bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supraorbital Keyhole Craniotomy for Basilar Artery Aneurysms: Accounting for the “Cliff” Effect
Authors: Stamates Melissa M. , Wong Andrew K. , Bhansali Anita , Wong Ricky H. 
Published: March 2017

Abstract

BACKGROUND: Treatment of basilar artery aneurysms is challenging. While endovascular techniques have dominated, there still remain circumstances where open surgical clipping is required or preferred. Minimally invasive “keyhole” approaches are being used more frequently to provide the durability of surgical clipping with a lower morbidity profile; however, careful patient selection is required. The supraorbital “keyhole” approach has been described for the treatment of basilar artery aneurysms, but careful assessment of the basilar exposure is necessary to ensure proper visualization of the aneurysm and ability to obtain proximal vascular control. Various methods of estimating the basilar artery exposure in this approach have been described, including the anterior skull base line and the posterior clinoid line, but both are unreliable and inaccurate.

OBJECTIVE: To propose a new method, the orbital roof-dorsum line, to simply and accurately predict the basilar artery exposure.

METHODS: CT angiograms for 20 consecutive unique patients were analyzed to obtain the anterior skull base line, posterior clinoid line, and the orbital roof-dorsum line. CT angiograms were then loaded onto a Stealth neuronavigation system (Medtronic, Minneapolis, Minnesota) to obtain “true” visualization lengths. A case illustration is presented.

RESULTS: Pairwise comparison tests demonstrated that both the anterior skull base and the posterior clinoid estimation lines differed significantly from the “true”  value (P < .0001). Our orbital roof-dorsum estimation provided results that accurately predicted the “true” value (P = .71).

CONCLUSION: The orbital roof-dorsum line provides a simple and reliable method of estimating basilar artery exposure and should be used whenever considering patients for surgical clipping by this approach.
A search for Ly α emitters around a concentrated region of strong Ly α absorbers at z = 2.3
Authors: Ogura Kazuyuki , Nagao Tohru , Imanishi Masatoshi , Kashikawa Nobunari , Taniguchi Yoshiaki , Kajisawa Masaru , Kobayashi Masakazu A. R. , Toba Yoshiki , Nobuhara Kodai 
Published: March 2017

Abstract
In order to investigate the physical relationship between strong Ly α absorbers ($\log N_{{\rm H}\,{{\small I}}} \ge 20.0\:$cm−2) such as damped Ly α absorption systems (DLAs) and young star-forming galaxies at high redshift, we have conducted narrow-band observations of Ly α emitters (LAEs) in a concentrated region of strong Ly α absorbers at z = 2.3, the J1230+34 field. Using a catalog of Ly α absorbers with $\log N_{\rm H\,{{\small I}}} \ge 20.0\:$cm−2 based on the Baryon Oscillation Spectroscopic Survey, we found six fields where three or more absorbers are concentrated within a (50 Mpc)3 cubic box in the comoving scale. Among them, we focus on the J1230+34 field, where two DLAs and two sub-DLAs are present. Our narrow-band imaging observations with Subaru/Suprime-Cam using a custom-made filter, NB400 (λc = 4003 Å and FWHM = 92 Å) yield a sample of 149 LAEs in this field. In the large scale (∼50 Mpc), we have found no differences between the obtained Ly α luminosity function and those in the blank fields at similar redshifts. We also compare the frequency distribution of the Ly α rest-frame equivalent width ($\mathit {EW}_{0}$) in the target field and other fields including both overdensity region and blank field, but find no differences. On the other hand, in the small scale (∼10 Mpc), we have found a possible overdensity of LAEs around a DLA with the highest ${\rm H}\,{\small I}$ column density ($N_{\rm H\,{{\small I}}} = 21.08\:$cm−2) in the target field while there are no density excesses around the other absorbers with a lower $N_{\rm H\,{{\small I}}}$.
Outstanding animal studies in allergy I. From asthma to food allergy and anaphylaxis
Authors: Jensen-Jarolim Erika , Pali-Schöll Isabella , Roth-Walter Franziska 
Published: March 2017

Purpose of review
Animal models published within the past 18 months on asthma, food allergy and anaphylaxis, all conditions of rising public health concern, were reviewed.

