bluuebunny/crossref_metadata_2025_split huggingface dataset:
Language Mapping in Aphasia
Authors: Wilson Stephen M. , Eriksson Dana K. , Yen Melodie , Demarco Andrew T. , Schneck Sarah M. , Lucanie Jillian M. 
Published: November 2019

PurposeRecovery from aphasia is thought to depend on neural plasticity, that is, functional reorganization of surviving brain regions such that they take on new or expanded roles in language processing. To make progress in characterizing the nature of this process, we need feasible, reliable, and valid methods for identifying language regions of the brain in individuals with aphasia. This article reviews 3 recent studies from our lab in which we have developed and validated several novel functional magnetic resonance imaging paradigms for language mapping in aphasia.MethodIn the 1st study, we investigated the reliability and validity of 4 language mapping paradigms in neurologically normal older adults. In the 2nd study, we developed a novel adaptive semantic matching paradigm and assessed its feasibility, reliability, and validity in individuals with and without aphasia. In the 3rd study, we developed and evaluated 2 additional adaptive paradigms—rhyme judgment and syllable counting—for mapping phonological encoding regions.ResultsWe found that the adaptive semantic matching paradigm could be performed by most individuals with aphasia and yielded reliable and valid maps of core perisylvian language regions in each individual participant. The psychometric properties of this paradigm were superior to those of other commonly used paradigms such as narrative comprehension and picture naming. The adaptive rhyme judgment paradigm was capable of identifying fronto-parietal phonological encoding regions in individual participants.ConclusionAdaptive language mapping paradigms offer a promising approach for future research on the neural basis of recovery from aphasia.Presentation Videohttps://doi.org/10.23641/asha.10257584
A Taxonomy of Brain–Behavior Relationships After Stroke
Authors: Turkeltaub Peter E. 
Published: November 2019

PurposeUnderstanding the brain basis of language and cognitive outcomes is a major goal of aphasia research. Prior studies have not often considered the many ways that brain features can relate to behavioral outcomes or the mechanisms underlying these relationships. The purpose of this review article is to provide a new framework for understanding the ways that brain features may relate to language and cognitive outcomes from stroke.MethodBrain–behavior relationships that may be important for aphasia outcomes are organized into a taxonomy, including features of the lesion and features of brain tissue spared by the lesion. Features of spared brain tissue are categorized into those that change after stroke and those that do not. Features that change are further subdivided, and multiple mechanisms of brain change after stroke are discussed.ResultsFeatures of the stroke, including size, location, and white matter damage, relate to many behavioral outcomes and likely account for most of the variance in outcomes. Features of the spared brain tissue that are unchanged by stroke, such as prior ischemic disease in the white matter, contribute to outcomes. Many different neurobiological and behavioral mechanisms may drive changes in the brain after stroke in association with behavioral recovery. Changes primarily driven by neurobiology are likely to occur in brain regions with a systematic relationship to the stroke distribution. Changes primarily driven by behavior are likely to occur in brain networks related to the behavior driving the change.ConclusionsOrganizing the various hypothesized brain–behavior relationships according to this framework and considering the mechanisms that drive these relationships may help investigators develop specific experimental designs and more complete statistical models to explain language and cognitive abilities after stroke. Eight main recommendations for future research are provided.Presentation Videohttps://doi.org/10.23641/asha.10257578
Investigating the nature of the extended structure around the Herbig star RCrA using integral field and high-resolution spectroscopy
Authors: Rigliaco E. , Gratton R. , Mesa D. , D’Orazi V. , Bonnefoy M. , Alcalà J. M. , Antoniucci S. , Bacciotti F. , Dima M. , Nisini B. , Podio L. , Barbieri M. , Claudi R. , Desidera S. , Garufi A. , Hugot E. , Janson M. , Langlois M. , Rickman E. L. , Sissa E. , Ubeira Gabellini M. , van der Plas G. , Zurlo A. , Magnard Y. , Perret D. , Roelfsema R. , Weber L. 
Published: November 2019

