bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a surgical rehearsal platform and improvement in aneurysm clipping measures: results of a prospective, randomized trial
Authors: Chugh A. Jessey , Pace Jonathan R. , Singer Justin , Tatsuoka Curtis , Hoffer Alan , Selman Warren R. , Bambakidis Nicholas C. 
Published: May 2016

OBJECTIVE
The field of neurosurgery is constantly undergoing improvements and advances, both in technique and technology. Cerebrovascular neurosurgery is no exception, with endovascular treatments changing the treatment paradigm. Clipping of aneurysms is still necessary, however, and advances are still being made to improve patient outcomes within the microsurgical treatment of aneurysms. Surgical rehearsal platforms are surgical simulators that offer the opportunity to rehearse a procedure prior to entering the operative suite. This study is designed to determine whether use of a surgical rehearsal platform in aneurysm surgery is helpful in decreasing aneurysm dissection time and clip manipulation of the aneurysm.

METHODS
The authors conducted a blinded, prospective, randomized study comparing key effort and time variables in aneurysm clip ligation surgery with and without preoperative use of the SuRgical Planner (SRP) surgical rehearsal platform. Initially, 40 patients were randomly assigned to either of two groups: one in which surgery was performed after use of the SRP (SRP group) and one in which surgery was performed without use of the SRP (control group). All operations were videotaped. After exclusion of 6 patients from the SRP group and 9 from the control group, a total of 25 surgical cases were analyzed by a reviewer blinded to group assignment. The videos were analyzed for total microsurgical time, number of clips used, and number of clip placement attempts. Means and standard deviations (SDs) were calculated and compared between groups.

RESULTS
The mean (± SD) amount of operative time per clip used was 920 ± 770 seconds in the SRP group and 1294 ± 678 seconds in the control group (p = 0.05). In addition, the mean values for the number of clip attempts, total operative time, ratio of clip attempts to clips used, and time per clip attempt were all lower in the SRP group, although the between-group differences were not statistically significant.

CONCLUSIONS
Preoperative rehearsal with SRP increased efficiency and safety in aneurysm microsurgery as demonstrated by the statistically significant improvement in time per clip used. Although the rest of the outcomes did not demonstrate statistically significant between-group differences, the fact that the SRP group showed improvement in mean values for all measures studied suggests that preoperative rehearsal may increase the efficiency and safety of aneurysm microsurgery. Future studies aimed at improving patient outcome and safety during surgical clipping of aneurysms will be needed to keep pace with the quickly advancing endovascular field.
Analysis of facial motor evoked potentials for assessing a central mechanism in hemifacial spasm
Authors: Wilkinson Marshall F. , Chowdhury Tumul , Mutch W. Alan , Kaufmann Anthony M. 
Published: May 2016

OBJECTIVE
Hemifacial spasm (HFS) is a cranial nerve hyperactivity disorder characterized by unique neurophysiological features, although the underlying pathophysiology remains disputed. In this study, the authors compared the effects of desflurane on facial motor evoked potentials (MEPs) from the spasm and nonspasm sides of patients who were undergoing microvascular decompression (MVD) surgery to test the hypothesis that HFS is associated with a central elevation of facial motor neuron excitability.

METHODS
Facial MEPs were elicited in 31 patients who were undergoing MVD for HFS and were administered total intravenous anesthesia (TIVA) with or without additional desflurane, an inhaled anesthetic known to centrally suppress MEPs. All measurements were completed before dural opening while a consistent mean arterial blood pressure was maintained and electroencephalography was performed. The activation threshold voltage and mean amplitudes of the MEPs from both sides of the face were compared.

RESULTS
There was a significantly lower mean activation threshold of facial MEPs on the spasm side than on the nonspasm side (mean ± SD 162.9 ± 10.1 vs 198.3 ± 10.1 V, respectively; p = 0.01). In addition, MEPs were also elicited more readily when single-pulse transcranial electrical stimulation was used on the spasm side (74% vs 31%, respectively; p = 0.03). Although desflurane (1 minimum alveolar concentration) suppressed facial MEPs on both sides, the suppressive effects of desflurane were less on the spasm side than on the nonspasm side (59% vs 79%, respectively; p = 0.03), and M waves recorded from the mentalis muscle remained unchanged, which indicates that desflurane did not affect the peripheral facial nerve or neuromuscular junction.

