bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventral tegmental area deep brain stimulation for chronic cluster headache: Effects on cognition, mood, pain report behaviour and quality of life
Authors: Cappon Davide , Ryterska Agata , Lagrata Susie , Miller Sarah , Akram Harith , Hyam Jonatham , Zrinzo Ludvic , Matharu Manjit , Jahanshahi Marjan 
Published: March 2019

Background Deep brain stimulation in the ventral tegmental area (VTA-DBS) has provided remarkable therapeutic benefits in decreasing headache frequency and severity in patients with medically refractory chronic cluster headache (CH). However, to date the effects of VTA-DBS on cognition, mood and quality of life have not been examined in detail. Methods The aim of the present study was to do so in a case series of 18 consecutive patients with cluster headache who underwent implantation of deep brain stimulation electrodes in the ventral tegmental area. The patients were evaluated preoperatively and after a mean of 14 months of VTA-DBS on tests of global cognition (Mini Mental State Examination), intelligence (Wechsler Abbreviated Scale of Intelligence), verbal memory (California Verbal Learning Test-II), executive function (Delis–Kaplan Executive Function System), and attention (Paced Auditory Serial Addition Test). Depression (Beck Depression Inventory and Hospital Anxiety and Depression Rating Scale-D), anxiety (Hospital Anxiety and Depression Rating Scale-A), apathy (Starkstein Apathy Scale), and hopelessness (Beck Hopelessness Scale) were also assessed. Subjective pain experience (McGill Pain Questionnaire), behaviour (Pain Behaviour Checklist) and quality of life (Short Form-36) were also evaluated at the same time points. Results VTA-DBS resulted in significant improvement of headache frequency (from a mean of five to two attacks daily, p < .001) and severity (from mean Verbal Rating Scale [VRS] of 10 to 7, p < .001) which was associated with significant reduction of anxiety (from mean HADS-A of 11.94 to 8.00, p < .001) and help-seeking behaviours (from mean PBC of 4.00 to 2.61, p < .001). VTA-DBS did not produce any significant change to any tests of cognitive function and any other outcome measures (BDI, HADS-D, SAS, BHS, McGill Pain Questionnaire, Short Form-36). Conclusion We confirm the efficacy of VTA-DBS in the treatment of medically refractory chronic cluster headache. The reduction of headache frequency and severity was associated with a significant reduction of anxiety. Furthermore, the result suggests that VTA-DBS for chronic cluster headache improves pain-related help-seeking behaviours and does not produce any change in cognition.
Student Nurses’ Experiences and Reflections on Pain Management in the Clinical Setting: An Exploratory Analysis of Students’ Choice of Assignment Topic
Authors: Carr Eloise C. J. , Hall Marc , Seneviratne Cydnee 
Published: March 2019

Background Pain, particularly chronic pain, represents a global health burden. The provision of undergraduate pain education for health professionals remains suboptimal, and yet pain features as an important competency for successful licensure in Canada. Purpose To explore what clinical events undergraduate nursing students identify as critical to their learning. If pain featured, then to describe the nature of the pain incident. Methods A retrospective cross-sectional design with a thematic analysis of year 3 undergraduate student nurses’ assignments was used. For the assignments identified as related to pain, a more detailed inductive content analysis was used to provide a condensed but broad description of the data. Results A total of 215 students participated. The most reported topics were pain (14.8%), patient assessment (10.2%), patient-/family-centered care (10.2%), and effective communication (9.8%). For those who described a pain encounter in their clinical experience, advocacy, managing the gap, and a lack of knowledge were the main focus. Conclusions This study provided valuable insights to the ways in which student nurses wrote about their experiences and management of pain in the clinical setting. Strengthening learning in the nursing curricula around advocacy and conflict management might provide new ways to improve pain education.
Short‐ and long‐term effects of transarterial chemoembolization on portal hypertension in patients with hepatocellular carcinoma
Authors: Scheiner Bernhard , Ulbrich Gregor , Mandorfer Mattias , Reiberger Thomas , Müller Christian , Waneck Fredrik , Trauner Michael , Kölblinger Claus , Ferlitsch Arnulf , Sieghart Wolfgang , Peck-Radosavljevic Markus , Pinter Matthias 
Published: March 2019

