bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pinprick Evoked Potentials—Reliable Acquisition in Healthy Human Volunteers
Authors: Rosner Jan , Scheuren Paulina Simonne , Stalder Stephanie Anja , Curt Armin , Hubli Michèle 
Published: April 2019

Abstract

Objective
Pinprick evoked potentials (PEPs) represent a novel tool to assess the functional integrity of mechano-nociceptive pathways with a potential toward objectifying sensory deficits and gain seen in neurological disorders. The aim of the present study was to evaluate the feasibility and reliability of PEPs with respect to age, stimulation site, and skin type.

Methods
Electroencephalographic responses evoked by two pinprick stimulation intensities (128 mN and 256 mN) applied at three sites (hand dorsum, palmar digit II, and foot dorsum) were recorded in 30 healthy individuals. Test–retest reliability was performed for the vertex negative–positive complex amplitudes, N-latencies, and pain ratings evoked by the 256mN stimulation intensity.

Results
Feasibility of PEP acquisition was demonstrated across age groups, with higher proportions of evoked potentials (&gt;85%) for the 256mN stimulation intensity. Reliability analyses, that is, Bland-Altman and intraclass correlation coefficients, revealed poor to excellent reliability upon retest depending on the stimulation sites.

Conclusions
This study highlights the reliability of PEP acquisition from cervical and lumbar segments across clinically representative age groups. Future methodological improvements might further strengthen PEP reliability in order to complement clinical neurophysiology of sensory nerve fibers by a more specific assessment of mechano-nociceptive pathways. Beyond looking at sensory deficits, PEPs may also become applicable to revealing signs of central sensitization, complementing the clinical assessment of mechanical hyperalgesia.
EXPERIMENTAL VALIDATION OF ALGORITHMS USED TO ESTIMATE EFFECTIVE DOSE DURING INTERVENTIONAL RADIOLOGY PROCEDURES
Authors: Negri P , Campi F , De Crescenzo S , Garlati L , Tambussi O 
Published: April 2019

Abstract
In IR procedures, in order to evaluate the effective dose, the importance of the double dosemeter has been recognised, one worn above and one under the apron. Over the last few decades several algorithms have been developed to combine the readings of the dosemeters, however currently there is no international consensus on which is the best one. In this work, eight irradiations, corresponding to typical interventional radiology procedures, were carried out in order to experimentally verify the accuracy of the algorithms. The patient was substituted by solid water-equivalent (RW3) layers, while effective dose to personnel was calculated by TLDs inside the Alderson Rando phantom. The results show that most of the algorithms, with a few exceptions, are too conservative, however there are many factors which can affect their accuracy, so it is impossible to achieve a high level of precision in the evaluation of the effective dose.
The tokenization of assets and property rights
Authors: Prince Michael von und zu Liechtenstein H S H 
Published: April 2019

Abstract
Blockchain paves the way for new entrepreneurial opportunities for the trust business. Especially in connection with tokenization, asset safekeeping processes can be handled directly by a trustee through the use of a blockchain system. Therefore, a deeper understanding of blockchain, the ways it can be applied, and the relevant tax and legal ramifications are inevitable.
Comparison of 2 Automated Pupillometry Devices in Critically III Patients
Authors: Robba Chiara , Moro Salihovic Bedrana , Pozzebon Selene , Creteur Jacques , Oddo Mauro , Vincent Jean-Louis , Taccone Fabio S. 
Published: April 2019

Background:
Automated pupillometry may help detect early cerebral disturbances in critically ill patients. It remains unclear whether different automated pupillometry devices can detect pupillary abnormalities with similar accuracy. The aim of this study was to compare the performance of 2 commercially available automated pupillometry devices—Neurolight Algiscan (NL) and NPi-200 (NP) versus standard pupillary light reflex (PLR) examination in an unselected cohort of critically ill patients.

Materials and Methods:
This prospective study included all adult (>18 y) patients admitted to the intensive care unit of a university hospital over a 20-day period. Measurements were made consecutively with each method once during the intensive care unit stay in each patient. To assess sensitivity and specificity, we calculated areas under the curve of the receiver operating characteristic curve.

