bluuebunny/crossref_metadata_2025_split huggingface dataset:
Der symptomatische Nierentumor beim metastasierten Nierenzellkarzinom – chirurgische Optionen
Authors: Gilbert Nils , Merseburger Axel , Kramer Mario 
Published: September 2018

ZusammenfassungJährlich erkranken in Deutschland über 14 000 Menschen an einem Nierenzellkarzinom. Bei 15 – 20 % liegen bei Diagnosestellung bereits Metastasen vor. Neben der medikamentösen Tumortherapie existieren auch chirurgische Konzepte bei der Behandlung des Primärtumors. Hierbei stehen die zytoreduktive sowie die palliative Nephrektomie (palliative nephrectomy, PN) im Vordergrund. Abhängig vom Wandel der systemischen Tumortherapie wurde auch die Sinnhaftigkeit der zytoreduktiven Nephrektomie (cytoreductive nephrectomy, CN) diskutiert. In der „Zytokin-Ära” etablierte sich die CN gefolgt von einer Therapie mit Interferon basierend auf 2 prospektiven randomisierten Studien und deren kombinierter Metaanalyse. Durch die Etablierung von Targeted-Therapien ab 2005 und das reine Vorliegen von retrospektiven Studien mit teilweise großen Patientenzahlen wurde der Stellenwert der CN kritisch hinterfragt. Mit der Veröffentlichung der CARMENA-Daten liegen nun aktuell erstmalig Daten vor, die die alleinige Therapie mit Sunitinib mit der CN gefolgt von Sunitinib vergleichen. Hierbei konnte gezeigt werden, dass die alleinige medikamentöse Therapie der kombinierten Therapie nicht unterlegen war – zumindest in der Gruppe der intermediate- und poor-risk Patienten. Nichtsdestotrotz bleiben auch diese Daten aufgrund diverser Kritikpunkte, wie dem hohen Anteil von Patienten mit poor-risk Konstellation sowie dem höheren Anteil von lokal fortgeschrittenen Tumorstadien im CN + Sunitinib-Arm, auf dem Prüfstand.Als Gründe für eine palliative Nephrektomie werden therapierefraktäre Schmerzen, Blutungen sowie schwere paraneoplastische Syndrome aufgeführt. Hierbei muss bei der Indikationsstellung berücksichtigt werden, dass gute supportive Therapiemaßnahmen und weniger invasive Therapien verfügbar sind. So können z. B. Blutungen durch Maßnahmen der interventionellen Radiologie in einer Vielzahl der Fälle adäquat kontrolliert werden.Im Rahmen der Entscheidungsfindung ist es unerlässlich, neben den Therapiealternativen, den Lokalbefund des Primärtumors sowie individuelle Risikofaktoren zu evaluieren.Rein technisch kann die palliative Nephrektomie offen oder laparoskopisch erfolgen und falls indiziert auch als Teilnephrektomie.
New Programming Modes of Spinal Cord Stimulation for Chronic Pain: A Systematic Review of Outcomes with Burst and High-Frequency Technology
Authors: Bergman Jeffrey , Dupré Derrick , Tomycz Nestor 
Published: September 2018

AbstractSpinal cord stimulation (SCS) is a well-established, evidence-based treatment for chronic pain. For decades, implantation of tonic SCS systems has relied on epidural electric lead placement to overlap regions of pain with paresthesias to achieve maximal postoperative pain relief. During the course of tonic SCS treatment, tolerances to the stimulation frequency may develop, leading to reduced efficacy. Recent developments in novel programming modes, such as high-frequency 10 kHz (HF10) and burst, stray from tonic SCS in their electrical stimulation delivery patterns and unique ability to deliver SCS without engendering paresthesias. To date, no review has analyzed outcomes of both HF10 SCS and burst SCS for chronic back and limb pain. This article aims to review all HF10 and burst SCS prospective observational and randomized controlled trials for chronic back and limb pain. The literature search identified 21 papers—10 HF10 SCS papers, 9 burst SCS papers, and 2 papers assessing both HF10 and burst SCS concurrently. Burst SCS and HF10 SCS have been subjected to randomized controlled studies and have used similar patient pain score reporting on a visual analog scale (VAS) and numeric rating scale (NRS). Results from these studies have reported significant reductions in axial back pain and limb pain in patients sustained for up 20 months with burst SCS treatment and up to 36 months with HF10 SCS. Both novel programming modes show promise as viable treatments for those suffering from chronic pain and/or patients who may no longer be responders to tonic SCS.
Complications and Avoidance in Neurointerventional Surgery
Authors: Rajpal Girish , Basheer Noufal 
Published: September 2018

