bluuebunny/crossref_metadata_2025 huggingface dataset:
One-piece Orbitozygomatic Craniotomy for Resection of Rathke's Cleft Cyst: Operative Video
Authors: Dossani Rimal , Patra Devi , Storey Christopher , Kalakoti Piyush , Sun Hai
Published: January 2018

Objective The video stars orbitozygomatic resection of Rathke's cleft cyst with suprasellar extension in a 37-year-old male patient presenting with severe headaches and bitemporal hemianopia. Clinical and radiological characteristics along with surgical technique (positioning, bony opening, surgical dissection and debulking, closure), histopathology, and postoperative course are described.

Methods Preoperative MRI demonstrated a noncontrast-enhancing cystic lesion in the sella with suprasellar extension causing compression of both optic nerves. A one-piece orbitozygomatic craniotomy was performed. The tumor was encountered in the interoptic space. First, the cyst was decompressed and fluid appearing like motor oil was aspirated. Both optic nerves were decompressed and dissected free from the cyst wall. Intraoperatively, the most challenging aspect was separating the tumor from surrounding vascular structures, including bilateral A1 arteries and the left carotid bifurcation. A combination of sharp and blunt dissection was utilized to free the tumor from adhesions to critical neurovascular structures. Once freed, the suprasellar aspect of the tumor was mobilized into the operative cavity and debulked. Finally, the sellar component of the tumor was removed all the way down to the sellar floor. Postoperative MRI demonstrated decompressed bilateral optic nerves with an intact pituitary stalk with preservation of normal pituitary gland. Histopathology identified pathognomonic features consistent with diagnosis of Rathke's cleft cyst, including flattened ciliated epithelium and presence of Rathke's cleft remnants.

Results Postoperatively, bilateral improvement in vision was noted with transient diabetes insipidus. Patient was discharged home on postoperative day 4.

Conclusion A one-piece orbitozygomatic craniotomy is an effective and safe strategy for resection of Rathke's cleft cysts with suprasellar extension.

The link to the video can be found at: https://youtu.be/-Yqtcd2gLSs.
Diagnóstico e conduta cirúrgica nos meningiomas de tubérculo selar
Authors: Mattei Tobias Alécio , Ramina Ricardo , Milano Jerônimo Buzetti , Aguiar Paulo Henrique , Mattei Josias Alécio
Published: January 2018

Os meningiomas do tubérculo selar, juntamente com os da goteira olfatória, estão entre os tumores mais freqüentes da fossa craniana anterior. Os sintomas característicos são déficits visuais, distúrbios do comportamento, crises epilépticas, anosmia e déficits motores. Devido a seu crescimento lento, o período do início dos sintomas até o diagnóstico tende a ser longo, geralmente excedendo dois anos. Quando o tumor atinge mais de 4 cm e comprime as estruturas neurovasculares adjacentes, a possibilidade de remoção cirúrgica total é limitada e a chance de melhora na função visual é baixa. O tratamento ideal dos meningiomas de tubérculo selar é a ressecção completa do tumor com descompressão dos vasos e parênquima cerebral adjacentes. Em virtude da escassez de grupos experientes especializados em cirurgia da base do crânio, muitos dos pacientes portadores de meningiomas de tubérculo selar são tratados em alguns centros com procedimentos alternativos, os quais apresentam resultados significativamente piores que as séries cirúrgicas mais recentes publicadas na literatura. Neste artigo, os autores apresentam um panorama geral acerca dos métodos diagnósticos para detecção e avaliação pré-operatória dos meningiomas de tubérculo selar. Também são enfatizados os benefícios do tratamento cirúrgico, o qual, se realizado por uma equipe experiente, pode ser curativo, apresentando menor morbidade que outras modalidades terapêuticas.
Detecção imuno-histoquímica de células apoptóticas em glioblastoma recidivante de paciente tratado com álcool perílico por via inalatória
Authors: da Fonseca Clovis Orlando , Silva Hilda Petrs , Futuro Débora , Miguez Leonardo , Nagel Janaina , Ribas Vinícius , Linden Rafael , Schwartsmann Gilberto , Gattass Cerli Rocha , Quirico-Santos Thereza
Published: January 2018

Introdução: Estudos in vitro mostram que radioterapia e/ou quimioterapia podem ativar as vias de sinalização do receptor do fator de crescimento epidérmico (EGFR) e Ras, aumentando a resistência cruzada das células de glioblastomas multiformes (GBM) ao tratamento. A inibição das atividades de EGFR e Ras através de inibidores tirosinas cinases elimina o antagonismo observado à administração seqüencial destas modalidades terapêuticas, induzindo apoptose nestas células. Em estudo prévio demonstramos que o tratamento com o álcool perílico (AP), inibidor da farnesilação da Ras, induz apoptose em linhagens celulares e células de explante de GBM. Objetivo: No presente estudo investigamos se a regressão parcial observada em GBM recorrente de paciente tratado com administração intranasal de AP é mediada por apoptose. Resultado: Ensaios com TUNEL (deoxynucleotidyl-mediated deoxyuridine triphosphate) e caspase-3 ativada evidenciaram presença de células apoptóticas nas lâminas de GBM tratado. Conclusão: Esses achados sugerem que estratégias adjuvantes visando à inativação das vias de sinalização do EGFR e Ras podem melhorar tanto a eficácia de terapia isolada como de terapia multimodal em gliomas.
Aspergilose do sistema nervoso central após transplante hepático: Relato de caso
Authors: Rocha Júnior Marco Antonio , Paula Guimarães Thaís de , Souza Gomes Elisa Conci de , dos Santos Juliana Machado Santiago , Ferreira Starling Carlos Ernesto
Published: January 2018

