bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural connectivity in multiple sclerosis and modeling of disconnection
Authors: Pagani Elisabetta , Rocca Maria A , De Meo Ermelinda , Horsfield Mark A , Colombo Bruno , Rodegher Mariaemma , Comi Giancarlo , Filippi Massimo 
Published: January 2019

Background: Multiple sclerosis (MS) is characterized by focal white matter damage, and when the brain is modeled as a network, lesions can be treated as disconnection events. Objective: To evaluate whether modeling disconnection caused by lesions helps explain motor and cognitive impairment in MS. Methods: Pathways connecting 116 cortical regions were reconstructed with magnetic resonance imaging (MRI) tractography from diffusion tensors averaged across healthy controls (HCs); maps of pathways were applied to 227 relapse-onset MS patients and 50 HCs to derive structural connectivity. Then, the likelihood of individual connections passing through lesions was used to model disconnection. Patients were grouped according to clinical phenotype (113 relapsing-remitting multiple sclerosis (RRMS), 69 secondary progressive multiple sclerosis (SPMS), 45 benign MS), and then network metrics were compared between groups (analysis of variance (ANOVA)) and correlated with motor and cognitive scores (linear regression). Results: Global metrics differentiated RRMS from SPMS and benign MS patients, but not benign from SPMS patients. Nodal connectivity strength replicated global results. After disconnection, few nodes were significantly different between benign MS and RRMS patients. Correlations revealed nodes pertinent to motor and cognitive dysfunctions; these became slightly stronger after disconnection. Conclusion: Connectivity did not change greatly after modeled disconnection, suggesting that the brain network is robust against damage caused by MS lesions.
Falls prevention for people with dementia: a knowledge translation intervention
Authors: Meyer Claudia , Hill Keith D , Hill Sophie , Dow Briony 
Published: January 2019

Purpose Strong evidence exists for falls prevention, yet uptake of strategies can be fragmented and limited. For people with dementia, adoption of strategies may be impacted by changes in memory and planning. This paper describes the findings of a knowledge translation intervention for adoption of falls prevention strategies for people with dementia. Methods Twenty-five dyads (people with dementia and their caregivers) participated in this mixed method intervention. The Knowledge to Action framework guided: collation of existing evidence into a useable format; identification of individual issues; understanding context; and evaluation of change over time. Demographic details, functional status, dementia severity, activity level, self-efficacy, falls risk and readiness to change behaviour were collected at baseline, 6 and 12 months. Goal setting and action planning using a discussion tool drove implementation. Results Falls rates were 5.4 falls per 1000 days for the 12-month period, with no significant change in functional capacity or self-efficacy. There was a non-significant trend towards reduced falls risk. Readiness to change behaviour for falls risk increased from 84% to 96% by 6 months, with most moving from contemplation into action ( n = 16), or preparation into action ( n = 36), with adoption of strategies high (82%). Conclusion Engagement with the person with dementia and their caregiver, through identification of their needs and preferences, and enabling choice resulted in high adoption of falls prevention strategies.
Comparative international testing of early childhood education: The democratic deficit and the case of Portugal
Authors: Sousa Diana , Grey Sue , Oxley Laura 
Published: January 2019

The Organisation for Economic Co-operation and Development (OECD) has a key role in driving educational discourse and global educational governance. Its comparative ‘Programme of International School Assessment’ (PISA) has explicitly linked the knowledge and skills of young people with the economic potential of countries. Through the International Early Learning and Child Well-Being Study (IELS), the OECD plans to extend its reach to early childhood education (ECE) by developing metrics to measure ‘quality’ in ECE. This focus gives weight to discourses centred around ideas of ‘what works’. The rhetoric derives from the principles that standards of learning and well-being can be improved by emulating notions of ‘best practice’ identified through comparative data.  This article uses the case of Portugal to illustrate the significant disconnect between the aims and pedagogies of ECE and the increasingly influential de-contextualised discourses concerning ranking, performance and outcomes, as espoused by the OECD IELS project. Using evidence from three diverse Portuguese ECE settings, we illustrate how conceptual understandings of democracy in each school closely reflected the individual school philosophies. We discuss how the dampening of localised realities, for example, through standardisation and de-contextualisation, could lead to a democratic deficit enabled by discourses which displace the purpose, complexity and subjectivity of ECE policy and practice.
Evaluation and Clinical Application of a Commercially Available Iterative Reconstruction Algorithm for CBCT-Based IGRT
Authors: Mao Weihua , Liu Chang , Gardner Stephen J. , Siddiqui Farzan , Snyder Karen C. , Kumarasiri Akila , Zhao Bo , Kim Joshua , Wen Ning Winston , Movsas Benjamin , Chetty Indrin J. 
Published: January 2019