Results:
A total of 112 patients were included in the study. There was a significant correlation between the 2 automated pupillometry devices for pupil size, constriction to light stimulation, and constriction velocity but not for pupillary latency. The mean bias for pupil size measured by the NL and the NP devices was −0.12 (limit of agreement [LoA], −1.29 to 1.06) mm, for pupil constriction −1.0% (LoA, −9.3% to 7.2%), and for latency 0.02 (LoA, −0.22 to 0.25) ms. There was a significant correlation between pupil size evaluated by clinical examination and that using the NL or NP. The areas under the curves for pupil constriction measured by NL and NP were 0.93 and 0.91, respectively, to detect clinically reactive pupils.

Conclusions:
Although there was a significant correlation between NL and NP values as well as with clinical examination of the PLR, the 2 devices were not always interchangeable, especially for the evaluation of pupillary latency.
The Diagnosis and Treatment of Comorbid Bipolar and Substance Use Disorders
Authors: Vaz Gina , Crockford David 
Published: April 2019

Les troubles bipolaires et les troubles de l’utilisation fréquente de substances se produisent de façon concomitante, compliquant le diagnostic et le traitement, ce qui entraîne souvent des résultats plus graves pour les deux troubles. Un cas clinique est utilisé pour illustrer des moyens pour différencier le trouble bipolaire des symptômes induits par des substances, puis examiner les options de traitement fondées sur des données probantes pour les troubles bipolaires simultanés et les troubles liés à la consommation de substances.

ABSTRACT
Bipolar disorders and substance use disorders frequently co-occur complicating diagnosis and treatment, often resulting in worse outcomes for both disorders. A clinical case is used to illustrate means to differentiate bipolar disorder from substance-induced symptoms, then review evidence-based treatment options for comorbid bipolar and substance use disorders.
A Comparative Analysis of Canadian University Policies Toward Alcohol, Drugs, and Gambling Use
Authors: Marchica Loredana , Zhao Yaxi , Richard Jeremie , Derevensky Jeffrey , Shaffer Howard J. 
Published: April 2019

ABSTRACT

Objectives:
Emerging adulthood remains a critical period in the participation of risky behaviors, including alcohol and substance use as well as gambling. College students are at greatest risk for participation in these risky behaviors because they are continuously exposed to multiple, drinking, substance use, and gambling environments without the support and guidance often present at home. Previous public policy studies have suggested that college and university policies might help decrease a variety of risky behaviors (eg, alcohol, substance use and gambling) among students. Although some studies have compared gambling-related policies to alcohol and substance use related policies in the United States, this has not yet been done in Canada. Thus, the current study constitutes the first Canadian comparison of college gambling policies to alcohol and substance use policies.

Methods:
Data were collected from 96 English and French colleges/universities across Canada adapting Shaffer et al's (2005) 15-item measure assessing the prevalence of gambling, alcohol and substance use related policies.

Results:
Analyses revealed significantly more schools had either an alcohol or substance use related policy (90% and 83%), compared to schools with a gambling-related policy (32%).

Conclusions:
The scarce prevalence of college gambling-related policies suggests that Canadian colleges and universities underestimate the risks associated with heavy participation in gambling activities. Although alcohol and substance use policies remain essential, gambling policies can have a significant influence on college student participatory behaviors. The present research suggests greater awareness and need for college and university administrators to develop appropriate gambling-related policies and programs.
Prescription Opioids, Opioid Use Disorder, and Overdose Crisis in Canada: Current Dilemmas and Remaining Questions
Authors: Gorfinkel Lauren , Wood Evan , Klimas Jan 
Published: April 2019

ABSTRACT
In Canada, a rise in opioid use disorder (OUD) and overdose has been linked to opioid prescriptions in a number of contexts. At the same time, relatively few patients prescribed opioids reportedly develop OUD. This combination of findings suggests a pressing need for research on specific avenues through which medically prescribed opioids influence OUD and overdose in Canada. In this commentary, we therefore discuss a few of the potential processes that might allow for medically prescribed opioids to indirectly influence rising overdose rates, and the processes that might account for inconsistencies between large correlational research and studies of OUD incidence in opioid-prescribed patients.