BackgroundTransarterial chemoembolization (TACE) affects hepatic perfusion, and might have an impact on portal pressure in patients with hepatocellular carcinoma (HCC).ObjectiveThe objective of this article is to report the secondary outcome “hepatic hemodynamics” from the AVATACE trial, a prospective randomized, placebo‐controlled trial on the efficacy of conventional TACE in combination with bevacizumab or placebo.MethodsHepatic venous pressure gradient (HVPG) was measured at baseline (prior to first TACE), within nine days (“acute effects”), two months (“intermediate effects”) and six months (“long‐term effects”) after the first TACE.ResultsOf 28 patients with early‐intermediate stage HCC, n = 20 (71%) had clinically significant portal hypertension (CSPH, HVPG ≥ 10 mmHg) at baseline (median, 12 (interquartile range (IQR): 9–19) mmHg). TACE had neither “acute effects” nor “intermediate effects” on HVPG. However, in 13 patients with available HVPG measurement at month 6, there was a significant increase in HVPG (median, 16 (IQR: 11–19) mmHg) compared with baseline (median, 10 (IQR: 5–12) mmHg; p = 0.007). Portal hypertension‐related complications occurred exclusively in patients with CSPH (8 (40%) vs 0).ConclusionsRepeated TACE was associated with a significant long‐term increase in HVPG. This should be considered when deciding whether to continue with TACE or switch to systemic treatment, since CSPH drives the development of complications.
Use of a Silicon Stoma Stent as an Interim Step in High‐Risk Tracheostomy Decannulation
Authors: Ross Jacqueline , McMurray Kristy , Cameron Tanis , Lanteri Celia 
Published: March 2019

ObjectiveTo describe use of a stoma stent to facilitate high‐risk decannulation.MethodsRetrospective chart review of 14 consecutive patients who received a stent from March 2013 to December 2016 at a quaternary health care service. Primary outcome measures were decannulation outcome and adverse events.ResultsDecannulation outcome: 12 of 14 patients had their tracheostomy tube (TT) removal facilitated by stent use. Patients had the stent for a median of 6 days (interquartile range, 49). Reasons for use included medical instability, risk of sputum retention, uncertain airway patency, and the need for ongoing airway access. All patients survived to discharge. One patient residing in the community has retained a stoma stent. Adverse events: One patient removed the stent on the day of insertion, necessitating reinsertion of the TT. Granulation tissue at the stoma site was seen in 2 patients.DiscussionA tracheostoma will normally close within 48 hours following decannulation, which is problematic if TT reinsertion is required. By using the stent, reversal of decannulation becomes a simple ward‐based procedure. In comparison to a TT, which is secured with ties, the stoma stent proved unsuitable for use in an agitated patient.Implications for PracticeDecreasing total cannulation time is of benefit as patients with tracheostomy are subject to high rates of complications and adverse events. A stoma stent poses little risk and a low morbidity burden to the patient in comparison to alternative management.
Neutrophil plasticity in the tumor microenvironment
Authors: Giese Morgan A. , Hind Laurel E. , Huttenlocher Anna 
Published: March 2019

AbstractNeutrophils act as the body’s first line of defense against infection and respond to diverse inflammatory cues, including cancer. Neutrophils display plasticity, with the ability to adapt their function in different inflammatory contexts. In the tumor microenvironment, neutrophils have varied functions and have been classified using different terms, including N1/N2 neutrophils, tumor-associated neutrophils, and polymorphonuclear neutrophil myeloid–derived suppressor cells (PMN-MDSCs). These populations of neutrophils are primarily defined by their functional phenotype, because few specific cell surface markers have been identified. In this review, we will discuss neutrophil polarization and plasticity and the function of proinflammatory/anti-inflammatory and protumor/antitumor neutrophils in the tumor microenvironment. We will also discuss how neutrophils with the ability to suppress T-cell activation, referred to by some as PMN-MDSCs, fit into this paradigm.
The London memory service audit and quality improvement programme
Authors: Cook Laura D. , Nichol Katie E. , Isaacs Jeremy D. 
Published: March 2019

Aims and methodMemory services have expanded significantly in the UK, but limited performance data have been published. The aim of this programme was to determine variation in London memory services and address this through service improvement projects. In 2016 London memory services were invited to participate in an audit consisting of case note reviews of at least 50 consecutively seen patients.ResultsTen services participated in the audit, totalling 590 patients. Variation was noted in neuroimaging practice, neuropsychology referrals, diagnosis subtype, non-dementia diagnoses, waiting times and post-diagnostic support. Findings from the audit were used to initiate four service improvement projects.Clinical ImplicationsMemory services should consider streamlining pathways to reduce waiting times, implementing pathways for patients who do not have dementia, monitoring appropriateness of neuroimaging, and working with commissioners and primary care to ensure that access to post-diagnostic interventions is consistent with the updated National Institute for Health and Care Excellence (NICE) dementia guideline.
Effectiveness of Aerobic Exercise Programs for Health Promotion in Metabolic Syndrome
Authors: MORALES-PALOMO FELIX , RAMIREZ-JIMENEZ MIGUEL , ORTEGA JUAN FERNANDO , MORA-RODRIGUEZ RICARDO 
Published: March 2019