Introdução: O acometimento do sistema nervoso central pelo Aspergillus é muito grave e com alto índice de mortalidade. Relato de caso: Descrevemos o caso de uma paciente transplantada hepática em uso de imunossupressores que evoluiu com piora clínica. Tomografia computadorizada e ressonância magnética revelaram múltiplas lesões cerebrais. Em decorrência de má condição clínica da paciente, optou-se pelo tratamento conservador e em três dias ela evolui para óbito. Estudo anatomopatológico constatou quadro compatível com aspergilose. Discussão: Em pacientes imunossuprimidos, a suspeita precoce da infecção central fúngica é essencial para tentar evitar uma evolução catastrófica como no caso relatado.
Melanocitoma meníngeo intramedular dorsal: Relato de caso
Authors: Polónia Patrícia , Lopes Tiago , Vilarinho António , Gonçalves Vitor , Cerejo António , Vaz Rui
Published: January 2018

Contexto: O melanocitoma meníngeo é uma lesão infrequente, benigna, mas localmente agressiva. Sua localização intramedular é muito rara, existindo apenas três casos descritos na literatura. A propósito deste caso clínico, os autores reveem a literatura e discutem as características clínicas, imagiológicas e histológicas desse tipo de lesão. Relato do caso: Homem de 54 anos de idade com melanocitoma meníngeo intramedular dorsal (T11). Clinicamente apresentou, de início, disestesias torácicas, sem déficits neurológicos associados, que se mantiveram estáveis ao longo de dois anos. Após esse período teve instalação súbita de paraparesia. O diagnóstico definitivo foi estabelecido por exame histológico e imunocitoquímico após ressecção cirúrgica parcial da lesão. A pesquisa de melanoma maligno cutâneo-mucoso ou ocular foi negativa. Apesar de evolução inicial favorável apresentou recrescimento tumoral dois anos e meio após a primeira cirurgia, sendo reoperado. Apesar da ausência de complicações diretamente relacionadas com a cirurgia, acabou por falecer por sepsis na sequência de ruptura de diverticulite intestinal semanas depois.
Abordagem atual aos aneurismas do topo da artéria basilar
Authors: Pires Aguiar Paulo Henrique , Tahara Adriana , Fuke Patricia Lure , Panagopoulos Alexandros Theodoros , Esteves Veiga José Carlos
Published: January 2018

Objetivo: Revisão crítica das abordagens atuais para aneurismas do topo da artéria basilar. Análise dos aspectos anatômicos e angiográficos relevantes para cirurgia. Métodos: Revisão crítica da literatura e relato da experiência dos autores. Resultados: Os principais acessos para aneurismas de topo de basilar de acordo com sua posição em relação ao dorso da sela são: Kawase transpetroso para os aneurismas baixos, transcavernoso para os médios e temporopolar para os altos. A monitoração eletrofisiológica e com doppler pode minimizar complicações isquêmicas por clipagem prolongada, estenose ou fechamento inadvertido de perfurantes. Neuroproteção e hipotermia devem ser consideradas em lesões gigantes e complexas. Lesões complexas geralmente excedem ao tratamento endovascular. Conclusão: Existe uma tendência na literatura a considerar o tratamento cirúrgico dos aneurismas como método ultrapassado; entretanto a tecnologia de novas formas de proteção cerebral, técnicas microcirúrgicas e evolução dos clipes são indispensáveis para lidar com o cérebro em condições ruins na fase aguda. Os procedimentos endovasculares não drenam hematomas, não tratam hidrocefalia nem retiram coágulos das cisternas para prevenir o vasoespasmo. Entretanto é necessário um seguimento a longo prazo para uma avaliação mais precisa. O neurocirurgião deve dominar as duas opções de tratamento e ser hábil para indicar o tratamento mais apropriado.
Meningioma gigante como causa de alterações psiquiátricas: Relato de caso
Authors: Zanatelli Marcelo Motta , Brumatti Jorge Ismael , Zanatelli Filipe Mota
Published: January 2018

Muitos dos pacientes neurológicos procuram auxílio médico devido a sintomas inespecíficos e subjetivos, nem sempre possíveis de diagnóstico claro e imediato. Dentre tais lesões, os tumores de crescimento lento como os meningiomas estão entre os mais encontrados. Pela acomodação cerebral peritumoral, esses tumores podem atingir volumes extremamente grandes com pouco ou nenhum sintoma associado. Relatamos o caso de paciente que estava sob medicação antipsicótica para tratamento de alterações comportamentais, atendido na Santa Casa de Misericórdia de Santos após crise convulsiva e traumatismo cranioencefálico. Durante a avaliação tomográfica foi encontrado volumoso tumor frontal com lise óssea e extensão para gálea e subcutâneo. Foi submetido à craniotomia eletivamente com ressecção completa da lesão de aproximadamente 9 cm e 145 gramas. O paciente recebeu alta no oitavo dia pós-operatório, consciente, orientado e sem sequelas neurológicas. Este relato visa atentar sempre para uma possível lesão ainda não identificada nos casos de pacientes com sintomas inespecíficos neurológicos, devendo a tomografia computadorizada de crânio, procedimento relativamente simples e quase sempre disponível, ser usada para tal fim.
Scoliosis: current overview and treatment considerations
Authors: da Silva Elton Gomes , Kojo Hamilton D. , Joaquim Andrei Fernandes , Shaffrey Christopher I.
Published: January 2018