Au Canada, une augmentation du trouble de l’usage des opioïdes (OUD) et la surdose ont été associées aux prescriptions d’opioïdes dans un certain nombre de contextes. Dans le même temps, relativement peu de patients qui se sont fait prescrire des opioïdes ont développés une OUD. Cette combinaison de résultats suggère un besoin pressant de recherche sur des avenues spécifiques par lesquelles les opioïdes prescrits par un médecin (MPO) influencent le DIU et l’overdose au Canada. Dans ces observations, nous discutons quelques-uns des processus potentiels qui pourraient permettre aux MPO d’influencer indirectement les taux de surdose croissants, et les processus qui pourraient expliquer les incohérences entre les grandes recherches corrélationnelles et les études d’incidence OUD chez les patients opioïdes.
Functional Outcome Trajectories Following Inpatient Rehabilitation for TBI in the United States: A NIDILRR TBIMS and CDC Interagency Collaboration
Authors: Dams-O'Connor Kristen , Ketchum Jessica M. , Cuthbert Jeffrey P. , Corrigan John D. , Hammond Flora M. , Haarbauer-Krupa Juliet , Kowalski Robert G. , Miller A. Cate 
Published: April 2019

Objective:
To describe trajectories of functioning up to 5 years after traumatic brain injury (TBI) that required inpatient rehabilitation in the United States using individual growth curve models conditioned on factors associated with variability in functioning and independence over time.

Design:
Secondary analysis of population-weighted data from a multicenter longitudinal cohort study.

Setting:
Acute inpatient rehabilitation facilities.

Participants:
A total of 4624 individuals 16 years and older with a primary diagnosis of TBI.

Main Outcome Measures:
Ratings of global disability and supervision needs as reported by participants or proxy during follow-up telephone interviews at 1, 2, and 5 years postinjury.

Results:
Many TBI survivors experience functional improvement through 1 and 2 years postinjury, followed by a decline in functioning and decreased independence by 5 years. However, there was considerable heterogeneity in outcomes across individuals. Factors such as older age, non-White race, lower preinjury productivity, public payer source, longer length of inpatient rehabilitation stay, and lower discharge functional status were found to negatively impact trajectories of change over time.

Conclusions:
These findings can inform the content, timing, and target recipients of interventions designed to maximize functional independence after TBI.
Brain Amygdala Volume Increases in Veterans and Active-Duty Military Personnel With Combat-Related Posttraumatic Stress Disorder and Mild Traumatic Brain Injury
Authors: Pieper Joel , Chang Douglas G. , Mahasin Sarah Z. , Swan Ashley Robb , Quinto Annemarie Angeles , Nichols Sharon L. , Diwakar Mithun , Huang Charles , Swan James , Lee Roland R. , Baker Dewleen G. , Huang Mingxiong 
Published: April 2019

Objective:
To identify amygdalar volumetric differences associated with posttraumatic stress disorder (PTSD) in individuals with comorbid mild traumatic brain injury (mTBI) compared with those with mTBI-only and to examine the effects of intracranial volume (ICV) on amygdala volumetric measures.

Setting:
Marine Corps Base and VA Healthcare System.

Participants:
A cohort of veterans and active-duty military personnel with combat-related mTBI (N = 89).

Design:
Twenty-nine participants were identified with comorbid PTSD and mTBI. The remaining 60 formed the mTBI-only control group. Structural images of brains were obtained with a 1.5-T MRI scanner using a T1-weighted 3D-IR-FSPGR pulse sequence. Automatic segmentation was performed in Freesurfer.

Main Measures:
Amygdala volumes with/without normalizations to ICV.

Results:
The comorbid mTBI/PTSD group had significantly larger amygdala volumes, when normalized to ICV, compared with the mTBI-only group. The right and left amygdala volumes after normalization to ICV were 0.122% ± 0.012% and 0.118% ± 0.011%, respectively, in the comorbid group compared with 0.115% ± 0.012% and 0.112% ± 0.009%, respectively, in the mTBI-only group (corrected P < .05).

