversos cortes e perfurações nos trabalhadores. Este trabalho procura demonstrar as abordagens e ferramentas da Ergonomia na investigação da atividade laboral do coletor de lixo. Para isso, parte-se de uma breve revisão bibliográfica discutindo a importância desta atividade e os seus riscos diários: físicos, biológicos e ambientais. Também a partir da aplicação de ferramentas ergonômicas investigativas constataram-se aspectos relevantes a essa situação de trabalho. O resultado da pesquisa apresenta recomendações que identificam que os atuais equipamentos de proteção individual, devem ter um desenvolvimento projetual mais assertivos quando investigada a atividade e o usuário no contexto de uso, levando em consideração a opinião do usuário e a percepção do projetista em relação ao produto investigado.
Avaliação sensorial de produtos de moda ambientalmente amigáveis: uma metodologia para análise pré-consumo
Authors: Mesacasa Andréia , Alves da Cunha Mário Antônio
Published: February 2017

Esta pesquisa apresenta a aplicação da metodologia de Avaliação Sensorial voltada a produtos de moda desenvolvidos a partir da reutilização de resíduos têxteis, como proposta para mensuração da aceitação do produto. A metodologia de avaliação de atributos sensoriais de qualidade é comumente empregada pelas indústrias alimentícias e de bebidas, mas não há relatos do emprego da mesma na indústria da moda. A aplicação de tal metodologia proporcionou a mensuração da percepção quanto a atributos sensoriais que podem influenciar na escolha e aquisição de produtos de moda, possibilitando uma análise global de parâmetros diretamente associados à intenção de compra. Os resultados da pesquisa também demonstraram que os consumidores estão dispostos a adquirir produtos produzidos a partir de resíduos da indústria de confecção.
A Novel Technique for the Quantitative Examination of Nasal Tip Support
Authors: Atighechi Saeid , Sajadinejad Batool Sadat , Farhadi Mohammad , Ahmadpour-Baghdadabad Mohammadali
Published: February 2017

Objective

We proposed a novel technique for the quantitative examination of tip recoil. The technique measures nasal tip strain as an objective measure of tip recoil. We used the term tip recoilometry to refer to this measurement technique.

Design

We performed case studies in two phases. Phase 1 included 30 candidates with normal tip recoil and 30 candidates with weak tip recoil. Phase 2 included 40 patients who had undergone open rhinoplasty surgery by either columella strut or caudal extension graft methods. We evaluated tip support of patients 1 year after the surgery.

Results

The nasal tip strain of normal target group before any surgery was 0.158 and that of the patients with nasal tip ptosis was 35% more than that of the normal target group. The methods columella strut and caudal extension graft achieved 43% and 74% nasal tip strain reduction, respectively.

Conclusion

The proposed technique can help a surgeon to select a proper plan and to evaluate the success of the surgery.
Endoscopic Surgery of a Sinonasal Inverted Papilloma: Surgical Strategy, Follow-up, and Recurrence Rate
Authors: Jiang Xiao-Dan , Dong Qing-Zhe , Li Shen-Ling , Huang Tian-Qiao , Zhang Nian-Kai
Published: February 2017

Background

Sinonasal inverted papilloma (SNIP) is noted for its high rate of recurrence and malignant transformation. Although many clinical studies have demonstrated the effectiveness of the endoscopic approach for SNIP, the surgical strategy has been the subject of much debate.

Objective

To evaluate the effectiveness of the endoscopic endonasal approach in SNIP.

Methods

A systematic review of patients with a diagnosis of SNIP and who had surgery at our institution from June 2005 to March 2013 was performed. All the patients who had postoperative follow-up for >2 years were enrolled. Each case was categorized into one of four stages as reported by Krouse. Demographic and tumor date, operative approach, complications, and recurrence rates were collected.

Results

A total of 125 patients were included in this study. There were 17 patients in stage 1, 40 in stage 2, 57 in stage 3, and 11 in stage 4. The overall recurrence rate was 8.0%. There was no significant difference in recurrence among the stages (all p > 0.05). Recurrence after endoscopic endonasal approach (8.4%) and a combined endoscopic and open exposure procedure (5.6%) were not significantly different (p > 0.05). The recurrence rate was significantly (p < 0.05) higher in patients with revision (15.6%) than in patients in the primary cases (3.8%). A common site of tumor origin was recorded to be from the maxillary sinus (40.2%). Twenty percent of recurrences were observed up to 5 years after surgery.