Scoliosis presents with lateral curvature of the spine greater than 10 degrees in x-ray and it can be associated with others deformities of the curvature of the spine. The management of this deformity is dependent of the classification and clinical presentation of the patient. This paper purposes to discuss to the initial evaluation of patients with scoliosis, distinguishing the different types of scoliosis and the management of patients with this diagnosis.
Subdural arachnoidal cyst of the spinal cord: etiology, clinical presentation, surgical strategy and results
Authors: Fonseca Joelton , Lynch José Carlos , Policarpo Fabiana , Esteves Celestino , Bomfim Cleber , Welling Leonardo
Published: January 2018

Objective: Of this study is identifying the clinical manifestations, discuss the etiology, and present the surgical treatment nuances and outcomes of patients with sub dural arachnoidal cysts (AC). Method: A retrospective study was carried out with 7 consecutives patients with spinal cord subdural AC, diagnosed, evaluated and operated at the Neurosurgical department of Servidores do Estado Hospital, from 1996 to 2010. The radiological studies, patient records, surgical descriptions and surgical videos, were reviewed, creating a database from which information was collected. The follow-up varied from 2 to 168 months (mean, 48 months). All cysts were histopathological verified. Results: Five AC were located on the thoracic spinal cord, one were located anterior in the cervical region, and one at the lumbar spinal level. The complete resection of the cyst was performed in 4 surgeries. Three patients had cysts located ventral to the cord, which precluded complete excision. The symptoms in four patients demonstrated major improvement. There was no operative death in this series, there was no major complications related to surgery. Conclusion: AC should be considered in the differential diagnosis of lesions causing myelopathy and/or a radicular pain syndrome. Microsurgical resection or generous fenestration in cysts effectively ameliorated patients’ symptomatology.
Spontaneous intracerebral hemorrhage treated by neuroendoscopy – Technical note
Authors: Romero Flávio Ramalho , Zanini Marco Antôno , Ducatti Luiz Gustavo , Gabarra Roberto Colichio
Published: January 2018

Spontaneous intracerebral hemorrhage (SICH) is responsible for 10%-15% of the acute stroke. Hematoma or the occlusion of cerebrospinal fluid (CSF) flow by ventricular clotting can result in obstructive hydrocephalus, increasing intracranial pressure, which needs urgent decompression. We report our results of management of spontaneous deep cerebral hematoma by endoscopic approach.
Brainstem cavernous malformation
Authors: Estramiana Ariel Roberto , Pinto de Santana Diana Lara , Figueiredo Eberval Gadelha , Teixeira Manoel Jacobsen
Published: January 2018

Cavernous malformation (CM) of the central nervous system (CNS) are acquired or developmental vascular malformations that represent the 5% to 15% of all vascular malformations of the CNS. Eighty to ninety percent of CM are supratentorial, 15% infratentorial, and 5% occur in the spinal cord. The subset of brainstem malformation presents as a very difficult paradigm for treating clinicians. The widespread use of magnetic resonance imaging (MRI) has increased the recognition of this disease. Clinical presentation, pathophysiology and treatment are discussed in this article.
Avaliação clínica da descompressão medular anterior em portadores de mielopatia cervical
Authors: Rezende Rodrigo , Junqueira de Faria Fernando , Cardoso Igor Machado , Batista Junior José Lucas , Júnior Chárbel Jacob
Published: January 2018

Objetivo: Avaliação clínica neurológica pré e pós-operatória de pacientes portadores de mielopatia cervical submetidos à descompressão medular por via anterior. Métodos: Utilização das escalas de Nurick e de JOA (Japanese Orthopaedic Association), adaptadas para a população brasileira, no período pré e pós-operatório, como método de mensuração do grau de comprometimento neurológico, aplicando-se o teste t de Student e o teste de Wilcoxon, com significância p < 0,05. Resultados: Participaram do estudo 30 pacientes. A média do JOA no pré-operatório foi de 9,5 (DP = 2,8) e no pós-operatório, de 13,5 (DP = 3,0). O valor médio de Nurick foi de 3,7 (DP = 1,2) e 2,1 (DP = 1,2) no pré e pós-operatório, respectivamente. Conclusão: A descompressão medular via anterior melhorou em cerca de 40% o quadro neurológico inicial, portanto pode ser considerada uma real opção de tratamento para pacientes portadores de mielopatia cervical.
Realidade virtual e estereoscopia no ensino da neuroanatomia e neurocirurgia
Authors: Tostes Ferreira Mauro Augusto , Silva Gusmão Sebastião Nataniel , Spetzler Robert Frederich
Published: January 2018

Objetivo: Por motivos diversos, o ensino da neuroanatomia durante a graduação médica e na residência de neurocirurgia é deficitário. Apresentamos a realidade virtual e a estereoscopia como eventuais métodos complementares de ensino à neuroanatomia e neurocirurgia. Método: Diversa gama de conteúdo digital interativo e estereoscópico foi produzida utilizando esterogramas de dissecações anatômicas. Resultados: A realidade virtual tenta melhor elaborar o ensino da neuroanatomia e neurocirurgia. Embora o trabalho verse sobre neuroanatomia e neurocirurgia, esses recursos podem ser empregados em qualquer área médica. Conteúdo anatômico de excelência foi adquirido e armazenado de modo que pôde ser manipulado por programa de realidade virtual e estereoscopia. Conclusão: A realidade virtual e a estereoscopia são ferramentas úteis no ensino e na aprendizagem da neuroanatomia e da neurocirurgia.
Accuracy of two different criteria for neurophysiological intraoperative monitoring (NIOM) in spine/spinal cord surgeries
Authors: Dominici Michele , Chaloult Erik , Ventura Fabrício Dutra , Comerlato Enio Alberto
Published: January 2018