ABSTRACT

Purpose
Continuous and interval are the two types of aerobic exercise training commonly used for health promotion. We sought to determine which aerobic exercise training program results in larger health improvements in metabolic syndrome (MetS) individuals.

Methods
One hundred twenty-one MetS patients (age, 57 ± 8 yr; weight, 92 ± 15 kg; and MetS factors, 3.8 ± 0.8 components) with low initial cardiorespiratory fitness (CRF) (V˙O2peak, 24.0 ± 5.5 mL·kg−1·min−1) were randomized to undergo one of the following 16-wk exercise program: (a) 4 × 4-min high-intensity interval training at 90% of HRMAX (4HIIT group; n = 32), (b) 50-min moderate-intensity continuous training at 70% of HRMAX (MICT group; n = 35), (c) 10 × 1-min HIIT at 100% of HRMAX (1HIIT group; n = 32), or (d) no exercise control group (CONT; n = 22). We measured the evolution of all five MetS components (i.e., MetS Z Score) and CRF (assessed by V˙O2peak) before and after intervention.

Results
MetS Z score decreased 41% after 4HIIT (95% confidence interval [CI], 0.25–0.06; P < 0.01) and 52% in MICT (95% CI, 0.24–0.06; P < 0.01), whereas it did not change in 1HIIT (decreased 24%; 95% CI, −0.16 to 0.03; P = 0.21) and CONT (increased 20%; 95% CI, −0.19 to 0.04; P = 0.22). However, the three exercise groups improved similarly their V˙O2peak (4HIIT, 11%; 95% CI, 0.14–0.33; MICT, 12%; 95% CI, 0.18–0.36; and 1HIIT, 14%; 95% CI, 0.21–0.40 L·min−1; all P < 0.001).

Conclusions
Our findings suggest that in sedentary individuals with MetS and low initial CRF level any aerobic training program of 16 wk with a frequency of three times per week is sufficient stimulus to raise CRF. However, the more intense but shorter 1HIIT training program is not effective on improving MetS Z score, and thus we caution its recommendation for health promotion purposes in this population.
Rediscovering the border region in linguistics: Cases from Southeastern Europe
Authors: Jussufi Lumnije 
Published: March 2019

Border region research has recently made its way into various different disciplines and is becoming increasingly useful for sociolinguistics. Nevertheless, in the context of the languages represented in Southeastern European Studies, it is still rather rare today and heretofore non-existent in the Albanian context. This can be explained by the fact that the pivotal research object –state borders– as well as the languages discussed are often used as political and ideological tools. Often, the language situation of a given border region is not taken into account at all, for the sake of preserving the image of linguistic –and thereby national– unity. This paper will show the results of a study in the Albanian-Macedonian border region of Dibra/Debar, which has been divided forroughly 100 years into two parts, situated East and West of the geopolitical border. The central question is to what extent the state border has exerted influence on local dialects, local standard languages, language behavior, and perception of language among the local population.
CHITOSAN-GLUCAN COMPLEXES OF HIGHEST MUSHROOMS: SELECTION, IDENTIFICATION AND DETER-MINATION OF SOME PROPERTIES
Authors: Минаков (Minakov) Денис (Denis) Викторович (Viktorovich) , Верещагин (Vereshchagin) Александр (Aleksandr) Леонидович (Leonidovich) , Мороженко (Morozhenko) Юрий (Yuriy) Васильевич (Vasil'evich) , Базарнова (Bazarnova) Наталья (Natal'ya) Григорьевна (Grigor'evna) 
Published: March 2019