Conclusion

Endoscopic surgery may be preferred for treating SNIP. The elevated recurrence rate after revision emphasized the significance of the first surgery. We encourage a follow-up period of at least 5 years.
Involvement of the Maxillary Sinus in Bisphosphonate-Related Osteonecrosis of the Jaw: Radiologic Aspects
Authors: Wasserzug Oshri , Kaffe Israel , Lazarovici Towy Sorel , Weissman Tal , Yahalom Ran , Fliss Dan M. , Yarom Noam
Published: February 2017

Background

The use of bisphosphonates is very common among patients with osteoporosis and multiple myeloma as well as those with bone metastases from various malignancies. The benefits of bisphosphonates are well recognized, but it became evident during the past decade that these medications portend the major adverse effect of osteonecrosis of the jaw, known as bisphosphonate-related osteonecrosis of the jaw.

Objective

Our aim was to evaluate the specific manifestations of bisphosphonate use on the maxillary sinus in patients with documented bisphosphonate-related osteonecrosis of the jaw.

Methods

A retrospective review of all the patients diagnosed between October 2003 to August 2014 as having bisphosphonate-related osteonecrosis of the jaw in a large university-affiliated tertiary care medical center. The records of 173 patients diagnosed as having bisphosphonate-related osteonecrosis of the jaw during the study period were retrieved. The available head and neck computed tomographic images were analyzed for cases of involvement of the maxilla.

Main Outcome Measures

Manifestations of bisphosphonate-related osteonecrosis of the jaw as observed on physical examination and on imaging studies.

Results

Seventy-one patients (41%) had involvement of the maxilla, 86 patients (49%) had involvement of the mandible, and 16 patients (9%) had involvement of both the maxilla and the mandible. Computerized tomography studies were available for 50 patients with involvement of the maxilla: 36 (72%) had evidence of maxillary sinus opacification (in comparison, the incidence of maxillary sinus opacification as an incidental finding in the general population is reported to be 19%, p < 0.0001). Sixteen patients (32%) had evidence of oroantral fistula, and five patients (10%) had oronasal fistula.

Conclusion

In addition to its well-established effects on the mandible and maxilla, bisphosphonate-related osteonecrosis of the jaw significantly affected the maxillary sinus. Its radiologic manifestations should be recognized by clinicians and especially by otolaryngologists.
Anosmia: Differential Diagnosis, Evaluation, and Management
Authors: Scangas George A. , Bleier Benjamin S.
Published: February 2017

The ability to scrutinize our surroundings remains heavily dependent on the sense of smell. From the ability to detect dangerous situations such as fires to the recollection of a fond memory triggered by an odor, the advantages of an intact olfactory system cannot be overstated. Outcomes studies have highlighted the profound negative impact of anosmia and parosmia on the overall quality of life. The National Institute on Deafness and Other Communication Disorders estimates that ∼1.4% of the United States population experiences chronic olfactory dysfunction and smell loss. Efforts have focused on improving both the diagnosis of olfactory dysfunction through olfactory testing and improved reporting of treatment outcomes of olfactory training. The purpose of this article was to review the differential diagnosis, workup, and current treatment strategies of anosmia and smell disorders.
Peripheral Blood T-Helper Cells and Eosinophil Populations in Patients with Atopic and Nonatopic Chronic Rhinosinusitis
Authors: Huang Zhenxiao , Nayak Jayakar V. , Sun Yan , Huang Qian , Zhou Bing
Published: February 2017

Background

Analysis of recent research indicated that T-helper cells may play an important role in the pathogenesis of chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP).

Objective

The purpose of this study was to investigate the peripheral blood Th1 and Th2 cells and eosinophil population in patients with CRS.

Methods

Peripheral blood samples were obtained from nine nonatopic controls, 37 patients with CRSsNP, and 66 patients with CRSwNP. The samples were then analyzed by flow cytometry analysis (Th1 cell [CD4+, interleukin 4−, interferon γ+]; and Th2 cell [CD4+, interleukin 4+, interferon γ−]). The patients were stratified into four groups based on their allergic status by using skin-prick test results and immunoglobulin E level measurements as the following: (1) nonatopic CRSsNP, (2) nonatopic CRSwNP, (3) atopic CRSsNP, and (4) atopic CRSwNP. Eosinophil counts were also compared. The severity of nasal diseases in these patients was assessed via the Lund-Mackay score.