CONCLUSIONS
Centrally acting inhaled anesthetic agents can suppress facial MEPs and therefore might interfere with intraoperative monitoring. The elevated motor neuron excitability and differential effects of desflurane between the spasm and nonspasm sides support a mechanism of central pathophysiology in HFS.
Clinical trial registration no.: B2012:099 (clinicaltrials.gov)
A comparison of open versus percutaneous cervical transfacet fixation
Authors: Husain Adeel , Akpolat Yusuf T. , Palmer Daniel K. , Rios David , Criswell Kevin R. , Cheng Wayne K. 
Published: May 2016

OBJECTIVE
The aim of this study is to describe a technique for percutaneous cervical transfacet screw placement and compare this technique to the open technique with regard to the accuracy of facet capture and the potential of placing neurovascular structures at risk.

METHODS
Eight cadaveric cervical spines were harvested. One side of each spine was assigned to the percutaneous group, and the other side to the open group. The spines were instrumented from C-3 to T-1 (80 screws). The distance to the spinal canal, foramen transversarium, and neural foramen were measured to determine the likelihood of placing neurovascular structures at risk. The percentage of the facet joint captured and the angle of screw trajectory compared with the ideal trajectory were used to determine the accuracy.

RESULTS
There were, in total, 11 misplacements of screws: 2 screws using the open technique and 9 screws using the percutaneous technique (p = 0.006). From a neurovascular point of view, 3 percutaneous screws violated the foramen transversarium. Two of these percutaneous screws violated the neural foramen. No neurovascular foramina were violated using the open technique. The open technique resulted in a significantly greater distance from the screw to the spinal canal (p < 0.001). The distance from the screw to the foramen transversarium (p = 0.015), as well as the distance from the screw to the neural foramen (p = 0.012), did not demonstrate statistical difference when using either technique. As for the accuracy of facet capture, 8 screws exhibited less than 15% purchase of the facet joint. Six of these screws were placed using the percutaneous technique, and 2 screws were placed using the open technique.

CONCLUSIONS
There is a higher incidence of screw misplacement using the percutaneous transfacet in comparison to the open transfacet technique. The accuracies of facet capture using the 2 techniques were not statistically different. Surgeons will need to understand the potential risk of using the percutaneous technique as an alternative to open transfacet fixation.
N-acetylaspartate in the motor and sensory cortices following functional recovery after surgery for cervical spondylotic myelopathy
Authors: Goncalves Sandy , Stevens Todd K. , Doyle-Pettypiece Patricia , Bartha Robert , Duggal Neil 
Published: May 2016

OBJECTIVE
Cervical spondylotic myelopathy (CSM) is the most common cause of reversible spinal cord dysfunction in people over the age of 55 years. Following surgery for symptomatic CSM, patients demonstrate motor improvement early in the postoperative course, whereas sensory improvement can lag behind. The authors of the present study hypothesized that changes in the concentration of N-acetylaspartate (NAA) in the motor and sensory cortices in the brain would emulate the time course of neurological recovery following decompression surgery for CSM. Their aim was to compare and contrast how metabolite levels in the motor and sensory cortices change after surgery to reverse downstream spinal cord compression.

METHODS
Twenty-four patients with CSM and 8 control subjects were studied using proton MR spectroscopy (1H-MRS) images acquired on a 3.0-T Siemens MRI unit. The 1H-MRS data (TE 135 msec, TR 2000 msec) were acquired to measure absolute levels of NAA from the motor and sensory cortices in the cerebral hemisphere contralateral to the side of greater deficit at baseline in each subject. Data were also acquired at 6 weeks and 6 months following surgery. Control subjects were also evaluated at 6 weeks and 6 months following baseline data acquisition. Neurological function was measured in each subject at all time points using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) questionnaire, and the American Spinal Injury Association (ASIA) neurological classification.

