bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracranial hypertension after Chiari decompression resolving after removal of a levonorgestrel-releasing intrauterine device: case report
Authors: Maragkos Georgios A. , Motiei-Langroudi Rouzbeh , Filippidis Aristotelis S. , Papavassiliou Efstathios 
Published: November 2018

Levonorgestrel-releasing intrauterine devices (LIUDs) are thought to release this progestin locally in the uterus to limit side effects. Authors here present a case of treatment-refractory hydrocephalus and pseudomeningocele (PMC), both of which fully resolved after LIUD removal.A 35-year-old woman with an implanted LIUD developed symptomatic PMC and hydrocephalus after suboccipital craniectomy for Chiari malformation type I. Over the next 8 months, she underwent ventriculoperitoneal shunt placement and two attempts at needle decompression of the fluid collection, which did not relieve her symptoms or the PMC, except for a few days at a time. Subsequently, she had her LIUD removed. Three weeks after removal of the LIUD, her symptoms as well as the fluid collection resolved completely without any further intervention. Thus, the increased intracranial pressure and associated persistence of the PMC may be partially attributed to the LIUD.This case indicates that a persistent problem (PMC and intracranial hypertension) that may be associated with the LIUD rapidly resolves after its removal. Implication of LIUDs as the cause of intracranial hypertension is still a matter of controversy. Further studies are needed to evaluate any potential causal relationship between LIUDs and intracranial hypertension, and physicians are advised to consider this scenario in their differential diagnosis.
Hypopituitarism after Gamma Knife radiosurgery for pituitary adenomas: a multicenter, international study
Authors: Cordeiro Diogo , Xu Zhiyuan , Mehta Gautam U. , Ding Dale , Vance Mary Lee , Kano Hideyuki , Sisterson Nathaniel , Yang Huai-che , Kondziolka Douglas , Lunsford L. Dade , Mathieu David , Barnett Gene H. , Chiang Veronica , Lee John , Sneed Penny , Su Yan-Hua , Lee Cheng-chia , Krsek Michal , Liscak Roman , Nabeel Ahmed M. , El-Shehaby Amr , Abdel Karim Khaled , Reda Wael A. , Martinez-Moreno Nuria , Martinez-Alvarez Roberto , Blas Kevin , Grills Inga , Lee Kuei C. , Kosak Mikulas , Cifarelli Christopher P. , Katsevman Gennadiy A. , Sheehan Jason P. 
Published: November 2018

OBJECTIVERecurrent or residual adenomas are frequently treated with Gamma Knife radiosurgery (GKRS). The most common complication after GKRS for pituitary adenomas is hypopituitarism. In the current study, the authors detail the timing and types of hypopituitarism in a multicenter, international cohort of pituitary adenoma patients treated with GKRS.METHODSSeventeen institutions pooled clinical data obtained from pituitary adenoma patients who were treated with GKRS from 1988 to 2016. Patients who had undergone prior radiotherapy were excluded. A total of 1023 patients met the study inclusion criteria. The treated lesions included 410 nonfunctioning pituitary adenomas (NFPAs), 262 cases of Cushing’s disease (CD), and 251 cases of acromegaly. The median follow-up was 51 months (range 6–246 months). Statistical analysis was performed using a Cox proportional hazards model to evaluate factors associated with the development of new-onset hypopituitarism.RESULTSAt last follow-up, 248 patients had developed new pituitary hormone deficiency (86 with NFPA, 66 with CD, and 96 with acromegaly). Among these patients, 150 (60.5%) had single and 98 (39.5%) had multiple hormone deficiencies. New hormonal changes included 82 cortisol (21.6%), 135 thyrotropin (35.6%), 92 gonadotropin (24.3%), 59 growth hormone (15.6%), and 11 vasopressin (2.9%) deficiencies. The actuarial 1-year, 3-year, 5-year, 7-year, and 10-year rates of hypopituitarism were 7.8%, 16.2%, 22.4%, 27.5%, and 31.3%, respectively. The median time to hypopituitarism onset was 39 months.In univariate analyses, an increased rate of new-onset hypopituitarism was significantly associated with a lower isodose line (p = 0.006, HR = 8.695), whole sellar targeting (p = 0.033, HR = 1.452), and treatment of a functional pituitary adenoma as compared with an NFPA (p = 0.008, HR = 1.510). In multivariate analyses, only a lower isodose line was found to be an independent predictor of new-onset hypopituitarism (p = 0.001, HR = 1.38).CONCLUSIONSHypopituitarism remains the most common unintended effect of GKRS for a pituitary adenoma. Treating the target volume at an isodose line of 50% or greater and avoiding whole-sellar radiosurgery, unless necessary, will likely mitigate the risk of post-GKRS hypopituitarism. Follow-up of these patients is required to detect and treat latent endocrinopathies.
Software-based simulation for preprocedural assessment of braided stent sizing: a validation study
Authors: Joshi Krishna Chaitanya , Larrabide Ignacio , Saied Ahmed , Elsaid Nada , Fernandez Hector , Lopes Demetrius K. 
Published: November 2018