Conclusions:
The ICV normalization analysis performed here may resolve previous literature discrepancies. This is an intriguing structural finding, given the role of the amygdala in the challenging neuroemotive symptoms witnessed in casualties of combat-related mTBI and PTSD.
Are Male Partners the Missing Link to Eliminating Mother-To-Child Transmission of HIV in Sub-Saharan Africa? Evidence From a Retrospective Case-Control Study
Authors: Nyandat Joram , Van Rensburg Gisela 
Published: April 2019

Abstract
When male partners of pregnant women living with HIV do not participate in antenatal care, it decreases the uptake of prevention of mother-to-child transmission interventions, which increases the risk of HIV transmission to newborns. We evaluated the association of male partner involvement and vertical HIV transmission at 6 weeks along 4 constructs: antenatal clinic accompaniment, mother's awareness of partner HIV status, disclosure of mother's HIV status to partner, and couple testing. Thirty-three HIV-exposed infants with positive 6-week polymerase chain reaction (PCR) results were compared with 144 HIV-exposed infants with a negative PCR. Mothers of PCR-negative infants were 14 times more likely to have disclosed their HIV status to their partners (odds ratio [OR] = 14.1 [5.0–39.4]), to be aware of partner HIV status (OR = 0.2 [0.1–0.96]), and to have been accompanied by their male partners to the antenatal clinic (OR = 0.6 [0.5–0.9]). There is a need for male engagement in prevention of mother-to-child transmission programs.
Couples’ Experience of the Decision-Making Process in Breast Reconstruction After Breast Cancer
Authors: Lamore Kristopher , Vioulac Christel , Fasse Léonor , Flahault Cécile , Quintard Bruno , Untas Aurélie 
Published: April 2019

Background
One in 3 women with breast cancer will have a mastectomy and face the decision of whether to have breast reconstruction (BR). This decision is shared by the women and their physician, as well as discussed with her partner.

Objective
This study aimed to understand the decision-making process of BR through a lexical analysis of the women and their partners' discourse. A secondary aim was to identify the differences between the couples when the woman had, or did not have, BR.

Methods
We conducted semistructured interviews with 9 women, and their partners, who underwent a mastectomy after a first episode of breast cancer. A lexical analysis using IRaMuTeQ software was carried out.

Results
The analysis yielded 3 classes, each one being more represented by one of the different BR categories. Class 1 contained words reflecting a preoccupation with body modification. Class 2 was related to the surgery and its consequences. Words contained in class 3 were about the couples’ issues regarding surgeries, treatments, and medical care. The question of temporality emerged particularly in classes 2 and 3.

Conclusions
This study underlines the differences in the discourse of couples when talking about BR decision-making. Furthermore, it shows the importance of giving women time to think about BR and discuss its issues.

Implication for Practice
Decisions about BR are difficult to make and should always be discussed between the women and health professionals, as BR is not always possible or desired by women. Partners need to be included in treatment decision-making.
Subcutaneous Migration: A Dynamic Anatomical Study of Gluteal Fat Grafting
Authors: Wall Simeon , Delvecchio Daniel , Teitelbaum Steven , Villanueva Nathaniel L. , Dayan Erez , Durand Paul , Sanniec Kyle , Rohrich Rod J. 
Published: April 2019

Background:
Recent anatomical studies have demonstrated that fat placed subjacent to the fascia of the gluteus maximus muscle can migrate deep through the muscle into the submuscular space, possibly causing tears in the gluteal veins, leading to fat embolisms. The purpose of this study was to define and to study subcutaneous migration and to determine whether fat placed in the subcutaneous space under a variety of pressures and fascial integrity scenarios can indeed migrate into the deep submuscular space.

Methods:
Four hemibuttocks from two cadavers were used. Proxy fat was inserted using syringes with various fascia scenarios (1: fascia intact; 2: cannula perforations; 3: 6mm fascia defects) or using expansion vibration lipofilling (4: fascia intact). Subcutaneous pressures were recorded. After injections, anatomical dissections were performed to evaluate the migration of the proxy fat for each of the scenarios.

Results:
Scenario 1: pressure reached approximately 125 to 150 mmHg and then plateaued and all the proxy fat remained in the subcutaneous space. Scenario 2: pressure reached a 199-mmHg plateau and no proxy fat spread deeper into the muscle or beneath it. Scenario 3: pressure gradually rose to 50 mmHg then fell again and the submuscular space contained a significant amount of proxy fat. Scenario 4: pressure rose to a maximum of 30 mmHg and all of the proxy fat remained in the subcutaneous space.