Recent findings
While domestic animals spontaneously develop asthma, food allergy and anaphylaxis, in animal models, divergent sensitization and challenge routes, dosages, intervals and antigens are used to induce asthmatic, food allergic or anaphylactic phenotypes. This must be considered in the interpretation of results. Instead of model antigens, gradually relevant allergens such as house dust mite in asthma, and food allergens like peanut, apple and peach in food allergy research were used. Novel engineered mouse models such as a mouse with a T-cell receptor for house dust mite allergen Der p 1, or with transgenic human hFcγR genes, facilitated the investigation of single molecules of interest. Whole-body plethysmography has become a state-of-the-art in-vivo readout in asthma research. In food allergy and anaphylaxis research, novel techniques were developed allowing real-time monitoring of in-vivo effects following allergen challenge. Networks to share tissues were established as an effort to reduce animal experiments in allergy which cannot be replaced by in-vitro measures.

Summary
Natural and artificial animal models were used to explore the pathophysiology of asthma, food allergy and anaphylaxis and to improve prophylactic and therapeutic measures. Especially the novel mouse models mimicking molecular aspects of the complex immune network in asthma, food allergy and anaphylaxis will facilitate proof-of-concept studies under controlled conditions.
A Mindfulness Program Adapted for Adolescents With Chronic Pain
Authors: Ruskin Danielle A. , Gagnon Michelle M. , Kohut Sara A. , Stinson Jennifer N. , Walker Kathryn S. 
Published: March 2017

Objectives:
Pediatric chronic pain is a major health issue that can lead to significant interference in daily functioning. Mindfulness-based interventions (MBI’s), which emphasize acceptance rather than control of pain, have gained increasing attention as a viable treatment option among adults with chronic pain. The effectiveness of MBIs for chronic pain in pediatric populations remains largely unknown. This prospective pre-post interventional study was conducted to examine the feasibility, acceptability, and initial effectiveness of an 8-week group MBI adapted for adolescents (MBI-A) with chronic pain.

Materials and Methods:
Self-report measures assessing pain characteristics, anxiety, depression, disability, pain catastrophizing, perceived social support, mindfulness, and pain acceptance were administered at baseline, postintervention, and at a 3-month follow-up. In addition, session data were collected to assess each session’s impact on patients’ coping with pain and stress, body awareness, and sense of feeling less alone.

Results:
In total, 42 consecutive patients in a tertiary care chronic pain clinic met eligibility criteria to participate in the MBI-A group. Of these, 21 participated. A treatment completion rate of 90.5% was observed. Between session mindfulness practice was reported by 77% of participants. Participants were highly satisfied with the MBI-A and all participants reported they would recommend the group to a friend. Improvements in pain acceptance were observed between baseline and the 3-month follow-up, in domains of Pain Willingness and Activity Engagement. Session data revealed improved body awareness and improved ability to cope with stress across sessions.

Discussion:
The MBI-A is a feasible, well-received intervention for adolescents with chronic pain conditions. Findings support the need for further investigation of the efficacy of MBI-A through randomized-controlled trials.
Prevalence and Impact on Weaning of Pleural Effusion at the Time of Liberation from Mechanical Ventilation
Authors: Dres Martin , Roux Damien , Pham Tài , Beurton Alexandra , Ricard Jean-Damien , Fartoukh Muriel , Demoule Alexandre 
Published: March 2017

Abstract

Background
Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown.

Methods
In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion (small, moderate, and large). Weaning failure was defined by a failed spontaneous breathing trial and/or extubation requiring any form of ventilatory support within 48 h. The primary endpoint was the prevalence of pleural effusion according to weaning outcome.

