bluuebunny/crossref_metadata_2025_split huggingface dataset:
DNA
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
The DNA contains the information that determines the cell phenotype. Epigenetic regulation of DNA transcription, repair of DNA damage, and tight control of the cell cycle are fundamental cell processes that determine the cellular heterogeneity, survival, plasticity, and repair in the nervous system. Epigenetics refers to heritable changes in gene expression that are independent of the DNA sequence (genetic code). Epigenetic mechanisms include: DNA methylation, histone and chromatin modifications, and effects of noncoding RNAs. Specific mutations in genes along these pathways can be associated with both neurodevelopmental and neurodegenerative disorders. To maintain genomic stability, cells activate a DNA damage response that detects and repairs the damaged DNA cycle. The elucidation of these mechanisms has led to development of novel approaches including DNA editing for treatment.
Axonal Transport
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Axonal transport is fundamental for neuronal survival and maintenance of neuronal connectivity and synaptic function. Anterograde transport delivers membrane-bound organelles synthesized and packaged in the cell body to the axon and synaptic compartments, and also allows traffic and turnover of cytoskeletal and metabolic components to dendrites and axons. Retrograde transport is necessary for removal and degradation of materials via the endosome-lysosome and autophagy-lysosome systems and for delivery of target-derived neurotrophic signals or injury signals back to the cell body. Bidirectional transport of mitochondria is important for energy delivery and mitochondria quality control. Axonal transport requires intact microtubules, motor proteins such as kinesin for anterograde and the dynein-dynactin complex for retrograde transport, correct attachment of cargo to motors, and sufficient ATP supplied by mitochondria. Impaired axonal transport is a prominent feature of many neurodevelopmental or adult-onset neurodegenerative disorders.
Mechanisms of Cell Death and Axonal Degeneration
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Cell death in the nervous system may occur via different mechanisms that eventually lead to irreversible membrane permeabilization and cell fragmentation. The two morphological correlates are apoptosis and necrosis, which frequently coexist with each other. The main triggers of neuronal cell death are accumulation of misfolded proteins, oxidative stress, DNA damage, energy failure, excitotoxicity injury, and activation of cell death cascades by products of inflammation. Mitochondria have a central role in several mechanisms of cell death, including intrinsic apoptosis, permeability transition-driven necrosis, and parthanatos. Impaired energy metabolism and glutamate-triggered excitotoxicity may lead to oxidative stress and iron-mediated lipid peroxidation, leading to ferroptosis. Inflammation may lead to cell deaths via formation of an inflammasome and necroptosis. Axonal injury impairs delivery of protective factors and impairs axonal transport, resulting in Wallerian degeneration and formation of large axonal swelling or spheroids. Elucidation of the molecular mechanisms of cell death has profound implications in development of approaches for neuroprotection.
Sensory Processing
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Sensory information reaches the cerebral cortex via several parallel channels that involve different receptor subtypes, sensory pathways, and first-order thalamic relay nuclei, which then relay modality-specific inputs to the primary sensory cortex. From primary sensory areas, information is first processed by unimodal (modality-specific) sensory association areas organized into two parallel streams; a dorsal stream for processing of visuospatial information via the posterior parietal cortex to guide attention, motor behavior, and spatial navigation, and a ventral stream for processing of object feature information via temporal lobe for object recognition. Impairment of these pathways at subcortical level or primary sensory cortex produces modality-specific sensory loss, involvement of association areas manifest with visual spatial neglect, and several forms of agnosia.
Motor Cortex
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Voluntary movements are organized to perform a purposeful task. A motor plan constitutes the overall strategy that is organized into motor programs, which control various parts of the performance. Control of voluntary movements depends on close interactions among the frontal motor areas, posterior parietal cortex, and prefrontal cortex. These areas not only are involved in initiation and execution of movement but also participate in cognitive processes, such as spatial attention, motor learning and adaptation, recognition of intentions of others, and suppression of inappropriate actions. Developments in electrophysiological techniques and functional neuroimaging have provided new insight into the cortical mechanisms of motor control. Disturbances in these mechanisms underlie several neurologic disorders, including apraxia and dystonia.
Vascular Anatomy and Physiology
Authors: Pachuski Justin , Verbeek Thomas A. , Smith Sadie E. , McQuillan Patrick M. , Urman Richard D. , Kaye Alan D. , Liu Henry 
Published: May 2021

