bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Music Therapy and Music-Based Interventions on Dementia: A Pilot Study
Authors: Dahms Rebecca , Eicher Cornelia , Haesner Marten , Mueller-Werdan Ursula 
Published: May 2021

Abstract
According to national dementia plan in many countries, the music implementation into the daily routine as an adjunctive therapy to medication treatment is common. However, the ability of long-term care facilities to implement individualized music therapy (MT) and music-based interventions is not sufficiently taken into account. This pilot study examined the frequency of use and acceptance of MT and technology-based music interventions (TBMI) as well as the influence of high and low usage of both interventions of dementia on behavioral and psychological symptoms (BPSD) at two timepoints. Furthermore, the influence on the combination of MT and TBMI of dementia within the nursing home setting on BPSD with a focus on agitation, apathy, depression, and quality of life at all timepoints was considered. In the present study, data from 30 people with dementia (PwD) aged on average 81 years were analyzed within an eight-week noncontrolled intervention study, including four-week follow-up. Initial outcome data indicated significant decreases at times T2 and T3 in agitation and apathy among PwD with a high usage of MT and TBMI than among those with a low usage. In general, reductions were obtained from all observed BPSD at all timepoints. Significant results were found only for agitation over time. Considering the demonstrated results, a long-term implementation of music within daily routines in nursing homes for PwD should be strived for.
Neuraxial Anesthesia
Authors: Cardenas Paulina 
Published: May 2021

Abstract
Neuraxial anesthesia is the preferred method of anesthetic care for the parturient. This chapter will discuss the different neuraxial techniques and how they are used for both labor and cesarean delivery. It will discuss single-shot spinal anesthesia, continuous spinal anesthesia (CSA), epidural anesthesia, and combined spinal-epidural (CSE) anesthesia. It will also discuss the relevant anatomy and physiology to consider when placing a neuraxial anesthetic. The pain pathways for the first and second stages of labor will be described. Common equipment used while placing a neuraxial anesthetic is reviewed. The recent addition of neuraxial ultrasonography to aid in placing neuraxial anesthesia is discussed.
Non-Opioid Analgesic Techniques for Labor and Vaginal Delivery
Authors: Nguyen Anvinh , Deng Yi , Nikolaidis Melissa A. 
Published: May 2021

Abstract
This chapter will review non-opioid analgesic techniques for vaginal delivery. There are three stages of vaginal delivery, and the different dermatomal coverage required for adequate relief of labor pain will be reviewed for each stage. As labor progresses through its predictable stages, different nerves are involved in the transmission of pain. The location of pain can be described by the spinal nerve roots that are carrying the noxious stimuli. The chapter will discuss epidural and regional techniques as well as the use of non-opioid oral medications, non-opioid intravenous medications, and inhalational medications for alleviating pain during vaginal delivery.
Obstetric Hemorrhage
Authors: Khan Faiza A. , Mhyre Jill M. 
Published: May 2021

Abstract
Obstetric hemorrhage remains a major cause of maternal morbidity and mortality. It is important to recognize that excessive bleeding may become life threatening if not identified early. Importance must be paid to recognition of the cause of bleeding and appropriate intervention. Hemorrhage can be antepartum or postpartum. Effective management requires a multidisciplinary approach for positive outcomes including collaboration of anesthesiologists with the obstetrician, neonatologist, and interventional/surgical services. Anesthesiologists should be involved in the management of all stages of hemorrhage for an effective approach. Use of national guidelines and checklists is recommended to ensure timely diagnosis and management. In this chapter, we review the different types of obstetric hemorrhage, the stages of hemorrhage, the general management plan, as well as specific considerations for each cause. We include multidisciplinary guidelines and algorithms that can be used to guide management.
Neonatal Assessment and Resuscitation
Authors: Kromah Fatoumata , Bhatt Darshna , Chahin Nayef , Yitayew Miheret , Khoury Joseph 
Published: May 2021