Results
Pleural effusion was detected in 51 of 136 (37%) patients and was quantified as moderate to large in 18 (13%) patients. As compared to patients with no or small pleural effusion, their counterparts were more likely to have chronic renal failure (39 vs. 7%; P = 0.01), shock as the primary reason for admission (44 vs. 19%; P = 0.02), and a greater weight gain (+4 [0 to 7] kg vs. 0 [−1 to 5] kg; P = 0.02). The prevalence of pleural effusion was similar in weaning success and weaning failure patients (odds ratio, 1.23; 95% CI, 0.61 to 2.49; P = 0.56), as was the prevalence of moderate to large pleural effusion (odds ratio, 0.89; 95% CI, 0.33 to 2.41; P = 1.00). Duration of mechanical ventilation and intensive care unit length of stay were similar between patients with no or small pleural effusion and those with moderate to large pleural effusion.

Conclusions
Significant pleural effusion was observed in 13% of patients at the time of liberation from mechanical ventilation and was not associated with an alteration of weaning outcome. (Anesthesiology 2017; 126:1107–15)
Effects of Hypertonic Saline and Sodium Lactate on Cortical Cerebral Microcirculation and Brain Tissue Oxygenation
Authors: Dostalova Vlasta , Schreiberova Jitka , Dostalova Vlasta , Paral Jiri , Kraus Jaroslav , Ticha Alena , Radochova Vera , Dostal Pavel 
Published: March 2017

Background:
Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model.

Methods:
Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3.75 mL/kg intravenous infusion of either 3.2% HTS (group HTS, n=9), half-molar sodium lactate (group HTL, n=10), or normal saline (group C, n=9). Brain tissue partial pressure of oxygen (PbtO2) and microcirculation in the cerebral cortex using sidestream dark-field imaging were evaluated before, 20 and 40 minutes after 15 minutes of hyperosmolar solution infusion. Global hemodynamic data were recorded, and blood samples for laboratory analysis were obtained at the time of sidestream dark-field image recording.

Results:
No differences in the microcirculatory parameters were observed between the groups before and after the use of osmotherapy. Brain tissue oxygen deteriorated over time in groups C and HTL, this deterioration was not significant in the group HTS.

Conclusions:
Our findings suggest that equivolemic, equiosmolar HTS and HTL solutions equally preserve perfusion of cortical brain microcirculation in a rabbit craniotomy model. The use of HTS was better in preventing the worsening of brain tissue oxygen tension.
A Teachable Moment After Orthopaedic Fracture in the Smoking Patient: A Randomized, Controlled Trial
Authors: Baron Matthew D. , DeFrancesco Christopher J. , Liu Tiffany C. , Leone Frank T. , Ahn Jaimo 
Published: March 2017

Objectives:
To assess whether education during hospitalization after an acute fracture changes patient attitudes toward smoking-related complications and to assess whether this change persists into the first outpatient follow-up visit.

Design:
Prospective, randomized, controlled trial.

Setting:
Level 1 trauma center.

Patients:
Inpatients with fractures who identified as smokers: 40 assessed for inclusion and randomized, 30 completed inpatient assessments, and 20 completed outpatient follow-up.

Intervention:
An educational intervention by the researcher to teach the patient about the harms of smoking regarding fracture healing.

Main Outcome Measures:
A novel questionnaire to assess the intervention via Likert scale responses, evaluating perceived risk, affective response, and self-role.

Results:
Education resulted in an increase in perceived risk and affective response within the cohort and an increase in perceived risk when compared with control subjects. No significant differences persisted into outpatient follow-up.

Conclusions:
This trial demonstrated that a teachable moment can have an early effect on certain attitudes toward smoking after an acute fracture. These changes did not persist at the first follow-up visit.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
GATA3 and MYB Expression in Cutaneous Adnexal Neoplasms
Authors: Pardal Joana , Sundram Uma , Selim M. Angelica , Hoang Mai P. 
Published: March 2017