Results

No significant differences in peripheral blood Th1 and Th2 cells were found among all the atopic, nonatopic CRS groups, and the nonatopic control groups. Peripheral blood eosinophil levels in atopic CRSwNP were significantly elevated compared with the nonatopic controls (p < 0.05), but no significant difference was found among all atopic and nonatopic CRS groups.

Conclusion

Analysis of our data demonstrated that a proportion of systemic Th1- and Th2-skewed lymphocytes in all CRS groups were similar to that in healthy subjects, irrespective of atopic status. The patients with CRSwNP and with atopy but not the patients with CRSsNP and with atopy demonstrated systemic eosinophilic inflammation. Further studies are needed to investigate underlying pathophysiologic mechanism or endotypes.
Filling in the gaps: estimating numbers of chlamydia tests and diagnoses by age group and sex before and during the implementation of the English National Screening Programme, 2000 to 2012
Authors: Chandra Nastassya L , Soldan Kate , Dangerfield Ciara , Sile Bersabeh , Duffell Stephen , Talebi Alireza , Choi Yoon H , Hughes Gwenda , Woodhall Sarah C
Published: February 2017

To inform mathematical modelling of the impact of chlamydia screening in England since 2000, a complete picture of chlamydia testing is needed. Monitoring and surveillance systems evolved between 2000 and 2012. Since 2012, data on publicly funded chlamydia tests and diagnoses have been collected nationally. However, gaps exist for earlier years. We collated available data on chlamydia testing and diagnosis rates among 15–44-year-olds by sex and age group for 2000–2012. Where data were unavailable, we applied data- and evidence-based assumptions to construct plausible minimum and maximum estimates and set bounds on uncertainty. There was a large range between estimates in years when datasets were less comprehensive (2000–2008); smaller ranges were seen hereafter. In 15–19-year-old women in 2000, the estimated diagnosis rate ranged between 891 and 2,489 diagnoses per 100,000 persons. Testing and diagnosis rates increased between 2000 and 2012 in women and men across all age groups using minimum or maximum estimates, with greatest increases seen among 15–24-year-olds. Our dataset can be used to parameterise and validate mathematical models and serve as a reference dataset to which trends in chlamydia-related complications can be compared. Our analysis highlights the complexities of combining monitoring and surveillance datasets.
Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 – linked to other German cities and European countries
Authors: Werber Dirk , Michaelis Kai , Hausner Marius , Sissolak Dagmar , Wenzel Jürgen , Bitzegeio Julia , Belting Anne , Sagebiel Daniel , Faber Mirko
Published: February 2017

Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24–52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016.
Meaningful use: an electronic medical record tool for cerebrospinal fluid shunt history
Authors: Governale Lance S. , Hoffman Jeffrey M.
Published: February 2017

The care of patients with shunted hydrocephalus can be complicated. The best assessment is provided when all data are available to the neurosurgery practitioner. However, data can be time-consuming to gather, especially in the setting of a busy practice, a trainee environment with duty-hour restrictions, and an electronic medical record (EMR) not specifically designed for the needs of subspecialists. For these reasons, the complete clinical picture, especially the historical component, is sometimes not assembled.

To address these shortcomings, the authors created a patient-level electronic CSF shunt history tool that leverages the power of the EMR concordant with the United States Centers for Medicare and Medicaid Services meaningful use principles. It is immediately available within the EMR for all users in all patient care contexts (e.g., outpatient, inpatient, perioperative, emergency, and remote access), centrally located, and designed to capture the vast range of circumstances inherent to the hydrocephalus population. Essential shunt data can be rapidly acquired and, as such, may decrease the likelihood of error in diagnosis and/or treatment. The tool also has the potential to aid the practicing neurosurgeon from clinical, quality improvement, and research standpoints. The authors have endeavored to describe this tool in a manner that would allow an interested neurosurgeon to share this publication with health information technology professionals to facilitate the development of a similar tool within their institution's own EMR platform.
Morbidity associated with 30-day surgical site infection following nonshunt pediatric neurosurgery
Authors: Sherrod Brandon A. , Rocque Brandon G.
Published: February 2017

OBJECTIVE

Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort.