Objective: Our objective was to compeer the accuracy between two warning criteria during the intraoperative neurophysiologic monitorization for spine/spinal cord surgery. Method: We used two different warning criteria to detect neurological damage. The first criterion was the amplitude reduction of the somatossensory-evoked potentials (SEP) or motor-evoked potentials (MEP) greater than 50% at least in one limb and the second criterion was the complete loss of one of the same potentials. These results were compared with the neurological examination and the sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) was calculated for each criterion. Results: The sensitivity, specificity, PLR and NLR were respectively for criterion 1 and 2 (0,92/0,58; 0,96/0,99; 24/46 and 0,09/0,57). Conclusion: The first criterion suggests a better sensitivity and accuracy as a warning criterion to avoid central neurological damage.
Cateter ventriculoperitoneal migrado para o escroto através de hérnia inguinal – Relato de caso
Authors: da Cunha Eduardo Procaci , Moreira Sérgio , Gomes Mário , Mesquita Isabel , Simões Vítor , Carvalho Ernesto de
Published: January 2018

A derivação ventriculoperitoneal é atualmente o método mais utilizado no tratamento da hidrocefalia comunicante. As complicações mais comuns são a disfunção do shunt e infecções. Este relato de caso tem como objetivo apresentar um doente com idas recorrentes ao serviço de urgência por agitação psicomotora e dor abdominal, e cujo cateter distal previamente desconectado encontrava-se alojado no interior do saco escrotal através de hérnia inguinoescrotal. A formação de hérnia inguinal com migração de cateter é um evento raro no adulto, sendo mais comum na criança, possivelmente pela maior taxa de patência do processo vaginal e aumento da pressão intra-abdominal. No momento em que este artigo foi redigido, não foi encontrado caso semelhante na literatura.
Erythropoietin in vasospasm. From bench to bedside?
Authors: Welling Leonardo Christiaan , Welling Mariana Schumacher , Figueiredo Eberval Gadelha , Teixeira Manoel Jacobsen
Published: January 2018

Aneurysmal subarachnoid haemorrhage is one of the most deleterious acute neurological diseases. The cerebral ischemia secondary to arterial vasospasm occurring after aneurysmal subarachnoid haemorrhage is still responsible for the considerable morbidity and mortality in these patients. Besides the knowledge of basic mechanisms of cerebral vasoespasm following aneurysmal subarachnoid haemorrhage, the prophylaxis and treatment of this pathology however still remain suboptimal. There is some evidence that acute erythropoietin treatment may reduce the severity of cerebral vasospasm and eventually improve outcome in aneurysmal subarachnoid haemorrhage patients. There are underlying mechanisms extend far beyond erythropoiesis: like enhancing neurogenesis, decreasing inflammation and apoptosis inhibition. In this review the authors describe many of the biologic effects, especially experimental studies and clinical studies that reported why the erythropoietin could be beneficial to patients with aneurysmal subarachnoid haemorrhage.
Epidemiology of traumatic spinal injuries in Brazil: systematic review
Authors: Botelho Ricardo Vieira , Gianini Albuquerque Luciana Dini , Junior Rafael Bastianello , Arantes Júnior Aluízio Augusto
Published: January 2018

Prevention remains the most effective way to reduce the burden of spinal injuries (SI). Estimating the incidence and causes of SI is essential for the development of prevention programs. To reveal the current state of Brazilian ST epidemiology. To evaluate the current state of Brazilian SI epidemiology, we performed an electronic search using the Lilacs database (Latin American and Caribbean Health Sciences Literature). Fifteen papers and one unsubmitted ongoing study (BH project) reported the epidemiologic status of ST in Brazil. The mean age of SI patients was 34,75 years, and 84% of patients were male. The most commonly affected segment was the cervical spine (36.65%). The incidence ranged from 16 to 26 patients per million per year (average 21 per million per year). The average rate of complete spinal cord injury among five papers was 34%. The average mortality in four papers was 11.58%. Analyzing published national epidemiological data enables the estimation of the current state of Brazilian SI epidemiology.
Infarto cerebral hemisférico: algoritmo de tratamento baseado em evidência
Authors: Campos Wuilker Knoner , Damian Guasti José Antônio
Published: January 2018

O infarto cerebral hemisférico maligno tem mortalidade de 80%, apesar do tratamento conservador. Ele representa infarto de mais de 50% do território da artéria cerebral média (ACM), entretanto, nem todos os pacientes irão desenvolver o curso maligno. O objetivo desta revisão foi encontrar os fatores preditivos do curso maligno do edema cerebral maligno e, a partir desses fatores, propor um algoritmo de tratamento e tomadas de decisões para o infarto cerebral hemisférico. Os preditores foram pesquisados em artigos no PubMed. Com base nos preditores encontrados com valor estatístico significativo, estruturou-se um algoritmo de gerenciamento para o infarto cerebral hemisférico. Os fatores preditivos de curso maligno foram: NIHSS > 15 hemisfério dominante e > 20 não dominante; oclusão da artéria carótida interna (ACI) ipsilateral à malformação do círculo de Willis; circulação colateral deficiente; tomografia computadorizada (TC) hipodensidade > 50% e ressonância magnética (RM) difusão > 145 cm3 do território da ACM; outro território vascular envolvido; perda da autorregulação; potencial evocado auditivo patológico; pressão intracraniana (PIC) > 35 mmHg e valores de pico de aminoácidos excitatórios medidos na microdiálise. Entretanto, esses dois últimos fatores aparecem apenas depois que o paciente está herniado. Os trials europeus definiram nível de evidência 1 para craniectomia descompressiva. Craniectomia descompressiva é o tratamento de primeira escolha para os pacientes < 60 anos com curso maligno do infarto hemisférico < 48h. Os fatores preditivos são importantes ferramentas para tomada de decisão quanto à indicação cirúrgica precoce.
Psicocirurgia para tratamento de transtorno obsessivo-compulsivo
Authors: Da Róz Leila Maria , Carvalhal Ribas Eduardo Santamaria , Ballester Gerson , Figueiredo Eberval Gadelha , Teixeira Manoel Jacobsen
Published: January 2018