Purpose: We have quantitatively evaluated the image quality of a new commercially available iterative cone-beam computed tomography reconstruction algorithm over standard cone-beam computed tomography image reconstruction results. Methods: This iterative cone-beam computed tomography reconstruction pipeline uses a finite element solver (AcurosCTS)-based scatter correction and a statistical (iterative) reconstruction in addition to a standard kernel-based correction followed by filtered back-projection-based Feldkamp-Davis-Kress cone-beam computed tomography reconstruction. Standard full-fan half-rotation Head, half-fan full-rotation Head, and standard Pelvis cone-beam computed tomography protocols have been investigated to scan a quality assurance phantom via the following image quality metrics: uniformity, HU constancy, spatial resolution, low contrast detection, noise level, and contrast-to-noise ratio. An anthropomorphic head phantom was scanned for verification of noise reduction. Clinical patient image data sets for 5 head/neck patients and 5 prostate patients were qualitatively evaluated. Results: Quality assurance phantom study results showed that relative to filtered back-projection-based cone-beam computed tomography, noise was reduced from 28.8 ± 0.3 HU to a range between 18.3 ± 0.2 and 5.9 ± 0.2 HU for Full-Fan Head scans, from 14.4 ± 0.2 HU to a range between 12.8 ± 0.3 and 5.2 ± 0.3 HU for Half-Fan Head scans, and from 6.2 ± 0.1 HU to a range between 3.8 ± 0.1 and 2.0 ± 0.2 HU for Pelvis scans, with the iterative cone-beam computed tomography algorithm. Spatial resolution was marginally improved while results for uniformity and HU constancy were similar. For the head phantom study, noise was reduced from 43.6 HU to a range between 24.8 and 13.0 HU for a Full-Fan Head and from 35.1 HU to a range between 22.9 and 14.0 HU for a Half-Fan Head scan. The patient data study showed that artifacts due to photon starvation and streak artifacts were all reduced, and image noise in specified target regions were reduced to 62% ± 15% for 10 patients. Conclusion: Noise and contrast-to-noise ratio image quality characteristics were significantly improved using the iterative cone-beam computed tomography reconstruction algorithm relative to the filtered back-projection-based cone-beam computed tomography method. These improvements will enhance the accuracy of cone-beam computed tomography-based image-guided applications.
A Generic Function Evaluator Implemented in Mata
Authors: Støvring Henrik 
Published: January 2019

Background When implementing new statistical procedures, there is often a need for simple—and yet computationally efficient—ways of numerically evaluating composite distribution functions. If the statistical procedure must support calculations for censored and noncensored cases, those calculations should be carried out using efficient computational implementations of both definite and indefinite integrals (e.g., calculation of tail areas of distribution functions). Method We developed a generic function evaluator such that users may specify a function using reverse Polish notation. As its argument the function evaluator takes a matrix of pointers and then applies the rows of this matrix to its internally defined stack of pointers. Accordingly, each row of the argument matrix defines a single operation such as evaluating a function on the current element of the stack, applying an algebraic operation to the two top elements of the stack, or manipulating the stack itself. Defining new composite distribution functions from other (atomic) distribution functions then corresponds to joining two or more function-defining matrices vertically. This approach can further be used to obtain integrals of any defined function. As an example we show how the density and distribution function for the minimum of two Weibull distributed random variables can be numerically evaluated and integrated. Results The procedure provides a flexible and extensible framework for implementing numerical evaluation of general, composite distributions. The procedure is numerically relatively efficient, although not optimal.
Spontaneous isolated superior mesenteric artery dissection: Systematic review and meta-analysis
Authors: Karaolanis Georgios , Antonopoulos Constantine , Tsilimigras Diamantis I , Moris Dimitrios , Moulakakis Konstantinos 
Published: January 2019