METHODS

The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program–Pediatric (NSQIP-P) 2012–2014 database, including all neurosurgical procedures performed on pediatric patients. Procedures were categorized by Current Procedural Terminology (CPT) codes. CSF shunts were excluded. Deep and superficial SSIs occurring within 30 days of an index procedure were identified. Deep SSIs included deep wound infections, intracranial abscesses, meningitis, osteomyelitis, and ventriculitis. The following outcomes occurring within 30 days of an index procedure were analyzed, along with postoperative time to complication development: sepsis, wound disruption, length of postoperative stay, readmission, reoperation, and death.

RESULTS

A total of 251 procedures associated with a 30-day SSI were identified (2.7% of 9296 procedures). Superficial SSIs were more common than deep SSIs (57.4% versus 42.6%). Deep SSIs occurred more frequently after epilepsy or intracranial tumor procedures. Superficial SSIs occurred more frequently after skin lesion, spine, Chiari decompression, craniofacial, and myelomeningocele closure procedures. The mean (± SD) postoperative length of stay for patients with any SSI was 9.6 ± 14.8 days (median 4 days). Post-SSI outcomes significantly associated with previous SSI included wound disruption (12.4%), sepsis (15.5%), readmission (36.7%), and reoperation (43.4%) (p < 0.001 for each). Post-SSI sepsis rates (6.3% vs 28.0% for superficial versus deep SSI, respectively; p < 0.001), wound disruption rates (4.9% vs 22.4%, p < 0.001), and reoperation rates (23.6% vs 70.1%, p < 0.001) were significantly greater for patients with deep SSIs. Postoperative length of stay in patients discharged before SSI development was not significantly different for deep versus superficial SSI (4.2 ± 2.7 vs 3.6 ± 2.4 days, p = 0.094). No patient with SSI died within 30 days after surgery.

CONCLUSIONS

Thirty-day SSI is associated with significant 30-day morbidity in pediatric patients undergoing nonshunt neurosurgery. Rates of SSI-associated complications are significantly lower in patients with superficial infection than in those with deep infection. There were no cases of SSI-related mortality within 30 days of the index procedure.
An investigation into quality of life improvement in patients undergoing microvascular decompression for hemifacial spasm
Authors: Lawrence Jesse D. , Frederickson Andrew M. , Chang Yue-Fang , Weiss Patricia M. , Gerszten Peter C. , Sekula Raymond F.
Published: February 2017

OBJECTIVE

Hemifacial spasm (HFS) is a movement disorder characterized by involuntary spasms of the facial muscles, and it can negatively impact quality of life (QOL). This retrospective study and systematic review with meta-analysis was conducted to investigate the QOL in patients with HFS following intervention with microvascular decompression (MVD) and botulinum toxin (BT).

METHODS

In the retrospective analysis, a QOL questionnaire was administered to all patients undergoing MVD performed by a single surgeon. The QOL questionnaire included unique questions developed based on the authors' experience with HFS patients in addition to the health-related QOL HFS-8 questionnaire. The authors also report on a systematic review of the English literature providing outcomes and complications in patients with HFS undergoing treatment with either MVD or BT.

RESULTS

Regarding the retrospective analysis, 242 of 331 patients completed the questionnaire. The mean score of the 10 QOL questions improved from 22.78 (SD 9.83) to 2.17 (SD 5.75) following MVD (p < 0.001). There was significant improvement across all subscales of the questionnaire between pre- and postoperative responses (p < 0.001). Regarding the systematic review, it is reported that approximately 90% of patients undergoing MVD for HFS experience a complete recovery from symptoms, whereas the mean peak improvement of symptoms following treatment with BT is 77%. Furthermore, patients undergoing MVD reported a greater improvement in the mean supplemental index of QOL as compared with patients receiving BT therapy.

CONCLUSIONS

Microvascular decompression offers a significant improvement in QOL in well-selected patients suffering from HFS, and may offer an increased benefit for QOL over BT injections.
Magnetic resonance imaging characteristics and the prediction of outcome of vestibular schwannomas following Gamma Knife radiosurgery
Authors: Wu Chih-Chun , Guo Wan-Yuo , Chung Wen-Yuh , Wu Hisu-Mei , Lin Chung-Jung , Lee Cheng-Chia , Liu Kang-Du , Yang Huai-che
Published: February 2017

OBJECTIVE

Gamma Knife surgery (GKS) is a promising treatment modality for patients with vestibular schwannomas (VSs), but a small percentage of patients have persistent postradiosurgical tumor growth. The aim of this study was to determine the clinical and quantitative MRI features of VS as predictors of long-term tumor control after GKS.