O transtorno obsessivo-compulsivo (TOC) é uma patologia incapacitante tanto na esfera social como na ocupacional. Está associado a uma morbidade bastante alta quando comparado a outras condições psiquiátricas e estima-se atualmente uma prevalência de 2% a 3% na população. Alguns estudos sugerem uma provável relação com uma disfunção do córtex frontal e do cíngulo, envolvendo o circuito de Papez. Esse circuito parece mediar os sintomas ansiosos, visto que lesões cirúrgicas dessas áreas afetam a ansiedade geralmente associada ao TOC. A neurocirurgia ablativa para o tratamento de distúrbios psiquiátricos foi muito utilizada até o desenvolvimento de psicofármacos efetivos. Recentemente, com os avanços técnicos do procedimento cirúrgico, auxiliado pelo conhecimento neurofisiológico, a psicocirurgia tornou-se mais precisa e segura. Porém, sua indicação se restringe como uma alternativa ao tratamento de pacientes com TOC refratário à terapia comportamental e/ ou medicamentosa.
Espondilolistese traumática do áxis – Experiência em 41 casos
Authors: Faleiro Rodrigo Moreira , Godoy Newton José , Campos Rafael Cardoso , Ávila Geraldo
Published: January 2018

Objetivo: Levantamento epidemiológico retrospectivo da prevalência de espondilolistese traumática do áxis no período de cinco anos em HJXXIII – FHEMIG. Métodos: Foram avaliados 1.136 casos de traumatismo raquimedular admitidos no período em HJXXIII – FHEMIG. Resultados: 762 (67%) correspondiam a trauma em segmento cervical, 41 casos (5,3%) a ETA. Predomínio em adultos jovens do sexo masculino. A etiologia mais comum foi acidente automobilístico. Segundo classificação de Levine, o tipo de fratura mais comum foi o tipo I (70,8%), seguido pelo tipo II (16%), tipo IIa (9,6%) e tipo III (3,2%). Conclusão: A espondilolistese traumática do áxis geralmente é uma fratura estável, sendo satisfatoriamente tratada por meio de órtese externa. Os déficits neurológicos são incomuns e, quando presentes, geralmente são decorrentes de lesões associadas.
Usage characteristics and adverse event rates ​of the direct puncture and pull techniques for percutaneous endoscopic gastrostomy in patients with malignant tumors of the upper aerodigestive tract
Authors: Teich Niels , Selig Lars , Liese Susanne , Schiefke Franziska , Hemprich Alexander , Mössner Joachim , Schiefke Ingolf
Published: January 2018

Background and study aims Patients with malignant tumors of the upper gastrointestinal tract are at risk of weight loss. Early supportive nutrition therapy is therefore recommended and usually requires placement of a percutaneous endoscopic gastrostomy (PEG). The aim of this study was to compare adverse events and usage characteristics of the direct puncture technique with those of the traditional pull technique when used in patients with endoscopically passable tumors. The primary endpoint was the rate of inflammatory adverse events (AEs) at the gastrostomy fistula. The secondary endpoint was the long-term rate of puncture-site metastases.

Patients and methods One hundred twenty patients (median age 56; IQR 36, 86 years) were randomized and treated per protocol in this prospective open randomized single-center study. Follow-ups were conducted on the third and seventh post-interventional days, after 1, 3 and 6 months and the last follow-up 5 years after intervention.

Results Within the short-term follow-up period of 6 months after PEG placement, AEs were noted in 47 patients (39.2 %). These included 22 inflammations and 16 device dislocations and were mainly found in the puncture group (33 vs. 14 in the pull group) with a significantly increased incidence in the first month after PEG insertion (P = 0.001). Evaluation of the 5-year data did not reveal any significant differences. The gastrostomy tube was used in 101 patients (84.2 %) (range 18 days to 5 years).

Conclusions Our results favor the pull technique for patients with endoscopically passable tumors of the upper gastrointestinal tract due to less short-term adverse events. Both systems contributed equally to secure long-term use.
Risk of colonic diverticular rebleeding according to endoscopic appearance
Authors: Kawanishi Koki , Kato Jun , Kakimoto Tetsuhiro , Hara Takeshi , Yoshida Takeichi , Ida Yoshiyuki , Maekita Takao , Iguchi Mikitaka , Kitano Masayuki
Published: January 2018

Background and study aims Re-commencement of bleeding (rebleeding) of colonic diverticula after endoscopic hemostasis is a clinical problem. This study aimed to examine whether endoscopic visibility of colonic diverticular bleeding affects the risk of rebleeding after endoscopic hemostasis.

Patients and methods We performed a retrospective review of endoscopic images and medical charts of patients with colonic diverticular bleeding who underwent endoscopic hemostasis. Endoscopic visibility was classified into two types according to visibility of the source of bleeding; source invisibility due to bleeding or attached hematin (type 1), or endoscopically visible responsive vessels (type 2). Rebleeding rates within one year after initial hemostasis were examined.

