bluuebunny/crossref_metadata_2025_split huggingface dataset:
La Formulación de Caso en Supervisión Clínica: Proceso Colaborativo Apoyado por Mapas Conceptuales.
Authors: González Brignardello Marcela Paz 
Published: March 2019

La práctica supervisada se encuentra en el ápice del proceso de formación y entrenamiento de los profesionales dedicados a la promoción del bienestar humano –en sentido amplio- y a la salud mental, de manera específica. En la práctica supervisada, los psicólogos noveles encuentran el apoyo del supervisor quien, además, debe asegurar los niveles de calidad del servicio prestado al paciente y al desarrollo de las competencias del supervisado. La capacidad de realizar formulaciones clínicas de casos es una de las competencias nucleares para el ejercicio de la práctica profesional. En concreto, la formulación clínica es el proceso de integración de la información obtenida a lo largo de las diferentes fases del proceso terapéutico y, a su vez, es el objeto de análisis sobre el cual el terapeuta y el supervisor realizarán el proceso de supervisión. Es en esta doble vertiente, de objeto y proceso, donde se hace necesario un método de representación gráfica sobre el cual se pueda representar y relacionar la información y, a la vez, negociar los significados correspondientes.Los mapas conceptuales son herramientas gráficas ampliamente utilizadas para organizar y representar el conocimiento. La elaboración de mapas promueve el proceso compartido de negociación de significados, y a la vez, facilita la expresión del conocimiento experto. Se propone aquí la utilización de los mapas conceptuales como herramienta idónea para la elaboración y representación gráfica de la formulación de casos y como herramienta colaborativa de amplia utilidad en el proceso de supervisión clínica.
La alianza terapeutica en la danza movimiento terapia con pacientes con discapacidad intelectual. Estudio de caso
Authors: Barnet-López Silvia , Pacheco Meritxell , Panhofer Heidrun , Zelaskowski Peter , Pérez-Testor Susana , Guerra-Balic Myriam 
Published: March 2019

Presentamos un estudio de caso cualitativo descriptivo. La participante es una mujer de 39 años con Discapacidad Intelectual, específicamente Síndrome de Down, que realizó una intervención individual en Danza Movimiento Terapia (DMT). Los objetivos del estudio son: (1) conocer los elementos relevantes de la Alianza Terapéutica (AT) que se estableció durante la intervención consistente en 19 sesiones en DMT y (2) observar si estos elementos de la AT contribuyen al éxito de los objetivos de la intervención. Los objetivos de la intervención fueron: aumentar el conocimiento del propio cuerpo, aumentar el control de impulsos y la tolerancia a la frustración, mejorar la comunicación y la relación con el otro y fomentar la iniciativa, la creatividad, la seguridad y su autonomía. El terapeuta realizó notas de campo para recoger los elementos más importantes del caso en relación a la construcción de la AT y de los objetivos de la intervención. Posteriormente se realizó un análisis de contenido. Los resultados muestran que se construyó una AT saludable, lo cual permitió alcanzar los objetivos de la terapia. Así mimo, este estudio de caso es una aportación al ámbito de la DMT, que nos permite conocer mejor el trabajo realizado en este tipo de intervenciones.
El Proceso Relacional de la Rabia desde una Perspectiva Personal. “Te odio porque te necesito”
Authors: Burper Angela 
Published: March 2019

La rabia es una emoción compleja. Este artículo refleja cómo la relación terapéutica puede ayudar a explorar su función como mecanismo de protección psicológica y los diferentes aspectos que subyacen en ella. En este personal caso práctico, también se describe la díada madre-hija en algunas etapas evolutivas.
Properties of Type-Ia Supernova Light Curves
Authors: Sukhbold Tuguldur 
Published: March 2019

Abstract
I show that the characteristic diffusion timescale and the gamma-ray escape timescale, of SN Ia ejecta, are related with each other through the time when the bolometric luminosity, L
bol, intersects with instantaneous radioactive decay luminosity, L

γ
, for the second time after the light-curve peak. Analytical arguments, numerical radiation-transport calculations, and observational tests show that L
bol generally intersects L

γ
at roughly 1.7 times the characteristic diffusion timescale of the ejecta. This relation implies that the gamma-ray escape timescale is typically 2.7 times the diffusion timescale, and also implies that the bolometric luminosity 15 days after the peak, L
bol(t
15), must be close to the instantaneous decay luminosity at that time, L

γ
(t
15). With the employed calculations and observations, the accuracy of L
bol = L

