bluuebunny/crossref_metadata_2025_split huggingface dataset:
Olfactory function and neurocognitive outcomes in old age: The Atherosclerosis Risk in Communities Neurocognitive Study
Authors: Palta Priya , Chen Honglei , Deal Jennifer A. , Sharrett A. Richey , Gross Alden , Knopman David , Griswold Michael , Heiss Gerardo , Mosley Thomas H. 
Published: March 2018

AbstractIntroductionWe tested the hypothesis that poor sense of smell is associated with lower cognitive function and higher mild cognitive impairment (MCI) prevalence.MethodsOlfaction, measured by the Sniffin' Sticks test, was categorized as olfactory impairment (OI) (score ≤6) or no OI (score >6). MCI was adjudicated based on review of a neuropsychological examination. Linear regression estimated the mean difference in cognitive factor scores, and log‐binomial regression quantified MCI prevalence among participants with versus without OI.ResultsParticipants with OI had lower mean factor scores (memory: −0.27 standard deviation [SD], 95% confidence interval [CI]: −0.35 to −0.19; language: −0.24 SD, 95% CI: −0.30 to −0.17; executive function/processing speed: −0.09 SD, 95% CI: −0.12 to −0.06; and general cognitive performance: −0.25 SD, 95% CI: −0.30 to −0.20). OI was also associated with MCI (n = 204; prevalence ratio = 1.56, 95% CI: 1.37, 1.78).DiscussionAn impaired sense of smell may serve as a readily accessible early marker of neurodegeneration and improve upon the prevailing delayed diagnoses and underascertainment of MCI/dementia.
The Effects of Partner Presence and Sexual Stimulation on the Appraisal of Vaginal Pressure and Sexual Arousal
Authors: Dewitte Marieke , Schepers Jan , Melles Reinhilde 
Published: March 2018

Abstract

Background
Sex research lacks experimental studies in which both partners participate in a laboratory procedure. This is relevant in the context of genital pain because painful vaginal sensations often occur in the presence of the partner.

Aim
To examine the effects of partner presence, sexual stimulation, and vaginal pressure on the appraisal of vaginal sensations and sexual arousal, ultimately aiming to increase the ecologic validity of laboratory designs.

Methods
A community sample of 42 women and their male partners watched sexual and neutral films while separated or together. We induced gradually increasing vaginal pressure in the women using an intravaginal inflatable rubber balloon.

Outcomes
Women reported on pleasant and painful vaginal pressure and perceived genital arousal. Men and women reported on subjective sexual arousal. We also examined whether these appraisals were moderated by relationship satisfaction.

Results
The appraisal of vaginal pressure varied as a function of relationship satisfaction. Less satisfied women reported more painful pressure than women who were highly satisfied and highly satisfied women appraised the pressure as more pleasant in the context of a sex film and in the presence (vs absence) of their partner. In men and women, although partner presence had a negative effect on subjective sexual arousal, the presence of the partner did increase women's perception of genital arousal when vaginal pressure was induced during a sex film, particularly when women felt highly satisfied with their relationship. Also, the effects on subjective sexual arousal were moderated by relationship satisfaction. For couples in which the woman was less satisfied, the induction of vaginal pressure resulted in higher subjective sexual arousal when the partner was absent compared with when he was present, whereas when the man felt less satisfied, partner presence had a positive effect on sexual arousal.

Clinical Implications
Interventions need to focus on the importance of sexual arousal during vaginal pressure stimulation and the way this is shaped by partner and relationship variables. Our results indicate that enhancing the relationship climate is an important target of intervention.

Strengths and Limitations
We did not include physical indices of genital arousal and did not use a clinical sample of women with genital pain.

Conclusions
The appraisal of vaginal sensations and sexual arousal are context-dependent responses that vary as a function of partner presence and sexual stimulation. Including both partners in the laboratory setting is important to create more valid models on sexual responding.
Pre‐low noise amplifier (LNA) filtering linearisation method for low‐power ultra‐wideband complementary metal oxide semiconductor LNA
Authors: Abbas Mohammed Nadhim , Khaleel Farooq Abdulghafoor 
Published: March 2018