OBJECTIVEThe authors sought to validate the use of a software-based simulation for preassessment of braided self-expanding stents in the treatment of wide-necked intracranial aneurysms.METHODSThis was a retrospective, observational, single-center study of 13 unruptured and ruptured intracranial aneurysms treated with braided self-expanding stents. Pre- and postprocedural angiographic studies were analyzed. ANKYRAS software was used to compare the following 3 variables: the manufacturer-given nominal length (NL), software-calculated simulated length (SL), and the actual measured length (ML) of the stent. Appropriate statistical methods were used to draw correlations among the 3 lengths.RESULTSIn this study, data obtained in 13 patients treated with braided self-expanding stents were analyzed. Data for the 3 lengths were collected for all patients. Error discrepancy was calculated by mean squared error (NL to ML −22.2; SL to ML −6.14, p < 0.05), mean absolute error (NL to ML 3.88; SL to ML −1.84, p < 0.05), and mean error (NL to ML −3.81; SL to ML −1.22, p < 0.05).CONCLUSIONSThe ML was usually less than the NL given by the manufacturer, indicating significant change in length in most cases. Computational software-based simulation for preassessment of the braided self-expanding stents is a safe and effective way for accurately calculating the change in length to aid in choosing the right-sized stent for optimal placement in complex intracranial vasculature.
Language lateralization with resting-state and task-based functional MRI in pediatric epilepsy
Authors: Desai Virendra R. , Vedantam Aditya , Lam Sandi K. , Mirea Lucia , Foldes Stephen T. , Curry Daniel J. , Adelson P. David , Wilfong Angus A. , Boerwinkle Varina L. 
Published: November 2018

OBJECTIVEDetermining language laterality in patients with intractable epilepsy is important in operative planning. Wada testing is the gold standard, but it has a risk of stroke. Both Wada and task-based functional MRI (tb-fMRI) require patient cooperation. Recently, resting-state fMRI (rs-fMRI) has been explored for language lateralization. In the present study, the correlation between rs-fMRI and tb-fMRI in language lateralization is estimated in a pediatric population with intractable epilepsy.METHODSrs-fMRI and tb-fMRI language lateralization testing performed as part of epilepsy surgery evaluation was retrospectively reviewed.RESULTSTwenty-nine patients underwent rs-fMRI and tb-fMRI; a total of 38 rs-fMRI studies and 30 tb-fMRI studies were obtained. tb-fMRI suggested left dominance in 25 of 30 cases (83%), right in 3 (10%), and in 2 (7%) the studies were nondiagnostic. In rs-fMRI, 26 of 38 studies (68%) suggested left dominance, 3 (8%) right dominance, 6 (16%) bilateral, and 3 (8%) were nondiagnostic. When tb-fMRI lateralized to the left hemisphere (25 cases), rs-fMRI was lateralized to the left in 23 patients (92%) and it was bilateral/equal in 2 (8%). When tb-fMRI lateralized to the right (3 cases), rs-fMRI lateralized to the right in all cases (100%). The overall concordance rate was 0.93 (95% CI 0.76–0.99) when considering cases with tb-fMRI and rs-fMRI performed within 6 months of each other, and tb-fMRI results were not nondiagnostic.CONCLUSIONSrs-fMRI significantly correlated with tb-fMRI in lateralizing language and suggests the potential role for identifying hemispheric dominance via rs-fMRI. Further investigation and validation studies are warranted.
Clinical evaluation and surveillance imaging of children with myelomeningocele and shunted hydrocephalus: a follow-up study
Authors: Wetzel Jeremy S. , Heaner David P. , Gabel Brandon C. , Tubbs R. Shane , Chern Joshua J. 
Published: November 2018