γ
at t = t
15 is found to be comparable to the simple version of “Arnett’s rule” (L
bol = L

γ
at t = t
peak). This relation aids the interpretation of SN Ia light curves and may also be applicable to general hydrogen-free explosion scenarios powered by other central engines.
Distinguishing Mergers and Disks in High-redshift Observations of Galaxy Kinematics
Authors: Simons Raymond C. , Kassin Susan A. , Snyder Gregory F. , Primack Joel R. , Ceverino Daniel , Dekel Avishai , Hayward Christopher C. , Mandelker Nir , Mantha Kameswara Bharadwaj , Pacifici Camilla , Vega Alexander de la , Wang Weichen 
Published: March 2019

Abstract
The majority of massive star-forming galaxies at z ∼ 2 have velocity gradients suggestive of rotation, in addition to large amounts of disordered motions. In this paper, we demonstrate that it is challenging to distinguish the regular rotation of a disk galaxy from the orbital motions of merging galaxies with seeing-limited data. However, the merger fractions at z ∼ 2 are likely too low for this to have a large effect on measurements of disk fractions. To determine how often mergers pass for disks, we look to galaxy formation simulations. We analyze ∼24,000 synthetic images and kinematic maps of 31 high-resolution simulations of isolated galaxies and mergers at z ∼ 2. We determine if the synthetic observations pass the criteria commonly used to identify disk galaxies and whether the results are consistent with their intrinsic dynamical states. Galaxies that are intrinsically mergers pass the disk criteria for anywhere from 0% to 100% of sightlines. The exact percentage depends strongly on the specific disk criteria adopted and weakly on the separation of the merging galaxies. Therefore, one cannot tell with certainty whether observations of an individual galaxy indicate a merger or a disk. To estimate the fraction of mergers passing as disks in current kinematics samples, we combine the probability that a merger will pass as a disk with theoretical merger fractions from a cosmological simulation. Taking the latter at face value, the observed disk fractions are overestimated by small amounts: at most by 5% at high stellar mass (1010–11
M
⊙) and 15% at low stellar mass (109–10
M
⊙).
Negligible Role for Deletion Mediated by cDC1 in CD8+ T Cell Tolerance
Authors: MacNabb Brendan W. , Kline Douglas E. , Albright Annie R. , Chen Xiufen , Leventhal Daniel S. , Savage Peter A. , Kline Justin 
Published: March 2019

Abstract
Deletion of CD8+ T cells by dendritic cells (DCs) is recognized as a critical mechanism of immune tolerance to self-antigens. Although DC-mediated peripheral deletion of autoreactive CD8+ T cells has been demonstrated using T cells reactive to model Ags, its role in shaping the naturally occurring polyclonal CD8+ T cell repertoire has not been defined. Using Batf3−/− mice lacking cross-presenting CD8α+ and CD103+ DCs (also known as type 1 conventional [cDC1]), we demonstrate that peripheral deletion of CD8+ T cells reactive to a model tissue Ag is dependent on cDC1. However, endogenous CD8+ T cells from the periphery of Batf3−/− mice do not exhibit heightened self-reactivity, and deep TCR sequencing of CD8+ T cells from Batf3−/− and Batf3+/+ mice reveals that cDC1 have a minimal impact on shaping the peripheral CD8+ T cell repertoire. Thus, although evident in reductionist systems, deletion of polyclonal self-specific CD8+ T cells by cDC1 plays a negligible role in enforcing tolerance to natural self-ligands.
Identification of Residues Critical for FPR2 Activation by the Cryptic Peptide Mitocryptide-2 Originating from the Mitochondrial DNA–Encoded Cytochrome b
Authors: Lind Simon , Gabl Michael , Holdfeldt André , Mårtensson Jonas , Sundqvist Martina , Nishino Kodai , Dahlgren Claes , Mukai Hidehito , Forsman Huamei 
Published: March 2019

