bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term outcomes of coil embolization of unruptured intracranial aneurysms
Authors: Koyanagi Masaomi , Ishii Akira , Imamura Hirotoshi , Satow Tetsu , Yoshida Kazumichi , Hasegawa Hitoshi , Kikuchi Takayuki , Takenobu Yohei , Ando Mitsushige , Takahashi Jun C. , Nakahara Ichiro , Sakai Nobuyuki , Miyamoto Susumu 
Published: January 2018

OBJECTIVELong-term follow-up results of the treatment of unruptured intracranial aneurysms (UIAs) by means of coil embolization remain unclear. The aim of this study was to analyze the frequency of rupture, retreatment, stroke, and death in patients with coiled UIAs who were followed for up to 20 years at multiple stroke centers.METHODSThe authors retrospectively analyzed data from cases in which patients underwent coil embolization between 1995 and 2004 at 4 stroke centers. In collecting the late (≥ 1 year) follow-up data, postal questionnaires were used to assess whether patients had experienced rupture or retreatment of a coiled aneurysm or any stroke or had died.RESULTSOverall, 184 patients with 188 UIAs were included. The median follow-up period was 12 years (interquartile range 11–13 years, maximum 20 years). A total of 152 UIAs (81%) were followed for more than 10 years. The incidence of rupture was 2 in 2122 aneurysm-years (annual rupture rate 0.09%). Nine of the 188 patients with coiled UIAs (4.8%) underwent additional treatment. In 5 of these 9 cases, the first retreatment was performed more than 5 years after the initial treatment. Large aneurysms were significantly more likely to require retreatment. Nine strokes occurred over the 2122 aneurysm-years. Seventeen patients died in this cohort.CONCLUSIONSThis study demonstrates a low risk of rupture of coiled UIAs with long-term follow-up periods of up to 20 years. This suggests that coiling of UIAs could prevent rupture for a long period of time. However, large aneurysms might need to be followed for a longer time.
Traumatic midline subarachnoid hemorrhage on initial computed tomography as a marker of severe diffuse axonal injury
Authors: Mata-Mbemba Daddy , Mugikura Shunji , Nakagawa Atsuhiro , Murata Takaki , Ishii Kiyoshi , Kushimoto Shigeki , Tominaga Teiji , Takahashi Shoki , Takase Kei 
Published: January 2018

OBJECTIVEThe objective of this study was to test the hypothesis that midline (interhemispheric or perimesencephalic) traumatic subarachnoid hemorrhage (tSAH) on initial CT may implicate the same shearing mechanism that underlies severe diffuse axonal injury (DAI).METHODSThe authors enrolled 270 consecutive patients (mean age [± SD] 43 ± 23.3 years) with a history of head trauma who had undergone initial CT within 24 hours and brain MRI within 30 days. Six initial CT findings, including intraventricular hemorrhage (IVH) and tSAH, were used as candidate predictors of DAI. The presence of tSAH was determined at the cerebral convexities, sylvian fissures, sylvian vallecula, cerebellar folia, interhemispheric fissure, and perimesencephalic cisterns. Following MRI, patients were divided into negative and positive DAI groups, and were assigned to a DAI stage: 1) stage 0, negative DAI; 2) stage 1, DAI in lobar white matter or cerebellum; 3) stage 2, DAI involving the corpus callosum; and 4) stage 3, DAI involving the brainstem. Glasgow Outcome Scale–Extended (GOSE) scores were obtained in 232 patients.RESULTSOf 270 patients, 77 (28.5%) had DAI; tSAH and IVH were independently associated with DAI (p < 0.05). Of tSAH locations, midline tSAH was independently associated with both overall DAI and DAI stage 2 or 3 (severe DAI; p < 0.05). The midline tSAH on initial CT had sensitivity of 60.8%, specificity of 81.7%, and positive and negative predictive values of 43.7% and 89.9%, respectively, for severe DAI. When adjusted for admission Glasgow Coma Score, the midline tSAH independently predicted poor GOSE score at both hospital discharge and after 6 months.CONCLUSIONSMidline tSAH could implicate the same shearing mechanism that underlies severe DAI, for which midline tSAH on initial CT is a probable surrogate.
Value of whole-body low-dose computed tomography in patients with ventriculoperitoneal shunts: a retrospective study
Authors: Pala Andrej , Awad Fadi , Braun Michael , Hlavac Michal , Wunderlich Arthur , Schmitz Bernd , Wirtz Christian Rainer , Coburger Jan 
Published: January 2018

