bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of atorvastatin on resolution of chronic subdural hematoma: a prospective observational study [RETRACTED]
Authors: Liu Hua , Liu Zhongkun , Liu Yong , Kan Shifeng , Yang Jian , Liu Hongyi 
Published: July 2016

OBJECTIVE
Chronic subdural hematoma (CSDH) is prevalent in the aged population and is commonly treated with bur hole drainage. This treatment, however, can lead to various surgical complications. Atorvastatin may cure CSDH via its antiinflammatory and proangiogenesis effects, but not all patients treated with this medication can avoid surgery. The authors' aim was to investigate the effect of atorvastatin and identify characteristics of patients with CSDH sensitive to atorvastatin therapy.

METHODS
A prospective, placebo-controlled observational study was conducted in 80 patients with evidence of CSDH. The patients were enrolled between February 2012 and August 2014 and were randomly assigned to either atorvastatin treatment (atorvastatin group) or placebo (control group). Patients were followed up for 12 months after initiation of treatment. Clinically relevant data were collected and compared between the 2 groups. The atorvastatin group was subdivided into patients who required surgery and those who did not, and characteristics of these subgroups were also compared. The relationship between atorvastatin treatment and need for surgery was investigated by means of multiple regression analysis using the following variables as predictors: age, sex, admission Markwalder grade, level of dependency in activities of daily living (ADL) as assessed with the modified Barthel Index, presence of hemiparesis, and hematoma volume.

RESULTS
The proportion of patients who required surgical intervention during the follow-up period was significantly lower in the atorvastatin group than in the control group (p = 0.001), and the mean time to surgery was longer in the atorvastatin group (p = 0.018). Within the atorvastatin group, there was a significant difference with respect to Markwalder grades, degree of dependency in ADL, percentage of patients with hemiparesis, and mean hematoma volume between the patients who required surgery during the follow-up period and those who did not (p = 0.002, p = 0.001, p = 0.001, and p = 0.012, respectively). The results of the logistic regression analysis showed that atorvastatin significantly reduced the probability of surgery and that female sex and favorable admission Markwalder grades and favorable dependency status with respect to ADL (independent, slightly dependent, or moderately dependent) were independent predictors of not requiring surgery.

CONCLUSIONS
Atorvastatin administration can promote the resolution of CSDH, especially for women with favorable Markwalder grades and favorable ADL dependency status at admission.
Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study
Authors: Macyszyn Luke , Attiah Mark , Ma Tracy S. , Ali Zarina , Faught Ryan , Hossain Alisha , Man Karen , Patel Hiren , Sobota Rosanna , Zager Eric L. , Stein Sherman C. 
Published: July 2016

OBJECTIVEMoyamoya disease (MMD) is a chronic cerebrovascular disease that can lead to devastating neurological outcomes. Surgical intervention is the definitive treatment, with direct, indirect, and combined revascularization procedures currently employed by surgeons. The optimal surgical approach, however, remains unclear. In this decision analysis, the authors compared the effectiveness of revascularization procedures in both adult and pediatric patients with MMD.METHODSA comprehensive literature search was performed for studies of MMD. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment using a direct and indirect revascularization technique. Utility values for the various outcomes and complications were extracted from the literature examining preferences in similar clinical conditions. Sensitivity analysis was performed.RESULTSA structured literature search yielded 33 studies involving 4197 cases. Cases were divided into adult and pediatric populations. These were further subdivided into 3 different treatment groups: indirect, direct, and combined revascularization procedures. In the pediatric population at 5- and 10-year follow-up, there was no significant difference between indirect and combination procedures, but both were superior to direct revascularization. In adults at 4-year follow-up, indirect was superior to direct revascularization.CONCLUSIONSIn the absence of factors that dictate a specific approach, the present decision analysis suggests that direct revascularization procedures are inferior in terms of quality-adjusted life years in both adults at 4 years and children at 5 and 10 years postoperatively, respectively. These findings were statistically significant (p < 0.001 in all cases), suggesting that indirect and combination procedures may offer optimal results at long-term follow-up.
Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors, and evolution
Authors: Esnault Pierre , Cardinale Mickaël , Boret Henry , D'Aranda Erwan , Montcriol Ambroise , Bordes Julien , Prunet Bertrand , Joubert Christophe , Dagain Arnaud , Goutorbe Philippe , Kaiser Eric , Meaudre Eric 
Published: July 2016