This study describes the use of a pre‐low noise amplifier (LNA) third‐order notch filter as a novel linearity enhancement technique for ultra‐wideband complementary metal oxide semiconductor LNA current‐reuse topology. The second/third order input intercept point (IIP2/3) has improved along the entire working bandwidth (BW) from 2.1 to 12.5 GHz. The suggested linearisation technique achieves maximum/minimum IIP2 improvement from 19.068 to 104.143 dBm at 6.4 GHz and from 22.5 to 57.42 dBm at 5.5 GHz, respectively. In addition, this work achieves maximum/minimum IIP3 improvement from −7.956 to 34.688 dBm at 6.4 GHz and from −9.986 to 8.281 dBm, respectively. Moreover, the suggested linearisation technique does not affect the total ultra‐wideband (UWB)‐LNA power consumption, which is only 6.7 mW. Furthermore, the linearised UWB‐LNA average noise figure is 1.6535 dB at the entire working BW. The simulation is performed and optimised with an advanced design system utilising BSIM3v3 TSMC 180 nm model files at different temperature values.
A new gamma-ray source unveiled by AGILE in the region of Orion
Authors: Marchili N. , Piano G. , Cardillo M. , Giuliani A. , Molinari S. , Tavani M. 
Published: March 2018

Context. Diffuse galactic γ-ray emission is produced by the interaction of cosmic rays (CRs) with the interstellar environment. The study of γ-ray emission is therefore a powerful tool that can be used to investigate the origin of CRs and the processes through which they are accelerated.
Aims. Our aim is to gain deeper insights into the nature of γ-ray emission in the region of Orion, which is one of the best studied sites of ongoing star formation, by analysing data from the AGILE satellite. Because of the large amount of interstellar medium (ISM) present in it, the diffuse γ-ray emission expected from the Orion region is relatively high. Its separation from the galactic plane also ensures a very small contribution from foreground or background emission, which makes it an ideal site for studying the processes of particle acceleration in star-forming environments.
Methods. The AGILE data are modelled through a template that quantifies the γ-ray diffuse emission expected from atomic and molecular hydrogen. Other sources of emission, such as inverse Compton (IC) scattering in interstellar radiation fields (ISRF) and extragalactic background, can be modelled as an isotropic contribution.
Results. Gamma-ray emission exceeding the amount expected by the diffuse emission model is detected with a high level of significance. The main excess is in the high-longitude part of Orion A, which confirms previous results from the Fermi Large Area Telescope. A thorough analysis of this feature suggests a connection between the observed γ-ray emission and the B0.5 Ia star κ Orionis.
Conclusions. We present the results of the investigation of γ-ray diffuse galactic emission from the region of Orion. The comparison between modelled and observed emission points towards the existence of higher-than-expected γ-ray flux from a 1° radius region centred in κ Orionis, compatible with the site where stellar wind collides with the ISM. Scattering on dark gas and cosmic-ray acceleration at the shock between the two environments are both discussed as possible explanations, with the latter hypothesis being supported by the hardness of the energy spectrum of the emission. If confirmed, this would be the first direct detection of γ-ray emission from the interaction between ISM and a single star’s stellar wind.
‘MAP’(ing) the Milestones in My Life
Authors: Joshi Bhawisha 
Published: March 2018

AbstractThis article talks about Joshi's method of mapping personalities and mapping Materia Medica. Joshi believes that all three kingdoms and their remedies can be compared and put on the same grid of easy remedy selection. This article takes you through Dr. Bhawisha's personal experiences with patients as well as some learning curves of her life that have helped in this development. To conclude she shares some useful insights that she has gathered through her interactions which became ‘Life-lessons’ as well as practical tips. She hopes that they will help the reader as well.
Kopfschmerz bei Medikamentenübergebrauch
Authors: Katsarava Z. , Nägel S. 
Published: March 2018