Objectives Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare disease with an incidence of 0.06%. The purpose of the meta-analysis was to identify the outcomes associated with the various treatment options in the management of asymptomatic and symptomatic patients with SISMAD. Methods Eligible studies were selected by searching PubMed, EMBASE, and Cochrane Library. Endpoints were outcome of asymptomatic patients treated conservatively, resolution of symptoms according to the treatment approach, rate of symptomatic patients switched from conservative to the endovascular and/or open repair, characteristics of the dissected lesion, and findings regarding the remodeling of superior mesenteric artery. Results We identified 30 studies including 729 patients. Among them, 608 (83.4%) were symptomatic and were managed with conservative (438/72%), and/or endovascular (139/22.8%) and/or open treatment (31/5%). The remaining were asymptomatic and they were treated solely conservatively. A high rate of resolution of symptoms (92.8%) was noted for patients treated conservatively. Conversion from conservative treatment to either endovascular or open procedure was required in 12.3% and 4.4%, respectively. Resolution of symptoms was observed in 100% for those treated with open procedure and 88.8% for those treated endovascularly. The pooled rate of bowel ischemia in patients treated conservatively was 3.75% (95% confidence interval = 1.15–7.27). Complete remodeling was achieved in 32% and partial in 26% of those who were treated conservatively. Conclusions The majority of symptomatic patients with SISAMD were treated conservatively and showed an uncomplicated course and only a small percentage required conversion to endovascular or open repair. This might highlight the benign course of the disease.
Anatomical, surgical and technical factors influencing continence after radical prostatectomy
Authors: Arroyo Carlos , Martini Alberto , Wang Joanna , Tewari Ashutosh K. 
Published: January 2019

Radical prostatectomy (RP) is the most frequent treatment with curative intent performed for prostate cancer to date. Different surgical approaches (perineal, transperitoneal, and extraperitoneal) and techniques (laparoscopic and robot assisted) have been described to increase the efficiency and potentially diminish the postoperative complications of this procedure. The aim of this narrative review is to investigate and define the factors that influence postprostatectomy urinary continence. We highlighted the anatomical landmarks and the modifications of surgical techniques aimed at improving the continence rates and thus, patient quality of life. After RP, the long-term continence rates range from 84% to 97%. In order to achieve good continence rates, a careful dissection along with meticulous anatomical reconstruction is required. To this end, a detailed knowledge of the periprostatic anatomy is mandatory.
Intravesical BCG: where do we stand? Past, present and future
Authors: Hobbs Catherine , Bass Edward , Crew Jeremy , Mostafid Hugh 
Published: January 2019

High and intermediate risk non-muscle invasive bladder cancer poses a real challenge for treatment. Approximately 70% of bladder cancer presents as non-muscle invasive and 20–25% will progress to muscle invasive disease. Recurrences occur in up to 70% but treatment options are limited. Intravesical bacillus Calmette–Guérin is still considered the bladder sparing treatment of choice despite its well documented pitfalls. This review considers how bacillus Calmette–Guérin has become the recommended treatment, its benefits and risks and the alternative options for treatment. Level of evidence: Not applicable for this multicentre audit.
Suspected adverse drug interaction between spinosad and milbemycin oxime in a cat
Authors: Jenkins Elizabeth L , De Souza Natalie J , Beatty Julia A , Barrs Vanessa RD 
Published: January 2019