OBJECTIVEBlunt cerebrovascular injuries (BCVIs) affect approximately 1% of patients with blunt trauma. An antithrombotic or anticoagulation therapy is recommended to prevent the occurrence or recurrence of neurovascular events. This treatment has to be carefully considered after severe traumatic brain injury (TBI), due to the risk of intracranial hemorrhage expansion. Thus, the physician in charge of the patient is confronted with a hemorrhagic and ischemic risk. The main objective of this study was to determine the incidence of BCVI after severe TBI.METHODSThe authors conducted a prospective, observational, single-center study including all patients with severe TBI admitted in the trauma center. Diagnosis of BCVI was performed using a 64-channel multidetector CT. Characteristics of the patients, CT scan results, and outcomes were collected. A multivariate logistic regression model was developed to determine the risk factors of BCVI. Patients in whom BCVI was diagnosed were treated with systemic anticoagulation.RESULTSIn total, 228 patients with severe TBI who were treated over a period of 7 years were included. The incidence of BCVI was 9.2%. The main risk factors were as follows: motorcycle crash (OR 8.2, 95% CI 1.9–34.8), fracture involving the carotid canal (OR 11.7, 95% CI 1.7–80.9), cervical spine injury (OR 13.5, 95% CI 3.1–59.4), thoracic trauma (OR 7.3, 95% CI 1.1–51.2), and hepatic lesion (OR 13.3, 95% CI 2.1–84.5). Among survivors, 82% of patients with BCVI received systemic anticoagulation therapy, beginning at a median of Day 1.5. The overall stroke rate was 19%. One patient had an intracranial hemorrhagic complication.CONCLUSIONSBlunt cerebrovascular injuries are frequent after severe TBI (incidence 9.2%). The main risk factors are high-velocity lesions and injuries near cervical arteries.
Endoscopic versus microscopic microvascular decompression for trigeminal neuralgia: equivalent pain outcomes with possibly decreased postoperative headache after endoscopic surgery
Authors: Lee John Y. K. , Pierce John T. , Sandhu Sukhmeet K. , Petrov Dmitriy , Yang Andrew I. 
Published: July 2016

OBJECTIVEEndoscopic surgery has revolutionized surgery of the ventral skull base but has not yet been widely adopted for use in the cerebellopontine angle. Given the relatively normal anatomy of the cerebellopontine angle in patients with trigeminal neuralgia (TN), the authors hypothesized that a fully endoscopic microvascular decompression (E-MVD) might provide pain outcomes equivalent to those of microscopic MVD (M-MVD) but with fewer complications.METHODSThe authors conducted a single-institution, single-surgeon retrospective study with patients treated in the period of 2006–2013. Before surgery, all patients completed a questionnaire that included a validated multidimensional pain-outcome tool, the Penn Facial Pain Scale (PFPS, formerly known as Brief Pain Inventory–Facial), an 11-point scale that measures pain intensity, interference with general activities of daily living (ADLs), and facial-specific ADLs. Using a standardized script, independent research assistants conducted follow-up telephone interviews.RESULTSIn total, 167 patients were available for follow-ups (66.5% female; 93 patients underwent M-MVD and 74 underwent E-MVD). Preoperative characteristics (i.e., TN classification, PFPS components, and medication use) were similar for the 2 surgical groups except for 2 variables. Patients in the M-MVD group had slightly higher incidence of V3 pain, and the 2 groups differed in the date of surgery and hence in the length of follow-up (2.4 years for the M-MVD group and 1.3 years for the E-MVD group, p < 0.05). There was a trend toward not finding neurovascular conflict at the time of surgery more frequently in the M-MVD than in the E-MVD group (11% vs 7%, p = 0.052). Internal neurolysis was more often performed in the E-MVD group (26% vs 7%, p = 0.001). The 2 groups did not significantly differ in the length of the MVD procedure (approximately 2 hours). Self-reported headaches at 1 month postoperatively were present in 21% of the patients in the M-MVD group versus 7% in the E-MVD group (p = 0.01). Pain outcomes at the most recent followup were equivalent, with patients reporting a 5- to 6-point (70%–80%) improvement in pain intensity, a 5-point (85%) improvement in pain interference with ADLs, and a 6-point (85%) improvement in interference with facial-specific ADLs. Actuarial freedom from pain recurrence was equivalent in the 2 groups, with 80% pain control at 3 years.CONCLUSIONSBoth the fully endoscopic MVD and the conventional M-MVD appear to provide patients with equivalent pain outcomes. Complication rates were also similar between the groups, with the exception of the rate of headaches, which was significantly lower in the E-MVD group 1 month postoperatively.
Correlation between intraoperative ultrasound and postoperative MRI in pediatric tumor surgery
Authors: Smith Heather , Taplin AmiLyn , Syed Sohail , Adamo Matthew A. 
Published: July 2016