OBJECTIVEThe gold standard for evaluation of ventriculoperitoneal (VP) shunt position, dislocation, or disconnection is conventional radiography. Yet, assessment with this modality can be challenging because of low image quality and can result in repetitive radiation exposure with high fluctuation in the radiation dose. Recently, CT-based radiation doses have been significantly reduced by using low-dose protocols. Thus, whole-body low-dose CT (LDCT) has become applicable for routine use in VP shunt evaluation. The authors here compared image quality and approximate radiation dose between radiography and LDCT in patients with implanted VP shunt systems.METHODSVentriculoperitoneal shunt systems have been investigated with LDCT scanning at the authors’ department since 2015. A consecutive series of 57 patients (70 investigations) treated between 2015 and 2016 was retrospectively assessed. A historical patient cohort that had been evaluated with radiography was compared with the LDCT patients in terms of radiation dose and image quality. Three independent observers evaluated projection of the valve pressure level and correct intraperitoneal position, as well as complete shunt projection, using a Likert-type scale of 1–5, where 1 indicated “not assessable” and 5 meant “assessable with high accuracy.” Descriptive statistics and the Mann-Whitney U-test were used for analysis.RESULTSTwenty-seven radiographs (38.6%) and 43 LDCT scans (61.4%) were analyzed. The median dose-length product (DLP) of the LDCT scans was 100 mGy·cm (range 59.9–183 mGy·cm). The median total dose-area product (DAP) of the radiographic images was 3177 mGy·cm2 (range 641–13,833 mGy·cm2). The estimated effective dose (EED) was significantly lower with the LDCT scan (p < 0.001). The median EED was 4.93 and 1.90 mSv for radiographs and LDCT, respectively. Significantly better identification of the abdominal position of the distal shunt catheter was achieved with LDCT (p < 0.001). Simultaneously, significantly improved visualization of the entire shunt system was realized with this technique (p < 0.001). On the contrary, identification of the valve settings was significantly worse with LDCT (p < 0.001).CONCLUSIONSWhole-body LDCT scanning allows good visualization of the distal catheter after VP shunt placement. Despite the fact that only a rough estimation of effective doses is possible in a direct comparison of LDCT and radiography, the data showed that shunt assessment via LDCT does not lead to greater radiation exposure. Thus, especially in difficult anatomical conditions, as in patients who have undergone multiple intraabdominal surgeries, have a high BMI, or are immobile, the use of LDCT shunt evaluation has high clinical value. Further data are needed to determine the value of LDCT for the evaluation of complications or radiation dose in pediatric patients.
Head shape at age 36 months among children with and without a history of positional skull deformation
Authors: Collett Brent R. , Leroux Brian G. , Wallace Erin R. , Gallagher Emily , Shao Jason , Speltz Matthew L. 
Published: January 2018