METHODS

The authors performed a retrospective study of all patients with VS treated with GKS using the Leksell Gamma Knife Unit between 2005 and 2013 at their institution. A total of 187 patients who had a minimum of 24 months of clinical and radiological assessment after radiosurgery were included in this study. Those who underwent a craniotomy with tumor removal before and after GKS were excluded. Study patients comprised 85 (45.5%) males and 102 (54.5%) females, with a median age of 52.2 years (range 20.4–82.3 years). Tumor volumes, enhancing patterns, and apparent diffusion coefficient (ADC) values were measured by region of interest (ROI) analysis of the whole tumor by serial MRI before and after GKS.

RESULTS

The median follow-up period was 60.8 months (range 24–128.9 months), and the median treated tumor volume was 3.54 cm3 (0.1–16.2 cm3). At last follow-up, imaging studies indicated that 150 tumors (80.2%) showed decreased tumor volume, 20 (10.7%) had stabilized, and 17 (9.1%) continued to grow following radiosurgery. The postradiosurgical outcome was not significantly correlated with pretreatment volumes or postradiosurgical enhancing patterns. Tumors that showed regression within the initial 12 months following radiosurgery were more likely to have a larger volume reduction ratio at last follow-up than those that did not (volume reduction ratio 55% vs 23.6%, respectively; p < 0.001). Compared with solid VSs, cystic VSs were more likely to regress or stabilize in the initial postradiosurgical 6–12-month period and during extended follow-up. Cystic VSs exhibited a greater volume reduction ratio at last follow-up (cystic vs solid: 67.6% ± 24.1% vs 31.8% ± 51.9%; p < 0.001). The mean preradiosurgical maximum ADC (ADCmax) values of all VSs were significantly higher for those with tumor regression or stabilization at last follow-up compared with those with progression (2.391 vs 1.826 × 10−3 mm2/sec; p = 0.010).

CONCLUSIONS

Loss of central enhancement after radiosurgery was a common phenomenon, but it did not correlate with tumor volume outcome. Preradiosurgical MRI features including cystic components and ADCmax values can be helpful as predictors of treatment outcome.
Subclinical Doses of ATP-Sensitive Potassium Channel Modulators Prevent Alterations in Memory and Synaptic Plasticity Induced by Amyloid-β
Authors: Salgado-Puga Karla , Rodríguez-Colorado Javier , Prado-Alcalá Roberto A. , Peña-Ortega Fernando
Published: February 2017

In addition to coupling cell metabolism and excitability, ATP-sensitive potassium channels (KATP) are involved in neural function and plasticity. Moreover, alterations in KATP activity and expression have been observed in Alzheimer’s disease (AD) and during amyloid-β (Aβ)-induced pathology. Thus, we tested whether KATP modulators can influence Aβ-induced deleterious effects on memory, hippocampal network function, and plasticity. We found that treating animals with subclinical doses (those that did not change glycemia) of a KATP blocker (Tolbutamide) or a KATP opener (Diazoxide) differentially restrained Aβ-induced memory deficit, hippocampal network activity inhibition, and long-term synaptic plasticity unbalance (i.e., inhibition of LTP and promotion of LTD). We found that the protective effect of Tolbutamide against Aβ-induced memory deficit was strong and correlated with the reestablishment of synaptic plasticity balance, whereas Diazoxide treatment produced a mild protection against Aβ-induced memory deficit, which was not related to a complete reestablishment of synaptic plasticity balance. Interestingly, treatment with both KATP modulators renders the hippocampus resistant to Aβ-induced inhibition of hippocampal network activity. These findings indicate that KATP are involved in Aβ-induced pathology and they heighten the potential role of KATP modulation as a plausible therapeutic strategy against AD.
Galantamine Response Associates with Agitation and the Prefrontal Cortex in Patients with Alzheimer’s Disease
Authors: Nakayama Sachiko , Suda Akimitsu , Nakanishi Atsushi , Motoi Yumiko , Hattori Nobutaka
Published: February 2017