OBJECTIVE
Malignant disease of the CNS is the primary etiology for deaths resulting from cancer in the pediatric population. It has been well documented that outcomes of pediatric neurosurgery rely on the extent of tumor resection. Therefore, techniques that improve surgical results have significant clinical implications. Intraoperative ultrasound (IOUS) offers real-time surgical guidance and a more accurate means for detecting residual tumor that is inconspicuous to the naked eye. The objective of this study was to evaluate the correlation of extent of resection between IOUS and postoperative MRI. The authors measured the correlation of extent of resection, negative predictive value, and sensitivity of IOUS and compared them with those of MRI.

METHODS
This study consisted of a retrospective review of the medical charts of all pediatric patients who underwent neurosurgical treatment of a tumor between August 2009 and July 2015 at Albany Medical Center. Included were patients who were aged ≤ 21 years, who underwent brain or spinal tumor resection, for whom IOUS was used during the tumor resection, and for whom postoperative MRI (with and without contrast) was performed within 1 week of surgery.

RESULTS
Sixty-two patients met inclusion criteria for the study (33 males, mean age 10.0 years). The IOUS results very significantly correlated with postoperative MRI results (φ = 0.726; p = 0.000000011; negative predictive value 86.3% [95% CI 73.7%–94.3%]). These results exemplify a 71% overall gross-total resection rate and 80% intended gross-total resection rate with the use of IOUS (i.e., excluding cases performed only for debulking purposes).

CONCLUSIONS
The use of IOUS may play an important role in achieving a greater extent of resection by providing real-time information on tumor volume and location in the setting of brain shift throughout the course of an operation. The authors support the use of IOUS in pediatric CNS tumor surgery to improve clinical outcomes at low cost with minimal additional operating-room time and no identified additional risk.
The Relationship between Centralization of Care and Geographic Barriers to Cystectomy for Bladder Cancer
Authors: Casey Martin F. , Wisnivesky Juan , Le Valerie H. , Sarpel Umut , Stensland Kristian D. , Oh William K. , Galsky Matthew D. 
Published: July 2016

Background: Centralization of cystectomy treatment for bladder cancer, while associated with improved outcomes, may impose geographic barriers to care. However, whether this effect may be counterbalanced by an increased number of high volume centers has not previously been explored. Objective: To characterize changes in geographic disparities to high volume cystectomy centers over time. Methods: Data on all inpatient admissions for cystectomy in New York State (NYS) from 1997–2011 was obtained from the Department of Health. Using these data, we classified hospitals according to cystectomy volume and measured patient distance traveled to a cystectomy center. Population weights, from the US Census, were used to describe changes in minimum travel distance to high- or very high-volume (HV/VHV) facilities across the NYS population. Results: Bladder cancer patients underwent cystectomies at 195 hospitals during the study period. In 1997–2001, eleven HV/VHV facilities accounted for 37.5% of all cystectomies, while sixteen HV/VHV hospitals accounted for 71.5% of all procedures during 2007–2011. Median distance traveled by cystectomy patients to all hospitals increased from 9.6 to 14.4 miles in 1997–2001 to 2007–2011, respectively. In the same time span, the median travel distance for the NYS population to a HV/VHV center decreased by 1.9 and 9.4 miles at the median and 75th percentile, respectively. Conclusions: Our findings demonstrate a complicated relationship between centralization and geographic access. While centralization has led to a decrease in overall access to cystectomy facilities, the process simultaneously improved access to high volume centers.
Biomechanical evaluation of polymethyl methacrylate with the addition of various doses of cefazolin, vancomycin, gentamicin, and silver microparticles
Authors: Ficklin Michael , Suber Jonathan , Gerard Patrick , Kowaleski Michael , Kunkel Kevin 
Published: July 2016