OBJECTIVEThe majority of children with myelomeningocele undergo implantation of CSF shunts. The efficacy of adding surveillance imaging to clinical evaluation during routine follow-up as a means to minimize the hazard associated with future shunt failure has not been thoroughly studied.METHODSA total of 300 spina bifida clinic visits during the calendar years between 2012 and 2016 were selected for this study (defined as the index clinic visit). Each index visit was preceded by a 6-month period during which no shunt evaluation of any kind was performed. At the index clinic visit, all patients were evaluated by a neurosurgeon. Seventy-four patients underwent previously scheduled surveillance CT or shunt series scans in addition to clinical evaluation (surveillance imaging group), and 226 patients did not undergo surveillance imaging (clinical evaluation group). Subsequent unexpected events, defined as emergency department visits, caregiver-requested clinic visits, and shunt revision surgeries were reviewed. The timing and likelihood of an unexpected event in each of the 2 groups were compared using Cox proportional hazard survival analysis. The rate of shunt revision surgery in the follow-up period as well as the associated outcomes and rate of complications were analyzed.RESULTSThe clinical characteristics of the 2 groups were similar. In the clinical evaluation group, 4 of 226 (1.8%) patients underwent shunt revision based on clinical findings during the index visit, compared to 8 of 74 (10.8%) patients in the surveillance imaging group who underwent shunt revision based on clinical and imaging findings at that visit (p < 0.05). In the subsequent follow-up period, there were 74 unexpected events resulting in 10 shunt revisions in the clinical evaluation group, for an event rate of 33% and operation rate of 13.5%. In the surveillance imaging group there were 23 unexpected events resulting in 2 shunt revisions, for an event rate of 34.8% and an operation rate of 8.7%; neither difference was statistically significant. The complication rate for shunt revision surgery was also not different between the groups.CONCLUSIONSObtaining predecided, routine surveillance imaging in children with myelomeningocele and shunted hydrocephalus resulted in more shunt revisions in asymptomatic patients. For patients who had negative results on surveillance imaging, the rate of shunt revision in the follow-up period was not significantly decreased compared to patients who underwent clinical examination only at the index visit.
Fourth ventricle stent placement for treatment of recurrent syringomyelia in patients with type I Chiari malformations
Authors: Riordan Coleman P. , Scott R. Michael 
Published: November 2018

OBJECTIVEIn patients with syringomyelia and type I Chiari malformation (CM-I) who have required reoperation because of persistent, recurrent, or expanding syrinx, the senior author placed a stent from the fourth ventricle to the cervical subarachnoid space in hopes of promoting circulation of CSF out of the ventricle and away from the central canal of the spinal cord. This study was undertaken to determine the long-term success of this operative stratagem in eliminating the syrinx, as well as to document the complications that occurred following stent placement. The technique utilized for placement of fourth ventricle stents is presented.METHODSThe surgical database of the senior author was reviewed to identify all patients who underwent stent placement at a reexploration of a suboccipital decompression for a CM-I conducted for a recurrent or ineffectively treated syringomyelia. The clinical and radiological data of these patients were analyzed to determine long-term efficacy and complications of the procedure.RESULTSFourteen patients (average age 10.7 ± 5.2 years, range 2.6–20.1 years) were identified who met these inclusion criteria. They each presented with recurrent, residual, or expanding syringomyelia following a prior decompression for a CM-I. The reoperation with stent placement was complicated by late stent dislodgement and recurrence or persistence of the syrinx in 2 patients (14%) and by neurological deficit in 1 patient (7%). There was 1 perioperative CSF leak (7%). In 1 other patient (7%), the stent dislodged after surgery but required no further intervention, as the syrinx remained collapsed. Two patients (14%) required late reoperation for stent replacement when syrinxes recurred. At the most recent imaging follow-up, the stent was positioned appropriately in 12 patients (86%; average follow-up 6.9 years, range 0.5–18.1 years), and the recurrent or residual syrinx was eliminated or reduced in size by 75% or greater in 13 patients (93%).CONCLUSIONSThe placement of a stent from the fourth ventricle to the cervical subarachnoid space was a highly effective treatment for patients with recurrent, residual, or expanding syringomyelia following an initial decompression of an associated CM-I. The sole neurological complication in this series was related to lysis of arachnoid scar rather than stent placement itself, but inability to maintain fixation of the stent in situ led to further surgery to replace the stent in 2 patients.
Using an artificial neural network to predict traumatic brain injury
Authors: Hale Andrew T. , Stonko David P. , Lim Jaims , Guillamondegui Oscar D. , Shannon Chevis N. , Patel Mayur B. 
Published: November 2018