Abstract
Neonatal care is complex, multifactorial, and multidisciplinary. The provider has to take into consideration physiologic, clinical, ethical, and technological factors that will impact the long-term neonatal outcome. This is an important consideration, as the US infant mortality rate remains higher than any other developed nation.1 The decrease in the rate of neonatal mortality in the US has been mainly attributed to better understanding of neonatal assessment, advances in neonatal resuscitation, and risk mitigation of birth-related neurological injuries. Understanding risk factors for poor fetal outcomes, neonatal assessment, and resuscitation is essential to the practice of obstetric anesthesia.
Anesthesia and Assisted Reproductive Techniques
Authors: Martin Nora , Farah Fadi , Reddy Shamantha 
Published: May 2021

Abstract
This book chapter covers the anesthetic management and associated challenges involved in assisted reproductive techniques. The average age of women starting their families has increased, which has led to a rise in infertility and assisted reproductive procedures. Ambulatory surgeries and office-based procedures for infertility are also becoming more prevalent given the new business models of healthcare. Understanding the various steps starting from hormonal stimulation to embryo transfer will help the anesthesiologist in not only administering safe care but also showing empathy towards these patients who go through an emotional roller coaster of conception. We will also discuss the different anesthetic techniques and their implications for the success of the assisted reproductive techniques.
Medicolegal Issues in Obstetric Anesthesia
Authors: Onyewu Samuel , Kromah Fatoumata 
Published: May 2021

