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

Abstract
Normal cell function and survival depend on carefully regulated synthesis, folding, trafficking, and degradation of proteins. The balance among these processes is referred to as proteostasis. Proteins undergo maturation and folding in the endoplasmic reticulum. This process is error-prone and can be affected by mutations, errors during transcription or translation, and cellular stressors. Several interacting mechanisms, including the endoplasmic reticulum stress response, the unfolded protein response, and degradation by the ubiquitin-proteasome and the autophagosome-lysosome systems prevent the accumulation of misfolded proteins. Protein misfolding and incorporation into fibrillary structures is a fundamental mechanism of many neurodegenerative disorders. Degeneration results from toxic gain-of-function of the intermediate fibril monomers, promoting the formation of aggregates and initiating a cascade of protein–protein interactions leading to neuronal dysfunction and death, associated with neuroinflammation. These protein aggregates may serve as templates or seeds to elicit aggregation of their respective normal endogenous partners in neighboring cells, leading to disease propagation.
Mitochondria and Energy Metabolism
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Mitochondria are membranous organelles critical for survival and function of neurons and other cells in the nervous system and many other tissues. Their main functions include production of ATP by oxidative phosphorylation, signaling via reactive oxygen species; intracellular calcium (Ca2+) homeostasis; synthesis of iron-sulfur (Fe-S) clusters; metabolism of lipids and amino acids, and synthesis of nucleotides, and heme. Maintenance of normal mitochondrial function and distribution is known as mitostasis, and requires highly regulated processes of mitochondrial biogenesis and quality control, fusion/fission, transport, and mitophagy. Mitochondrial dysfunction is a critical mechanism of neurologic diseases. They include disorders directly affecting OXPHOS and metabolic functions; primary disorders of mitostasis; and most adult-onset neurodegenerative disorders indirectly affecting mitostasis through defects in axonal transport and autophagy.
Cholinergic Transmission
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Acetylcholine (ACh) is a major neurotransmitter in the central and peripheral nervous systems. Cholinergic neurons in the central nervous system include the basal forebrain cholinergic group that projects to the cerebral cortex and has a major role in attention, sensory processing, and memory; the mesopontine group that projects to the thalamus, basal ganglia, and brainstem areas and is involved in arousal, reward, and control of muscle tone; and large aspiny neurons of the striatum controlling basal ganglia function. In the periphery, ACh is the neurotransmitter of motor neurons innervating skeletal muscle; preganglionic neurons innervating autonomic ganglia; and parasympathetic, enteric, and sudomotor sympathetic neurons. Acetylcholine acts via nicotinic receptors to elicit fast excitation and several subtypes of muscarinic receptors that exert a variety of modulatory actions. Given the widespread distribution and targets of ACh, cholinergic systems have a major role in a variety of neurologic disorders, including Alzheimer disease, neuromuscular transmission defects, and autonomic manifestation of autoimmune diseases, drugs, or toxins.
Monoaminergic Systems
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Central monoaminergic systems are involved in behavioral arousal, attention, motivation, and control of motor, nociceptive, and autonomic processing. They include dopaminergic, noradrenergic, serotonergic, and histaminergic neurons with cell bodies in restricted areas of the brainstem and hypothalamus and widespread axonal projections targeting multiple brain regions. Via their multiple receptor mechanisms, these systems exert a complex and behavioral-state-dependent modulation of excitability of neurons and neuronal networks. In the periphery, norepinephrine is the major neurotransmitter of the sympathetic system. Monoaminergic systems are affected in genetic disorders of monoamine metabolism, neurodegenerative conditions, and psychiatric disorders. These systems are also a major target for pharmacologic therapy.
Microglia and Neuroinflammation
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Microglia maintain cellular, synaptic, and myelin homeostasis during development and normal function and response to injury. Surveilling icroglia actively explore their environment by dynamically extending thin processes that respond to local signals. Activated (“reactive,” or “effector”) microglia constitute a heterogeneous population that dynamically change in phenotype depending on their environmental context and may mediate either injury or neuroprotection, repair, and circuit refinement. Any type of injury in the CNS elicits activation of microglia, astrocytes, and oligodendrocyte precursors, which together with infiltrating cells from the blood in the case of blood-brain barrier disruption interact via several signals to elicit elimination of pathogens, limit the spatial extent of the lesion, and eventually promote tissue remodeling, repair, and remyelination. Neuroinflammation is a feature of essentially all types of neurologic disorders, including traumatic, vascular, and inflammatory/demyelinating lesions; autoimmune encephalitis; and neurodegenerative disorders and has a major role in mechanisms of epilepsy and pain.
Neocortical Organization and Circuits
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
The cerebral cortex consists of multiple areas that differ from each other in terms of microstructural architecture, functional specialization, connectivity with other areas, and topographic organization. All cortical areas share a fundament cell composition, consisting of excitatory (principal) projection neurons, primarily pyramidal neurons, and different subtypes of local inhibitory GABAergic interneurons. Most pyramidal neurons participate in intra- or interhemispheric corticocortical connections; some project to subcortical targets, including the thalamus, basal ganglia, brainstem, and spinal cord. The different subtypes of GABAergic interneurons participate in feedforward, feedback, and disinhibitory circuits by targeting different domains of the principal cells and other GABAergic interneurons. Processing of information in the cerebral cortex critically depends on the precise synchronization of neuronal ensembles, both within local networks and across relatively long distances between separate brain regions. The interactions between principal cells and GABAergic interneurons have a critical role in determining these coordinated cortical oscillations. Dysfunction of these cortical circuits is at the core of many neurologic and psychiatric disorders, including seizures, dementia, and schizophrenia, to name a few.
Hippocampal and Amygdala Circuits
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
The hippocampus and the amygdala are medial temporal lobe structures that constitute core elements of the so-called limbic system. The hippocampus and its cortical connections form a posterior limbic circuit critical for encoding, storage, and retrieval of episodic and visuospatial memory. The amygdala and its cortical and subcortical connections form an anterior limbic circuit involved in emotional processing and social behavior. The intrinsic circuits of both the hippocampus and the amygdala consist of serial excitatory connections strongly regulated by local GABAergic neurons. Due to their relatively simple organization, the circuits of the hippocampus and amygdala have been extensively studied and provided the basis for elucidation of mechanisms of synaptic plasticity and learning. The hippocampus and amygdala are strongly interconnected with each other both anatomically and functionally, and they are both affected in disorders manifested with abnormal memory and emotional processing, such as mesial temporal lobe epilepsy and limbic encephalitis.
Thalamus and Thalamocortical Interactions
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
The thalamus is critical for the routing of information and coordinating the forebrain activity responsible for arousal, attention, sensory processing, motor control, cognition, and behavior. It contains first-order relay nuclei that selectively project to modality-specific primary cortical sensory areas, high-order relay nuclei that participate in cortico-thalamo-cortical interactions for attention and high-level cognitive processing, motor nuclei that mediate influences of the cerebellum and basal ganglia, and intralaminar and midline nuclei that participate global cortical activation and control the function of the striatum. All these nuclei provide excitatory inputs to the cortex via thalamocortical neurons. Thalamocortical activity is controlled by GABAergic neurons of the reticular nucleus of the thalamus, which regulate the firing pattern of thalamocortical neurons during the sleep-wake cycle and in the setting of selective attention. Extrathalamic GABAergic, cholinergic, and monoaminergic inputs also strongly regulate the thalamic circuits in a behavioral state-dependent manner. Disruption in thalamocortical circuits is a major mechanism in disorders of impaired awareness such as absence and temporal lobe seizures and in the pathophysiology of cognitive disorders.
Vascular Anesthesia Procedures
Authors: Urman Richard , Kaye Alan 
Published: May 2021

