bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcomes of Cervical Laminoplasty: Results at Two Years
Authors: Stamates Melissa M. , Cui Michael X. , Roitberg Ben Z. 
Published: May 2017

Abstract

BACKGROUND: Laminoplasty is an established treatment for cervical myelopathy. Multiple variations have emerged, many advocating the use of allograft, but controversy persists.

OBJECTIVE: To assess medium-term clinical outcomes in patients who underwent laminoplasty with autograft at our institution.

METHODS: Thirty-two consecutive patients (19 male, 13 female, average age 66 yr) from our prospective outcome registry that underwent cervical laminoplasty between 2009 and 2013 were reviewed. Computed tomography (CT) scan was performed immediately postoperatively and at 6-mo follow-up. Parameters included patient perception of outcome, Nurick score, Neck Disability Index (NDI), visual analog scale for neck pain, and SF-36.

RESULTS: On retrospective analysis, all patients felt improved at 3 mo postoperatively; at 2 yr, this rate was 91%. Improvements were seen in Nurick scores, from 3.16 ± 0.9 preoperatively to 1.94 ± 0.8 at 2 yr; NDI score from 28.7% ± 9% preoperatively to 20.8% ± 9.6% at 2 yr; visual analog scale from 2.8 ± 1.2 preoperatively to 1.7 ± 0.9 at 2 yr; and SF-36 physical component summary from 27.9 ± 10 preoperatively to 37.8 ± 11.9 at 2 yr. All values reached significance at all follow-up points (P < .05) with the exception of 6-mo NDI values (P = .062). No C5 palsy, graft complications, or reclosure was observed in any patient during the follow-up period.

CONCLUSION: Laminoplasty with autograft is a safe and effective method to treat cervical myelopathy, with good medium-term clinical outcome. No reclosures were observed. Bony fusion was seen in all cases on CT scan. Our study found good outcomes in the performance of open-door laminoplasty without hardware, in the treatment of cervical stenosis.
The Superior Cerebellar Artery Aneurysm: A Posterior Circulation Aneurysm with Favorable Microsurgical Outcomes
Authors: Rodríguez-Hernández Ana , Walcott Brian P. , Birk Harjus , Lawton Michael T. 
Published: May 2017

Abstract

BACKGROUND: Superior cerebellar artery (SCA) aneurysms are usually grouped with aneurysms that arise from the upper basilar artery or more broadly, the posterior circulation. However, the SCA aneurysm has distinctive anatomy that facilitates safe surgical management, notably few associated perforating arteries, and excellent exposure in the carotid-oculomotor triangle.

OBJECTIVE: To demonstrate the outcomes of patients treated with microsurgery in a continuous surgical series.

METHODS: Sixty-two patients harboring 63 SCA aneurysms were retrospectively reviewed from a prospectively maintained database, focusing on clinical characteristics, surgical techniques, and clinical outcomes.

RESULTS: Of 31 patients (49%) presenting with subarachnoid hemorrhage, the SCA aneurysm was the source in 16 (25%). Thirty-three aneurysms were complex (52%) and 43 patients (59%) had multiple aneurysms. Fifty-seven SCA aneurysms (90.5%) were clipped and 5 were bypassed/trapped or wrapped. Complete angiographic occlusion was achieved in 91.7%. Permanent neurological morbidity occurred in 3 patients and 3 patients that presented in coma after subarachnoid hemorrhage died. All patients with “simple” aneurysms and without subarachnoid hemorrhage had improved or unchanged modified Rankin scale scores. Overall, outcomes were stable or improved in 82.5% of patients.

CONCLUSION: SCA aneurysms are favorable for microsurgical clipping with low rates of permanent morbidity and mortality. Microsurgery should be considered alongside endovascular techniques as a treatment option in many patients.
The Berlin International Consensus Meeting on Concussion in Sport
Authors: Davis Gavin A , Ellenbogen Richard G , Bailes Julian , Cantu Robert C , Johnston Karen M , Manley Geoffrey T , Nagahiro Shinji , Sills Allen , Tator Charles H , McCrory Paul 
Published: May 2017