Abstract
This chapter highlights medicolegal issues in obstetric anesthesia and reviews expectations for the anesthesiologist involved in the care of obstetric patients. Obstetric anesthesia is a unique subspecialty in anesthesiology. It is the only subspecialty where the anesthesiologist is primarily responsible for two patients at the same time (while performing one anesthetic). In this era of tremendous medical advancements in patient care, women with debililating medical conditions live long enoughto childbearing age, hence the obstetric anesthesiologist is often involved in the management of high-risk pregnant patients with complex medical history. Pregnant patients with complex medical conditions have increased risk for severe maternal and fetal/neonatal mortality and morbidity. Therefore, when dealing with high-risk obstetric patients, the potential for medicolegal issues is greater compared to nonpregnant or healthy pregnant patients. Trends in medical liability claims for obstetric anesthesiologists have changed over the years. There has been a reduction in maternal death, neonatal death, and brain damage claims; however, maternal nerve and minor-injury claims are increasing. The most common reasons for anesthesia-related malpractice liability claims are anesthesia delay, substandard care, inadequate or inaccurate documentation, poor communication, and medication errors.
Vesicular Trafficking
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Normal cell function depends on the appropriate synthesis, maturation, sorting, and delivery of fully processed proteins and other macromolecules to specific intracellular compartments; uptake of material from the cell exterior; and regulated intracellular processing and degradation of proteins, lipids, complex carbohydrates, abnormal aggregates, and senescent organelles. These fundamental functions involve secretory, endocytic, and autophagic pathways. The secretory pathway is responsible for protein maturation, sorting, and delivery of transmembrane and secreted proteins from their site of synthesis to their final destinations. Synaptic vesicle exocytosis is a special form of secretion that allows rapid communication between neurons. The endocytic pathway starts with the internalization of material via endosomes. Endosomal content can be transported back to the cell body, recycled to cell compartments, or delivered for degradation by the lysosome. Abnormal protein aggregates or damaged organelles undergo autophagy, which involves formation of an autophagosome and degradation by the lysosome. Impaired vesicular trafficking is a fundamental mechanism in a large number of neurodegenerative disorders, including hereditary spastic paraplegia, lower motor neuron syndromes, and Parkinson disease.
Neurotransmission, Neuromodulation, and Plasticity
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Neurochemical signals released at synapses or by perisynaptic glial cell processes include excitatory and inhibitory amino acids, acetylcholine, monoamines, neuropeptides, purines, lipid mediators, nitric oxide, growth factors, cytokines, and extracellular matrix proteins. These signals produce three fundamental effects on their target: classical neurotransmission, neuromodulation, and plasticity. Classical neurotransmission is the rapid, precise transmission of excitatory or inhibitory signals. Neuromodulation affects the probability of neurotransmitter release or responsiveness of the postsynaptic cells to the neurotransmitter. Synaptic plasticity refers to the use-dependent changes in efficacy of transmission of excitatory signals, eventually associated with change in dendritic structure and connectivity. Plasticity also involves interactions among synapses, glial cell, and the extracellular matrix. Abnormalities of synaptic transmission and plasticity are common disease mechanisms in neurologic disorders and are therapeutic targets.
Glutamatergic Transmission and Synaptopathies
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
L-glutamate is the primary excitatory neurotransmitter in the adult central nervous system (CNS). Glutamatergic inputs are critical for fast synaptic excitation, use-dependent synaptic plasticity, shaping of activity of local circuits and networks, neuron–astrocyte interactions, and myelination by oligodendrocytes. Plasticity of glutamatergic synapses is critical for development and maintenance of synaptic connections and for mechanisms of learning and adaptation in the CNS. Induction of these forms of glutamatergic synaptic plasticity depends on the activity-dependent expression and recycling of glutamate receptor subunits. Impaired plasticity of glutamatergic synapses is a major disease mechanism in neurodevelopmental intellectual disability, Alzheimer disease, limbic encephalitis, and cerebellar ataxia.
Astrocytes and Astrocyte–Neuron Interactions
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Astrocytes constitute approximately 30 percent of cells in the CNS and are the most abundant glial cells. They constitute a structural and functionally heterogeneous population and are critically involved in development, homeostasis, synaptic and neuronal network activity, and response to injury and repair in the CNS. They have a major role in synaptic formation during development and maintenance of extracellular fluid and potassium homeostasis, antioxidant protection, metabolic support to active neurons and oligodendrocytes, local regulation of cerebral blood flow, uptake and recycling of synaptic glutamate and γ-aminobutyric acid (GABA), synaptic plasticity, and coordination of activity in neuronal networks in the adult CNS. Astrocytes are primarily affected in metabolic, genetic, and immune astrocytopathies and have a major role in the pathophysiology of epilepsy and in vascular, immune, inflammatory, and neurodegenerative disorders.