AbstractBecause neurointerventional surgery is a minimally invasive technique does not mean that it is qualified for complication-free procedures. Rather working about 2 m away from the three-dimensional (3D) target lesion and looking at two-dimensional (2D) images makes it one of the most complication-prone subspecialties. Advancement in hardwares, techniques, and technologies with continuous ability to learn and modify accordingly can only keep the complication rate low as compared with traditional vascular neurosurgery.
Elimination of the error signal in the superior colliculus impairs saccade motor learning
Authors: Kojima Yoshiko , Soetedjo Robijanto 
Published: September 2018

SignificanceTheories of cerebellar-dependent motor learning use the error between the desired and actual movement to correct the erroneous movement. To support this idea, several studies have tried to eliminate the error signal to the cerebellum and demonstrate an impairment of learning. However, such former approaches have not been successful because blocking the error signal also affected the movement to be learned. In this study, we selectively block an error signal for saccade adaptation, a type of cerebellar motor learning, by inactivating the source of the error signal in the superior colliculus without affecting the movement to be learned. Saccade adaptation was impaired. Thus, our study provides the first experimental evidence that an error signal is required for cerebellar motor learning.
Length of local cohomology of powers of ideals
Authors: Dao Hailong , Montaño Jonathan 
Published: September 2018

Let

R
R

be a polynomial ring over a field

k
k

with irrelevant ideal

m

\mathfrak {m}

and dimension

d
d

. Let

I
I

be a homogeneous ideal in

R
R

. We study the asymptotic behavior of the length of the modules

H

m

i

⁡
(
R

/

I
n

)

\operatorname {H}^{i}_{\mathfrak {m}}(R/I^n)

for

n
≫
0

n\gg 0

. We show that for a fixed number

α
∈

Z

\alpha \in \mathbb {Z}

,

lim sup

n
→
∞

λ
(

H

m

i

⁡
(
R

/

I
n

)

⩾
−
α
n

)

n
d

>
∞
.

\limsup _{n\rightarrow \infty }\frac {\lambda (\operatorname {H}^{i}_{\mathfrak {m}}(R/I^n)_{\geqslant -\alpha n}) }{n^d}>\infty .

It follows that

lim sup

n
→
∞

λ
(

H

m

i

⁡
(
R

/

I
n

)
)

n
d

>
∞

\limsup _{n\rightarrow \infty }\frac {\lambda (\operatorname {H}^{i}_{\mathfrak {m}}(R/I^n)) }{n^d}>\infty

when

X
=
Proj
⁡
R

/

I

X = \operatorname {Proj} R/I

is locally a complete intersection (lci) and

i
⩽
dim
⁡
X

i\leqslant \dim X

. We also establish that the actual limit exists and is rational for certain classes of monomial ideals

I
I

such that the lengths of local cohomology of

I
n

I^n

are eventually finite. Our proofs use Gröbner deformation and Presburger arithmetic. Finally, we utilize more traditional commutative algebra techniques to show that

lim inf

n
→
∞

λ
(

H

m

i

⁡
(
R

/

I
n

)

n
d

>
0

\liminf _{n\rightarrow \infty }\frac {\lambda (\operatorname {H}^{i}_{\mathfrak {m}}(R/I^n)}{n^d}>0

under certain conditions when

R

/

I

R/I

is either

F
F

-pure or lci.
Three-Dimensional Computed Tomographic Study on the Periorbital Branches of the Ophthalmic Artery: Arterial Variations and Clinical Relevance
Authors: Zhao Wei-Rui , Wang Hai-Bin , Luo Cheng-En , Kong Xiang-Xue , Zhan Wen-Feng , Luo Sheng-Kang 
Published: September 2018

Abstract

Background
Filler injection is a popular cosmetic procedure, but it can entail vascular complications. Periorbital injections have the highest risk within the entire injection area.

Objectives
The authors sought to systematically screen for periorbital arterial variations prior to treatment.

Methods
The external carotid arteries of 10 cadaveric heads were infused with adequate lead oxide contrast. The facial and superficial temporal arteries of another 11 cadaveric heads were injected with the contrast in sequential order. Computed tomography (CT) scanning was performed after injection of contrast, and 3-dimensional (3D) CT scans were reconstructed using validated algorithms.