Abstract
This important chapter reviews basic vascular anatomy and physiology. The vascular system is part of the cardiovascular system, which maintains blood supply to all organs and tissues to upkeep human metabolic activities. The vascular system has three components: arteries, veins, and capillaries. These components are where oxygen, nutrients, and metabolites exchange. Vascular wall biology has been a very hot topic for the last decades because it is involved in numerous physiological and pathological processes, yet many aspects remain unknown. There are three layers in the vascular wall: tunica intima, tunica media, and tunica adventitia. Adventitia has mainly collagenous and elastic fibers, and its physiological function was mostly unknown until recently; it is believed to be involved in the pathogenesis of atherosclerosis. The vascular tone can be altered by neurohumoral and other factors. The brain, the heart, and other vital organs have the capability to regulate their blood flow via a phenomenon called autoregulation, which maintains relatively constant blood flow to vital organs over a wide range of perfusion pressures.
Preoperative Evaluation and Optimization of the Vascular Surgery Patient
Authors: Bumbarger Katharine , Lutzker Tatiana N. , Gage Parr K. 
Published: May 2021

Abstract
The care of the patient with vascular disease can be complicated as these patients are often high risk with multiple comorbidities. They are frequently frail and can have hypertension, diabetes, pulmonary disease, coronary artery disease, congestive heart failure, cerebral vascular disease, delirium, dementia, renal insufficiency, renal failure, peripheral vascular disease, and more. A complete preoperative evaluation and patient optimization will help ensure that the best anesthetic plan is chosen for the patient. Preoperative optimization uses the information that has been gained from the evaluation to ensure that the patient’s medical conditions are as optimized as possible in order to undergo surgery, a procedure, and anesthesia.
Perioperative Considerations for Carotid Endarterectomy
Authors: Tverdohleb Tatiana , Diaz Katherine , Chen Michelle , Lutzker Tatiana N. , Gage Parr K. , Tharian Antony R. 
Published: May 2021

Abstract
Carotid endarterectomy (CEA) is a common surgical technique for carotid revascularization. CEA is done in order to prevent cerebral vascular accidents (CVAs) or strokes. There is a high risk of morbidity and mortality, such as myocardial infarction and CVA, associated with this procedure. Therefore, different types of anesthetic management and various neuromonitoring techniques have been recommended by investigators. General anesthesia with inhaled anesthetics has demonstrated better neuroprotection from focal cerebral ischemia when compared with regional anesthesia. Regional anesthesia has been associated with less hemodynamic fluctuation and decreased risk of perioperative myocardial ischemia. Superficial, intermediate, and deep cervical plexus blocks (or a combination of superficial and deep cervical plexus blocks) are recognized regional anesthetic techniques utilized for CEA. In addition, neuromonitoring techniques such as somatosensory evoked potentials, motor-evoked potentials, cerebral oximetry, and patient response during regional anesthesia have been utilized to minimize cerebral ischemia intraoperatively. This chapter summarizes the perioperative considerations for patients undergoing CEA.
Endovascular Procedures of the Abdomen/Lower Extremities
Authors: Sankova Susan K. , Yoon Jeongae 
Published: May 2021