The work is devoted to the study of chitosan-glucan complexes obtained from the higher fungi of the autumnal marmot (Armillaria mellea), shiitake (Lentinula edodes) and grifola frutosa (Grifola frondosa), optimization of the method of isolation and expansion of their use for various areas of the national economy. As objects of research, strains of fungi L. edodes F-1000 and G. frondosa 2639 isolated from commercial mycelium and A. mellea D-13 strain isolated from fruiting bodies harvested from Betula pendula stems in natural habitats of the Altai Territory. When analyzing the IR spectroscopy data, it was established that the samples of chitosan-glucan complexes isolated from the fruiting bodies of fungi are identical to the structure of chitosan obtained in the traditional way from the king crab (Paralithodes camtschaticus). It was found that the test chitosan-glucan complexes in terms of intrinsic viscosity (1.6–2.2 cm3/g), molecular weight (37.5–51.8 kDa) and deacetylation degree (75.6–79.5%) significantly exceed the chitosan-glucan complexes obtained from the oyster mushroom (Pleurotus osteratus) and are comparable to the chitosan-glucan complexes of mold fungi (Aspergillus niger). At the same time, the chitosan-glucan complexes from A. mellea D-13 are closest to the chitosan isolated from P. camtschaticus in the above indices. According to the physico-chemical properties, the investigated chitosan-glucan complexes correspond to the requirements of food chitosan (TU 9289-067-00472124).
TOTAL CHLORINE-FREE BLEACHING OF SULFATE HARDWOOD PULP WITH HYDROGEN PEROXIDE
Authors: Хакимова (Hakimova) Фирдавес (Firdaves) Харисовна (Harisovna) , Синяев (Sinyaev) Константин (Konstantin) Андреевич (Andreevich) 
Published: March 2019

The work is devoted to the study of the possibility and feasibility of environmentally safe bleaching of sulfate hardwood pulp by TCF-technology without the use of traditional oxygen and ozone as a delignifying reagent.
The TCF-technology of sulphate hardwood pulp bleaching (scheme Pa-EP-Pd-Aac-P-A) was developed with only one oxidizing reagent – hydrogen peroxide. It is proposed to carry out of pulp delignification with hydrogen peroxide in an acid medium conditions, additional delignification and bleaching – with hydrogen peroxide in an alkaline medium conditions.
Soft oxidizing effect of hydrogen peroxide used at all stages of bleaching provides selectivity of the process along with ecological compatibility of the scheme. The mechanical strength of pulp varies during bleaching in accordance with the change of the degree of delignification and is very moderate, and the total loss of pulp fibers is only 6.1%.
Production of hardwood sulfate pulp, as well as sulfite, is associated with difficulties caused by a "harmful" resin at a small proportion of extractives. The proposed scheme of bleaching provides a high degree of resin removal and contributes to the depitching, i.e. decision of very important problems in sulphate hardwood pulp production.
Trichoderma dan Gliocladium untuk Mengendalikan Penyakit Busuk Akar Fusarium pada Bibit Kelapa Sawit
Authors: Juariyah Siti , Tondok Efi Toding , Sinaga Meity Suradji 
Published: March 2019

Trichoderma and Gliocladium for Controling Fusarium Root Rot Disease of Oil Palm SeedlingsFusarium spp. have been reported as the causal agent of common spear rot and crown rot diseases on oil palm. An effective strategy to control these diseases is not available yet. This research was aimed to find biocontrol agents for effective control of crown rot disease on oil palm seedlings caused by Fusarium spp. The experiment consisted of 3 parts i.e. pathogenicity test of 3 isolates of Fusarium, identification and in vitro test of biocontrol agents, and in planta test of biocontrol agents against Fusarium spp. In vitro test was done through dual culture test and test for volatile compound produced by the biocontrol agents. In planta test was conducted through inoculation of Fusarium spp. into oil palm seedlings growing on medium containing selected biocontrol agents i.e. Trichoderma harzianum, T. virens, T. inhamatum, and Gliocladium fimbriatum. In vitro test showed that Gliocladium fimbriatum 1 and 2 were inhibited effectively the growth of Fusarium spp. on the dual culture test, whereas T. harzianum Gadingrejo 2 was inhibited effectively the growth of Fusarium spp. on volatile compound test. The application of biocontrol agents was effective to protect oil palm seedlings from Fusarium spp. infection.
Towards verified continuous integration in the engineering of automated production systems
Authors: Mund Jakob , Bougouffa Safa , Badr Iman , Vogel-Heuser Birgit 
Published: March 2019