Abstract
This book reviews the practice of vascular anesthesia, which is now increasingly recognized as a subspecialty of anesthesia, and looks at developments and latest evidence in neuraxial, regional, and general anesthesia techniques. It explores essential topics on vascular anatomy, common vascular procedures, and anesthetic techniques in general and regional anesthesia. It also includes subjects relating to complications, perioperative patient monitoring, and post-operative management. The book begins with an analysis of the basic vascular anatomy and physiology, which covers the three components of the vascular system where oxygen, nutrients, and metabolites exchange: artery, vein, and capillaries. It ends with the anesthetic approach on patients that are presented for vascular surgery and considered to be a very sick, comorbid population with higher ASA classification.
Hemostasis, Thrombosis, Transfusion, and Blood Conservation
Authors: Henderson Reney A. 
Published: May 2021

Abstract
In vascular surgical procedures, there is a balance of anticoagulation and coagulation that must take place for a successful surgery. This chapter reviews goals in coagulation and hemostasis in vascular surgery. For vascular surgery, patients must be anticoagulated to inhibit occlusion and thrombosis of vasculature. Once the procedure is completed, anticoagulation must be reversed to obtain hemostasis. The method to regain hemostasis varies and can be by the administration of reversal agents, hemostatic agents, or allogenic blood products. This process can sometimes be simplified by using thromboelastography as a guide for treatment. This chapter also touches on blood conservation (cell salvaging techniques) and the use of alternative blood products.
Invasive Anesthesia Procedures for Perioperative Care
Authors: Kuo Frederick H. , Nikolaidis Melissa , Deng Yi 
Published: May 2021