Abstract
Similar to bacteria, synthesis of mitochondrial DNA–encoded proteins requires an N-formylated methionine to initiate translation. Thus, the N-formylated methionine peptides originating from mitochondria should be recognized as danger signals. To date, only one such peptide, denoted as mitocryptide-2 (MCT-2), originating from the N-terminal of the mitochondrial cytochrome b, has been isolated from mammalian tissues. Human neutrophils express FPR1 and FPR2 that detect formyl peptides, and the precise structural determinants for receptor recognition remain to be elucidated. MCT-2 is known to activate neutrophils through FPR2 but not FPR1. The aim of this study was to elucidate the structural determinants of importance for receptor preference and human neutrophil activation in MCT-2 by generating a series of MCT-2 variants. We show that there is an absolute requirement for the N-formyl group and the side chain of Met1 at position 1 of MCT-2 but also the C terminus is of importance for MCT-2 activity. We also uncovered individual side chains that positively contribute to MCT-2 activity as well as those suppressed in the response. The MCT-2 peptide and its two polymorphic variants ([Thr7]MCT-2 and [Ser8]MCT-2) all activated neutrophils, but MCT-2 containing Ile7 and Asn8 was the most potent. We also show that some peptide variants displayed a biased FPR2-signaling property related to NADPH oxidase activation and β-arrestin recruitment, respectively. In conclusion, we disclose several critical elements in MCT-2 that are required for neutrophil activation and disclose structural insights into how FPR2 recognition of this mitochondrial DNA–derived peptide may increase our understanding of the role of FPR2 in aseptic inflammation.
Is Freehand Technique of Pedicle Screw Insertion in Thoracolumbar Spine Safe and Accurate? Assessment of 250 Screws
Authors: Vijayeswaran N. , Venkatesh Raju , Murugesan G. , Balamurugan S. , Indunesh K. , Pradeep T. T. 
Published: March 2019

ABSTRACT
Background: Pedicle screw fixation is one of the widely used procedures for instrumentation and stabilization of the thoracic and lumbar spine. It has the advantage of stabilizing all the three columns in single approach. Various assistive techniques are available to place the pedicle screws more accurately but at the expense of increased exposure to radiation, prolonged surgical duration, and cost. Objective: The objective of this study is to determine the accuracy and safety of pedicle screw fixation in the thoracolumbar spine using freehand surgical technique. Materials and Methods: We evaluated all patients who underwent pedicle screw fixation of the thoracolumbar spine for various ailments at our institute from January 2016 to December 2017 with postoperative computed tomography scan for placement accuracy. We used Gertzbein classification to grade pedicle breaches. Screw penetration more than 4 mm was taken as critical and those less than that were classified as noncritical. Results: A total of 256 screws inserted in T1–L5 vertebrae were included from 40 consecutive patients. Six screws were excluded according to selection criteria. The mean age was 39 years. Trauma (36 patients) was the common reason for which the pedicle screw fixation was done followed by degenerative disease (2 patients) and tumour (2 patients). A total of ten pedicle screw breaches (4%) were identified in eight patients. Among these, three critical breaches (1.2%) were occurred in two patients which required revision. The remaining seven breaches were noncritical and kept under close observation and follow-up. Conclusion: Pedicle screw had become the workhorse of posterior stabilization of the spine. Based on external anatomy and landmarks alone, freehand technique for pedicle screw fixation can be performed with acceptable safety and accuracy avoiding cumulative radiation exposure and prolonged operative time.
Symptomatic Extracranial Carotid Artery Thrombus: An Indian Experience
Authors: Karan Vivek , Vyas Devashish , Bohra Vikram , Huded Vikram 
Published: March 2019

ABSTRACT
Introduction: Symptomatic intraluminal carotid artery thrombus (ICT) is an uncommon finding, whose incidence increases with the percentage of stenosis. The optimal treatment modality to address carotid artery thrombus is not well established. We present our data of medical management of carotid artery thrombus with antiplatelet and anticoagulation. Methods: We reviewed our data from January 1, 2016 to December 31, 2017. Patients with extracranial carotid artery thrombus underwent a catheter digital subtraction angiogram to confirm the presence of thrombus. Medical management was done with dual antiplatelets along with low-molecular-weight heparin, and a check angiogram was done after 14 days. Factors contributing to the persistence of thrombus were analyzed. Results: A total of 21 patients diagnosed with acute ischemic stroke and extracranial carotid artery thrombus. Three patients opted for endarterectomy. Eighteen patients underwent medical management. Nine (50%) had a resolution of thrombus. Those with persistent thrombus were significantly older (average age 64 vs. 43 years, P = 0.008). They also had significantly higher proportions of hypertension (100% vs. 44%, P = 0.029), diabetes mellitus (89% vs. 11%, P = 0.003), and underlying carotid stenosis (100% vs. 33%, P = 0.009). Conclusion: Our regimen of dual antiplatelets plus short-term anticoagulation is safe and effective in the management of ICT. Large-scale studies are warranted to determine the optimal regimen and duration of medical treatment.
Timed Vibration Sense and Joint Position Sense Testing in the Diagnosis of Distal Sensory Polyneuropathy
Authors: Prabhakar Appaswamy Thirumal , Suresh Tharan , Kurian Dilu Susan , Mathew Vivek , Shaik Atif Iqbal Ahmed , Aaron Sanjith , Sivadasan Ajith , Benjamin Rohit Ninan , Alexander Mathew 
Published: March 2019