Sleep–Wake Cycle and Circadian Rhythms
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Wake and sleep states are defined by behavioral and electrophysiological biomarkers such as the electroencephalogram and electromyogram. Studies using selective neuronal activation and inactivation in experimental animals show that the control of the wake–sleep cycle primarily depends on glutamatergic and GABAergic neurons distributed in the basal forebrain, hypothalamus, and brainstem. These neurons receive modulatory influence of cholinergic, monoaminergic, and peptidergic neurons. Whereas arousal depends on brainstem and basal forebrain mechanisms, the maintenance of the waking states and the transition from wakefulness to sleep depend on the hypothalamus. The sleep–wake cycle is primarily regulated by the circadian rhythm and homeostatic sleep pressure. Sleep has a critical role in memory consolidation, synaptic plasticity, and maintenance of homeostasis in CNS. Disturbances of circadian regulation and sleep architecture are major manifestations of genetic, neurodegenerative, and autoimmune disorders.
Behavioral State Control
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Information processing, cognition, and behavior are dynamically modulated by several groups of cholinergic and monoaminergic neurons that provide widespread but functionally distinct inputs to the cerebral cortex and subcortical areas. These neurons are active during wakefulness and increase their activity in response to behaviorally relevant environmental stimuli. Via different presynaptic and postsynaptic receptors located in principal neurons and local interneurons, these cholinergic and monoaminergic systems participate in the maintenance of arousal and have a major role in sensory processing, selective attention, motivation, and action selection. These systems are selectively vulnerable in neurodegenerative disorders and also have a major role in psychiatric disorders.
Spinal Motor Control
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Motor neurons in the spinal cord brainstem motor nuclei (motoneurons) are the final effectors of central motor control and provide the output to skeletal muscles, forming motor units. The activity of spinal motoneurons is controlled by descending cortical and brainstem inputs largely via premotor circuits involving excitatory or inhibitory interneurons. These circuits elicit specific patterns of motoneuron activation controlling muscle synergies under the influence of descending corticospinal and brainstem motor pathways. Central pattern generators are interneuron circuits that can autonomously generate activation of motoneurons in the absence of descending commands or afferent feedback and include those involved in locomotion, respiration, and swallowing. Disorders affecting motor neurons or their control by afferent, cortical, or cerebellar influences constitute a large proportion of neurological diseases.
Cerebellar Circuits
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
The cerebellum has a critical role in control of timing and coordination of movement, acquisition of skills, and cognitive and affective functions. It participates in motor control via both immediate online adjustments of motor performance and long-term adaptive motor learning, referred to as supervised or error-based learning. Most of the cerebellum is interconnected with association areas of the cerebral cortex. The cerebellum is a major target of genetic, degenerative, metabolic, and immune disorders. Experimental evidence indicates that disrupted Purkinje cell pacemaking activity and synaptic plasticity in the cerebellum have a major role in the pathophysiology of ataxia. The cerebellar circuits also have a major role in the pathophysiology of different types of tremor.
Autonomic Control and Survival
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
The autonomic nervous system controls the moment-to-moment activity of visceral organs and has a critical in survival, homeostasis, and adaptations to internal or external challenges. The autonomic outputs are mediated by the sympathetic, parasympathetic, and enteric nervous systems under the influence of several interconnected areas distributed throughout the central nervous system (CNS). They include lower brainstem areas mediating autonomic reflexes, and upper brainstem areas that integrate autonomic and respiratory control with behavioral arousal. These areas are also the effectors of descending commands from the hypothalamus, amygdala, and cerebral cortex and provide feedback inputs to these areas. Disorders affecting autonomic control may manifest with autonomic failure that severely affects quality of life, and sometimes with life-threatening impaired control of blood pressure and respiration during sleep.
Executive Control
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
Attention, working memory, decision-making, and executive control are fundamental cognitive functions that involve large-scale networks largely defined on the basis of functional magnetic resonance imaging (fMRI) studies. These networks include areas of the lateral and medial prefrontal, orbitofrontal, anterior, and midcingulate cortices, anterior insula, and lateral and medial posterior parietal cortices as well as areas of the temporal lobe and temporoparietal junction. These networks include the dorsal and ventral attention networks, frontoparietal, cingulo-opercular and salience control networks, and the default mode network. These networks are located along a hierarchical gradient of cortical organization. Dysfunction of large-scale cortical networks is a cardinal feature of neurodegenerative dementias and psychiatric disorders.
Regional Anesthesia
Authors: Berg Kent B. , Kiley Sean , Buchanan Patrick J. , Robicsek Steven A. 
Published: May 2021