Context. We present a detailed analysis of the extended structure detected around the young and close-by Herbig Ae/Be star R CrA. This is a young triple system with an intermediate mass central binary whose separation is of the order of a few tens of the radii of the individual components, and an M-star companion at about 30 au.
Aims. Our aim is to understand the nature of the extended structure by means of combining integral-field and high-resolution spectroscopy.
Methods. We conducted the analysis based on FEROS archival optical spectroscopy data and adaptive optics images and integral-field spectra obtained with SINFONI and SPHERE at the VLT.
Results. The observations reveal a complex extended structure that is composed of at least two components: a non-uniform wide cavity whose walls are detected in continuum emission up to 400 au, and a collimated wiggling-jet detected in the emission lines of helium and hydrogen. Moreover, the presence of [Fe II] emission projected close to the cavity walls suggests the presence of a slower moving wind, most likely a disk wind. The multiple components of the optical forbidden lines also indicate the presence of a high-velocity jet co-existing with a slow wind. We constructed a geometrical model of the collimated jet flowing within the cavity using intensity and velocity maps, finding that its wiggling is consistent with the orbital period of the central binary. The cavity and the jet do not share the same position angle, suggesting that the jet is itself experiencing a precession motion possibly due to the wide M-dwarf companion.
Conclusions. We propose a scenario that closely agrees with the general expectation of a magneto-centrifugal-launched jet. These results build upon the extensive studies already conducted on R CrA.
Delir erkennen in 3 Schritten
Authors: von Haken Rebecca , Hansen Hans-Christian 
Published: November 2019

Abstract
Background Clinicians are commonly confronted with the differential diagnosis of altered mental status, impaired cognition and altered level of consciousness in hospitalized patients including those admitted to medical, geriatric, emergency, intensive and post-operative care units. Although delirium is the most common acute neuropsychiatric condition in the acute hospital setting this diagnosis is commonly delayed, made too late or missed altogether.
Difficulties and importance of timely diagnosis The causes of delirious states are manifold. Both, direct damage to the brain tissue as well as encephalopathy as a result of other medical diseases, can be the cause of delirium. Depending on the predisposition delirious syndromes can be provoked by minor medical interventions. Clinical presentation is very variable, but remains largely independent of the triggering mechanisms. Purely catatonic, hypoactive, hyperactive and excitatory types as well as mixed forms can be distinguished.Immediate diagnosis of a delirious syndrome and rapid elucidation of its causes are keys for the implementation of curative therapy. There is a need to act fast because delirious phases are associated with significantly longer hospital stay and increased morbidity as a result of long-term cognitive deficits as well as increased mortality. As negative outcome is closely linked to the duration of a delirious episode, early diagnosis and rapid termination of the delirium constitute a significant positive predictor of outcome. In this respect, delirium represents an emergency, with or without concomitant cerebral or extracerebral symptoms.
Transitionspsychiatrie – Herausforderungen und Lösungsansätze
Authors: Banaschewski Tobias , Fegert Jörg M. , Freyberger Harald , Karow Anne , Reif Andreas , Schaff Christa , Voderholzer Ulrich , Driessen Martin 
Published: November 2019

ZusammenfassungBrüche in der psychiatrischen Versorgung beim Übergang vom Jugend- in das Erwachsenalter führen – gerade bei schweren psychischen Erkrankungen – häufig zu einer erheblichen Behandlungsverzögerung und einer besonders hohen Rate von Therapieabbrüchen mit hohem Risiko für frühe Chronifizierungen. Die gemeinsame Task-Force Transition der Deutschen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (DGKJP) und der Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) hat daher allgemeine, sektoren- und störungsspezifische Lücken im deutschen psychiatrischen Versorgungssystem analysiert, die einer gelingenden Transition ins erwachsenenpsychiatrische Versorgungssystem entgegenstehen. Der Artikel fasst die Ergebnisse der Task-Force zusammen, skizziert die Ziele und Herausforderungen transitionspsychiatrischer Behandlungsmodelle und deren strukturelle und fachliche Voraussetzungen. Daraus werden die Forderungen und Empfehlungen an Psychiatrieplanung, Gesundheits- und Forschungspolitik sowie Aus-, Fort- und Weiterbildung weitergeleitet, um die Transition von einer adoleszentenzentrierten hin zu einer erwachsenenorientierten psychiatrischen Versorgung in Zukunft optimal zu gestalten.
Therapie der ambulant erworbenen und nosokomialen Pneumonie
Authors: Kramme Evelyn , Dalhoff Klaus , Ewig Santiago 
Published: November 2019