Results Of 93 patients with successful endoscopic hemostasis, 38 (41 %) showed type 1 visibility, while the remaining presented type 2. All patients received hemostasis with clipping, rebleeding developed in 20 patients (22 %). Type 1 visibility was more likely to be observed in patients with rebleeding (65 % vs. 34 %, P = 0.013). Multivariate analysis revealed that after endoscopic hemostasis, type 1 visibility (invisible source) was the only independent risk factor for colonic diverticular rebleeding (odds ratio, 3.05; 95 % confidence interval, 1.03 – 9.59, P = 0.044). Kaplan-Meier curve showed the cumulative incidence of rebleeding was significantly higher in patients with type 1 visibility than those with type 2 visibility (P = 0.0033, log-rank test)

Conclusion Hemostasis by clipping for colonic diverticular bleeding without definite observation of the source of bleeding may not be sufficiently effective. Other hemostatic methods, including band ligation, should be considered when the source of bleeding is unclear.
Classical molecular dynamics simulation of microwave heating of liquids: The case of water
Authors: Afify N. D. , Sweatman M. B.
Published: January 2018

We perform a complete classical molecular dynamics study of the dielectric heating of water in the microwave (MW) region. MW frequencies ranging from 1.0 to 15.0 GHz are used together with a series of well-known empirical force fields. We show that the ability of an empirical force field to correctly predict the dielectric response of liquids to MW radiation should be evaluated on the basis of a joint comparison of the predicted and experimental static dielectric constant, frequency-dependent dielectric spectra, and heating profiles. We argue that this is essential when multicomponent liquids are studied. We find that both the three-site OPC3 and four-site TIP4P-ϵ empirical force fields of water are equally superior for reproducing dielectric properties at a range of MW frequencies. Despite its poor prediction of the static dielectric constant, the well-known SPCE force field can be used to accurately describe dielectric heating of water at low MW frequencies.
Dual-induced multifractality in online viewing activity
Authors: Qin Yu-Hao , Zhao Zhi-Dan , Cai Shi-Min , Gao Liang , Stanley H. Eugene
Published: January 2018

Although recent studies have found that the long-term correlations relating to the fat-tailed distribution of inter-event times exist in human activity and that these correlations indicate the presence of fractality, the property of fractality and its origin have not been analyzed. We use both detrended fluctuation analysis and multifractal detrended fluctuation analysis to analyze the time series in online viewing activity separating from Movielens and Netflix. We find long-term correlations at both the individual and communal levels and that the extent of correlation at the individual level is determined by the activity level. These long-term correlations also indicate that there is fractality in the pattern of online viewing. We first find a multifractality that results from the combined effect of the fat-tailed distribution of inter-event times (i.e., the times between successive viewing actions of individuals) and the long-term correlations in online viewing activity and verify this finding using three synthesized series. Therefore, it can be concluded that the multifractality in online viewing activity is caused by both the fat-tailed distribution of inter-event times and the long-term correlations and that this enlarges the generic property of human activity to include not just physical space but also cyberspace.
Surface roughness effects on contact line motion with small capillary number
Authors: Yang Feng-Chao , Chen Xiao-Peng , Yue Pengtao
Published: January 2018

In this work, we investigate how surface roughness influences contact line dynamics by simulating forced wetting in a capillary tube. The tube wall is decorated with microgrooves and is intrinsically hydrophilic. A phase-field method is used to capture the fluid interface and the moving contact line. According to the numerical results, a criterion is proposed to judge whether the grooves are entirely wetted or not at vanishing capillary numbers. When the contact line moves over a train of grooves, the apparent contact angle exhibits a periodic nature, no matter whether the Cassie-Baxter or the Wenzel state is achieved. The oscillation amplitude of apparent contact angle is analyzed and found to be inversely proportional to the interface area. The contact line motion can be characterized as stick-jump-slip in the Cassie-Baxter state and stick-slip in the Wenzel state. By comparing to the contact line dynamics on smooth surfaces, equivalent microscopic contact angles and slip lengths are obtained. The equivalent slip length in the Cassie-Baxter state agrees well with the theoretical model in the literature. The equivalent contact angles are, however, much greater than the predictions of the Cassie-Baxter model and the Wenzel model for equilibrium stable states. Our results reveal that the pinning of the contact line at surface defects effectively enhances the hydrophobicity of rough surfaces, even when the surface material is intrinsically hydrophilic and the flow is under the Wenzel state.
High-performance field emission device utilizing vertically aligned carbon nanotubes-based pillar architectures
Authors: Gupta Bipin Kumar , Kedawat Garima , Gangwar Amit Kumar , Nagpal Kanika , Kashyap Pradeep Kumar , Srivastava Shubhda , Singh Satbir , Kumar Pawan , Suryawanshi Sachin R. , Seo Deok Min , Tripathi Prashant , More Mahendra A. , Srivastava O. N. , Hahm Myung Gwan , Late Dattatray J.
Published: January 2018

The vertical aligned carbon nanotubes (CNTs)-based pillar architectures were created on laminated silicon oxide/silicon (SiO2/Si) wafer substrate at 775 °C by using water-assisted chemical vapor deposition under low pressure process condition. The lamination was carried out by aluminum (Al, 10.0 nm thickness) as a barrier layer and iron (Fe, 1.5 nm thickness) as a catalyst precursor layer sequentially on a silicon wafer substrate. Scanning electron microscope (SEM) images show that synthesized CNTs are vertically aligned and uniformly distributed with a high density. The CNTs have approximately 2–30 walls with an inner diameter of 3–8 nm. Raman spectrum analysis shows G-band at 1580 cm−1 and D-band at 1340 cm−1. The G-band is higher than D-band, which indicates that CNTs are highly graphitized. The field emission analysis of the CNTs revealed high field emission current density (4mA/cm2 at 1.2V/μm), low turn-on field (0.6 V/μm) and field enhancement factor (6917) with better stability and longer lifetime. Emitter morphology resulting in improved promising field emission performances, which is a crucial factor for the fabrication of pillared shaped vertical aligned CNTs bundles as practical electron sources.
Dipole pinning effect on photovoltaic characteristics of ferroelectric BiFeO3 films
Authors: Biswas P. P. , Thirmal Ch. , Pal S. , Murugavel P.
Published: January 2018