Abstract
Patients presenting for vascular surgery frequently have multiple comorbidities associated with increased surgical risk. Additionally, certain types of vascular surgery can induce stress on the patient and create increased risk for complications. These factors often necessitate closer monitoring to facilitate early intervention. The anesthesiologist may elect to perform certain invasive procedures to aid in perioperative care. Procedures reviewed include placement of peripheral intravenous catheters, arterial catheters, central venous catheters, pulmonary artery catheters, and lumbar cerebrospinal fluid drains. For each procedure, this chapter discusses clinical applications, contraindications, site selection, required equipment and setup, placement techniques, potential usage of ultrasound guidance, and possible complications.
Regional Anesthesia
Authors: Herzig Samuel , Medrano Elilary Montilla , Gritchenko Karina 
Published: May 2021

Abstract
Patients presenting for vascular surgery typically have significant comorbidities. Procedures can vary from minor to quite large with significant blood loss and fluid shifts, and can be elective or emergent. Perioperative morbidity and mortality in the context of co-existing cardiovascular disease, diabetes, dementia and other factors all provide great concern to the anesthesiologist in their approach towards the vascular patient. The anesthetic approach to such patients must therefore be taken with great forethought. Many times, these procedures can be localized to a particular extremity or well-defined set of dermatomes, and regional anesthesia has become one important option for the complicated vascular patient. In this chapter, the risks, benefits, and feasibility of various regional techniques are discussed in the context of patients presenting for carotid endarterectomy, vascular access placement, and major lower extremity vascular surgery.
Postoperative Management of Vascular Surgery Patients and Complications
Authors: Rabai Ferenc , Cooper Michol A. , Covington Derek B. 
Published: May 2021

Abstract
Vascular surgery carries an increased risk of a variety of complications in the immediate and extended postoperative periods. Major vascular operations, such as thoracoabdominal aortic aneurysm repairs and limb revascularizations, are commonly associated with prolonged operative time, ischemic reperfusion injuries, large blood losses, and systemic inflammatory response syndrome. Additionally, vascular patients usually present with a high burden of comorbidities. These factors increase the risk of multiple organ systems failing postoperatively. Myocardial injury, postoperative pulmonary complications, acute kidney injury, and neurovascular complications are relatively common and have been shown to increase morbidity and mortality. Close monitoring and an appropriate level of care ensure a safe transition into the postoperative phase. Recent data suggest that risk stratification with modern diagnostic tools and laboratory tests using sensitive biomarkers play pivotal roles in the early detection of deteriorating organ function and initiation of timely intervention. Evidence-based postoperative management guidelines and care bundles (e.g., prehabilitation, enhanced screening for myocardial injury, lung-protective ventilator management, kidney protection strategies, and enhanced recovery protocols) show promise in preventing, mitigating, and effectively treating complications with an overarching goal of optimizing postoperative outcomes and ensuring that patients recover successfully.
Thoracic Radiology
Authors: Freels Parker D. , Wynn Gregory C. , Meyer Travis , Giuratrabocchetta Giuseppe 
Published: May 2021

Abstract
Diagnostic imaging plays an important role in patient care and management. Particularly in the procedural setting, the likelihood of a patient receiving some form of perioperative imaging is high. Therefore, the anesthesiologist should be familiar with the various available radiologic tools, their proper utilization, and the common imaging findings. These diagnostic imaging techniques allow clinicians the opportunity to gain insight into a patient’s unique anatomy and, based on these findings, prepare for a more appropriate patient-centered course of treatment based on these findings. Thoracic radiology is an extensive subject with a long list of potential pathology that can occur within the chest. In this chapter, the authors’ goal is to review the more routinely used imaging modalities (radiography, computed tomography, and ultrasonography) while focusing on some of the most common diseases, disorders, and defects of the thorax encountered by anesthesiologists during their daily practice. These include abnormalities of the airways, lungs, pleura, vasculature, and esophagus.
Physiology of One-Lung Ventilation
Authors: Shanmugam Geetha , Pla Raymond 
Published: May 2021

Abstract
Ventilation and perfusion are matched under physiologic conditions for optimal gas exchange and oxygenation. Ventilation involves the entry and exit of air from the lungs, while perfusion involves the flow of blood through alveolar pulmonary capillaries. Both are necessary for the diffusion of oxygen into and carbon dioxide out of the bloodstream. During thoracic surgery, the ventilation/perfusion (V/Q) relationship is disrupted by induction of general anesthesia, lateral decubitus positioning, one-lung ventilation, and the open chest. Despite ventilation/perfusion alterations, severe hypoxia is usually avoided with the aid of several intrinsic and extrinsic factors. This chapter will delve into the changing V/Q relationship that occurs during thoracic surgery; modifying factors, including hypoxic pulmonary vasoconstriction and position, among others; and strategies to address hypoxia intraoperatively.
Bronchoscopic Anatomy
Authors: Panjeton Geoffrey D. , Kirk Fowler W. , Panjeton Hess , Deng Yi , White Jeffrey D. 
Published: May 2021