Abstract
This chapter continues an overview of endovascular procedures, focusing on interventions below the diaphragm. Endovascular intervention has become the major technique for management of abdominal aortic aneurysms (AAAs), both ruptured and unruptured. Advancements in endovascular techniques have shortened AAA operative and recovery times and permitted intervention on patients previously felt too tenuous for an open surgical approach. Peripheral artery disease (PAD) can also be treated with a variety of endovascular techniques, including angioplasty, atherectomy, and stenting. Endovascular interventions in PAD have similarly reduced the recovery burden for patients and provide similar outcomes to open procedures. The minimally invasive nature of the endovascular approach often allows greater flexibility in anesthetic technique compared to open procedures. In conjunction with the procedural approach, the patient’s health status, preferences, and anesthesiologist preferences permit a choice of anesthesia care that may lie along a spectrum ranging from local anesthesia with minimal sedation to full general endotracheal anesthesia. The endovascular approach does, however, present specific anesthesia management concerns in both the intra- and postoperative period, which are reviewed in this chapter.
Surgery for Vascular Access in Renal Dialysis
Authors: Hoffman Christopher Ryan , Xia Zhongyuan , Liu Henry 
Published: May 2021

Abstract
End-stage renal disease is a widely prevalent condition worldwide. Its impact on morbidity and mortality necessitates surgical intervention to establish renal replacement therapy. Insufficient supply and demand render renal transplantation an option for a minority of patients requiring treatment. Multiple procedures have been put into practice to establish dialysis access. Selecting the appropriate procedure can depend on the urgency of intervention, patient clinical status, anatomic limitations, and patient/provider preference. Complications can vary, but most commonly include infection, primary patency failure, stenosis, thromboembolic phenomena, device failure, and surgical complication. The anesthesia modality is most commonly a general anesthetic. However, some procedures can be achieved under regional anesthesia or local anesthetic infiltration. Thorough preoperative assessment and optimization is required to improve outcomes in a patient population commonly experiencing multiple organ system comorbidities. This typically requires a multidisciplinary care team, including cardiology, nephrology, surgery, and anesthesiology and potentially other specialties on an individual basis to reduce perioperative morbidity and mortality and improve outcomes.
Preoperative Evaluation and Optimization
Authors: Belfar Alexandra L. , Duong Kevin , Deng Yi , Nikolaidis Melissa 
Published: May 2021

Abstract
This chapter focuses on the pre-operative evaluation and optimization of patients prior to thoracic surgery. Of primary importance is a thorough assessment of pulmonary mechanics, lung parenchymal function, and cardiopulmonary reserve. Within these categories, specific parameters to consider include forced expiratory volume, carbon monoxide diffusing capacity, and the maximum rate of oxygen consumption. The Thoracic Revised Cardiac Risk Index can be utilized for cardiac risk stratification and to assess the need for referral to a cardiologist for additional presurgical optimization. Pre-operative interventions such as smoking cessation, adequate nutrition, exercise, and pulmonary rehabilitation can decrease the incidence of respiratory complications.
Pneumonectomy
Authors: Wood Lacey , Tharian Antony 
Published: May 2021

Abstract
Pneumonectomy is a complex surgical procedure requiring a multidisciplinary approach and multifaceted anesthetic management. In this chapter, the authors begin with the history of pneumonectomy and indications and contraindications to the procedure. There is an overview of lung cancer, staging, and appropriate treatment for the different stages of lung cancer. The preoperative evaluation is briefly summarized with an algorithm to follow and is then covered in depth through breaking it down into cardiovascular risk assessment and evaluation, cardiac risk calculators, respiratory mechanics, lung parenchymal function, and finally evaluation of the cardiopulmonary interaction. The surgical procedure and types of pneumonectomy are explained for a thorough understanding before diving into anesthetic management. Preoperative planning and appropriate review prior to taking the patient to the operating room are covered, followed by a discussion of lines and monitors, lung isolation, one-lung ventilation recommendations, hemodynamic management and clamping of the pulmonary artery, supplemental studies, intraoperative fluid management, special considerations for extrapleural pneumonectomy and tracheal sleeve pneumonectomy, guidelines for extubation, and pain management. Lastly, postoperative monitoring and complications including cardiac arrhythmias, stroke, perioperative pulmonary complications and postneumonectomy pulmonary edema, bronchopleural fistula, and cardiac herniation are described.
Esophagectomy
Authors: Perry Tiffany D. , Desvarieux Tricia , Sidoran Kevin 
Published: May 2021