RESULTS
In the motor cortex of patients, NAA levels decreased significantly (p < 0.05) at 6 weeks and 6 months postsurgery compared with baseline levels. In the sensory cortex of patients, NAA levels decreased significantly (p < 0.05) only at 6 months after surgery compared with baseline and 6-week levels. No significant changes in NAA were found in control subjects. Clinical scores demonstrated significant (p < 0.05) motor recovery by 6 weeks, whereas sensory improvements (p < 0.05) appeared at only 6 months.

CONCLUSIONS
Findings suggest that metabolite changes in both the motor and sensory cortices mimic the time course of functional motor and sensory recovery in patients with CSM. The temporal course of neurological recovery may be influenced by metabolic changes in respective cortical regions.
GLOBAL SPIRAL ARMS FORMATION BY NON-LINEAR INTERACTION OF WAKELETS
Authors: Kumamoto Jun , Noguchi Masafumi 
Published: May 2016

ABSTRACT
The formation and evolution of galactic spiral arms is not yet clearly understood despite much analytic and numerical work. Recently, the new idea has been proposed that local density enhancements (wakelets) arising in the galactic disk connect with each other and make global spiral arms. However, the understanding of this mechanism is not yet sufficient. We analyze the interaction of wakelets by using N-body simulations, including perturbing point masses, which are heavier than individual N-body particles and act as the seeds for wakelets. Our simulation facilitates a more straightforward interpretation of numerical results than previous works by putting a certain number of perturbers in a well-motivated configuration. We detected a clear sign of non-linear interaction between wakelets, which make global spiral arms by connecting two adjacent wakelets. We found that the wavenumber of the strongest non-linear interaction depends on galactic disk mass and shear rate. This dependence is consistent with the prediction of a swing amplification mechanism and other previous results. Our results unify previous results that were consistent with each other.
VUV PHOTO-PROCESSING OF PAH CATIONS: QUANTITATIVE STUDY ON THE IONIZATION VERSUS FRAGMENTATION PROCESSES
Authors: Zhen Junfeng , Castillo Sarah Rodriguez , Joblin Christine , Mulas Giacomo , Sabbah Hassan , Giuliani Alexandre , Nahon Laurent , Martin Serge , Champeaux Jean-Philippe , Mayer Paul M. 
Published: May 2016

ABSTRACT
Interstellar polycyclic aromatic hydrocarbons (PAHs) are strongly affected by the absorption of vacuum ultraviolet (VUV) photons in the interstellar medium (ISM), yet the branching ratio between ionization and fragmentation is poorly studied. This is crucial for the stability and charge state of PAHs in the ISM in different environments, affecting in turn the chemistry, the energy balance, and the contribution of PAHs to the extinction and emission curves. We studied the interaction of PAH cations with VUV photons in the 7–20 eV range from the synchrotron SOLEIL beamline, DESIRS. We recorded by action spectroscopy the relative intensities of photo-fragmentation and photo-ionization for a set of eight PAH cations ranging in size from 14 to 24 carbon atoms, with different structures. At photon energies below ∼13.6 eV fragmentation dominates for the smaller species, while for larger species ionization is immediately competitive after the second ionization potential (IP). At higher photon energies all species behave similarly; the ionization yield gradually increases, leveling off between 0.8 and 0.9 at ∼18 eV. Among isomers, PAH structure appears to mainly affect the fragmentation cross section but not the ionization cross section. We also measured the second IP for all species and the third IP for two of them; all are in good agreement with theoretical ones, confirming that PAH cations can be further ionized in the diffuse ISM. Determining actual PAH dication abundances in the ISM will require detailed modeling. Our measured photo-ionization yields for several PAH cations provide a necessary ingredient for such models.
Regards croisés d’acteurs gérontologiques territorialisés sur la loi Hôpital Patients Santé et Territoires (HPST)
Authors: Blanchet Mickaël 
Published: May 2016