Ferroelectric bismuth ferrite is an attractive candidate for switchable devices. The effect of dipole pinning due to the oxygen vacancy layer on the switching behavior of the BiFeO3 thin film fabricated by the chemical solution deposition method was studied after annealing under air, O2, and N2 environment. The air annealed film showed well defined and dense grains leading to a lower leakage current and superior electrical properties compared to the other two films. The photovoltage and transient photocurrent measured under positive and negative poling elucidated the switching nature of the films. Though the air and O2 annealed films showed a switchable photovoltaic response, the response was severely affected by oxygen vacancies in the N2 annealed film. In addition, the open circuit voltage was found to be mostly dependent on the polarization of BiFeO3 rather than the Schottky barriers at the interface. This work provides an important insight into the effect of dipole pinning caused by oxygen vacancies on the switchable photovoltaic effect of BiFeO3 thin films along with the importance of stoichiometric, defect free, and phase pure samples to facilitate meaningful practical applications.
Structural and optical characteristics of in-situ sputtered highly oriented 15R-SiC thin films on different substrates
Authors: Mourya Satyendra , Jaiswal Jyoti , Malik Gaurav , Kumar Brijesh , Chandra Ramesh
Published: January 2018

In this work, we have reported the in-situ fabrication of nanocrystalline rhombohedral silicon carbide (15R-SiC) thin films by RF-magnetron sputtering at 800 °C substrate temperature. The structural and optical properties were investigated for the films grown on four different substrates (ZrO2, MgO, SiC, and Si). The contact angle measurement was performed on all the substrates to investigate the role of interfacial surface energy in nucleation and growth of the films. The XRD measurement revealed the growth of (1 0 10) orientation for all the samples and demonstrated better crystallinity on Si substrate, which was further corroborated by the TEM results. The Raman spectroscopy confirmed the growth of rhombohedral phase with 15R polytype. Surface characteristics of the films have been investigated by energy dispersive x-ray spectroscopy, FTIR, and atomic force microscope (AFM) to account for chemical composition, bonding, and root mean square surface roughness (δrms). The optical dispersion behavior of 15R-SiC thin films was examined by variable angle spectroscopic ellipsometry in the wide spectral range (246–1688 nm), including the surface characteristics in the optical model. The non-linear optical parameters (χ3 and n2) of the samples have been calculated by the Tichy and Ticha relation using a single effective oscillator model of Wemple and Didomenico. Additionally, our optical results provided an alternative way to measure the ratio of carrier concentration to the effective mass (N/m*). These investigated optical parameters allow one to design and fabricate optoelectronic, photonic, and telecommunication devices for deployment in extreme environment.
Theoretical study on the perpendicular anisotropic magnetoresistance using Rashba-type ferromagnetic model
Authors: Yahagi Y. , Miura D. , Sakuma A.
Published: January 2018

We investigated the anisotropic magnetoresistance (AMR) effects in ferromagnetic-metal multi-layers stacked on non-magnetic insulators in the context of microscopic theory. We represented this situation with tight-binding models that included the exchange and Rashba fields, where the Rashba field was assumed to originate from spin–orbit interactions as junction effects with the insulator. To describe the AMR ratios, the DC conductivity was calculated based on the Kubo formula. As a result, we showed that the Rashba field induced both perpendicular and in-plane AMR effects and that the perpendicular AMR effect rapidly decayed with increasing film thickness.
Patterns of infaunal macromollusc assemblages in a subtropical marine park: implications for management
Authors: Marshall Jennifer E. , Bucher Daniel J. , Smith Stephen D. A.
Published: January 2018

Characterisation of habitats and communities is necessary to allow managers knowledge of the ecological resources they are charged with conserving. However, the high cost of gathering such data often precludes their incorporation into conservation planning, and habitat surrogates are often relied upon to represent underlying biotic patterns. In New South Wales (NSW), Australia, extensive surveys informed the development of a state-wide habitat classification scheme (HCS) for biodiversity management based on the distribution of habitat types by water depth. To test the suitability of the current HCS for soft sediments, we compared infaunal mollusc assemblages at two different depths, and at scales of kilometres to tens of kilometres, within five coastal regions of the Cape Byron Marine Park (CBMP). Mollusc assemblages differed significantly between depths and among the range of spatial scales examined, and patterns were significantly correlated with mean grain size and sorting. Species richness also differed between depths and among sampling locations, whereas abundance differed between depths and among sites nested within locations. Although the present study provides preliminary support for the relevance of the NSW HCS depth categories in the CBMP, it also suggests that future refinement should consider the inclusion of categories based on sediment characteristics.
Inter- and intra-regional patterns of stable isotopes in Dosidicus gigas beak: biological, geographical and environmental effects
Authors: Liu Bi Lin , Lin Jing Yuan , Chen Xin Jun , Jin Yue , Wang Jin Tao
Published: January 2018