Abstract
Esophagectomy is a challenging procedure from a surgical and anesthetic perspective with high morbidity and mortality. Thorough preoperative evaluation is important for anesthetic planning and management. Minimizing aspiration risk is of critical importance during induction of anesthesia. There are multiple surgical approaches with minimally invasive approaches gaining traction. Most approaches require one-lung ventilation (OLV), and protective ventilatory strategies should be employed. Hypotension and arrhythmias are common intraoperative complications due to manipulation of the heart and large vessels during dissection. Postoperatively, pulmonary complications are common and a large source of mortality. Adequate pain control via thoracic epidural or potentially paravertebral blocks play an important role in reducing pulmonary complications and promoting early recovery. Enhanced recovery after surgery programs are increasingly prevalent for esophagectomy and provide a multidisciplinary perioperative treatment protocol with the goal of reducing complications, promoting recovery and improving treatment outcomes.
Visit 4
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
In Visit 4, clinicians focus on four primary goals. First, they conduct a review of the verbal rehearsal strategies taught in the last session, asking about what verbal rehearsal strategies were used, for what, when, where, and modified as needed. Second, clinicians and survivors work together to review the cognitive restructuring skills of realistic probabilities and decatastrophizing, primarily by inquiring how helpful these methods are in rethinking memory problems or barriers and which method appeared to aid coping and how. Next, the external strategies of keeping a schedule and memory routines are taught, including the rationale for keeping a schedule and day planner; the importance of keeping one schedule organizer and consulting the schedule daily; and the rationale for keeping memory routines and the importance of keeping it simple. Finally, homework involves applying the chosen compensatory strategies. The clinician should seek specifics about when and where the strategies will be used.
Inhaled anaesthetics and morbid obesity
Authors: De Baerdemaeker Luc , Hendrickx Jan , De Wolf Andre M. 
Published: May 2021

Abstract
Even though morbid obesity affects many factors governing uptake, distribution, and elimination (i.e. pharmacokinetics) of inhaled anaesthetics, its overall effects are modest. Obesity-induced pharmacodynamic changes are also small or non-existent: the minimum alveolar concentration (MAC) and MACawake of modern anaesthetics does not differ between lean and morbidly obese patients.
Obstructive sleep apnoea
Authors: Raveendran Raviraj , Chung Frances 
Published: May 2021

Abstract
Recent understanding of sleep physiology, pathogenesis of obstructive sleep apnoea (OSA), and anaesthetic effects on OSA has resulted in significant changes in the perioperative management of OSA patients. The incidence of OSA is increasing in proportion to the increase in obesity incidence. A significant number of OSA patients are not diagnosed when they present for elective surgery. Recent outcome studies on surgical populations have shown that OSA patients have increased morbidity. At the same time, algorithm-based management and the use of continuous positive airway pressure show promising results in perioperative outcomes. Anaesthesiologists have a vital role in managing OSA patients by identifying OSA and associated comorbid conditions. This chapter reviews the epidemiology, pathophysiology, and management of OSA in morbidly obese patients.
Cardiopulmonary resuscitation in the obese patient
Authors: Stander Eric 
Published: May 2021

Abstract
Cardiopulmonary resuscitation (CPR) in obese patients carries several challenges not seen in other populations and understanding of the differences in anatomy, physiology, pharmacology, and outcomes will assist the physician in better performance during this critical moment with improved outcomes. The probability of needing to perform cardiac resuscitation in obese patients is increasing, simply in that the number of patients who are obese is increasing, and obesity carries higher risks of morbidity. According to the Centers for Disease Control and Prevention, in 2013, 28.3% of the population in the United States were obese (28.0–28.6 at 95% confidence interval), and this number has been increasing yearly since 2011. This chapter reviews considerations in the management of the airway, optimal ventilations during CPR, best options for circulation, and medications used during CPR in obese patients. Objective data are limited, in respect to CPR in obese patients, and continued research is necessary in all phases of this therapy. An especially acute problem, not discussed enough, might just be availability of reasonable intravenous access.
Day care surgery
Authors: Sultana Adrian 
Published: May 2021