Behavioral and psychological symptoms of dementia (BPSD) occur in up to 80% of AD patients and represent one of the largest factors contributing to caregiver burden. To analyze the effect of galantamine on BPSD and caregiver burden, we treated a total of 50 patients with mild AD for 12 weeks and evaluated them using the Neuropsychiatric Inventory (NPI) and Japanese version of the Zarit Caregiver Burden Interview (ZBI). We also performed regional cerebral blood flow single photon emission computed tomography (rCBF SPECT) at baseline using three-dimensional sterotatic surface projections. Total NPI and ZBI scores did not significantly change after 12-week galantamine treatment. To identify the characteristics of patients who showed improvement after galantamine treatment, we divided patients into two groups, those with and those without sub-items on the NPI. Patients with aggression showed improvement in ZBI scores ( p < 0.05). A comparison of rCBF SPECT between these two groups indicated that patients with aggression exhibited increased rCBF in the right prefrontal cortex compared with those without aggression. In a patient with aggression, 20-month treatment with galantamine inhibited increases in the rCBF area in the right prefrontal lobe. These results suggest that galantamine response may be related to aggression and dysfunction of the prefrontal cortex.
Genetic Stratification to Identify Risk Groups for Alzheimer’s Disease
Authors: Marioni Riccardo E. , Campbell Archie , Hagenaars Saskia P. , Nagy Reka , Amador Carmen , Hayward Caroline , Porteous David J. , Visscher Peter M. , Deary Ian J.
Published: February 2017

Stratification by genetic risk factors for Alzheimer’s disease (AD) may help identify groups with the greatest disease risk. Biological changes that cause late-onset AD are likely to occur years, if not decades prior to diagnosis. Here, we select a subset of the Generation Scotland: Scottish Family Health Study cohort in a likely preclinical age-range of 60–70 years (subset n = 3,495 with cognitive and genetic data). We test for cognitive differences by polygenic risk scores for AD. The polygenic scores are constructed using all available SNPs, excluding those within a 500 kb distance of the APOE locus. Additive and multiplicative effects of APOE status on these associations are investigated. Small memory decrements were observed in those with high polygenic risk scores for AD (standardized beta –0.04, p = 0.020). These associations were independent of APOE status. There was no difference in AD polygenic scores across APOE haplotypes ( p = 0.72). Individuals with high compared to low polygenic risk scores for AD (top and bottom 5% of the distribution) show cognitive decrements, albeit much smaller than for APOE ɛ4 ɛ4 compared to ɛ3 ɛ3 individuals (2.3 versus 3.5 fewer points on the processing speed test, and 1.8 versus 2.8 fewer points on the memory test). Polygenic risk scores for AD may help identify older individuals at greatest risk of cognitive decline and preclinical AD.
Interactive Effects of Dementia Severity and Comorbidities on Medicare Expenditures
Authors: Zhu Carolyn W. , Cosentino Stephanie , Ornstein Katherine A. , Gu Yian , Andrews Howard , Stern Yaakov
Published: February 2017

Background: Few studies have examined how dementia and comorbidities may interact to affect healthcare expenditures.

Objective: To examine whether effects of dementia severity on Medicare expenditures differed for individuals with different levels of comorbidities.

Methods: Data are drawn from the Washington Heights-Inwood Columbia Aging Project (WHICAP). Comprehensive clinical assessments of dementia severity were systematically carried out at ∼18 month intervals. Dementia severity was measured by Clinical Dementia Rating (CDR). Comorbidities were measured by a modified Elixhauser comorbidities index. Generalized linear models examined effects of dementia severity, comorbidities, and their interactions on Medicare expenditures (1999–2010).

Results: At baseline, 1,280 subjects were dementia free (CDR = 0, 66.4%), 490 had very mild dementia (CDR = 0.5, 25.4%), 108 had mild dementia (CDR = 1, 5.6%), and 49 had moderate/severe dementia (CDR = 2/3, 2.5%). Average annual Medicare expenditures for individuals with moderate/severe dementia were more than twice as high as those who were dementia free (CDR = 0: $9,108, CDR = 0.5/1: $11,664, CDR≥2: $19,604, p < 0.01). Expenditures were approximately 10 times higher among those with≥3 comorbidities than among those with no comorbidities ($2,612 for those with no comorbidities, to $6,109 for those with 1, $10,656 for those with 2, and $30,244 for those with≥3 comorbidities, p < 0.001). Dementia severity was associated with higher expenditures, but comorbidities were the most important predictor of expenditures. We did not find strong interaction effects between number of comorbidities and dementia severity.