We analysed stable carbon (δ13C) and nitrogen (δ15N) isotopes of 478 Dosidicus gigas specimens collected outside the Ecuadorian, Peruvian and Chilean exclusive economic zones in the south-eastern Pacific Ocean during 2009 to 2013. There were significant spatial differences both in δ13C and δ15N values across regions, with the lowest values off Ecuador and the highest values off Chile. A small intra-regional range of isotope values indicates that squid off Ecuador feed at the same trophic level with similar primary production. In contrast, a large intra-regional range of isotope values suggests that squid off Chile, especially Peru, migrate over a large geographic range and occupy a wide range of trophic levels. A generalised additive model was used to estimate the biological (mantle length and age), geographical (latitude, and distance to the shelf break) and environmental (sea-surface temperature and chlorophyll-a) effects on isotope values. Best fitted generalised additive models explained 54.0% of the variability in δ13C and 93.1% of the variability in δ15N. The yield relationships between isotopes and explanatory variables increase our understanding of D. gigas habitats, movement and feeding ecology in the south-eastern Pacific Ocean.
A comprehensive appraisal of four kinds of forage under irrigation in Xilingol, Inner Mongolia, China
Authors: Yan Yulong , Wan Zhiqiang , Chao Ran , Ge Yiqing , Chen Yali , Gu Rui , Gao Qingzhu , Yang Jie
Published: January 2018

Planting of forage can alleviate grazing pressure on natural ecosystems. In the Inner Mongolian environment, higher forage yields can be expected under irrigation because water is a key factor that limits plant growth. Lower grass yield caused by land degradation and climatic change highlight the potential importance of irrigated forage for maintaining livestock production in this environment. The present study in the Xilingol area of Inner Mongolia aimed to identify forage varieties producing high-yielding, quality forage. Three lucerne (alfalfa) varieties (Medicago sativa L. cvv. Aohan and Zhaodong, Medicago varia Martyn) and a grass (Elymus nutans Griseb) were assessed. Irrigation commenced when soil moisture at 10 cm depth reached the wilting coefficient, and ceased when soil reached field capacity. After 4 months, irrigation had significantly increased specific leaf area, tiller numbers and yield under irrigation (P < 0.05) in all varieties. Yield of cv. Zhaodong was highest at 5111 kg ha–1. Forage quality was evaluated by using yield, leaf : stem ratio and crude fibre, crude protein and crude fat contents. Forage quality was significantly higher in the three lucerne varieties than in the grass, under both irrigation and natural rainfall, with no significant difference among the three lucerne varieties. Cost–benefit analysis showed that irrigation was much more profitable for the three lucerne varieties than for the grass because of the lower market value and yield of the grass.
Sign-creation in the Seattle DeafBlind community
Authors: Edwards Terra
Published: January 2018

This article examines the social and interactional foundations of sign-creation among DeafBlind people in Seattle, Washington. Linguists studying signed languages have proposed models of sign-creation that involve the selection of an iconic gestural representation of the referent which is subjected to grammatical constraints and is thereby incorporated into the linguistic system. Drawing on 18 months of ethnographic fieldwork and more than 190 hours of video recordings of interaction and language use, I argue that a key interactional mechanism driving processes of sign-creation among DeafBlind people in Seattle is deictic integration. Deictic integration restricts the range of contextual values that the grammar can retrieve by coordinating systems of reference with patterns in activity. This process brings language into alignment with the world as it is perceived by the users of that language, making a range of potentially iconic relations available for selection in the creation of new signs.
The Spanish component in Lingua Franca
Authors: Operstein Natalie
Published: January 2018

The best-documented variety of Lingua Franca (lf), the one spoken in Algiers just before the French colonization of Algeria, comprises three main Romance lexical components; in order of numerical importance, these are Italian, Spanish and French. While it is agreed that the French component is the most recent one, the relationship between the Spanish and the Italian components has given rise to competing diachronic interpretations. This paper examines probable Spanish contributions to Algerinelfin the lexicon, copula and pronominal possession. It contributes to our understanding of the origins and evolution of Algerinelf, as revealed through language-internal analysis of its lexical and structural components.
Language contact in the Philippines
Authors: Gonzales Wilkinson Daniel Wong
Published: January 2018

This article narrates the sociohistory of the Philippines through the lens of a Sinitic minority group – the Chinese Filipinos. It provides a systematic account of the history, language policies, and educational policies in six major eras, beginning from the precolonial period until the Fifth Republic (960 – present). Concurrently, it presents a diachronic narrative on the different linguistic varieties utilized by the ethnic minority, such as English, Hokkien, Tagalog, and Philippine Hybrid Hokkien (PHH). Following an exposition on how these varieties were introduced to the ecology is a discussion focused on contact that highlights potential theories as to how Philippine contact varieties like PHH emerged. How this account contributes to the overall language ecology forms the conclusion. Overall, this article delineates the socio-historical sources that intrinsically play a significant role in the (re)description of Philippine contact varieties. In its breadth, this article goes beyond providing second-hand information, and presents ideas that can be crucial for understanding how Philippine contact languages work.
I Eat, Therefore I Am
Authors: Kelly Dan , Morar Nicolae
Published: January 2018

This chapter examines the set of relations that hold between food and cuisine, eating and dining, and norms, social roles, and identities, in a way that continues to be informed by current work in empirical moral psychology. It unpacks the notion of a social role in terms of social norms, the often unwritten rules that regulate behavior and social interactions, and describes recent empirical work that illuminates the power and psychological underpinning of norm-based cognition, with an emphasis on how disgust animates many food norms. Finally, it discusses the ethical implications of this perspective for assessing food norms and considers how attempts to alter a person’s eating habits can run up against deep and distinctive forms of psychological resistance when they are also attempts to change who she is.