ZusammenfassungEs ist ein durch die Internationale Kopfschmerzgesellschaft akzeptierter Konsens,dass die häufige Einnahme von Akutmedikation zur Zunahme oder Chronifizierung von episodischen Kopfschmerzen führen kann.Dieser Kopfschmerz wird als Medikamentenübergebrauchskopfschmerz(MÜKS) bezeichnet.Definiert ist der MÜKS als ein Kopfschmerz,der an mindestens 15 Tagen pro Monat bei Patienten, die seit über 3 Monaten Akuttherapeutika im Übermaß einnehmen,auftritt. Die kritische Einnahmegrenze liegt für Triptane, Opioide und Kombinationsanalgetikabei 10 Tagen, für einfache Analgetikabei 15 Tagen pro Monat. Das Konzept fußt auf der Annahme, dass Menschen mit Migräne oder einem Kopfschmerz vom Spannungstyp ein besonders vulnerables trigeminalesSchmerzsystem haben, welches auf Schmerzmittelübergebrauchmit Sensitisierung der Schmerzverarbeitung und Chronifizierung des Kopfschmerzes reagiert. Der MÜKS wirddeswegen als sekundärer Kopfschmerz betrachtet.Das Mittel der Wahl zur Behandlungist nach aktueller Lehrmeinung eine Entzugsbehandlung.Diesem Konzept wird aber widersprochen.Die Gegner argumentieren,dass die häufige Schmerzmitteleinnahme lediglichbei einem Teil der Kopfschmerzpatientenzur Chronifizierung führt und man sich beidiesen nicht sicher sein kann, dass die Zunahme der Kopfschmerzfrequenz tatsächlich dieFolge des Schmerzmittelgebrauches ist, sondern,dass der übermäßige Schmerzmittelgebrauchdie Folge der häufigeren/chronifizierten Kopfschmerzen ist. Weiter wird argumentiert,die Verläufe würden sich nicht infolge derEntzugsbehandlung, sondern als Konsequenz einer multimodalen Therapie inklusive medikamentöser Prophylaxe und psychologischerund edukativer Betreuung bessern. Deswegensei der MÜKS keine eigene Entität. Durch dieDiagnose eines MÜKS stigmatisiere man dieBetroffenen, enthalte ihnen die nötigenSchmerzmedikamente vor und lasse sie unnötigleiden. In dieser Übersichtsarbeit beleuchtendie Autoren den aktuellen Stand der Literaturund stellen die Argumente für und gegenden MÜKS dar.
Wave Change of Intraoperative Transcranial Motor-Evoked Potentials During Corrective Fusion for Syndromic and Neuromuscular Scoliosis
Authors: Ando Kei , Kobayashi Kazuyoshi , Ito Kenyu , Tsushima Mikito , Morozumi Masayoshi , Tanaka Satoshi , Machino Masaaki , Ota Kyotaro , Nishida Yoshihiro , Ishiguro Naoki , Imagama Shiro 
Published: March 2018

Abstract

BACKGROUND
There is little information on intraoperative neuromonitoring during correction fusion surgery for syndromic scoliosis.

OBJECTIVE
To investigate intraoperative TcMEPs and conditions (body temperature and blood pressure) for syndromic scoliosis.

METHODS
The subjects were 23 patients who underwent 25 surgeries for corrective fusion using TcMEP. Patients were divided into groups based on a decrease (DA+) or no decrease (DA−) of the amplitude of the TcMEP waveform of ≥70%. The groups were compared for age, sex, disease, type of surgery, fusion area, operation time, estimated blood loss, body temperature, blood pressure, Cobb angle, angular curve (Cobb angle/number of vertebra), bending flexibility, correction rate, and recovery.

RESULTS
The mean Cobb angles before and after surgery were 85.2° and 29.1°, giving a correction rate of 68.2%. There were 16 surgeries (64.0%) with intraoperative TcMEP wave changes. The DA+ and DA− groups had similar intraoperative conditions, but the short angular curve differed significantly between these groups. Amplitude deterioration occurred in 4 cases during first rod placement, in 8 during rotation, and in 3 during second rod placement after rotation. Seven patients had complete loss of TcMEP. However, most TcMEP changes recovered after pediclectomy or decreased correction. The preoperative angular curve differed significantly between patients with and without TcMEP changes (P < .05).

CONCLUSION
Intraoperative TcMEP wave changes occurred in 64.0% of surgeries for corrective fusion, and all but one of these changes occurred during the correction procedure. The angular curve was a risk factor for intraoperative motor deficit.
Combined Nasoseptal and Inferior Turbinate Flap for Reconstruction of Large Skull Base Defect After Expanded Endonasal Approach: Operative Technique
Authors: Boetto Julien , Labidi Moujahed , Watanabe Kentaro , Hanakita Shunya , Bouazza Schahrazed , Passeri Thibault , Bernat Anne-Laure , Froelich Sebastien 
Published: March 2018

Abstract

BACKROUND
Increasing indications for endoscopic endonasal approaches have led neurosurgeons to develop new reconstruction techniques for larger skull base defects. Vascularized grafts have been a great adjunction to reduce the rate of cerebrospinal fluid leak and can also be used to cover exposed critical structures such as the internal carotid artery. The nasoseptal flap and the inferior or middle turbinate flap are thus widely used in endoscopic skull base surgery, but may be insufficient for very large defects.