OBJECTIVEIn this study, the authors examined head shape through age 36 months for children with and without a history of positional plagiocephaly and/or brachycephaly (PPB).METHODSInfants with PPB (cases) were identified through a craniofacial clinic at the time of diagnosis. Infants without diagnosed PPB were identified through a participant registry. Clinician ratings of 3D cranial images were used to confirm the presence or absence of PPB. The cohort included 235 case infants (diagnosed PPB, confirmed with 3D imaging), 167 unaffected controls (no diagnosed PPB, no deformation detected), and 70 affected controls (no diagnosed PPB, discernible skull deformation). Participants were seen in infancy (age 7 months, on average) and again at ages 18 and 36 months. At each visit, automated 3D measures of skull deformation quantified posterior flattening and generated an absolute asymmetry score. The authors also used automated 2D measures to approximate overall asymmetry (approximate oblique cranial length ratio) and calculate the cephalic index. They used linear regression to compare cases to unaffected controls and to compare affected versus unaffected controls on all measures. They also calculated the proportion of children in each group with “persistent PPB,” defined as one or more head shape measures above the 95th percentile relative to unaffected controls at 36 months.RESULTSHead shape became more rounded and symmetric for children with and without PPB, particularly between infancy and age 18 months. However, children with PPB continued to show greater skull deformation and asymmetry than unaffected controls at age 36 months. These differences were large in magnitude, ranging from 1 to 2 standard deviations (SDs), and in most (85.6%) of the cases, there was evidence of persistent PPB at 36 months. Similarly, although differences were more modest (i.e., 0.26–0.94 SD), affected controls continued to exhibit skull deformation on most measures relative to unaffected controls and approximately 30% had persistent PPB. Within the case group, head shape at 36 months was similar for untreated patients with PPB and for those who received helmet treatment and for patients with and without a history of torticollis.CONCLUSIONSAlthough head shape continues to improve, children with a history of skull deformation in infancy continue to exhibit measureable cranial flattening and asymmetry through age 36 months.
Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation
Authors: Lindsey Derek P. , Parrish Robin , Gundanna Mukund , Leasure Jeremi , Yerby Scott A. , Kondrashov Dimitriy 
Published: January 2018

OBJECTIVEBilateral symptoms have been reported in 8%–35% of patients with sacroiliac (SI) joint dysfunction. Stabilization of a single SI joint may significantly alter the stresses on the contralateral SI joint. If the contralateral SI joint stresses are significantly increased, degeneration may occur; alternatively, if the stresses are significantly reduced, bilateral stabilization may be unnecessary for patients with bilateral symptoms. The biomechanical effects of 1) unilateral stabilization on the contralateral SI joint and 2) bilateral stabilization on both SI joints are currently unknown. The objectives of this study were to characterize bilateral SI joint range of motion (ROM) and evaluate and compare the biomechanical effects of unilateral and bilateral implant placement for SI joint fusion.METHODSA lumbopelvic model (L5–pelvis) was used to test the ROM of both SI joints in 8 cadavers. A single-leg stance setup was used to load the lumbar spine and measure the ROM of each SI joint in flexion-extension, lateral bending, and axial rotation. Both joints were tested 1) while intact, 2) after unilateral stabilization, and 3) after bilateral stabilization. Stabilization consisted of lateral transiliac placement of 3 triangular titanium plasma-sprayed (TPS) implants.RESULTSIntact testing showed that during single-leg stance the contralateral SI joint had less ROM in flexion-extension (27%), lateral bending (32%), and axial rotation (69%) than the loaded joint. Unilateral stabilization resulted in significant reduction of flexion-extension ROM (46%) on the treated side; no significant ROM changes were observed for the nontreated side. Bilateral stabilization resulted in significant reduction of flexion-extension ROM of the primary (45%) and secondary (75%) SI joints.CONCLUSIONSThis study demonstrated that during single-leg loading the ROMs for the stance (loaded) and swing (unloaded) SI joints are significantly different. Unilateral stabilization for SI joint dysfunction significantly reduces the ROM of the treated side, but does not significantly reduce the ROM of the nontreated contralateral SI joint. Bilateral stabilization is necessary to significantly reduce the ROM for both SI joints.
Functional outcome in pediatric hydrocephalus: results of applying the Spanish version of the Hydrocephalus Outcome Questionnaire
Authors: Iglesias Sara , Ros Bienvenido , Martín Álvaro , Carrasco Antonio , Rius Francisca , Arráez Miguel Ángel 
Published: January 2018