ABSTRACT
Introduction: Distal sensory polyneuropathy (DSP) is one of the most common neurological disorders. Although several studies have studied the role of the neurological examination in DSP, there are only limited studies on the utility of timed vibration sense (VBS) and joint position sense (JPS) testing in the diagnosis of DSP. Objectives: The objective is to study the utility of timed VBS testing and JPS testing at the great toe in clinical detection of DSP. Methods: This study was prospectively conducted in the neurology department of a tertiary care hospital in India. Patients with DSP referred to the electrophysiology laboratory from August 2017 to December 2017 were screened. Patients with symptomatic DSP which was confirmed by electrophysiological studies were taken as cases and normal participants with no symptoms or electrophysiological findings suggestive of DSP served as controls. Results: We studied 127 patients and 194 controls. The mean age of the patients was 48.7 (14.5) years in the patient group and 39.7 (14.5) years in the control group. The male: female ratio was 77/50 in the patient group and 112/82 in the control group. Abnormal clinical examination was found in 95% of the patients with DSP. The most common abnormal examination components were impaired ankle reflexes (70%), vibration (85%), and JPS (39.6%) sensation. Using the receiver operating characteristic curve for the diagnosis of DSP, a vibratory response lasting <8 s at the great toe had a sensitivity of 85% and specificity of 42.8%. For JPS testing at the great toe, obtaining two or more incorrect responses had a sensitivity of 33% and specificity of 87.6%. Conclusion: VBS testing was more sensitive and JPS testing was more specific in making a clinical diagnosis of DSP. For timed VBS, duration of >8 s at the great toe was a useful test to rule out DSP, and for JPS testing at the great toe, obtaining two or more incorrect responses was a useful test in ruling in the diagnosis of DSP.
Concurrent Venous Stenting of the Transverse and Occipito-Marginal Sinuses: An Analogy with Parallel Hemodynamic Circuits
Authors: Buell Thomas J. , Raper Daniel M. S. , Ding Dale , Chen Ching-Jen , Wang Tony R. , Taylor Davis G. , Ilyas Adeel , Kalani Mohammad Y. S. , Park Min S. , Mahaney Kelly B. , Liu Kenneth C. 
Published: March 2019

ABSTRACTNonthrombotic intracranial venous occlusive disease (NIVOD) has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH) and various non-IIH headache syndromes. Endovascular stenting of stenotic, dominant transverse sinuses (TSs) may reduce trans-stenosis pressure gradients, decrease intracranial pressure, and alleviate symptoms in a subset of NIVOD patients. We present a case in which concurrent stenting of the occipito-marginal sinus obliterated the residual trans-stenosis pressure gradient across an initially stented dominant TS. We hypothesize that this observation may be explained using an electric-hydraulic analogy, and that this patient’s dominant TS and occipito-marginal sinus may be modeled as a parallel hemodynamic circuit. Neurointerventionalists should be aware of parallel hemodynamic drainage patterns and consider manometry and possibly additional stenting of stenotic, parallel venous outflow pathways if TS stenting alone fails to obliterate the trans-stenosis pressure gradient.
Microsurgical Management for Aneurysm Arising from a Low-Lying Internal Carotid Artery-Posterior Communicating Artery Bifurcation through the Anterior Temporal Approach
Authors: Suzuki Taro , Kashimura Hiroshi , Akamatsu Yosuke , Aso Kenta 
Published: March 2019

ABSTRACTA low-lying internal carotid artery (ICA) running closer to the skull base than in usual cases prevents use of the standard transsylvian approach (TSA) to view an aneurysm through the retrocarotid space. A 75-year-old male had a 10-day history of headache and left eyelid ptosis. Initial computed tomography (CT) showed no evidence of subarachnoid hemorrhage. Emergency three-dimensional CT angiography showed a saccular aneurysm with bleb arising from the left horizontally projecting ICA. The aneurysm was approached through the TSA but could not be visualized well. We used the anterior temporal approach (ATA) followed by the TSA, offering a more lateral line of vision and allowing the surgeon to visualize the aneurysmal neck. The aneurysm was successfully obliterated. The ATA provided a better lateral view than the standard TSA for the ICA aneurysm. We emphasize the effectiveness of ATA for aneurysm arising from a low-lying IC-posterior communicating artery bifurcation.
A Rare Case of an Extensive Multi-compartment Epidermoid Presenting with Pure Motor Trigeminal Neuropathy, Case Report and Review of Literature
Authors: Gohil Jaypalsinh , Rajasekar Gopikrishnan , Shivhare Pankaj , Nair Prakash , Abraham Mathew 
Published: March 2019