AbstractThe Fifth International Conference on Concussion in Sport was held in Berlin in October 2016. A series of 12 questions and subquestions was developed and the expert panel members were required to perform a systematic review to answer each question. Following presentation at the Berlin meeting of the systematic review, poster abstracts and audience discussion, the summary Consensus Statement was produced. Further, a series of tools for the management of sport-related concussion was developed, including the Sport Concussion Assessment Tool Fifth edition (SCAT5), the Child SCAT5, and the Concussion Recognition Tool Fifth edition. This paper elaborates on this process, the outcomes, and explores the implications for neurosurgeons in the management of sport-related concussion.
CO Multi-line Imaging of Nearby Galaxies (COMING). II. Transitions between atomic and molecular gas, diffuse and dense gas, gas and stars in the dwarf galaxy NGC 2976
Authors: Hatakeyama Takuya , Kuno Nario , Sorai Kazuo , Kaneko Hiroyuki , Miyamoto Yusuke , Muraoka Kazuyuki , Takeda Miho , Yanagitani Kazuki , Kishida Nozomi , Umei Michiko , Tanaka Takahiro , Tomiyasu Yuto , Nakanishi Hiroyuki , Saita Chey , Ueno Saeko , Salak Dragan , Matsumoto Naoko , Morokuma-Matsui Kana , Pan Hsi-An , Nakai Naomasa 
Published: May 2017

Abstract
In this study, we present the results of 12CO(J = 1–0), 13CO(J = 1–0), and C18O(J = 1–0) simultaneous observations of the dwarf galaxy NGC 2976 conducted as a part of the CO Multi-line Imaging of Nearby Galaxies (COMING) project using the Nobeyama 45 m telescope. We investigated the properties of the molecular gas and star formation in NGC 2976. We found that the molecular gas fraction depends on the surface densities of the total gas and the star formation rate, according to the main stellar disks of spiral galaxies. The ratio of 12CO(J = 3–2) to 12CO(J = 1–0) implies that the temperature of the molecular gas increases with decreases in the surface density of molecular gas. We detected 13CO(J = 1–0) by using the stacking method. The ratio between the integrated intensities of 12CO(J = 1–0) and 13CO(J = 1–0) was 27 ± 11. These ratios imply that the diffuse gas phase is dominant in low surface density regimes. We obtained a lower limit of the ratio between the integrated intensities of 12CO(J = 1–0) and C18O(J = 1–0) of 21. The relation between the surface densities of the total gas and the star formation rate followed a power-law index of 2.08 ± 0.11, which was larger than that between the surface densities of the molecular gas and the star formation rate (1.62 ± 0.17). The steep slope in the relation between the surface densities of the total gas and the star formation rate can be attributed to the rapid increase in the fraction of molecular gas at the surface density of ∼ 10 M⊙. The kinematics of the molecular gas suggest that the bar-like feature rotates with a rigid-body rotation curve rather than a certain pattern speed.
Hyponatremia in Guillain–Barré Syndrome
Authors: Rumalla Kavelin , Reddy Adithi Y. , Letchuman Vijay , Mittal Manoj K. 
Published: May 2017

Abstract

Objectives:
To evaluate incidence, risk factors, and in-hospital outcomes associated with hyponatremia in patients hospitalized for Guillain–Barré Syndrome (GBS).

Methods:
We identified adult patients with GBS in the Nationwide Inpatient Sample (2002–2011). Univariate and multivariable analyses were used.

Results:
Among 54,778 patients hospitalized for GBS, the incidence of hyponatremia was 11.8% (compared with 4.0% in non-GBS patients) and increased from 6.9% in 2002 to 13.5% in 2011 (P < 0.0001). Risk factors associated with hyponatremia in multivariable analysis included advanced age, deficiency anemia, alcohol abuse, hypertension, and intravenous immunoglobulin (all P < 0.0001). Hyponatremia was associated with prolonged length of stay (16.07 vs. 10.41, days), increased costs (54,001 vs. 34,125, $USD), and mortality (20.5% vs. 11.6%) (all P < 0.0001). In multivariable analysis, hyponatremia was independently associated with adverse discharge disposition (odds ratio: 2.07, 95% confidence interval, 1.91–2.25, P < 0.0001).

Conclusions:
Hyponatremia is prevalent in GBS and is detrimental to patient-centered outcomes and health care costs. Sodium levels should be carefully monitored in high-risk patients.
Concurrent Paraspinous Myopathy and Myasthenia Gravis
Authors: Romano Alissa E. , Al-Qudah Zaid , Kaminski Henry J. , Katirji Bashar , Salame Karim 
Published: May 2017