Conclusions: Increasing dementia severity and higher comorbidities are associated with higher Medicare expenditures. Care of individuals with dementia should focus on management of comorbidities.
The Effects of LW-AFC on the Hippocampal Transcriptome in Senescence-Accelerated Mouse Prone 8 Strain, a Mouse Model of Alzheimer’s Disease
Authors: Wang Jianhui , Liu Yang , Cheng Xiaorui , Zhang Xiaorui , Liu Feng , Liu Gang , Qiao Shanyi , Ni Ming , Zhou Wenxia , Zhang Yongxiang , Li Fei
Published: February 2017

The senescence-accelerated mouse prone 8 (SAMP8) strain is considered a robust experimental model for developing preventative and therapeutic treatments for Alzheimer’s disease (AD), a neurodegenerative disease which cannot be effectively prevented, halted, or cured. Our previous studies showed that LW-AFC, a new formula derived from the classical traditional Chinese medicinal prescription Liuwei Dihuang decoction, ameliorates cognitive deterioration in PrP-hAβPPswe/PS1 ΔE9 transgenic mice and SAMP8 mice. This study aims to investigate the mechanism that mediates how LW-AFC improves cognitive deficit on the basis of the transcriptome. We conducted a genome-wide survey of gene expression in the hippocampus in mice from the senescence accelerated mouse resistant 1 (SAMR1) strain, from SAMP8 and from LW-AFC treated SAMP8. The results showed that LW-AFC reversed the transcriptome in the hippocampus of SAMP8 mice. The specific investigation of altered gene expression in subtypes defined by cognitive profiles indicated that the systemic lupus erythematosus pathway, spliceosomes, amyotrophic lateral sclerosis, and the insulin signaling were involved in the improvement of cognitive ability by LW-AFC. The expression of genes Enpp2, Etnk1, Epdr1, and Gm5900 in the hippocampus were correlated with that of LW-AFC’s ameliorating cognitive impairment in SAMP8 mice. Because LW-AFC is composed of polysaccharides, glycosides, and oligosaccharides, we infer that LW-AFC has direct or indirect effects on altering gene expressions and regulating pathways in the hippocampus of SAMP8 mice. These data are helpful for the enhanced identification of LW-AFC as new therapeutic modalities to AD.
Intranasal Insulin Transport is Preserved in Aged SAMP8 Mice and is Altered by Albumin and Insulin Receptor Inhibition
Authors: Rhea Elizabeth M. , Humann Samantha R. , Nirkhe Surabhi , Farr Susan A. , Morley John E. , Banks William A.
Published: February 2017

Insulin delivered to the level of the cribriform plate (intranasal insulin) is being investigated for its ability to enhance memory in people with Alzheimer’s disease (AD). Recent work has shown intranasal insulin can be detected in young CD-1 mice within 5 min and is still present 60 min after injection. The current study determined whether intranasal insulin transport and the subsequent brain distribution of insulin varies in young, healthy mice (CD-1) compared to those with an AD-like phenotype (aged SAMP8) or those pre-disposed to develop such a phenotype (young SAMP8). We showed transport does not vary among these three mouse cohorts, suggesting that intranasal uptake and brain pharmacokinetics do not differ with AD-like signs or the genetic predisposition to developing them. We found that co-administration with bovine serum albumin increased levels of insulin in most brain regions. In addition, the insulin receptor inhibitor, S961, decreases the amount of insulin transported throughout the brain after intranasal injection. These results show insulin delivery to the brain by intranasal administration can be modified with agents such as albumin, may be dependent on the insulin receptor, and is not affected by an AD-like phenotype as presented by the SAMP8 mouse.
Classification of Depression, Cognitive Disorders, and Co-Morbid Depression and Cognitive Disorders with Perfusion SPECT Neuroimaging
Authors: Amen Daniel G. , Krishnamani Pavitra , Meysami Somayeh , Newberg Andrew , Raji Cyrus A.
Published: February 2017

Background: Depression and cognitive disorders (CDs) are two common co-morbid afflictions that commonly present with overlapping symptoms.

Objective: To evaluate if perfusion neuroimaging with brain SPECT can distinguish persons with depression from those with CDs or both conditions.