L’action gérontologique recouvre plusieurs domaines d’intervention allant de la prise en charge médicale aux actions relatives à l’environnement de vie des personnes âgées. Malgré cette hétérogénéité ; les politiques de la vieillesse se sont concentrées sur l’accompagnement des personnes âgées dépendantes et ont, dans ce cadre, confié aux départements le rôle de leadership gérontologique. Seulement, la loi relative à l’Hôpital, aux Patients, à la Santé et aux Territoires (HPST) du 21 juillet 2009 et la création des agences régionales de santé (ARS) de l’État dont l’objectif est d’unifier et rendre plus efficace les politiques de santé ont remis en question les équilibres territoriaux et sectoriels qui prévalaient jusque-là dans le domaine gérontologique. Deux années après sa mise en application, il ressort de recherches régionales et locales que la loi s’est traduite par de nouveaux équilibres institutionnels et par la diffusion de l’offre médico-sociale et gérontologique sur le territoire sous un registre concurrentiel et administratif. Dans ce sens, le territoire en tant qu’espace où se formulent des réponses collectives entre institutions, professionnels et usagers, possibilité pourtant offerte par la Loi, constitue une méthodologie à développer.
GREEN INFRASTRUCTURE AND TRANSIT-ORIENTED MIXED USE DEVELOPMENT: THE ALEWIFE AREA OF CAMBRIDGE, MASSACHUSETTS
Authors: Batchelor James P. , Biancavilla David , Hegemann Ingeborg , Woodbury Catherine Daly 
Published: May 2016

INTRODUCTION This paper is a case study of the progress on environmental and development fronts in this critical area of Cambridge, Massachusetts. Portions of the riverine system to the north (Little River and Alewife Reservation) have been restored and include public amenities, and the park to the east (Danehy Park) has been realized. The degraded industrial land uses that had comprised the bulk of the land use have made a transition to a dynamic, mixed-used neighborhood. This paper presents both the public and the private strategies undertaken to accomplish these goals. These strategies are presented in three parts: Public Infrastructure: Constructed Stormwater Wetlands and Larger Stormwater Management Goals Site Development: Environmental Strategies Urban Development Goals: Mixed-Use Neighborhood
A MODEL OF A NEAR-ZERO ENERGY HOME (nzeh) USING PASSIVE DESIGN STRATEGIES AND PV TECHNOLOGY IN HOT CLIMATES
Authors: Syed Ashraf T. , Abdou Adel A. 
Published: May 2016

INTRODUCTION Recent development has seen a drastic increase in energy use trends in Saudi Arabian buildings leading to a demand for an effective course of action for energy conservation and production. A case study-based research initiative exploring near-zero energy potential in Saudi Arabia was undertaken. A 4-bedroom detached single-family faculty residence at King Fahd University of Petroleum and Minerals (KFUPM) representing common regional housing design trends was utilized. A base case simulation model of the house was developed and validated using short-term and real-time energy consumption data. Three sets of strategies: passive design strategies, representative codes and standards, and renewable technology were employed in the new design of the house. Passive strategies comprised a green roof, a ventilated wall system, a sloped roof, and insulation for thermal bridges. These alternatives helped reduce the annual energy consumption of the house by 17.2%. The most recent version of the International Energy Conservation Code (IECC 2012) was also incorporated along with ASHRAE Standard 62.2 for ventilation. The code and standard together reduced the annual energy consumption by 31.1%. Solar PV was then utilized to reduce grid utilization for the remainder of the house energy loads. This strategy provided 24.7% of the total energy consumed annually. A combination of strategies showed a 70.7% energy consumption reduction, thereby decreasing the energy index of the house from 162.9 to 47.7 kWh/m2/yr. The Zero Energy Building (ZEB) concepts and strategies utilized in this study demonstrate a socially responsible approach to achieving near-zero energy performance for an existing house.
À l’heure du bilan quinquennal, quels enjeux stratégiques pour le Défenseur des droits ?
Authors: Medard Inghilterra Robin 
Published: May 2016