Abstract:Knowledge of staining pattern of certain immunostains might be useful in the classification of cutaneous adnexal tumors that can have clinical importance. We studied GATA3 and MYB expression in archival materials of 220 adnexal tumors comprised of sebaceous carcinomas, follicular tumors, apocrine carcinoma, predominantly apocrine tumors, predominantly eccrine tumors, and others including adenoid cystic carcinomas. Nuclear GATA3 expression was seen in 70% (153/220) of cases, including sebaceous carcinoma (93%), apocrine carcinoma (93%), follicular neoplasms (100%), and predominantly apocrine neoplasms (69%), yet only 38% of predominantly eccrine neoplasms. Nuclear MYB expression was seen in 43% (81/188) of cases, including adenoid cystic carcinoma (90%), predominantly apocrine tumors (66%), follicular neoplasms (49%), apocrine carcinomas (14%), predominantly eccrine tumors (11%), and sebaceous carcinomas (4%). GATA3 and MYB expression were noted in 43% (9/21) and 24% (5/21) of cutaneous metastases, respectively. Expression of both GATA3 and MYB was noted in 33% (60/184) of primary adnexal tumors versus 19% (4/21) of cutaneous metastases. GATA3 preferentially labels tumors with follicular, sebaceous, and apocrine differentiation. MYB is potentially a helpful stain in the distinction of desmoplastic trichoepithelioma versus basal cell carcinoma. The coexpression of GATA3 and MYB might be helpful in the distinction of primary cutaneous adnexal carcinoma versus metastatic breast, salivary gland, or urothelial carcinoma.
Management of Children with Autism Spectrum Disorder in the Anesthesia and Radiographic Context
Authors: Berglund Ingalill Gimbler , Björkman Berit , Enskär Karin , Faresjö Maria , Huus Karina 
Published: March 2017

ABSTRACT:

Objective:
As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these children's preparation for anesthesia and radiologic procedures.

Methods:
Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden. A list of items was created from a previous survey and the literature. In the first round, the items with <60% agreement were discarded. Items were merged, and a new list was created. Two more similar rounds were performed. In the last 2 rounds, 21 participants responded, and 80% agreement was considered to be consensus.

Results:
The final guidelines consisted of 14 items and a checklist of 16 factors. The 5 areas covered by the items and the checklist were as follows: planning involving parents/guardians, features in the environment, and use of time, communication, and the health care professionals. The organization was important in making it possible for the health care professional to care for the individual child according to the child's needs. It was important to involve the parents/guardians to obtain knowledge about the functioning of the child.

Conclusion:
A caring encounter involving a child with ASD in the anesthesia and radiology contexts requires advance planning, catered specifically to the individual needs of each child. To accomplish this, general knowledge regarding ASD and ASD's particular manifestation in the child entrusted to their care is required from the health care workers. The organization needs to have structures in place to facilitate this process.
G Protein–Coupled Receptor Signaling Through β-Arrestin–Dependent Mechanisms
Authors: Jean-Charles Pierre-Yves , Kaur Suneet , Shenoy Sudha K. 
Published: March 2017

Abstract:
β-arrestin1 (or arrestin2) and β-arrestin2 (or arrestin3) are ubiquitously expressed cytosolic adaptor proteins that were originally discovered for their inhibitory role in G protein–coupled receptor (GPCR) signaling through heterotrimeric G proteins. However, further biochemical characterization revealed that β-arrestins do not just “block” the activated GPCRs, but trigger endocytosis and kinase activation leading to specific signaling pathways that can be localized on endosomes. The signaling pathways initiated by β-arrestins were also found to be independent of G protein activation by GPCRs. The discovery of ligands that blocked G protein activation but promoted β-arrestin binding, or vice-versa, suggested the exciting possibility of selectively activating intracellular signaling pathways. In addition, it is becoming increasingly evident that β-arrestin–dependent signaling is extremely diverse and provokes distinct cellular responses through different GPCRs even when the same effector kinase is involved. In this review, we summarize various signaling pathways mediated by β-arrestins and highlight the physiologic effects of β-arrestin–dependent signaling.
Noncanonical Roles of G Protein-coupled Receptor Kinases in Cardiovascular Signaling
Authors: Schumacher Sarah M. , Koch Walter J. 
Published: March 2017