ZUSAMMENFASSUNGDie ambulant erworbene Pneumonie (community-acquired pneumonia, CAP) ist weltweit die häufigste vital bedrohliche Infektion. In Deutschland wird sie mit zunehmender Alterung der Gesellschaft mehr und mehr zu einer geriatrischen Erkrankung. Entscheidend für die Therapie ist die Schweregradbeurteilung, die nach dem CRB65-Score erfolgt. In der Klinik wird zur Abklärung der Ätiologie eine mikrobiologische Basisdiagnostik empfohlen, diese besteht aus respiratorischer Kultur, Blutkulturen, bei mittelschwerer und insbesondere schwerer Pneumonie auch dem Legionellen-Antigentest im Urin. Weitere Tests sind nach anamnestischen Hinweisen gezielt einzusetzen. Die Auswahl der Therapie wird bei der CAP in erster Linie vom Schweregrad bestimmt. Die Therapiedauer sollte bei CAP nicht mehr als 5–7 Tage betragen.Die nosokomiale Pneumonie spielt eine Hauptrolle unter den im Krankenhaus erworbenen Infektionen. Die Mehrzahl der Fälle tritt bei beatmeten Patienten auf. Anders als bei der CAP prägen „Problemkeime“ wie Staphylococcus aureus, Enterobakterien und Pseudomonas aeruginosa das Erregerspektrum der nosokomialen Pneumonie. Eine Zunahme multiresistenter Erreger (MRE) wird weltweit beobachtet. Die Wahl der kalkulierten Therapie erfolgt nach dem MRE-Risiko und dem Schweregrad der Infektion. Eine regelhafte initiale Kombinationstherapie wird nur noch dann empfohlen, wenn sowohl ein erhöhtes MRE-Risiko als auch Schweregradkriterien vorliegen. Deeskalation und Antibiotic Stewardship (ABS) sind integraler Bestandteil des Therapiekonzepts, dabei geht es vorrangig um die Begrenzung des Antibiotikaeinsatzes.
Activities of Serum Adenosine Deaminase and its Isoenzymes in
Patients with Systemic Lupus Erythematosus, Rheumatoid Arthritis, Ankylosing
Spondylitis and Myasthenia Gravis
Authors: Zhao-wei Gao , Zhao Guan-hua , Li Rui-cheng , Wang Hui-ping , Liu Chong , Zhang Hui-zhong , Dong Ke 
Published: November 2019

Abstract
Objective The aim of this study was to evaluate the changes and
diagnostic value of serum ADA activity in autoimmune diseases, including
systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing
spondylitis (AS), and myasthenia gravis (MG).
Methods Serum ADA activity, including total ADA (tADA) and its isoenzymes
(ADA1 and ADA2), was determined in patients with different autoimmune diseases
(144 RA, 114 SLE, 55 AS, 68 MG). The changes in serum ADA activity in patients
were analysed. A receiver operating characteristic (ROC) curve analysis was
applied to evaluate the diagnostic performance of serum ADA activity.
Results Compared with healthy controls, the serum tADA activity in SLE
patients was significantly increased (p<0.001), while the serum tADA
activity in patients with RA, AS and MG did not change (p>0.05). The ROC
analysis showed that the optimal cut-off value of serum tADA activity for SLE
diagnosis was 10.5 U/L (79.8% specificity and
74.6% sensitivity; likelihood ratio (LR): 3.693; p<0.001).
Moreover, our results showed that there were no significant changes of ADA1 and
ADA2 activity in RA, AS and MG patients, while the serum ADA2 activity was
significantly increased in SLE patients. The ROC analysis showed that ADA2
activity could be used in diagnosing SLE with 75.4% specificity and
78.1% sensitivity (LR: 3.175). Based on the ROC curve analysis, serum
tADA activity (79.8% specificity and 74.6% sensitivity;
likelihood ratio (LR): 3.693) and ADA2 activity (75.4% specificity and
78.1% sensitivity; LR: 3.175) are unlikely to be used in diagnosing SLE.
Furthermore, there was a positive correlation between tADA activity and SLE
disease activity (r=0.303, p=0.010). Notably, serum tADA
activity in SLE patients with arthritis was higher than in patients without
arthritis (p=0.005), which suggests that tADA activity might be related
to lupus arthritis.
Conclusion These findings suggest that serum tADA and ADA2 activity might
play an important role in SLE progression.
Immunsuppression beim nierentransplantierten Patienten über 65 Lebensjahre
Authors: Reshetnik Alexander 
Published: November 2019