Abstract
Paraspinous myopathy is a rare neuromuscular disorder characterized by selective involvement of the cervical, thoracic, or lumbar muscles. Leading clinical features include a bent spine or dropped head (antecollis). In myasthenia gravis (MG), patients may have camptocormia secondary to neuromuscular junction dysfunction of the paraspinal muscles, and this condition usually responds to acetylcholinesterase inhibitors or immunosuppressive treatments. However, concomitant MG and paraspinous myopathy with histologic and electrophysiologic evidence of myopathic changes of the paraspinal muscles has only been reported twice in the literature. In this case series, 5 patients with MG with paraspinous myopathy are reported. While neck and extension truncal weakness is not uncommon in MG, most often the weakness is due to neuromuscular junction dysfunction. Coexisting paraspinous myopathy and MG is under-recognized, is often resistant to mainstay treatments, and should be considered in patients presenting with neck or trunk extensor weakness.
Safe Hydration Volume to Prevent Contrast-induced Acute Kidney Injury and Worsening Heart Failure in Patients With Heart Failure and Preserved Ejection Fraction After Cardiac Catheterization
Authors: Bei Wei-jie , Wang Kun , Li Hua-long , Lin Kai-yang , Guo Xiao-sheng , Chen Shi-qun , Liu Yong , Yi Shi-xin , Luo De-mou , Chen Ji-yan , Tan Ning 
Published: May 2017

Abstract:
Few studies have investigated the efficacy and safety of hydration to prevent contrast-induced acute kidney injury (CI-AKI) and worsening heart failure (WHF) after cardiac catheterization in heart failure and preserved ejection fraction (HFpEF; HF and EF ≥50%) patients. We recruited 1206 patients with HFpEF undergoing cardiac catheterization with periprocedural hydration volume/weight (HV/W) ratio data and investigated the relationship between hydration volumes and risk of CI-AKI and WHF. Incidence of CI-AKI was not significantly reduced in individuals with higher HV/W [quartile (Q) 1, Q2, Q3, and Q4: 9.7%, 10.2%, 12.7%, and 12.2%, respectively; P = 0.219]. Multivariate analysis indicated that higher HV/W ratios were not associated with decreased CI-AKI risks [Q2 vs. Q1: odds ratio (OR), 0.95; Q3 vs. Q1: OR, 1.07; Q4 vs. Q1: OR, 0.92; all P > 0.05]. According to multivariate analysis, higher HV/W significantly increased the WHF risk (Q4 vs. Q1: adjusted OR, 8.13 and 95% confidence interval, 1.03–64.02; P = 0.047). CI-AKI and WHF were associated with a significantly increased risk of long-term mortality (mean follow-up, 2.33 years). For HFpEF patients, an excessively high hydration volume might not be associated with lower risk of CI-AKI but may increase the risk of postprocedure WHF.
Qualitative Analysis of Prosecutors’ Perspectives on Sexual Assault Nurse Examiners and the Criminal Justice Response to Sexual Assault
Authors: Schmitt Thaddeus , Cross Theodore P. , Alderden Megan 
Published: May 2017

ABSTRACT

Objective:
The aim of this study was to understand prosecutors’ perspectives on the contribution of Sexual Assault Nurse Examiners (SANEs) to evidence collection and trials in sexual assault cases.

Background:
Several studies have suggested that a sexual assault case is more likely to progress in the criminal justice system when a SANE conducts the forensic medical examination. However, little is known about how prosecutors perceive SANEs and what they value about SANEs versus other medical professionals.

Method:
Semistructured interviews, conducted in one jurisdiction with eight assistant district attorneys who prosecute sexual assault cases, included questions about the value of SANEs in evidence collection and trials. Interview transcripts were analyzed to identify common themes and variability among prosecutors.

Results:
Most prosecutors identified advantages for SANEs in evidence collection, trial preparation, and testimony. Specific advantages cited by one or more prosecutors included superior documentation, thoroughness of the physical examination, better identification of injuries, quality of relationships with patients, professionalism, skill in trial preparation and testifying, and credibility with jurors.

Discussion:
These findings help validate SANEs’ contribution to the criminal justice response to sexual assault, despite the study’s limitations in sample size and inclusion of only one jurisdiction. The study also suggests the value of further education about SANEs for prosecutors who may not have the opportunity to learn about the range of skills SANEs possess.
Incidence and Risk Factors of Hypoxemia During Interventional Rigid Bronchoscopy Under Spontaneous-assisted Ventilation
Authors: Chumpathong Saowapark , Tscheikuna Jamsak , Boonsombat Thanatporn , Muangman Saipin , Luansritisakul Choopong 
Published: May 2017

Background:
Interventional rigid bronchoscopy for tracheobronchial stenosis can be performed under total intravenous anesthesia and spontaneous-assisted ventilation. Intraoperative hypoxemia can occur during this procedure, but the incidence and risk factors have not yet been determined.