OBJECTIVEPediatric traumatic brain injury (TBI) is common, but not all injuries require hospitalization. A computational tool for ruling in patients who will have a clinically relevant TBI (CRTBI) would be valuable, providing an evidence-based way to safely discharge children who are at low risk for a CRTBI. The authors hypothesized that an artificial neural network (ANN) trained on clinical and radiologist-interpreted imaging metrics could provide a tool for identifying patients likely to suffer from a CRTBI.METHODSThe authors used the prospectively collected, publicly available, multicenter Pediatric Emergency Care Applied Research Network (PECARN) TBI data set. All patients under the age of 18 years with TBI and admission head CT imaging data were included. The authors constructed an ANN using clinical and radiologist-interpreted imaging metrics in order to predict a CRTBI, as previously defined by PECARN: 1) neurosurgical procedure, 2) intubation > 24 hours as direct result of the head trauma, 3) hospitalization ≥ 48 hours and evidence of TBI on a CT scan, or 4) death due to TBI.RESULTSAmong 12,902 patients included in this study, 480 were diagnosed with CRTBI. The authors’ ANN had a sensitivity of 99.73% with precision of 98.19%, accuracy of 97.98%, negative predictive value of 91.23%, false-negative rate of 0.0027%, and specificity for CRTBI of 60.47%. The area under the receiver operating characteristic curve was 0.9907.CONCLUSIONSThe authors are the first to utilize artificial intelligence to predict a CRTBI in a clinically meaningful manner, using radiologist-interpreted CT information, in order to identify pediatric patients likely to suffer from a CRTBI. This proof-of-concept study lays the groundwork for future studies incorporating iterations of this algorithm directly into the electronic medical record for real-time, data-driven predictive assistance to physicians.
Impaired functional recovery of endothelial colony-forming cells from moyamoya disease in a chronic cerebral hypoperfusion rat model
Authors: Choi Seung Ah , Chong Sangjoon , Kwak Pil Ae , Moon Youn Joo , Jangra Anshika , Phi Ji Hoon , Lee Ji Yeoun , Park Sung-Hye , Kim Seung-Ki 
Published: November 2018

OBJECTIVEEndothelial colony-forming cells (ECFCs) isolated from pediatric patients with moyamoya disease (MMD) have demonstrated decreased numbers and defective functioning in in vitro experiments. However, the function of ECFCs has not been evaluated using in vivo animal models. In this study, the authors compared normal and MMD ECFCs using a chronic cerebral hypoperfusion (CCH) rat model.METHODSA CCH rat model was made via ligation of the bilateral common carotid arteries (2-vessel occlusion [2-VO]). The rats were divided into three experimental groups: vehicle-treated (n = 8), normal ECFC-treated (n = 8), and MMD ECFC-treated (n = 8). ECFCs were injected into the cisterna magna. A laser Doppler flowmeter was used to evaluate cerebral blood flow, and a radial arm maze test was used to examine cognitive function. Neuropathological examinations of the hippocampus and agranular cortex were performed using hematoxylin and eosin and Luxol fast blue staining in addition to immunofluorescence with CD31, von Willebrand factor, NeuN, myelin basic protein, glial fibrillary acidic protein, and cleaved caspase-3 antibodies.RESULTSThe normal ECFC-treated group exhibited improvement in the restoration of cerebral perfusion and in behavior compared with the vehicle-treated and MMD ECFC-treated groups at the 12-week follow-up after the 2-VO surgery. The normal ECFC-treated group showed a greater amount of neovasculogenesis and neurogenesis, with less apoptosis, than the other groups.CONCLUSIONSThese results support the impaired functional recovery of MMD ECFCs compared with normal ECFCs in a CCH rat model. This in vivo study suggests the functional role of ECFCs in the pathogenesis of MMD.
Information Retrieval Menggunakan Latent Semantic Indexing Pada Ebook
Authors: Susanto Gaguk , Purwanto Hari Lugis 
Published: November 2018