Abstract:G protein-coupled receptor kinases (GRKs) are classically known for their role in regulating the activity of the largest known class of membrane receptors, which influence diverse biological processes in every cell type in the human body. As researchers have tried to uncover how this family of kinases, containing only 7 members, achieves selective and coordinated control of receptors, they have uncovered a growing number of noncanonical activities for these kinases. These activities include phosphorylation of nonreceptor targets and kinase-independent molecular interactions. In particular, GRK2, GRK3, and GRK5 are the predominant members expressed in the heart. Their canonical and noncanonical actions within cardiac and other tissues have significant implications for cardiovascular function in healthy animals and for the development and progression of disease. This review summarizes what is currently known regarding the activity of these kinases, and particularly the role of GRK2 and GRK5 in the molecular alterations that occur during heart failure. This review further highlights areas of GRK regulation that remain poorly understood and how they may represent novel targets for therapeutic development.
Is the Future of Coronary Arterial Revascularization a Hybrid Approach?
Authors: Giambruno Vincenzo , Hafiz Ahmad , Fox Stephanie A. , Jeanmart Hugues , Cook Richard C. , Khaliel Feras H. , Teefy Patrick , Sridhar Kumar , Lavi Shahar , Bagur Rodrigo , Randhawa Varinder K. , Iglesias Ivan , Jones Philip M. , Harle Christopher C. , Bainbridge Daniel , Chu Michael W. A. , Kiaii Bob B. 
Published: March 2017

Objective Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. Methods From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers. Patients underwent 6-month angiographic follow-up. The mean ± SD clinical follow-up was 77.82 ±41.4 months. Results Successful hybrid coronary revascularization occurred in 196 of the 203 patients. One hundred forty-six patients underwent simultaneous surgical and percutaneous intervention. Nineteen patients underwent PCI before surgery, and 38 patient underwent PCI after surgery. No in-hospital mortality occurred. The mean ± SD ICU stay was 1 ± 1 days and the mean ± SD hospital stay was 5 ± 2 days. Only 13.3% of the patients required a blood transfusion. Six-month angiographic follow-up has been performed in the 95 patients, and it demonstrated a left internal thoracic artery anastomotic patency of 97.9% and stent patency of 92.6%. A total of 77.8 ± 41.4-month clinical follow-up demonstrated 95.1% survival, 92.6% freedom from angina, and 90.7% freedom from any form of coronary revascularization. Conclusions Hybrid coronary revascularization seems to be a promising and safe revascularization strategy. It provides selected patients with an alternative, functionally complete revascularization with minimal surgical trauma and good long-term clinical outcomes.
Eligibility for Minimally Invasive Coronary Artery Bypass
Authors: Dillon Kate E. M. , Johnson Marjorie , Chan Ian L. , Kiaii Bob 
Published: March 2017

Objective A variable that necessitates conversion to a conventional full-sternotomy coronary artery bypass procedure from a robotic-assisted endoscopic single-vessel small thoracotomy is the inability to visualize the left anterior descending coronary artery within the surrounding epicardial adipose tissue using the endoscopic camera. The purpose of this study was to determine whether anatomical properties of the epicardial adipose tissue examined using preoperative computed tomography (CT) images are able to predict and thus reduce the need for intraoperative conversion based on effective preoperative exclusion criteria. Methods Retrospective analysis of patient preoperative CT angiography scans from both converted (n = 17) and successful robotic-assisted (n = 17) procedures was performed. Where possible, measurements of epicardial adipose tissue were acquired from axial slices, at the most accessible segment of the left anterior descending coronary artery. Results Results indicate that patients who successfully underwent the endoscopic single-vessel small thoracotomy procedure (mean ± SD depth, 4.9 ±1.9 mm) had significantly less epicardial adipose tissue (38%, P = 0.002) overlying the vessel toward the lateral chest wall than those who were converted to the full-sternotomy approach intraoperatively (mean ± SD depth, 7.9 ± 3.2 mm). Using this as a retrospective exclusion criterion reduces the conversion rate for this group by 47%, while maintaining a high specificity (94%). No significant differences exist between the two groups with respect to the remaining epicardial adipose tissue measurements or body mass index. Conclusions The addition of CT angiography measurements of the epicardial adipose tissue overlying the left anterior descending coronary artery may enhance preoperative surgical planning for this procedure, thereby reducing the instances of procedural changes.