Abstract
Continuous integration (CI) is widely used in software engineering. The observed benefits include reduced efforts for system integration, which is particularly appealing for engineering automated production systems (aPS) due to the different disciplines involved. Yet, while many individual quality assurance means for aPS have been proposed, their adequacy for and systematic use in CI remains unclear. In this article, the authors provide two key contributions: First, a quality model for a model-based engineering approach specifically developed for aPS. Based thereon, a discussion of the suitable verification techniques for aPS and their systematic integration in a CI process are given. As a result, the paper provide a blueprint to be further studied in practice, and a research agenda for quality assurance of aPS.
Bydgostian hand exoskeleton – own concept and the biomedical factors
Authors: Kopowski Jakub , Mikołajewski Dariusz , Macko Marek , Rojek Izabela 
Published: March 2019

Abstract
An exoskeleton is defined as a distinctive kind of robot to be worn as an overall or frame, effectively supporting, or in some cases substituting for, the user’s own movements. In this paper a new three-dimensional (3D) printed bydgostian hand exoskeleton is introduced and biomedically characterized. The proposed concept is promising, and the described approach combining biomechanical factors and 3D modeling driven by detailed hand exoskeleton patterns may constitute a key future method of ergonomic hand exoskeleton design and validation prior to manufacturing. Despite the aforementioned approach, we should be aware that hand exoskeleton constitutes hand support and rehabilitation robot system developing with the user; thus, certain coordination and continuity of the “hardware” part of the whole system and the training paradigm are essential for therapy efficacy.
Complexities of cognition in poetic art: Matthew Arnold's “The Last Word”
Authors: Freeman Margaret H. 
Published: March 2019

Abstract
The cognitive complexity of Matthew Arnold's poem “The Last Word” has resulted in diverging literary critical evaluations. By applying several cognitive approaches to the poem, I develop a reading that reveals the poem's underlying coherence. I then address the question of how that reading might reflect Arnold's own intentions and motivations in responding to adversaries of his social criticism. In doing so, I hope to present a way of showing how both cognitive approaches to literature and traditional literary expertise complement each other in contributing to our understanding of the complexities of human minding: the integration of sensations, emotions, and conceptual reasoning that constitute the way we experience and interact with each other and the world of which we are a part.
Congenital cytomegalovirus infection presenting as a fetal intra-abdominal cyst
Authors: Mills Emily , Janicki Mary Beth , Figueroa Reinaldo 
Published: March 2019

Abstract

Background
Fetal intra-abdominal cysts have an incidence of 1/500–1/1000 live births. Cysts can be physiologic or pathologic and can either spontaneously regress or require intervention and treatment. Cytomegalovirus (CMV) is the most common cause of congenital infection in the USA with an incidence of 0.2–2%. The risk of transmission is greatest with a primary maternal infection and the severity of fetal injury increases when transmission occurs in the first half of the pregnancy. An infectious etiology for a fetal intra-abdominal cyst has not been reported to the best of our knowledge.

Case presentation
A 31-year-old multigravida presented at 19 weeks’ gestation for an anatomical survey. The female fetus was noted to have a 2.4 × 2.0 × 3.1 cm echolucent cyst in the right side of the abdomen. Three weeks later, the cyst was not seen; however, there was free fluid and a few echogenic areas within the fetal abdomen. Maternal serum tested positive for CMV IgM and IgG titers, and the CMV IgG avidity test was 0.75, consistent with high avidity. At 27 weeks’ gestation, ascites remained and a pericardial effusion was noted. Amniocentesis resulted in >2,000,000 copies of CMV DNA by polymerase chain reaction (PCR) in the amniotic fluid. The patient underwent termination of the pregnancy at 29 weeks of gestation.

Conclusion
It would be important to consider an infectious etiology in the differential diagnosis of fetal intra-abdominal cysts as the outcome in the fetus with congenital CMV infection could be much different. Amniocentesis is considered the best option for the diagnosis of fetal congenital CMV infection if performed after 21 weeks’ gestation and more than 6 weeks from maternal infection.
Morning report innovation: Case Oriented Report and Exam Skills
Authors: Goyal Amit , Garibaldi Brian , Liu Gigi , Desai Sanjay , Manesh Reza 
Published: March 2019

Abstract
Morning report is a valuable educational conference but is often a stand-alone classroom-based discussion which misses the opportunity for bedside education. In this report, we describe an innovative morning report structure – the Case Oriented Report and Exam Skills (CORES) – that addresses this pitfall of the traditional case conference format and brings learners to the bedside. The key components of CORES include highlighting concepts of clinical reasoning, emphasizing evidence-based and hypothesis-driven physical exam (HDPE), and integrating emerging bedside technologies such as point-of-care ultrasound (POCUS).