Ebook merupakan buku elektronik sebagai pengganti buku kertas yang dapat dibuka dalam perangkat elektronik (smartphone, laptop atau PC). Bagi guru/pengajar maupun siswa/mahasiswa tentunya memiliki koleksi ebook yang banyak dalam komputer dan lebih cenderung hanya tersimpan dalam hardisk dan jarang sekali dibuka padahal isi dalam ebook tersebut mengandung bermacam-macam ilmu pengetahun. Ilmu pengetahuan dari ebook tersebut tentunya dapat dimanfaat untuk merubah komputer menjadi asisten cerdas yang sangat bermanfaat bagi pemiliknya. Asisten cerdas akan memberikan referensi dengan cepat mengenai informasi yang dibutuhkan oleh pemilik komputer. Oleh karena itu pemanfaatan ebook untuk dasar pembentukan sumber ilmu pengetahuan memerlukan suatu media yang menjembatani antara pemilik dan perangkat. Sistem information retrieval dibutuhkan untuk memanfaatkan sumber pengetahuan yang ada dalam koleksi ebook tersebut sehingga proses pencarian informasi dapat dilakukan dengan cepat. Proses information retrieval dilakukan dengan menggunakan metode Latent Semantic Indexing. LSI merupakan sebuah metode automatic indexing dan retrieval dengan memanfaatkan semantic structure yang secara implisit terdapat dalam suatu dokumen untuk digunakan dalam pencarian dokumen yang relevan dengan terms dalam kueri. Oleh sebab itu Information Retrieval Menggunakan Latent Semantic Indexing pada ebook sangat dibutuhkan bukan hanya para pengajar saja tapi bagi semua masarakat yang ingin menjadikan perangkat komputernya menjadi asisten pintar.
Diversidad de avispas parasitoides (Hymenoptera) en agroecosistemas de palto (Persea americana Mill.) y mandarina (Citrus spp.) en Cañete, Lima, Perú
Authors: Collantes González Rubén , Rodríguez Berrio Alexander 
Published: November 2018

<p>El presente estudio ilustra la diversidad de avispas parasitoides (<em>Hymenoptera</em>), en los agroecosistemas de palto y mandarina en Cañete, Lima (Perú). Se seleccionaron aleatoriamente 48 fincas situadas en los distritos de San Vicente, San Luis, Quilmaná, Nuevo Imperial, Imperial y Lunahuaná, realizándose colecta de especímenes y muestras vegetales con ayuda de red entomológica, viales con etanol al 70%, bolsas plásticas, cámaras de recuperación de parasitoides, entre otros materiales. Posteriormente, se procedió con la identificación en laboratorio mediante el uso de claves taxonómicas y se desarrolló un análisis clúster jerárquico (método de Ward y distancia euclidiana cuadrada fijada en cinco), para analizar la proximidad entre familias de parasitoides según su importancia ecológica, considerándose como variables para el análisis el número de morfoespecies, plantas asociadas, cantidad de especímenes, localidades de colecta y taxa parasitados. Los resultados obtenidos muestran un total de 92 especímenes colectados, pertenecientes a 10 familias de <em>Hymenoptera parasitoides</em>; destacando <em>Braconidae </em>(14 especies, 28 especímenes) e <em>Ichneumonidae </em>(nueve especies, 38 especímenes), las cuales fueron ubicadas en un mismo conglomerado, debido a que ambos taxa registraron los mayores valores para todas las variables analizadas. Otras familias de parasitoides encontradas fueron <em>Pteromalidae</em>, <em>Mymaridae</em>, <em>Encyrtidae</em>, <em>Eulophidae</em>, <em>Aphelinidae</em>, <em>Chalcididae</em>, <em>Scoliidae </em>y <em>Pompilidae</em>.</p>
Étude du comportement de l'aluminium lors de l'interaction H2O-verre : apport de la spectrométrie XPS et de la sonde ionique
Authors: Thomassin Jean-Hugues , Scherrer Stanislas , Baillif Patrick , Touray Jean-Claude , Naudin Francis 
Published: November 2018

Pour mieux comprendre l'effet protecteur de l'aluminium sur les verres industriels soumis à la corrosion, on a abordé par deux méthodes (spectrométrie XPS, sonde ionique) l'étude de la composition superficielle d'un verre altéré par des solutions aqueuses.
Le matériau choisi est un verre flotté sur bain d'étain («float glass ») marqué sur plus d'une centaine d'angströms de profondeur par un profil de concentration de Sn.
Les expériences ont été menées à 20° C et 90° C, dans l'eau pure et dans des solutions diluées d'AlCl3 (2 ppm et 100 ppm Al). On a déterminé les profils SIMS de Sn, Si, Al et les rapports XPS Sn3d5/2/Si2p) et Al2p/Si2p) à deux incidences différentes.
L'ensemble des résultats permet :
— d'estimer le recul de l'interface initial par référence au profil de l'étain,
— d'établir une relation inverse entre ce recul et la concentration en Al des solutions,
— de mettre en évidence, dans tous les cas, un fort enrichissement superficiel en aluminium,
— d'observer une très forte incorporation d'Al dans le verre hydraté lors des attaques par les solutions à 2 ppm Al,
— de présenter un modèle de structure de la partie la plus superficielle du verre altéré.