ZUSAMMENFASSUNGÄltere Patienten stellen eine zunehmende Population unter den Transplantierten. Leider sind die empirischen Daten zur immunsuppressiven Therapie in diesem Kollektiv bislang begrenzt. Die vorhandene Evidenz deutet jedoch darauf hin, dass verfügbare moderne Immunsuppressionsprotokolle unter Beachtung spezieller Besonderheiten bei älteren Patienten auch in dieser Klientel problemlos eingesetzt werden können. Dennoch sollten zukünftige randomisierte Studien ältere Empfänger einschließen, um die Empirik in dieser zunehmend größeren Population zu erweitern.
Introduction of Disc Material into the Vertebral Canal by Fenestration of Thoracolumbar Discs Following Decompressive Surgery
Authors: Harris Georgina , Freeman Paul 
Published: November 2019

Abstract
Objective Intervertebral disc extrusion is a common disease affecting chondrodystrophic dogs. It has been reported that fenestration of thoracolumbar intervertebral discs reduces recurrence of disc extrusion and is associated with a low complication rate. One complication reported is iatrogenic introduction of disc material into the canal directly following fenestration. This study aimed to ascertain if, and at what frequency, additional disc material may be introduced into the vertebral canal by fenestration of the affected disc following decompressive surgery.
Study Design Twenty-one dogs that underwent hemilaminectomy and disc fenestration for the treatment of thoracolumbar intervertebral disc extrusion had intraoperative assessment of the vertebral canal before and after fenestration. The spinal cord was first decompressed by hemilaminectomy and removal of all visible extruded disc material within the vertebral canal. Once no further material was visible, manual fenestration of the affected disc was performed. The vertebral canal was re-inspected, and the presence or absence of additional material was noted and included in the surgery report.
Results Seven dogs showed the presence of new disc material in the vertebral canal post fenestration.This preliminary study shows that additional disc material can be forced into the vertebral canal by fenestration following decompressive surgery, with a frequency of 7/21.
Conclusion This illustrates the importance of checking the vertebral canal after fenestration of an extruded intervertebral disc.
Position and Relations of Ovary in Developing Human Fetuses
Authors: Momin Ambath D. , Singh Naranbabu 
Published: November 2019

Abstract
Aim: The aim of the study is to relook into the gross development of human ovary and its relation to other pelvic organs. Materials and methods:The materials studied consisted of 52 normal human female fetuses of different gestational ages starting from 14th week to 40 weeks, collected from Dept, of Obstetrics and Gynecology, RIMS, Imphal with permission from the local ethical committee. Results: The ovaries are almond shaped and are located in false pelvis till term. The orientations of the ovaries were different at different age groups. Till 16 week the ovary was found to be placed vertically, at 18 weeks obliquely in 66.66% and vertically in 33.33% instances. Thereafter ovaries were placed obliquely in the false pelvis till 29th week. At 30th week they were found to be almost horizontal till 38th week of gestation and at 40th week they regained oblique orientation. Weight and all the dimensions of the ovary were found to increase with increasing gestational weeks. The weight and dimension of right ovary was slightly more than that of left ovary. During early weeks ovarian size is greater than that of uterus but as the age advances, size of uterus becomes bigger than ovary. Conclusion: Ovaries lie vertically in early weeks of gestation and become oblique in mid trimester. The ovary becomes temporarily horizontal at the end of third trimester only to become oblique at term. The detailed knowledge of developmental anatomy will help the clinician to deal with the diseases related to ovary.
The Morphometric study of Internal acoustic meatus in dry skulls of South Indian adults
Authors: KV Vinay ,   Pretty R,   Vishal K,   Beena N
Published: November 2019

Abstract
Background: The internal acoustic meatus (IAM) is a bony canal present between labyrinth and posterior cranial fossa. The normal morphometry of IAM is useful during evaluation of cases of skull trauma, congenital anomalies of IAM affecting the individual nerves, and in pre evaluation of surgeries of ear. The present study was done to determine the normal dimensions of IAM and to have a morphological database of the IAM for South Indian population. Materials & methods: The present study was conducted on 37 temporal bones of adult skulls. The impression of IAM was taken by injecting polyvinyl siloxane (PVS) impression material into the IAM and the dimensions were measured by using digital vernier callipers on right and left side separately. The height and width of IAM at porous, middle and fundus were measured and tabulated. Results: As there was no significant statistical difference between the parameters of right and left sides the data were pooled together. The mean height & width of IAM at porous end was 4.5mm & 6.42mm respectively. The mean height & width of IAC at its middle portion was 4.04mm & 4.91mm respectively. The mean height & width of IAM at the fundus was 3.8mm and 4.60mm respectively. The superior length & inferior length was 8.60 & 8.70mm respectively. Conclusion:This study provides a ready reference for dimensions of IAM of adult dry skull in South Indian population. The present study confirms that there is difference in the dimensions of IAM among different races and regions and thus emphasizes the need to have normal data for our population.
Error-Based Teaching Approach Decreases Vessel Anastomosis Errors: A Pilot Study
Authors: de Haas Eric , Stone Jill P. , de Haas William , Schrag Christiaan H. 
Published: November 2019