OBJECTIVE
To present a new mucosal flap used to cover large skull base defects in which the mucosa of the inferior turbinate, inferior meatus, nasal floor, and nasal septum is harvested in 1 piece keeping both vascular pedicles intact (inferior turbinate and septal arteries).

METHODS
We describe a surgical technique to harvest a combined inferior turbinate-nasoseptal flap.

RESULTS
Technical pearls and surgical pitfalls are described through 2 clinical cases in which the nasoseptal mucosa was partially damaged during a previous surgery, rendering the nasoseptal flap insufficient by itself. The flap is harvested thanks to 2 mucosal cuts: a first circular cut around the choanal arch and the junction between the hard and the soft palate, and a second one combining classical cuts of the nasoseptal flap and the inferior turbinate flap.

CONCLUSION
The inferior turbinate-nasoseptal flap can be a useful alternative in patients whose septal mucosa was partially damaged and/or with very large postoperative skull base defects.
New Hypotension Treatment for Septic Shock
Authors: Aschenbrenner Diane S. 
Published: March 2018

Giapreza, an exogenous form of angiotensin II, has been approved to treat hypotension in adults with septic or other distributive shock. It should be added to the vasopressors used in the standard treatment of hypotension and shock.Giapreza use can cause thrombotic and thromboembolic events. Patients receiving the drug require prophylaxis with anticoagulants.
Major Change in Warning for Asthma Drugs
Authors: Aschenbrenner Diane S. 
Published: March 2018

The Food and Drug Administration has removed the black box warning from the labeling of combination long-acting β-agonists (LABAs) and corticosteroids used in asthma treatment. The warning stated that these combination drugs may increase the risk of serious asthma-related events such as hospitalization, intubation, or death.Single-ingredient LABAs will continue to receive this black box warning.
New Route for Buprenorphine Administration
Authors: Aschenbrenner Diane S. 
Published: March 2018

Buprenorphine, used to treat opioid use disorder, is now available in a once-monthly injectable form and sold under the trade name Sublocade. It can be initiated after the patient has received and tolerated a consistent dose of a transmucosal buprenorphine–naloxone product for at least a week.Sublocade must be administered by a health care professional. Nurses and NPs who administer the drug must confirm they are injecting it into the subcutaneous tissue, as injection into a vessel could lead to serious harm or death.
Applying American Society of Addiction Medicine Performance Measures in Commercial Health Insurance and Services Data
Authors: Thomas Cindy Parks , Ritter Grant A. , Harris Alex H.S. , Garnick Deborah W. , Freedman Kenneth I. , Herbert Barbara 
Published: March 2018

Objectives:
ASAM's Standards of Care for the Addiction Specialist established appropriate care for the treatment of substance use disorders. ASAM identified three high priority performance measures for specification and testing for feasibility in various systems using administrative claims: use of pharmacotherapy for alcohol use disorder (AUD); use of pharmacotherapy for opioid use disorder (OUD); and continuity of care after withdrawal management services. This study adds to the initial testing of these measures in the Veteran's Health Administration (VHA) by testing the feasibility of specifications in commercial insurance data (Cigna).

Methods:
Using 2014 and 2015 administrative data, the proportion of individuals with an AUD or OUD diagnosis each year who filled prescriptions or were dispensed appropriate FDA-approved pharmacotherapy. For withdrawal management follow up, the proportion with an outpatient encounter within seven days was calculated. The sensitivity of specifications was also tested.

Results:
Rates of pharmacotherapy for AUD ranged from 6.2% to 7.6% (depending on year and specification details), and rates for OUD pharmacotherapy were 25.0% to 29.7%. Seven-day follow up rate after withdrawal management in an outpatient setting was 20.5%, and an additional 39.7% in an inpatient or residential setting.