Case summary A 12-year-old male neutered Tonkinese cat was presented for acute ataxia, weakness, altered mentation and generalised tremors. The cat had been administered oral spinosad (140 mg; 33.5 mg/kg) 48 h prior to the onset of clinical signs, and an oral anthelmintic containing milbemycin oxime (16 mg; 3.8 mg/kg) and praziquantel (40 mg; 9.6 mg/kg) 12 h before the onset of clinical signs. On physical examination, dull-to-obtunded mentation, tetraparesis, ataxia and mild tremors of facial, limb and trunk muscles were noted. Serum biochemical changes and urinalysis were consistent with haemoconcentration. The results of a complete blood count, urine culture and serology for feline leukaemia virus, feline immunodeficiency virus and cryptococcal antigen were negative. The patient was monitored in hospital and all clinical signs resolved within 24 h. Relevance and novel information The neurological signs in this case were consistent with macrocyclic lactone neurotoxicity, which is suspected to have occurred from an adverse drug interaction between spinosad and milbemycin oxime. This report serves to highlight the potential for this adverse drug interaction between these commonly used prophylactic drugs.
Surgical Outcomes of Biventricular Repair for Hypoplastic Left Ventricle With Congenital Mitral Valve Stenosis
Authors: Shimada Masatoshi , Hoashi Takaya , Nakata Tomohiro , Ozawa Hideto , Kurosaki Kenichi , Kitano Masataka , Ichikawa Hajime 
Published: January 2019

Objective: Surgical outcomes of biventricular repair for hearts with hypoplastic left ventricle with congenital mitral valve stenosis are described. Serial changes of left ventricular geometry and clinical features after biventricular repair were reviewed. Methods: Eight patients with hypoplastic left ventricle and congenital mitral valve stenosis who underwent first surgical intervention for biventricular circulation in neonatal or infantile period between 2001 and 2014 comprise the study population. Serial change in left ventricular end-diastolic diameter, left ventricular mass index, and relative wall thickness after biventricular repair were evaluated by two-dimensional echocardiography. Results: The median Z-scores of left ventricular end-diastolic diameter and mitral valve diameter before the first surgical intervention were −3.0 (range, −4.8 to −2.0) and −1.0 (−2.9 to 2.1), respectively. Mitral valves were surgically treated in five patients; they were replaced in two and repaired in three patients. Left ventricular end-diastolic diameter Z-score at five years after biventricular repair was 0.1 (−3.0 to 1.0), which was significantly larger than before first surgical intervention ( P = .005). Left ventricular mass index, on the other hand, did not change, but relative wall thickness significantly decreased ( P = .009). Postoperative catheter study showed pulmonary hypertension with high left ventricular end-diastolic pressure in more than half of survivors. Conclusions: Left ventricle increased in size after the biventricular repair with appropriate mitral valve procedures before progression of pulmonary hypertension. Left ventricular mass, however, did not accompany the increase. Some patients may have suffered from mild, but certain restrictive left ventricular physiology and subsequent pulmonary hypertension as the result of abnormal remodeling process of the myocardium.
Virtual cystoscopy and colonoscopy to assess deep infiltrating endometriosis
Authors: Rault Emmanuel , Philip Charles-André , Cortet Marion , Dubernard Gil 
Published: January 2019

Introduction: Faced with a suspicion of endometriosis, transvaginal sonography is the first-line procedure to diagnose deep infiltrating endometriosis. Methods: We recently introduced the FlyThru® mode from TOSHIBA aplio 500. With the 3D acquisition (Multiplanar Reconstruction), we can assess the deep invasion of the endometriosis nodule into the digestive and bladder wall and provide a virtual colonoscopy or cystoscopy. The entire wall of the organ can be explored either by starting the animation or by rotating the arrow. The detection threshold can be adjusted manually from 45 to 100 in order to remove any artifacts. Results: We reported two deep infiltrating endometriosis nodules explored with FlyThru mode: the first one in the rectum and the second in the bladder. Similar to a colonoscopy, the virtual animation of the FlyThru mode showed the progression into the intestine lumen until the visualization of the bulge of the nodule. Operators can appreciate precisely the location, the degree of stenosis, and the circumferential involvement of the bowel wall. The bulges of the two nodules were also visible into the bladder. The size of the lesions was assessed and related to bladder volume, which represents important preoperative data. Conclusion: Three dimensional-transvaginal sonography combined with the FlyThru mode allows the enhanced practitioner to diagnose and assess the invasion of an endometriosis nodule in a single procedure.
Reconstruction with biological methods following intercalary excision of femoral diaphyseal tumors
Authors: Salunke Abhijeet Ashok , Shah Jaymin , Chauhan Tapan Singh , Parmar Rahul , Kumar Ashok , Koyani Himanshu , Garg Nikhil , Bhole Makarand , Merja Manthan , Pandit Jyotindra , Pandya Shashank , Kamani Mayur 
Published: January 2019