Abstract
Major vascular surgical procedures are commonly performed on patients with significant comorbidities. Regional anesthetic techniques may be used as the primary mode of anesthesia or to supplement general anesthesia for open or endovascular surgical procedures. This chapter focuses on the management of thoracic and abdominal aortic repair, as well as revascularization of the lower extremities. Although general anesthesia is still used in a majority of these surgeries, neuraxial and regional options allow for the reduction of opioid administration and provide hemodynamic stability while maintaining safety. An understanding of vascular anatomy, the surgical procedure, as well as neuraxial or regional anesthesia technique, is critical for success. Finally, anticoagulant medication management, coordination of the timing of the procedure, and postoperative management are crucial to reduce the risk of complications in this challenging patient population.
Normal Respiratory Physiology
Authors: Renschler Jordan S. , Jeha George M. , Kaye Alan D. 
Published: May 2021

Abstract
Patient positioning should optimize exposure for surgery while minimizing potential harm to the patient. Concerns for patient positioning include interfering with respiration or circulation, compressing peripheral nerves of skin, and causing musculoskeletal discomfort. This chapter will review basic respiratory physiology and introduce physiological and anatomical considerations during thoracic anesthesia, including the supine position and the lateral decubitus, both closed and open chest. It will cover lung isolation techniques, including anatomical landmarks, double-lumen tubes, bronchial blocker, bronchoscopy. with consideration of specific indications and basic lung mechanics and pulmonary function. It will also examine different types of equipment for thoracic anesthesia, such as the double-lumen tube and the bronchial blocker, and their uses.
Patient Positioning and Surgical Considerations
Authors: Ho Phi , Deng Yi , Nikolaidis Melissa 
Published: May 2021

Abstract
It is a collaborative effort among all operating room personnel to ensure safety and well-being of the patient while providing optimal surgical exposure. Lateral positioning is the most common position for most thoracic surgeries. Proper assessment of patient positioning is of utmost importance to mitigate peripheral nerve injuries. Understanding physiologic changes with changes in position is prudent in treatment of hemodynamic changes. This chapter discusses numerous positionings to ensure surgical access that mitigate risks for neurological injuries such as damage to the ulnar nerve. In addition to lateral positioning, the authors examine the flexed lateral decubitus (kidney), supine, and lateral semiprone positions.
Anesthetic Management Techniques in Thoracic Surgery
Authors: Liu Henry , Chen Xiangdong , Kaye Alan D. , Urman Richard D. 
Published: May 2021

Abstract
Although anesthetic management for thoracic surgery can be challenging, ventilation and hemodynamic monitoring are critical. In this chapter, we begin with a brief history of the pneumothorax challenge that surgeons and anesthesiologists needed to overcome during intrathoracic surgical procedures. They then discuss the intraoperative ventilation and hemodynamic monitoring approaches, as well as management strategies for intraoperative hypoxemia. There are newer anesthetic approaches such as nonintubating techniques for thoracic surgical procedures, and a greater emphasis on the application of goal-directed fluid therapy and the multimodal analgesic strategies.
Anesthesia for Pleural Space Procedures
Authors: Arora Harendra , Smeltz Alan 
Published: May 2021

Abstract
A variety of conditions can involve the pleural space that may require surgical intervention. Diseases that involve the pleura include pleurisy, pneumothorax, pleural effusion, hemothorax, chylothorax, empyema, and pleural tumors, as well as alveolopleural or bronchopleural fistula. Surgical interventions for treatment of pleural diseases include catheter drainage, debridement, decortication, pleurodesis, and thoracic duct ligation or repair of bronchopleural or alveolopleural fistula. Aside from overall patient assessment and workup, the preanesthetic evaluation should focus on cardiopulmonary risks to determine patients’ tolerance to one-lung ventilation. Anesthetic plan typically includes general anesthesia with or without one-lung isolation techniques. There are specific cases that may benefit from awake anesthetic techniques in order to allow maintenance of spontaneous ventilation. Most patients undergoing surgery for pleural disease can be extubated at the end of the procedure unless their cardiopulmonary status is rather tenuous. Postoperative analgesia is best addressed through a multimodal approach with certain cases benefiting from epidural or paravertebral analgesia.
Lung Transplantation
Authors: Francis Loren , McKinnon Jared 
Published: May 2021

Abstract
Anesthesia for lung transplant surgery involves careful preoperative assessment, close intraoperative monitoring, prompt evaluation and treatment of hemodynamic and respiratory instability, and clear communication with the surgical team. This chapter discusses key elements of lung transplant surgery and offers clinical guidance for the cardiothoracic anesthesiologist. It details preoperative, intraoperative, and postoperative management considerations and offers a focused overview of mechanical support strategies. Specifically, pulmonary artery catheter placement is explained, relevant transesophageal echocardiography anatomy is reviewed, and ventilator and fluid management strategies are discussed. The chapter begins with the preoperative assessment and then moves to intraoperative management. The chapter ends with a discussion of mechanical support and posttransplant management.