Abstract
Background Microsurgical anastomosis of vessels is a challenging skill that surgical residents should practice on models before attempting in the clinical setting. These skills are often taught using synthetic materials, animal tissue, or live animal models. With increasing constraints on surgical resident's time, it is important to maximize efficiency of microsurgical training. The purpose of this study is to determine if teaching surgical residents about common vessel anastomosis errors decreases the total number of suture errors during a 4-day training course.
Methods Plastic surgery residents (R1–R3) were randomly assigned to receive additional teaching focused on either common microsurgical errors or traditional microsurgical manuals. The residents then performed anastomosis on rat femoral arteries in which the total number of sutures and errors were recorded by staff microsurgeons who were blinded to the intervention.
Results Residents who received teaching on common microsurgical errors performed a total of 73 sutures of which 12 were errors. The control group who studied using traditional microsurgical manuals performed a total of 125 sutures of which 38 were errors. There was a statistically significant decrease in the total number of suture errors (Fisher's exact test; p-value = 0.04) and in the number of partial depth bite errors (Fisher's exact test p-value = 0.03).
Conclusion Teaching surgical residents about common vessel anastomosis errors decreased the total number of errors when compared with traditional education methods using microsurgery manuals. Partial depth bite errors were also decreased through error-based teaching.
Pott’s Spine with Tubercular Meningitis and Primary Optic Atrophy: An Enigma with a Rare Cautionary Tale
Authors: Khan Khursheed Alam , Saraswat Kunj Bihari , Marbate Tushar , Gupta Ashok 
Published: November 2019

AbstractTuberculosis of spine, known as Pott’s spine, is a significant health risk. Misdiagnosis or delayed diagnosis with lack of timely interventions lead to serious neurological complications and is associated with morbidity and mortality. We present a case of Pott’s spine who developed tubercular meningitis with decreased vision due to primary optic atrophy, to highlight the significance of thorough clinical and neuroradiological workup with instillation of prompt antitubercular therapy in patients of central nervous system tuberculosis (CNS TB). This association of Pott’s spine with decreased vision secondary to primary optic atrophy due to tubercular involvement of the second cranial nerve is very rare. Here, associated risk factors, varied clinical presentations, complications, and treatment of CNS TB are reviewed.
Management of Hyperactive Delirium in the Pediatric Intensive Care Unit: Case Series of Three Young Children
Authors: Jesus Anna O. , Jones Lotte , Linares Rebecca , Buck Marcia L. , Frank Deborah U. 
Published: November 2019

AbstractChildren in the intensive care unit (ICU) are at high risk of developing delirium, given their underlying disease processes, the adverse effects of treatments and medications, and the stressful, abnormal environment. If prevention and nonpharmacologic measures to treat delirium are unsuccessful, atypical antipsychotics are considered, although they are not approved by Food and Drug Administration for the treatment of pediatric delirium and could have significant adverse side effects. This case report presents three pediatric patients with hyperactive ICU delirium that risked life-threating complications who were successfully treated with short courses of atypical antipsychotic medications.
Endovascular Treatment of Hepatic Venous Outflow Obstruction after Liver Transplant
Authors: Pandhi Mithil B. , Lipnik Andrew J. , Niemeyer Matthew M. 
Published: November 2019

AbstractLiver transplantation provides definitive treatment to address acute or chronic end-stage liver disease and its complications. Hepatic venous outflow obstruction is an infrequent complication of liver transplantation that affects graft survival by compromising outflow via transplant hepatic veins or inferior vena cava. It can occur in the early postoperative phase or in a delayed manner, resulting in venous congestion, graft dysfunction, graft failure, and death. This article addresses the pathophysiology of venous outflow obstruction as it relates to different surgical techniques and patient populations, the noninvasive tools for diagnosis, and the endovascular options for treatment along with their safety, efficacy, and durability.