Aim: The aim of this study was to assess outcomes of biological (nonvascularized fibula grafts and extracorporeal irradiated autologous bone grafts) methods used for reconstruction of intercalary defects after resection of femoral diaphyseal tumors. Materials and Methods: This study included 28 patients who had undergone intercalary resection in femoral diaphyseal tumors between 2011 and 2016. The mean follow-up period was 24 months (range 12–57 months). Results: The mean union time for diaphyseo-diaphyseal union was 10.5 and 11 months in nonvascularized fibula group and extracorporeal radiotherapy (ECRT) group, respectively. The mean union time for metaphyseo-diaphyseal union was 6.5 months in both nonvascularized fibula and ECRT groups. Six patients had distant metastasis, and one patient had local recurrence. The mean Musculoskeletal Tumor Society score was 28 at the last follow-up. Two patients had surgical site infection in the nonvascularized fibula group. Implant failure was found in one patient of the ECRT group requiring revision surgery. Three patients had nonunion (two from the nonvascularized fibula group and one from the ECRT group). Conclusion: The present study indicates that the biological reconstruction modalities provide good functional outcomes in diaphyseal tumors of femur. Nonvasularized fibula and ECRT-treated autografts reconstruction provides good results, and union timing is comparable. The outcomes of the current study are promising as compared to the results in the reviewed literature. The reconstruction method depends on the resources available at the oncological center and the conversance with the method of the treating surgeon.
Can a School-Based Intervention Improve the Oral Health-Related Quality of Life of Brazilian Children?
Authors: Tomazoni F. , Vettore M.V. , Baker S.R. , Ardenghi T.M. 
Published: January 2019

Introduction: Evidence of the effectiveness of oral health promotion strategies among children from different socioeconomic backgrounds is necessary to support the implementation of public health interventions. Objectives: This study aimed to test the effectiveness of a school-based intervention to enhance the sense of coherence (SOC) and oral health-related quality of life (OHRQoL) of socially vulnerable Brazilian children. Furthermore, we explored the pathways by which the intervention may improve OHRQoL and SOC, assessing the direct and indirect pathways among demographic, clinical, socioeconomic, behavioral, and psychosocial variables. Methods: In this cluster-randomized trial, 5 primary schools in Brazil were randomly allocated into intervention and control groups. The intervention comprised 7 sessions of SOC-based activities over 2 mo, which focused on making the school environment a place to develop children’s SOC through involving teachers, school staff, and children. Trained teachers delivered the intervention. OHRQoL and SOC data were collected at baseline, 2 wk after the intervention, and at 3-mo follow-up. Results: Information about oral clinical conditions, socioeconomic status, OHRQoL, and SOC was obtained from 356 children aged 8 to 14 y (165 in the intervention group and 191 in the control group). Children from the SOC-based intervention group reported fewer impacts of their oral health on their daily lives (Child Perceptions Questionnaire mean, 7.22) than those from the control group (9.14). The intervention group also reported greater improvement of SOC at 2 wk (SOC mean, 52.98) and 3 mo (52.75) than the control group (52.21 and 51.65, respectively). Conclusion: The intervention was effective in improving SOC and OHRQoL among socially vulnerable Brazilian children. Moreover, SOC was a relevant predictor for oral symptom and functional status in this population (Brazilian Clinical Trials Registry RBR-2N9NHJ). Knowledge Transfer Statement: Clinicians and policy makers can use the results of this study to decide which approach to use when planning public health policy to improve the SOC and OHRQoL of socially vulnerable children. Our findings can assist policy makers in making more appropriate community health decisions in school environments that will improve community empowerment.