Results
Three types of periorbital blood vessels were found to derive from the ophthalmic artery, including 30% directly originating from the ophthalmic artery, 65% originating from its trochlear branch, and 5% originating from its supraorbital branch. In the forehead, the ophthalmic artery, originating from the internal carotid arteries, formed anastomoses between the frontal branch of the superficial temporal artery, originating from the external carotid artery, with the deep and superficial branches of the supratrochlear and supraorbital arteries, respectively. The lateral orbit and malar plexus can be classified into 4 types based on the trunk artery: the zygomatic orbital artery (27%), the transverse facial artery (23%), the premasseteric branch of the facial artery (19%), and all 3 contributing equally (31%).

Conclusions
Postmortem 3D CT can map periorbital arterial variations. The branching pattern of the ophthalmic artery, the ophthalmic angiosome in the forehead, and the distribution of the lateral orbit and malar plexus were identified at high resolution to guide clinical practice.
Mortality and adverse events with brand and generic clopidogrel in the US Food and Drug Administration Adverse Event Reporting System
Authors: Serebruany Victor L , Hall Trygve S , Atar Dan , Agewall Stefan , Hyun Kim Moo , Geudelin Bernard , Lomakin Nikita , Marciniak Thomas A 
Published: September 2018

Abstract

Aims
Clopidogrel is commonly used even after expiring patents. The brand clopidogrel (BC) was dealt by single company, while numerous manufacturers produce generic clopidogrel (GC). There are no convincing data to compare the safety of different formulations. Therefore, the data yielded from international, uniform, government-mandated registries may be useful.

Methods and results
We assessed primary causative adverse events (PCAE) after BC and GC in the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). The outcomes were divided into death, cardiac, thrombotic/embolic, haemorrhagic, and rash/dermal complications. These primary endpoints were then examined by proportional reporting ratios (PRR) and chi-square (χ2). Among total FAERS (n = 9 466 679) reports, overall BC (n = 88 863) cases were more common than after GC (n = 36 559). When triaged by PCAE role, BC (n = 18 328) was also more abundant than GC (n = 3987). The reported death rates were more than doubled after BC [18.4% vs. 7.0%; PRR = 0.38; 95% confidence interval (95% CI) 0.32–0.43; χ2=369.7; P<0.0001] for total FAERS, and consistent for late 2010–2017 (17.6% vs. 7.0% PRR = 0.40; 95% CI 0.37–0.45; χ2=286.2; P<0.004) PCAE cases. In contrast, GC trended to co-report more cardiac (14.6% vs. 13.3%; PRR = 1.12; 95% CI 1.0–1.25; χ2=3.5; P<0.06). The haemorrhagic (40.9% vs. 32.3%; PRR = 1.45; 95% CI 1.33–1.57; χ2=75.8; P<0.0001), and rash/dermal (5.4% vs. 4.6%; PRR = 1.20; 95% CI 1.0–1.44; χ2=3.75; P<0.05) events were also more common for GC. Thrombotic/embolic events were reported equally (at 7.0%) after each formulation.

Conclusion
The PCAE profiles differ with BC and GC in FAERS. While deaths reports were higher, the rates of cardiac, haemorrhagic, and skin complications were less common for BC. Despite expected reporting bias, this may indicate that the manufacturers of GC are reluctant to report deaths to the FDA. However, the overall adverse event profile suggests potentially better safety of BC over GC formulations.
Form—Function—Content
Authors: Arndt Matthew 
Published: September 2018

AbstractArnold Schoenberg’s concept of formal function, as formulated by Erwin Ratz, has become a staple of music theory since it was reimagined and systematized by William E. Caplin. However, this concept has been criticized for not speaking to the content of a piece of music, its particularity and meaning. By defining formal components, parts, and functions in line with the conceptual metaphors that underlie musical form, one may establish the inseparability of form and content. The definitions proposed here apply to art music from the eighteenth to the early twentieth centuries, the latter demonstrated through an analysis of Schoenberg’s Op. 11, No. 1.
Biomarkers of Exposure Among “Dual Users” of Tobacco Cigarettes and Electronic Cigarettes in Canada
Authors: Czoli Christine D , Fong Geoffrey T , Goniewicz Maciej L , Hammond David 
Published: September 2018