ABSTRACTEpidermoid cysts are benign slow-growing tumors, clinical signs and symptoms at the time of presentation are related to the location and extent of the lesion. The motor fibers of the trigeminal nerve are fairly resistant to extraneous compression. Intracranial lesions in the vicinity of the trigeminal nerve usually present with sensory symptoms without affecting the motor component. We report a rare case of a middle cranial fossa epidermoid presenting with pure motor trigeminal neuropathy.
Impact of Etiology on Efficacy of Oral Triclofos in Recording Pediatric Electroencephalography: A Tertiary Care Center Study
Authors: Matta Gopi Srikanth , Peddisetty Ravi Prakash 
Published: March 2019

ABSTRACT
Background and Objectives: Oral triclofos is a frequently used sedative in pediatric age to record sleep Electroencephalography (EEG). This study is aimed to assess efficacy, safety profile, need for second dose, and rescheduling of oral triclofos in relation to etiology. Materials and Methods: This is a retrospective study done enrolling all children aged 6 months to 5 years referred for EEG over 1 year. After a trial for natural sleep, the first dose of oral triclofos was given. If a child does not sleep after an hour, the second dose was given and rescheduled if does not sleep even with the second dose. Age, sex, diagnosis, sleep latency, sleep duration, adverse effects, EEG findings, patients needing second dose, and rescheduling were noted. Descriptive statistics and Chi-square test were used to analyze data. Results: A total of 384 children required oral triclofos. The common etiologies for sleep study were atypical febrile seizures, hypoxic-ischemic encephalopathy (HIE) sequelae, and behavioral disorders such as autism and attention-deficit hyperactive disorder (ADHD). Including the second dose, we were able to successfully record sleep EEG in 372 (96.8%) patients. Rescheduling was required in 3.2% of patients. Mean sleep-onset latency was 36 min and mean sleep duration was 84 min. Single dose was sufficient in 329 (85.6%) and the second dose in 55 (14.4%). Thirty (38.5%) children of HIE sequelae (P < 0.001) required the second dose followed by behavioral disorders (29.1%, P = 0.03). Irritability, vomiting, and dizziness were common side effects which resolved spontaneously. Conclusions: Oral triclofos was effective as sedative for recording EEG. Children with HIE sequelae and behavioral disorders such as autism/ADHD more commonly required second dosing and rescheduling.
Intracranial Hemorrhage in a Young Woman: An Unusual Initial Presentation of Undiagnosed Choriocarcinoma
Authors: Agarwal Navneet , Jain S. K. , Sharma Vinod , Singhvi Shashi , Gandhi Sapna 
Published: March 2019

ABSTRACTChoriocarcinoma is an uncommon tumor. Undiagnosed choriocarcinoma initially presenting with intracranial hemorrhage in an apparently healthy female is rare and presents a diagnostic difficulty. The authors report a case presenting as intracranial hemorrhage of unsuspected choriocarcinoma. As the measurement of beta-human chorionic gonadotropin (β-hCG) would have helped in the preoperative diagnosis, estimation of serum β-hCG levels is suggested in the diagnostic workup of a female of reproductive age group when radiological investigations are inconclusive. Craniotomy and excision of tumor followed by chemotherapy and radiotherapy may improve the outcome.
A Treatable Encephalopathy in a Peritoneal Dialysis Patient - Cefepime- Induced Encephalopathy
Authors: Khoo Ching Soong , Tee Tze Yuan , Tan Hui Jan , Ali Raymond Azman 
Published: March 2019

ABSTRACTWe report a patient with end-stage renal disease on peritoneal dialysis, who developed encephalopathy after receiving a few doses of cefepime. He recovered clinically and electroencephalographically after having discontinued the culprit agent and undergone hemodialysis. This case highlights the importance of promptly recognizing this reversible encephalopathy, which can lead to the avoidance of unnecessary workup, reduce the length of hospital stay, and thereby improve the patients’ outcome.