Summary
Objectives: Numerous studies have examined the biomechanics of polymethyl methacrylate (PMMA) with added antibiotics, but direct comparison between studies is difficult. Our purpose was to evaluate the effects of the addition of antibiotic drugs and silver on compressive and bending strength of PMMA. Our null hypothesis was that there would be no significant difference in the compressive strength or bending strength of PMMA with the addition of silver or varying amounts of antibiotic drugs.
Methods: Polymethyl methacrylate was mixed with cefazolin, gentamicin, vancomycin, or silver; the control was PMMA alone. Antibiotic groups contained 20 g PMMA and 0.5 g, 1 g, 2 g, or 3 g of antibiotic. Silver groups had 0.25 g silver powder alone added to 20 g PMMA or silver with PMMA and 0, 0.5 g or 1 g of antibiotic. Samples underwent four-point bending and compression testing in air at room temperature and prevailing humidity. Pairwise comparisons between groups and to the ASTM and ISO standards were performed.
Results: Compression: All antibiotic and silver groups were weaker than the control. Samples with cefazolin tended to be stronger than other antibiotic groups with equivalent doses of antibiotic. All groups were above the ASTM standard, except 3 g vancomycin. Four-point bending: The addition of antibiotics did not significantly affect bending strength in groups with lower doses of antibiotics. The silver + PMMA group was weaker than the control. No groups were significantly below the ISO standard except the 3 g vancomycin group.
Clinical significance: The addition of antibiotic or silver decreased the biomechanical strength in all samples, but not below the ASTM or ISO standard for most groups. The addition of cefazolin appears to affect strength the least, while high doses of vancomycin alter strength the most.
Bone morphogenetic protein 2 stimulates chondrogenesis of equine synovial membrane-derived progenitor cells
Authors: Chen Yuwen , Caporali Evelyn , Stewart Matthew 
Published: July 2016

SummaryObjectives: Bone morphogenetic protein 2 (BMP-2) is critical for skeletal and cartilage development, homeostasis and repair. This study was conducted to clone and characterize equine BMP-2, develop expression constructs for equine BMP-2, and to determine whether BMP-2 can stimulate chondrogenesis of equine synovial membrane-derived progenitor cells (SMPC).Methods: Equine BMP-2 cDNA was amplified from chondrocyte RNA, and then transferred into an expression plasmid and adenoviral vector. Effective expression of equine BMP-2 was confirmed using a BMP reporter cell line. SMPC were isolated from synovium, expanded through two passages and transferred to chondrogenic cultures, with recombinant human (rh) transforming growth factor beta 1 (TGF-[uni03B2]1) or rhBMP-2. Chondro-genesis was assessed by up-regulation of collagen types II and X, and aggrecan mRNA, secretion of collagen type II protein and sulfated glycosaminoglycans (sGAG), and by alkaline phosphatase induction. Chondrogenic stimulation of SMPC by the equine BMP-2 adenovirus was assessed by sGAG secretion and histology.Results: The mature equine BMP-2 peptide is identical to human and murine peptides. Recombinant human BMP-2 and TGF-[uni03B2]1 stimulated equivalent amounts of collagen type II protein in SMPC pellets, but sGAG secretion was doubled by BMP-2. Neither factor stimulated hypertrophic marker expression. The equine BMP-2 adenoviral vector induced chondrogenesis comparably to rhBMP-2 protein, with no indication of hypertrophy.Clinical significance: Bone morphogenetic protein 2 is a potent inducer of SMPC nonhypertrophic chondrogenesis, supporting the use of this combination for articular cartilage repair applications.
CAN HELIUM ENVELOPES CHANGE THE OUTCOME OF DIRECT WHITE DWARF COLLISIONS?
Authors: Holcomb Cole , Kushnir Doron 
Published: July 2016