Abstract
A functional understanding of normal tracheobronchial anatomy as well as its clinically relevant variations is essential to effective, safe perioperative anesthetic evaluation and management for thoracic procedures. This chapter reviews the anatomy of the airway and lung structures that are encountered during basic bronchoscopy. The larynx, trachea, and tracheobronchial tree, including right and left lung and bronchial anatomy and vascular supply to the trachea and bronchial tree, are presented in addition to key identifying features for each structure. Labeled illustrations and bronchoscopic images are provided for reference and clarity. The vascular supply is also described and depicted. This chapter includes possible anatomical and pathological variants that may be discovered during bronchoscopy.
Visit 3
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
In this visit, survivors review their practice and response to quick relaxation, and their overall ability to use relaxation skills in daily life. They also review their use of self-instructional training, review homework, and discuss any other memory and attention problems they’ve noticed. Visit 3 involves reviewing verbal rehearsal strategies (verbal rehearsal, spaced rehearsal, chunking, and rhymes) and selecting one to focus on. The survivor learns how to identify and challenge thinking that leads to excessive stress or erodes their emotional strength and resilience (use of probability estimation and Decatastrophizing). They will also practice the new memory and attention strategy and identify how and where it will be best applied and used in daily activity.
Visit 6
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
In Visit 6, survivors are introduced to combined internal and external strategies: active listening and verbal rehearsal for socializing. Active listening is a compensatory strategy used in MAAT to help reduce social avoidance due to cognitive difficulties. Active listening involves using basic interviewing methods, such as summarizing and clarifying what one heard, so that survivors can compensate for parts of conversation they may miss. It presents an opportunity to clarify and “verbally rehearse” the conversational point to register and remember. Verbal rehearsal also provides a strategy to help become re-engaged in previously avoided social activity. Three steps can be taken to aid with active listening skills: (1) review nonverbal behaviors and paralinguistic tone; (2) review summarization (when the listener repeats back a summary of what it is they believed they heard, thus rehearsing the message); and (3) review clarification to seek assurance that what was heard was the intended message. Further, fatigue management and sleep improvement are highlighted if relevant to the survivor, with the rationale of using simple behavior change to minimize the potential impact of sleep problems and fatigue on cognitive function.
Visit 8
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
In this last visit, the first part of the visit involves a review of visualization strategies, which ones were used and in which situations. The survivor and clinician then work together to form a maintenance plan that will help the survivor to continue to apply and refine MAAT compensatory and coping strategies. Emphasis is not on the end of MAAT, but “the end of the beginning.” A review of all compensatory strategies learned to date is completed and are detailed on how they will be applied in daily life in the maintenance plan. The survivor also identifies a plan for continued review of the MAAT Survivor Workbook and a source of social support in order that compensatory strategies continue to be applied and refined over the course of his or her lifetime. The intent is to maintain continued memory skills building and adaptations through life.
Visit 2
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
In Visit 2, the clinician sets the frame for homework by following up on assignments from Visit 1 without being punitive about tasks that were not done. Rather, the clinician reinforces progress/successes and brainstorms corrective actions. A review of self-monitoring worksheets should assist in identifying themes in memory and attention failures (e.g., verbal-auditory, visual-attention, recall of written or auditory information, ability to follow instruction) while acknowledging the role of environmental factors and inner physical and emotional states (e.g., anxiety, frustration, fatigue, hunger, pain). A review of progressive muscle relaxation sets the stage for learning quick relaxation. The important internal strategy of self-instructional training is introduced.
Visit 8
Authors: Ferguson Robert J. , Gillock Karen Lee 
Published: May 2021

Abstract
In Visit 8, the last MAAT visit, the clinician emphasizes the theme of maintaining continuous mastery and refinement of MAAT principles and adaptive skills going forward in life. Visit 8 begins with a review of visualization and the degree to which visualization methods are useful and practical for the survivor. After discussion about specific experiences with visualization (modifying as necessary), discussion is turned to developing a plan to maintain the new behaviors and attitudes toward self-managing CRCI in daily life. Emphasis is placed on the notion that MAAT is not completed; rather, Visit 8 represents “the end of the beginning.” Continuous application and use of MAAT compensatory strategies will become more routine with time, and this requires maintenance of awareness and use. Cognitive performance failures will likely wax and wane due to numerous factors, including the chronic nature of CRCI. Constructing the maintenance plan entails reviewing each of the adaptive strategies with the survivor and completing a provided form. In addition, the clinician and survivor identify a schedule of at least monthly review of the survivor workbook to help maintain and adapt MAAT skills with changes in life. They also identify sources of social support to help the survivor maintain consistency. Finally, the clinician and survivor may identify a schedule of follow-up or “booster” visits to reinforce maintenance.