OBJECTIVEThe aims of the study were to assess whether the Spanish version of the Hydrocephalus Outcome Questionnaire (HOQ) could be useful for the evaluation and comparison of outcomes in the patients in the authors’ region with those in patients in other institutions and to analyze predictors of functional outcome in patients with a shunt.METHODSThe authors performed this cross-sectional study between March 2015 and April 2016. All the parents of a pediatric patient with hydrocephalus who attended the Hospital Regional Universitario de Málaga neurosurgery outpatient clinic were invited to enroll in the study and complete the HOQ–Spanish version. Age at diagnosis and at the time of the study, clinical data, shunt complications, and socioeconomic factors were also recorded. A descriptive analysis was performed, and independent variables related to the HOQ scores were studied.RESULTSA total of 132 patients participated in the study (100% participation rate). The mean ages were 16.74 months (range 0–142 months) at diagnosis and 10.45 years (range 5–16 years) at the time of the study. The mean overall HOQ score was 0.68 (on a scale from 0 [worse] to 1.0 [best]). Factors related to a worse quality of life were seizures, motor or visual impairment, shunt infection, need for shunt revision, need for more than 2 shunt revisions (range 0–8 revisions), symptomatic overdrainage, and older age at the time of the study.CONCLUSIONSThe HOQ–Spanish version is useful in the authors’ region; the dimension scores found in this study were comparable to those previously reported by referral centers. Future goals should be to prevent shunt complications, routinely get children to reach functional status, and refer patients for adjuvant therapy promptly.
Complications following intracranial pressure monitoring in children: a 6-year single-center experience
Authors: Ma Ruichong , Rowland David , Judge Andrew , Calisto Amedeo , Jayamohan Jayaratnam , Johnson David , Richards Peter , Magdum Shailendra , Wall Steven 
Published: January 2018

OBJECTIVEIntracranial pressure (ICP) monitoring is an important tool in the neurosurgeon’s armamentarium and is used for a wide range of indications. There are many different ICP monitors available, of which fiber-optic intraparenchymal devices are very popular. Here, the authors document their experience performing ICP monitoring from 2005 to 2015 and specifically complication rates following insertion of the Microsensor ICP monitor.METHODSA retrospective case series review of all patients who underwent ICP monitoring over a 10-year period from 2005 to 2015 was performed.RESULTSThere were 385 separate operations with an overall complication rate of 8.3% (32 of 385 cases). Hardware failure occurred in 4.2% of cases, the CSF leakage rate was 3.6%, the postoperative hemorrhage rate was 0.5%, and there was 1 case of infection (0.3% of cases). Only patients with hardware problems required further surgery as a result of their complications, and no patient had any permanent morbidity or mortality from the procedure. Younger patients (p = 0.001) and patients with pathologically high ICP (13% of patients with high ICP vs 6.5% of patients with normal ICP; p = 0.04) were significantly more likely to have complications. There was no significant difference in the complication rates between general neurosurgical patients and craniofacial patients (7.6% vs 8.8%, respectively; p = 0.67).CONCLUSIONSIntraparenchymal ICP monitoring is a safe procedure associated with low complications and morbidity in the pediatric craniofacial and neurosurgical population and should be offered to appropriate patients to assess ICP with the reassurance of the safety record reported in this study.
Drought and Disaster in a Revolutionary Age: Colonial Antigua during the American Independence War
Authors: Berland Alexander Jorge , Endfield Georgina 
Published: January 2018

Abstract
The American War of Independence (1775-1783) spelled crisis for the British West Indies. Trade embargos between rebelling and loyal territories, losses to American pirates, and hostilities with other European states left the Crown's tropical Atlantic colonies short of the imports that normally sustained their populations and commerce. Historians have studied the dynamics of these developments in considerable detail, but have tended to focus on economic, social and political dimensions of the subject matter. Although some investigations have highlighted that climate variability compounded agricultural and subsistence problems in certain locations, the role of climate has rarely been subject to the same level of scrutiny. The present paper addresses this theme by focusing on the island of Antigua (Lesser Antilles) and the severe drought it experienced during the war period. Based on extensive analysis of original, largely unpublished archival sources, the implications of deficient rainfall for human livelihoods, fiscal stability and governmental crisis management are examined. By supplementing findings with evidence from other episodes of warfare and extreme climate phenomena in the late 1700s and early 1800s, it is argued that successive years of drought were pivotal in defining the severe human and economic losses sustained in Antigua during the American independence conflict. The agency of this weather event must, however, be understood as the product of its dynamic interaction with the backdrop of a colonial regime under profound socio-economic and geopolitical stress.
Are There Echoes of the AD 536 Event in the Viking Ragnarok Myth? A Critical Appraisal
Authors: Nordvig Mathias , Riede Felix 
Published: January 2018