ABSTRACT
A pivotal feature for the viability of white dwarf (WD) collisions as SN Ia progenitors is that a significant fraction of the mass is highly compressed to the densities required for efficient 56Ni production before the ignition of the detonation wave. Previous studies have employed model WDs composed of carbon–oxygen (CO), whereas WDs typically have a non-negligible helium envelope. Given that helium is more susceptible to explosive burning than CO under the conditions of WD collision, a legitimate concern is whether or not early time He detonation ignition can lead to early time CO detonation, drastically reducing 56Ni synthesis. We investigate the role of He in determining the fate of WD collisions by performing a series of two-dimensional hydrodynamics calculations. We find that a necessary condition for non-trivial reduction of the CO ignition time is that the He detonation birthed in the contact region successfully propagates into the unshocked shell. We determine the minimal He shell mass as a function of the total WD mass that upholds this condition. Although we utilize a simplified reaction network similar to those used in previous studies, our findings are in good agreement with detailed investigations concerning the impact of network size on He shell detonations. This allows us to extend our results to the case with more realistic burning physics. Based on the comparison of these findings against evolutionary calculations of WD compositions, we conclude that most, if not all, WD collisions will not be drastically impacted by their intrinsic He components.
DISENTANGLING AGN AND STAR FORMATION ACTIVITY AT HIGH REDSHIFT USING HUBBLE SPACE TELESCOPE GRISM SPECTROSCOPY
Authors: Bridge Joanna S. , Zeimann Gregory R. , Trump Jonathan R. , Gronwall Caryl , Ciardullo Robin , Fox Derek , Schneider Donald P. 
Published: July 2016

ABSTRACT
Differentiating between active galactic nucleus (AGN) activity and star formation in z ∼ 2 galaxies is difficult because traditional methods, such as line-ratio diagnostics, change with redshift, while multi-wavelength methods (X-ray, radio, IR) are sensitive to only the brightest AGNs. We have developed a new method for spatially resolving emission lines using the Hubble Space Telescope/Wide Field Camera 3 G141 grism spectra and quantifying AGN activity through the spatial gradient of the [O iii]/Hβ line ratio. Through detailed simulations, we show that our novel line-ratio gradient approach identifies ∼40% more low-mass and obscured AGNs than obtained by classical methods. Based on our simulations, we developed a relationship that maps the stellar mass, star formation rate, and measured [O iii]/Hβ gradient to the AGN Eddington ratio. We apply our technique to previously studied stacked samples of galaxies at z ∼ 2 and find that our results are consistent with these studies. This gradient method will also be able to inform other areas of galaxy evolution science, such as inside-out quenching and metallicity gradients, and will be widely applicable to future spatially resolved James Webb Space Telescope data.
THE FORMATION AND EARLY EVOLUTION OF A CORONAL MASS EJECTION AND ITS ASSOCIATED SHOCK WAVE ON 2014 JANUARY 8
Authors: Wan (万霖丰) Linfeng , Cheng Xin , Shi Tong , Su Wei , Ding M. D. 
Published: July 2016

ABSTRACT
In this paper, we study the formation and early evolution of a limb coronal mass ejection (CME) and its associated shock wave that occurred on 2014 January 8. The extreme ultraviolet (EUV) images provided by the Atmospheric Imaging Assembly (AIA) on board the Solar Dynamics Observatory disclose that the CME first appears as a bubble-like structure. Subsequently, its expansion forms the CME and causes a quasi-circular EUV wave. Interestingly, both the CME and the wave front are clearly visible at all of the AIA EUV passbands. Through a detailed kinematical analysis, it is found that the expansion of the CME undergoes two phases: a first phase with a strong but transient lateral over-expansion followed by a second phase with a self-similar expansion. The temporal evolution of the expansion velocity coincides very well with the variation of the 25–50 keV hard X-ray flux of the associated flare, which indicates that magnetic reconnection most likely plays an important role in driving the expansion. Moreover, we find that, when the velocity of the CME reaches ∼600 km s−1, the EUV wave starts to evolve into a shock wave, which is evidenced by the appearance of a type II radio burst. The shock’s formation height is estimated to be ∼0.2 R
sun, which is much lower than the height derived previously. Finally, we also study the thermal properties of the CME and the EUV wave. We find that the plasma in the CME leading front and the wave front has a temperature of ∼2 MK, while that in the CME core region and the flare region has a much higher temperature of ≥8 MK.