Conclusions:
The gluteus maximus fascia is a stout wall that sets up the dangerous condition of deep intramuscular migration with subfascial injections and the protective condition of subcutaneous migration with suprafascial injections. These persuasive findings are profound enough to propose a new standard of care: no subfascial or intramuscular injection should be performed, and all injections should be performed exclusively into the subcutaneous tissue.
Perfusion Bioreactor Culture of Bone Marrow Stromal Cells Enhances Cranial Defect Regeneration
Authors: Gandhi Jarel K. , Kao Shu-Wei , Roux Brianna M. , Rodriguez Raul A. , Tang Shu-Jun , Fisher John P. , Cheng Ming-Huei , Brey Eric M. 
Published: April 2019

Background:
Cell-seeded biomaterial scaffolds have been proposed as a future option for reconstruction of bone tissue. The ability to generate larger, functional volumes of bone has been a challenge that may be addressed through the use of perfusion bioreactors. In this study, the authors investigated use of a tubular perfusion bioreactor system for the growth and differentiation of bone marrow stromal (mesenchymal stem) cells seeded onto fibrin, a highly angiogenic biomaterial.

Methods:
Cells were encapsulated within fibrin beads and cultured either within a tubular perfusion bioreactor system or statically for up to 14 days. Scaffolds were analyzed for osteogenic differentiation. A rodent cranial defect model (8-mm diameter) was used to assess the bone regeneration of scaffolds cultured in the bioreactor, statically, or used immediately after formation. Immunohistochemistry was used to visualize CD31+ vessel density. Micro–computed tomographic imaging was used to visualize mineral formation within the defect volume.

Results:
Tubular perfusion bioreactor system–cultured samples showed significantly greater osteodifferentiation, indicated by an increase in VEGF expression and mineral deposition, compared with statically cultured samples. Increased expression of OPN, RUNX2, VEGF, and CD90 was seen over time in both culture methods. After implantation, bioreactor samples exhibited greater bone formation and vessel density compared with all other groups. Analysis of micro–computed tomographic images showed full union formation through the greatest diameter of the defect in all bioreactor samples and the highest levels of mineralized volume after 8 weeks.

Conclusion:
Mesenchymal stem cells encapsulated in fibrin beads and cultured in the tubular perfusion bioreactor system resulted in increased vascularization and mineralized tissue formation in vivo relative to static culture.
Three-Dimensionally Printed Hyperelastic Bone Scaffolds Accelerate Bone Regeneration in Critical-Size Calvarial Bone Defects
Authors: Huang Yu-Hui , Jakus Adam E. , Jordan Sumanas W. , Dumanian Zari , Parker Kelly , Zhao Linping , Patel Pravin K. , Shah Ramille N. 
Published: April 2019

Background:
Autologous bone grafts remain the gold standard for craniofacial reconstruction despite limitations of donor-site availability and morbidity. A myriad of commercial bone substitutes and allografts are available, yet no product has gained widespread use because of inferior clinical outcomes. The ideal bone substitute is both osteoconductive and osteoinductive. Craniofacial reconstruction often involves irregular three-dimensional defects, which may benefit from malleable or customizable substrates. “Hyperelastic Bone” is a three-dimensionally printed synthetic scaffold, composed of 90% by weight hydroxyapatite and 10% by weight poly(lactic-co-glycolic acid), with inherent bioactivity and porosity to allow for tissue integration. This study examines the capacity of Hyperelastic Bone for bone regeneration in a critical-size calvarial defect.

Methods:
Eight-millimeter calvarial defects in adult male Sprague-Dawley rats were treated with three-dimensionally printed Hyperelastic Bone, three-dimensionally printed Fluffy–poly(lactic-co-glycolic acid) without hydroxyapatite, autologous bone (positive control), or left untreated (negative control). Animals were euthanized at 8 or 12 weeks postoperatively and specimens were analyzed for new bone formation by cone beam computed tomography, micro–computed tomography, and histology.

Results:
The mineralized bone volume–to–total tissue volume fractions for the Hyperelastic Bone cohort at 8 and 12 weeks were 74.2 percent and 64.5 percent of positive control bone volume/total tissue, respectively (p = 0.04). Fluffy–poly(lactic-co-glycolic acid) demonstrated little bone formation, similar to the negative control. Histologic analysis of Hyperelastic Bone scaffolds revealed fibrous tissue at 8 weeks, and new bone formation surrounding the scaffold struts by 12 weeks.

Conclusion:
Findings from our study suggest that Hyperelastic Bone grafts are effective for bone regeneration, with significant potential for clinical translation.