AbstractIntroduction“Dual use” refers to the concurrent use of tobacco cigarettes (smoking) and electronic cigarettes (e-cigarettes; vaping). Although dual use is common among e-cigarette users, there is little evidence regarding biomarkers of exposure among dual users and how these change under different conditions of product use.MethodsA nonblinded within-subjects crossover experiment was conducted with adult daily dual users (n = 48) in Ontario, Canada. Participants completed three consecutive 7-day periods in which the use of tobacco cigarettes and e-cigarettes was experimentally manipulated, resulting in four study conditions: Dual use, Tobacco cigarette use, E-cigarette use, and No product use. Repeated measures models were used to examine changes in product use and biomarkers of exposure.ResultsCompared to dual use, cotinine remained stable when participants exclusively smoked (p = .524), but significantly decreased when they exclusively vaped (p = .027), despite significant increases in e-cigarette consumption (p = .001). Levels of biomarkers of exposure to toxicants, including carbon monoxide (CO), 1-hydroxypyrene (1-HOP), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), were significantly lower when participants exclusively vaped than when they engaged in dual use (CO = −41%, p < .001; 1-HOP = −31%, p = .025; NNAL = −30%, p = .017). Similar findings were observed among participants abstaining from both products as compared to dual use (CO: −26%, p < .001; 1-HOP = −14% [ns]; NNAL = −35%, p = .016). In contrast, levels of biomarkers of exposure increased when participants exclusively smoked as compared to dual use (CO = +21%, p = .029; 1-HOP = +23%, p = .048; NNAL = +8% [ns]).ConclusionsAlthough dual use may reduce exposure to tobacco smoke constituents to some extent, abstaining from smoking is the most effective way to reduce such exposure.ImplicationsPublic health authorities should clearly communicate the relative risk of e-cigarettes and tobacco cigarettes to the general public, focusing on two salient points: (1) e-cigarettes are not harmless, but they are less harmful than tobacco cigarettes; and (2) using e-cigarettes while smoking may not necessarily reduce health risks; therefore, consumers should stop smoking completely to maximize potential health benefits.
Hypopigmented Interface T-Cell Dyscrasia and Hypopigmented Mycosis Fungoides: A Comparative Study
Authors: Youssef Randa , Mahgoub Doaa , Zeid Ola A. , Abdel-Halim Dalia M. , El-Hawary Marwa , Hussein Marwa F. , Morcos Mary A. , Aboelfadl Dalia M. , Abdelkader Heba A. , Abdel-Galeil Yosra , Abdel-Halim Mona R. E. 
Published: September 2018

Abstract:
Hypopigmented interface T-cell dyscrasia (HITCD) is a distinct form of lymphoid dyscrasia that may progress to hypopigmented mycosis fungoides (HMF). We compared both diseases as regards their CD4/CD8 phenotype and expression of granzyme B and tumor necrosis factor-alpha (TNF-α) and how these are affected by narrow-band UVB (nb-UVB). The study included 11 patients with HITCD and 9 patients with HMF. They received nb-UVB thrice weekly until complete repigmentation or a maximum of 48 sessions. Pretreatment and posttreatment biopsies were stained using anti CD4, CD8, TNF-α, and granzyme B monoclonal antibodies. Epidermal lymphocytes were CD8 predominant in 54.5% and 66.7% of HITCD and HMF cases, respectively, whereas dermal lymphocytes were CD4 predominant in 63.6% and 66.7%, respectively. Significantly, more dermal infiltrate was encountered in HMF (P = 0.041). In both diseases, granzyme B was only expressed in the dermis, whereas TNF-α was expressed both in the epidermis and dermis. No difference existed as regards the number of sessions needed to achieve repigmentation or cumulative nb-UVB dose reached at end of study. (P > 0.05). Narrow-band UVB significantly reduced only the epidermal lymphocytes in both diseases (P ≤ 0.05) with their complete disappearance in 8 (72.7%) HITCD and 6 (66.7%) HMF cases. In both diseases, nb-UVB did not affect granzyme B or TNF-α expression (P > 0.05). In conclusion, both diseases share the same phenotype, with HITCD being a milder form of T-cell dysfunction. In both diseases, epidermal lymphocytes are mainly CD8+-exhausted cells lacking cytotoxicity, whereas dermal cells are mostly reactive cells exerting antitumor cytotoxicity. Tumor necrosis factor-alpha mediates hypopigmentation in both diseases and prevents disease progression. Repigmentation after nb-UVB in both diseases occurs before and independently from disappearance of the dermal infiltrate.
Laser Ablation of the Recipient Area With Platelet-Rich Plasma–Enriched Epidermal Suspension Transplant in Vitiligo Surgery: A Pilot Study
Authors: Garg Suruchi , Dosapaty Namrata , Arora Amanjot Kaur 
Published: September 2018

BACKGROUND
Noncultured epidermal cell suspension transplantation is a very popular surgical modality for treating vitiligo. However, the procedure can be modified to improve results.