Abstract
Anaesthetists encounter morbidly obese patients in every aspect of their daily practice and especially as ambulatory (day) surgery candidates. Restrictions on body mass index for day surgery appear to have become obsolete and obese patients who are medically fit do well after day case surgery. The less invasive group of bariatric surgical operations including endoluminal procedures may be accepted as outpatients. Comprehensive preoperative assessment focusing on airway, respiratory, and cardiovascular issues is recommended. The full gamut of sophisticated airway equipment and all-round airway skills must be available in the day surgery environment to adequately deal with these patients. An ideal anaesthetic technique is discussed in the chapter.
Epidemiology and genetics of Sjögren’s syndrome
Authors: Bowman Simon J. 
Published: May 2021

Abstract
Sjögren’s syndrome (SS) is a chronic, immune-mediated condition of unknown aetiology, characterized by focal lymphocytic infiltration of exocrine glands associated with dry mouth and dry eyes. It occurs either as a primary disorder (primary SS (pSS)), or as a secondary condition in which the glandular features occur, typically as a late feature of other rheumatic diseases, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma (secondary SS). There is a strong female bias. Typically pSS affects women in middle age, with an estimated prevalence of 0.04%–0.4%. Of patients with pSS, 75% have anti-Ro and/or anti-La antibodies, often with raised immunoglobulin levels (hypergammaglobulinaemia). There is a 44-times increased risk of mucosa-associated lymphoid tissue (MALT) B-cell lymphoma in pSS, typically affecting the salivary glands. Anti-Ro/La antibodies are typically associated with the HLA-DR3-DQ2 haplotype. Genome-wide screening has identified interferon-related and B-cell-related genes linked to pSS.
Salivary gland biopsy—procedure and histopathology
Authors: Fisher Benjamin 
Published: May 2021

Abstract
The most commonly biopsied glands for the diagnosis of Sjögren’s syndrome (SS) are the labial minor salivary glands. Techniques employed include wedge biopsies, the Daniels technique, punch biopsies, and ‘minimally invasive’ procedures. The Daniels technique is described together with its possible complications and its potential advantages over other approaches. The typical histological change associated with SS is a focal lymphocytic sialadenitis (FLS), which needs to be distinguished from a nonspecific chronic sialadenitis. Once the presence of FLS is established, the number of lymphocytic foci with ≥ 50 mononuclear cells are counted, divided by the glandular surface area in mm2, then multiplied by 4 to give the number of foci per 4 mm2. FLS with a focus score ≥ 1 is currently established as the threshold for a biopsy to be considered supportive of a diagnosis of SS. Other features that should be reported include the presence of germinal centre-like lesions and lymphoepithelial lesions.
Haematological manifestations of Sjögren’s syndrome
Authors: Yeoh Su-Ann , Ciurtin Coziana 
Published: May 2021

Abstract
Haematological abnormalities in primary Sjögren’s syndrome (pSS) may present in various ways—anaemia (the most frequently occurring cytopoenia), leucopoenia (lymphopoenia or neutropoenia), thrombocytopoenia, hypergammaglobulinaemia, or hypocomplementaemia—all of which can occur either in isolation or in combination. They occur more commonly in patients with positive anti-Ro/SSA status and can occur even before sicca symptoms appear. Patients with pSS have an increased risk of developing non-Hodgkin’s lymphoma, with mucosa-associated lymphoid tissue non-Hodgkin’s lymphoma of the salivary glands being the most common. Adverse haematological prognostic factors include hypocomplementaemia, hypergammaglobulinaemia, and cryoglobulinaemia. In this review, we also discuss therapeutics used in pSS treatment and their effect on haematological abnormalities.