Le 29 mars 2011, la protection extrajuridictionnelle des droits et libertés connaissait une mutation d’ampleur via la promulgation des lois organique (n° 2011-333) et ordinaire (n° 2011-334) relatives au Défenseur des droits. Cinq années plus tard, c’est désormais ancré au sein du paysage institutionnel que le Défenseur des droits remettait en février dernier son rapport annuel d’activité au Président de la République ainsi qu’aux présidents de l’Assemblée nationale et du Sénat. À l’instar des précédents, ce rapport décline de manière détaillée les actions conduites au cours de l’exercice 2015, caractérisé notamment par le renforcement des collaborations institutionnelles, la forte augmentation des saisines liées à la déontologie des forces de sécurité ou encore la montée en puissance du département « Promotion de l’égalité et accès aux droits ». De surcroît, à l’heure du bilan quinquennal, il fournit l’occasion d’une interrogation sur les enjeux stratégiques qui semblent façonner l’avenir de sa mission.
High Reliability Electronics for Demanding Aircraft Applications – An Overview
Authors: Brewer Roger 
Published: May 2016

Abstract
The primary form of generated power on any typical aircraft (Tactical, Airlift, Commercial) requires conversion in multiple different forms (voltage levels, aircraft compliant frequency) and at various power levels to meet the total needs of the vehicle. DC:AC Power Conversion (Inverters), AC-DC Generator (conditioning) electronics, AC-AC frequency conditioning and DC:DC Power Conversion are all forms of conversion within the power system (primary, secondary tiers) typical of any aircraft. Additionally, within the power distribution network often solid state power switches in later generation aircraft and fighters are used to control and manage power (control power ramp-up for example) to loads and isolate electrical faults. The conditioning, conversion and control of this power with high reliability devices can often occur in more extreme environments (high temperatures, high vibration and confined spaces) and can present challenging issues for aerospace and specifically aircraft. Weight objectives can further add to the challenges. This paper will discuss, at largely a level based on acquired and compiled lessons learned, some of the aforementioned challenges including the susceptibility to both electrically and mechanically induced failure modes in power devices encountered in aircraft.
The paper will also discuss the notion that while Wide Band Gap (WBG) technology may be the right answer in some/many applications, it may not be the answer in achieving high reliability given a specific combination of application and operating conditions. Reliability issues can be focused around: a) packaging optimization, b) manufacturing tolerances and c) selecting the right vendor to do the job. Further, the ability to receive adequate forms of cooling from the aircraft (if not otherwise constrained and if cooling margins permit) to power electronics will also be discussed as an obvious and significant driver in maintaining high reliability and integrity in more demanding (and higher power) applications. Trade assessments that can occur with specific generator electronics will be discussed at a non-specific, and generalized, level.
The main body of the paper will be concluded with a discussion on the potential application of WBG technology in a variety of applications mentioned for aircraft while pointing out unique aspects that may be relevant in the future adoption of this technology. Finally, a conclusion will be provided reiterating various points throughout the paper and areas of potential follow-on activity.
Effect of isothermal aging at 250 °C on shear strength of joints using Au nanoporous bonding for die attach
Authors: Nishikawa H. , Matsunaga K. , Kim M-S. , Saito M. , Mizuno J. 
Published: May 2016

Abstract
High-temperature joining is a key technology for electronic component assembly and other high-temperature applications. Recently, focusing on the sintering behavior of metal particles, the joining process using a nanoparticle paste has been proposed as an alternative to establish a high-temperature joining technology. In this study, a feasibility study has been conducted to determine whether an Au nanoporous sheet can be used for joint material. We evaluated the effect of isothermal aging at 250 °C on shear strength of joints using an Au nanoporous sheet. The shear strength of the joint after isothermal storage at 250 °C for 1000 h was more than 25 MPa.
Design and Testing of a High Temperature Inverter
Authors: Krishnamurthy Shashank , Savulak Stephen , Wang Yang 
Published: May 2016

Abstract
The emergence of wide band gap devices has pushed the boundaries of power converter operations and high power density applications. It is desirable to operate a power inverter at high switching frequencies to reduce passive filter weight and at high temperature to reduce the cooling system requirement. The paper describes the design and test of a power electronic inverter that converts a fixed input DC voltage to a variable voltage variable frequency three phase output. The component selection and design were constrained such that the inverter can operate at an ambient temperature of 170°C. The design of the key functional components such as the gate drive, power module, controller and communication will be discussed in the paper. Test results for the inverter at high temperature will also be presented.