OBJECTIVE
To study the extent of repigmentation with noncultured trypsinized fragmented epidermal suspension using platelet-rich plasma (PRP) as a suspending agent and pixel erbium yttrium aluminium garnet laser for ablation of recipient area in patients with stable vitiligo.

MATERIALS AND METHODS
Autologous noncultured tiny epidermal fragments suspended in PRP were grafted on superficially pixel erbium YAG laser-ablated vitiligo lesions in 10 patients. The repigmentation was evaluated over a period of 6 months using a digital image analysis system.

RESULTS
Repigmentation was observed as early as 2 weeks after the treatment. Of 20 lesions, 12 (60%) showed excellent response; of which 10 lesions (50%) showed complete repigmentation in 8 weeks only. There were no milia or keloid formation, donor-site scarring, stuck on appearance at recipient site or infection.

CONCLUSION
This study indicates that PRP-enriched epidermal suspension transplant (LA-PEEST) has the potential to improve the rate of healing and repigmentation in vitiligo patches. Further investigations and larger controlled trials are required to establish this technique as a rapid surgical method to restore pigmentation.
Characterizing, Assessing, and Treating Cognitive Dysfunction in Major Depressive Disorder
Authors: McIntyre Roger S. , Lee Yena , Carmona Nicole E. , Subramaniapillai Mehala , Cha Danielle S. , Lee JungGoo , Lee Jae-Hon , Alageel Asem , Rodrigues Nelson B. , Park Caroline , Ragguett Renee-Marie , Rosenblat Joshua E. , Almatham Fahad , Pan Zihang , Rong Carola , Mansur Rodrigo B. 
Published: September 2018

Learning objectives
After participating in this activity, learners should be better able to:
• Characterize cognitive dysfunction in patients with major depressive disorder.
• Evaluate approaches to treating cognitive dysfunction in patients with major depressive disorder.

Abstract
Cognitive dysfunction is a core psychopathological domain in major depressive disorder (MDD) and is no longer considered to be a pseudo-specific phenomenon. Cognitive dysfunction in MDD is a principal determinant of patient-reported outcomes, which, hitherto, have been insufficiently targeted with existing multimodal treatments for MDD. The neural structures and substructures subserving cognitive function in MDD overlap with, yet are discrete from, those subserving emotion processing and affect regulation. Several modifiable factors influence the presence and extent of cognitive dysfunction in MDD, including clinical features (e.g., episode frequency and illness duration), comorbidity (e.g., obesity and diabetes), and iatrogenic artefact. Screening and measurement tools that comport with the clinical ecosystem are available to detect and measure cognitive function in MDD. Notwithstanding the availability of select antidepressants capable of exerting procognitive effects, most have not been sufficiently studied or rigorously evaluated. Promising pharmacological avenues, as well as psychosocial, behavioral, chronotherapeutic, and complementary alternative approaches, are currently being investigated.
Unique Features of the INESSS-ONF Rehabilitation Guidelines for Moderate to Severe Traumatic Brain Injury: Responding to Users' Needs
Authors: Bayley Mark Theodore , Lamontagne Marie-Eve , Kua Ailene , Marshall Shawn , Marier-Deschênes Pascale , Allaire Anne-Sophie , Kagan Corinne , Truchon Catherine , Janzen Shannon , Teasell Robert , Swaine Bonnie 
Published: September 2018

Objective:
Traumatic brain injury (TBI) clinical practice guidelines are a potential solution to rapidly expanding literature. The project objective was to convene experts to develop a unique set of TBI rehabilitation recommendations incorporating users' priorities for format and implementation tools including indicators of adherence.

Methods:
The Guidelines Adaptation & Development Cycle informed recommendation development. Published TBI recommendations were identified and tabulated. Experts convened to adapt or, where appropriate, develop new evidence-based recommendations. These draft recommendations were validated by systematically reviewing relevant literature. Surveys of experts and target users were triangulated with strength of evidence to identify priority topics.

Results:
The final recommendation set included a rationale, implementation tools (algorithms/adherence indicators), key process indicators, and evidence summaries, and were divided in 2 sections: Section I: Components of the Optimal TBI Rehabilitation System (71 recommendations) and Section II: Assessment and Rehabilitation of Brain Injury Sequelae (195 recommendations). The recommendations address top priorities for the TBI rehabilitation system: (1) intensity/frequency of interventions; (2) rehabilitation models; (3) duration of interventions; and (4) continuity-of-care mechanisms. Key sequelae addressed (1) behavioral disorders; (2) cognitive dysfunction; (3) fatigue and sleep disturbances; and (4) mental health.

Conclusion:
This TBI rehabilitation guideline used a robust development process to address users' priorities.