Abstract
Recent scholarship suggests that the Nordic apocalypse, Ragnarok, can be linked historically to one or several geological or climate events in the sixth century ad. Climatic fluctuations and a 'dust veil' during the period of ad 536-550 have been recorded across the Northern Hemisphere, and in Scandinavia this seems to coincide with considerable changes in settlement patterns. Consequently, much later literary sources on Nordic mythology have been interpreted as local memories of the cooling of the Northern Hemisphere. In this article we offer a critical perspective on the combining of Nordic literary sources from the thirteenth century with archaeological records of the sixth century. We address the need for developing a viable method within the scope of what we identify as the palaeoenvironmental humanities perspective on past ecological changes. By defining a palaeoenvironmental humanities perspective through the interdisciplinary conjoining of archaeology, social theory and literature, we attempt to strike a balance between material and non-material sources in the study of pre-historical environmental changes.
High-resolution Observations of Cen A: Yellow and Red Supergiants in a Region of Jet-induced Star Formation?*
Authors: Markakis K. , Eckart A. , Castro N. , Sánchez-Monge Á. , Labadie L. , Nishiyama S. , Britzen S. , Zensus J. A. 
Published: January 2018

Abstract
We present the analysis of near-infrared (NIR), adaptive optics Subaru and archived HST imaging data of a region near the northern middle lobe of the Centaurus A (Cen A) jet, at a distance of ∼15 kpc northeast from the center of NGC5128. Low-pass filtering of the NIR images reveals a strong—

above the background mean—signal at the expected position of the brightest star in the equivalent HST field. Statistical analysis of the NIR background noise suggests that the probability to observe a

signal at the same position, in three independent measurements due to stochastic background fluctuations alone is negligible (

) and, therefore, that this signal should reflect the detection of the NIR counterparts of the brightest HST star. An extensive photometric analysis of this star yields V − I, visual–NIR, and NIR colors expected from a yellow supergiant with an estimated age

Myr. Furthermore, the second and third brighter HST stars are, likely, also supergiants in Cen A, with estimated ages

Myr and

Myr, respectively. The ages of these three supergiants are in good agreement with the ages of the young massive stars that were previously found in the vicinity and are thought to have formed during the later phases of the jet-H i cloud interaction that appears to drive the star formation in the region for the past ∼100 Myr.
What Are “X-shaped” Radio Sources Telling Us? II. Properties of a Sample of 87
Authors: Saripalli Lakshmi , Roberts David H. 
Published: January 2018

Abstract
In an earlier paper, we presented Jansky Very Large Array multi-frequency, multi-array continuum imaging of a unique sample of low-axial ratio radio galaxies. In this paper, the second in the series, we examine the images to learn the phenomenology of how the off-axis emission relates to the main radio source. Inversion-symmetric offset emission appears to be bimodal and to originate from one of two strategic locations: outer ends of radio lobes (outer-deviation) or from inner ends (inner-deviation). The latter sources are almost always associated with edge-brightened sources. With S- and Z-shaped sources being a subset of outer-deviation sources, this class lends itself naturally to explanations involving black hole axis precession. Our data allow us to present a plausible model for the more enigmatic inner-deviation sources with impressive wings; as for outer-deviation sources these too require black hole axis shifts, although they also require plasma backflows into relic channels. Evolution in morphology over time relates the variety in structures in inner-deviation sources including XRGs. With features such as non-collinearities, central inner-S “spine,” corresponding lobe emission peaks, double and protruding hotspots not uncommon, black hole axis precession, drifts, or flips could be active in a significant fraction of radio sources with prominent off-axis emission. At least 4% of radio galaxies appear to undergo black hole axis rotation. Quasars offer a key signature for recognizing rotating axes. With a rich haul of sources that have likely undergone axis rotation, our work shows the usefulness of low-axial ratio sources in pursuing searches for binary supermassive black holes.