Methods: Inclusion criteria were DSM-IV defined depression or CDs (Alzheimer’s disease, vascular dementia, dementia not otherwise specified, and amnestic disorders not otherwise specified) including persons with both (total n = 4,541; 847 CDs, 3,269 depression, 425 with both). Perfusion differences between the groups were calculated using two-sampled t-tests corrected for multiple comparisons. Diagnostic separation was determined with discriminant analysis. Feature selection revealed predictive regions in delineating depression from CDs and comorbid cases.

Results: Persons with CDs had lower cerebral perfusion compared to depression. In co-morbid persons, cerebral hypoperfusion was additive, with regions showing lower regional cerebral blood flow compared to either diagnosis alone. Both baseline and concentration SPECT regions yielded correct classification of 86% and leave one out cross-validation of 83%. AUC analysis for SPECT regions showed 86% accuracy, 80% sensitivity and 75% specificity. Discriminant analysis separated depression and CDs from comorbid cases with correct classification of 90.8% and cross validated accuracy of 88.6%. Area under the curve was 83% with sensitivity of 80% and specificity of 70%. Feature selection identified the most predictive regions in left hippocampus, right insula, cerebellar, and frontal lobe regions.

Conclusion: Quantitative perfusion SPECT neuroimaging distinguishes depression from dementia and those with both co-morbidities. Perfusion brain SPECT can be utilized clinically to delineate between these two disorders.
A Meta-Analysis of Memantine for Depression
Authors: Kishi Taro , Matsunaga Shinji , Iwata Nakao
Published: February 2017

We conducted a systematic review and meta-analysis on whether memantine was beneficial for the treatment of depressive symptoms in major depressive disorder (MDD) and bipolar disorder (BD). The analysis included double-blind, randomized, placebo-controlled trials of memantine in MDD and BD. The primary outcome measures for efficacy and safety were response rate and all-cause discontinuation, respectively. Risk ratio (RR) and standardized mean difference with 95% confidence intervals (95% CI) were calculated. We identified six trials including 451 patients: MDD, four trials ( n = 189), three of which studied memantine augmentation for antidepressants; BD, two trials ( n = 262), both on memantine augmentation for mood stabilizers. The mean study duration was 8.33 weeks, and the mean age of patients was 39.9 years. Memantine was not superior to placebo with regard to response rate (RR = 0.92, 95% CI = 0.70–1.20, I2 = 72%), remission rate, improvement of depressive symptoms scale score, all-cause discontinuation (RR = 0.84, 95% CI = 0.60–1.18, I2 = 0%), discontinuation due to inefficacy and adverse events, or incidence of individual adverse events including decreased appetite, dizziness, nausea, and sedation. Although we conducted sensitivity analyses of the response rate to determine the reasons for the heterogeneity (diagnosis, age of patients, memantine dose, memantine augmentation, geographical region, and statistical population), we did not seek confounding factors. Memantine did not improve the treatment efficacy for depressive symptoms in MDD and BD patients. Long-term study of memantine for depression is required.
Dual-afferent sensory input training for voluntary movement after stroke: A pilot randomized controlled study
Authors: Bae Seahyun , Kim Kyung-Yoon
Published: February 2017

BACKGROUND: Stimulation through afferent sensory input is necessary to improve voluntary functional movement in stroke patients.

OBJECTIVES: Dual-afferent sensory input, which combines electromyography-triggered functional electric stimulation (ETFES) and action observation, was investigated to determine its effects on voluntary movements in stroke patients.

METHODS: This study was conducted on 18 patients with left hemiplegia diagnosed between 6 and 24 months prior. The 9 subjects in the dual-afferent sensory input (DASI) group underwent ETFES with action observation training for 4 weeks (20 min/d, 5 d/wk), while the 9 control group subjects underwent functional electric stimulation (FES) for the same duration. The outcome measures were the movement-related cortical potential (MRCP), H-reflex, electromyography (EMG), and balance.

RESULTS: The control and DASI groups showed significant increases in MRCP, muscle activity, and balance, while H-reflex was significantly decreased. MRCP and balance showed significant differences between DASI and control groups.

CONCLUSIONS: DASI stimulates voluntary movement in patients, causes rapid activation of the cerebral cortex, and reduces excessive excitation of spinal motor neurons. Therefore, DASI, which stimulates voluntary movement, has a greater effect on brain activation in stroke patients.