Conclusions:
Application of ASAM specifications is feasible in commercial administrative data. Because of varying system needs and payment practices across health systems, measures may require adjustment for different settings. Moving forward, important focus will be on the continued refinement of these measures with the new ICD-10 coding systems, new formulations of current medications, and new payment approaches such as bundled payment.
Surgical Approaches for the Treatment of Thoracic Disk Herniation
Authors: Nayak Nikhil R. , Bauman Joel A. , Stein Sherman C. , Thawani Jayesh P. , Malhotra Neil R. 
Published: March 2018

Study Design:
A decision analysis.

Objective:
To perform a decision analysis utilizing postoperative complication data, in conjunction with health-related quality of life (HRQoL) utility scores, to rank order the average health utility associated with various surgical approaches used to treat symptomatic thoracic disk herniation (TDH).

Summary of Background Data:
Symptomatic TDH is an uncommon entity accounting for <1% of all symptomatic herniated disks. A variety of surgical approaches have been developed for its treatment, which may be classified into 4 major categories: open anterolateral transthoracic, minimally invasive anterolateral thoracoscopic, posterior, and lateral. These treatments have varying risk/benefit profiles, but there is still no set algorithm for choosing an approach in cases with multiple surgical options.

Methods:
We searched Medline, EMBASE, and the Cochrane Library for relevant articles on surgical approaches for TDHs published between 1990 and August 2014. Pooled complication data and HRQoL utility scores associated with each complication were evaluated using standard meta-analytic techniques to determine which surgical approach resulted in the highest average HRQoL.

Results:
Posterior surgical approaches resulted in the highest average HRQoL, followed by thoracoscopic, lateral, and finally open anterolateral transthoracic procedures. The higher average HRQoL associated with posterior approaches over all others was highly significant (P<0.001); conversely, the open anterolateral approach resulted in a lower average postoperative utility compared with all other approaches (P<0.001).

Conclusions:
The results of this decision analysis favor posterior over lateral approaches, and thoracoscopic over open anterolateral approaches for the treatment of symptomatic TDHs, which may guide surgeons in cases where multiple surgical options are feasible. Future studies, such as randomized clinical trials, are necessary to ascertain whether novel surgical strategies have risk/benefit profiles that ultimately supersede those of traditional approaches, and whether enough cases are encountered by the average surgeon to justify their adoption.
Adult Spinal Deformity Correction with Multi-level Anterior Column Releases
Authors: Demirkiran Gokhan , Theologis Alexander A. , Pekmezci Murat , Ames Christopher , Deviren Vedat 
Published: March 2018

Study Design:
Case series.

Objective:
To evaluate radiographic and clinical outcomes of adults with spinal deformity treated with multilevel anterior column releases (ACR).

Summary of Background Data:
Pedicle subtraction osteotomy can be used effectively to correct spinal deformity; however, it is not without complications. ACR is an attractive alternative minimally invasive technique for spinal deformity correction, although few clinical reports on its clinical effectiveness exist.

Methods:
Adults with spinal deformity who underwent multilevel ACRs (≥2) followed by open posterior instrumentation with a minimum 1-year follow-up were retrospectively reviewed. Deformity radiographic data and clinical outcomes, including the Oswestry Disability Index (ODI) and the EuroQol-5D were analyzed.

Results:
Eight patients [7 female, 1 male; mean age 65 y (49–79 y)] met inclusion criteria. The mean follow-up was 18.4 months (12–28 mo). The average number of levels treated with an ACR per patient was 2.4 (2–3). There were no anterior approach–related complications. The average number of levels instrumented posteriorly was 8.1 (3–15). Six patients underwent Schwab type 1 posterior osteotomies (partial facetectomies). After the first anterior stage, there was a significant increase in the lumbar lordosis and significant decreases in the sagittal vertical axis, pelvic tilt, and lumbopelvic mismatch (P<0.05). After the second stage there was no significant change in the sagittal vertical axis, lumbar lordosis, pelvic tilt, or lumbopelvic mismatch relative to the values obtained after ACR. There was significantly less disability postoperatively [ODI: 15 (0–30)] compared with preoperatively [ODI: 46 (16–80)] (P<0.01). There was significant improvement in general health after operation, as assessed by the EuroQol-5D utility scores [preop: 0.44 (0.21–0.82) vs. postop: 0.71 (0.60–0.80)] (P=0.01). Back and leg visual analog scale pain scores improved significantly postoperatively.

Conclusions:
A staged approach using multilevel ACRs with open posterior instrumentation has an acceptable complication profile and provides excellent restoration of sagittal and coronal balance and pelvic parameters in adults with spinal deformity.