Methods:
Medical records of patients who underwent rigid bronchoscopy for the treatment of tracheobronchial stenosis under total intravenous anesthesia and spontaneous-assisted ventilation during the study period from January 2011 to December 2012 were retrospectively reviewed.

Results:
There were 126 patients who underwent 263 procedures. The 2 main causes of tracheobronchial stenosis were tuberculosis (41.3%) and malignancy (35.7%). The 2 main locations of stenotic area were the trachea (58.6%) and the left main bronchus (46.4%). Tracheobronchial dilatation and stent insertion were performed in 78.7% and 21.3% of patients, respectively. The incidence of intraoperative hypoxemia was 25.5%. Independent risk factors for intraoperative hypoxemia were a degree of tracheal stenosis ≥75% (odds ratio: 2.48; 95% confidence interval, 1.19-5.17) and tumor removal procedure (odds ratio: 2.9; 95% confidence interval, 1.13-7.41).

Conclusions:
Incidence of intraoperative hypoxemia during interventional rigid bronchoscopy for tracheobronchial stenosis under spontaneous-assisted ventilation was 25.5%. Risk factors for hypoxemia were a degree of tracheal stenosis ≥75% and tumor removal procedure.
The positive predictive value of an ambulance prealert for stroke and transient ischaemic attack
Authors: Brown Craig W. , Macleod Mary J. 
Published: May 2017

Objective
Therapeutic options for ischaemic stroke, such as thrombolysis or thrombectomy, are time sensitive. Multiple innovations have been established to reduce the symptom-to-needle time. One such innovation is the prealerting of emergency department (ED) or stroke unit staff by prehospital personnel of suspected stroke patients. The diagnosis of stroke can sometimes be difficult, with stroke mimics being a recognized issue. The prealert mobilizes ED, stroke and imaging personnel, which, for a true-positive, improves door-to-needle times. However, there are a proportion of false-positive prealerts (nonstrokes) that have a significant resource activation implication. The aim of this study was to evaluate the positive predictive value of a prealert for stroke and transient ischaemic attack (TIA).

Methods
Ambulance service prealert forms for stroke and TIA collated by the ED were compared with the Scottish Stroke Audit database findings, ED electronic notes and imaging reports to establish whether the prealert was a true-positive or a false-positive.

Results
A prealert was obtained for 77 patients as query stroke/TIA. The true-positive rate was 52 and the false-positive rate was 25. The positive predictive value was 0.675. The median symptom-to-arrival time for prealerted patients was 97 min and the door-to-needle time for thrombolysis (n=17 patients) was 38 min.

Conclusion
The diagnosis of true-positive stroke can be difficult in the prehospital environment. Although prealert has been shown to improve the patient’s journey in terms of door-to-thrombolysis times, we have identified that the prealert has a significant false-positive rate that has important resource allocation and activation consequences. Further analysis of this may inform paramedic training and improve protocols for information handover.
Donor-derived infections in solid organ transplant patients: toward a holistic approach
Authors: Benamu Esther , Wolfe Cameron R. , Montoya José G. 
Published: May 2017

Purpose of review
Solid organ demand far exceeds organ supply. Strategies to increase the donor pool include the liberalization of selection criteria without increasing the risk of unexpected donor-derived infection (DDI), a rare complication of transplantation carrying high morbidity and mortality. We review the challenging aspects in the prevention of DDI, focusing on the complexities of data sharing and efficient communication and the role infectious diseases specialists play in the process.

Recent findings
Advances in donor screening, transmission recognition and reporting allow for a better estimation of the risk of DDI. However, there is great variability in the frequency and methods with which organ procurement organizations report transmission events.
Moreover, the Scientific Registry of Transplant Recipients provides limited donor and recipient outcome infectious diseases related data. Infectious disease contribution to the allocation process has been found to improve organ donation efficiency and communication between involved parties. Although communication gaps are strongly associated with infection transmission (relative risk 2.36%, confidence interval 1.48–3.78), effective communication minimizes or prevents infection in transplant recipients (X2
(1) 13.13, P = 0.0003).

Summary
Prospective research is still required to define optimal screening protocols and further prevent transmission of infection. A holistic approach is likely to result in enhanced transplantation safety. Toward this goal, development of standards of investigation; improvement in reporting and data sharing; and strategies ensuring coordinated and rapid communication among parties involved in the allocation process need to be pursued.
Mycobacterium chimaera infections associated with heater–cooler units in cardiac surgery
Authors: Schreiber Peter W. , Sax Hugo 
Published: May 2017

Purpose of review

Mycobacterium chimaera infections following cardiac surgery have been reported from an increasing number of countries. These infections are characterized by a poor prognosis with a case fatality rate around 50% despite treatment. Since the first description in 2013, our understanding has grown steadily. Several outbreak investigations, case series, and experiments with heater–cooler units (HCUs) have been published. This review summarizes the current knowledge.

Recent findings

M. chimaera transmission occurs during cardiopulmonary bypass via bioaerosols emitted from contaminated HCU water systems. Manifestations of M. chimaera infection comprise endocarditis, vascular graft infections, surgical site infections, and dissemination. So far, all cases were exposed to a single HCU brand. Samples from the manufacturing site as well as clonality of M. chimaera strains isolated from HCUs and patients suggest a contamination already at time of delivery representing the main source for the outbreak. Nevertheless, HCU contamination in hospitals cannot be excluded.

Summary
Improved awareness of physicians of M. chimaera infection is crucial to prompt adequate diagnostic workup in patients that have been exposed to HCU presenting with compatible symptoms. For risk mitigation, strict separation between the air volume in contact with HCUs and critical clinical areas such as operating rooms is essential.
SM22 a Plasma Biomarker for Human Transmural Intestinal Ischemia
Authors: Schellekens Dirk H. S. M. , Reisinger Kostan W. , Lenaerts Kaatje , Hadfoune M’hamed , Olde Damink Steven W. , Buurman Wim A. , Dejong Cornelis H. C. , Derikx Joep P. M. 
Published: May 2017

Objective:
To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia.

Background:
Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperative because it mandates emergency surgery. Since early clinical and radiological signs are nonspecific, there is an urgent need for accurate biomarkers. SM22 is a potential marker for transmural damage because of its abundant expression in intestinal smooth muscles.

Methods:
SM22 concentrations were measured using a newly built enzyme-linked immunosorbent assay. SM22 release was assessed in plasma and intestinal tissue of rats subjected to intestinal ischemia. Blood and tissue were sampled at baseline and followed up to 24 hours of ischemia. Next, organ-specific SM22 arteriovenous concentration differences were studied in both rats and patients. Finally, plasma from patients with intestinal ischemia, other acute abdominal complaints, and healthy volunteers were tested for SM22.

Results:
SM22 concentrations were significantly elevated in rats from 4 hours of ischemia onwards. Furthermore, SM22 plasma concentrations closely paralleled the histological increasing degree of intestinal smooth muscle damage. Arteriovenous calculations showed that SM22 was specifically released by the intestines and renally cleared. First data of SM22 release in man demonstrated that patients with transmural intestinal ischemia had significantly higher plasma SM22 levels than patients with only ischemic mucosal injury, other acute abdominal diseases, or healthy controls.

Conclusions:
This study shows that SM22 is released into the circulation upon severe ischemia of the intestinal muscle layers. Plasma levels of SM22 are potentially useful for the detection of transmural intestinal damage.
Total Brain and Hippocampal Volumes and Cognition in Older American Indians
Authors: Cholerton Brenna , Omidpanah Adam , Madhyastha Tara M. , Grabowski Thomas J. , Suchy-Dicey Astrid M. , Shibata Dean K. , Nelson Lonnie A. , Verney Steven P. , Howard Barbara V. , Longstreth William T. , Montine Thomas J. , Buchwald Dedra 
Published: May 2017

Background:
Estimates of hippocampal volume by magnetic resonance imaging have clinical and cognitive correlations and can assist in early Alzheimer disease diagnosis. However, little is known about the relationship between global or regional brain volumes and cognitive test performance in American Indians.

Materials and Methods:
American Indian participants (N=698; median age, 72 y) recruited for the Cerebrovascular Disease and its Consequences in American Indians study, an ancillary study of the Strong Heart Study cohort, were enrolled. Linear regression models assessed the relationship between magnetic resonance imaging brain volumes (total brain and hippocampi) and cognitive measures of verbal learning and recall, processing speed, verbal fluency, and global cognition.

Results:
After controlling for demographic and clinical factors, all volumetric measurements were positively associated with processing speed. Total brain volume was also positively associated with verbal learning, but not with verbal recall. Conversely, left hippocampal volume was associated with both verbal learning and recall. The relationship between hippocampal volume and recall performance was more pronounced among those with lower scores on a global cognitive measure. Controlling for APOE ε4 did not substantively affect the associations.

Conclusions:
These results support further investigation into the relationship between structural Alzheimer disease biomarkers, cognition, genetics, and vascular risk factors in aging American Indians.