bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clipping of previously coiled cerebral aneurysms: efficacy, safety, and predictors in a cohort of 111 patients
Authors: Daou Badih , Chalouhi Nohra , Starke Robert M. , Barros Guilherme , Ya'qoub Lina , Do John , Tjoumakaris Stavropoula , Rosenwasser Robert H. , Jabbour Pascal 
Published: February 2016

OBJECTIVE
With the increasing number of aneurysms treated with endovascular coiling, more recurrences are being encountered. The aim of this study was to evaluate the efficacy and safety of microsurgical clipping in the treatment of recurrent, previously coiled cerebral aneurysms and to identify risk factors that can affect the outcomes of this procedure.

METHODS
One hundred eleven patients with recurrent aneurysms whose lesions were managed by surgical clipping between January 2002 and October 2014 were identified. The rates of aneurysm occlusion, retreatment, complications, and good clinical outcome were retrospectively determined. Univariate and multivariate logistic regressions were performed to identify factors associated with these outcomes.

RESULTS
The mean patient age was 50.5 years, the mean aneurysm size was 7 mm, and 97.3% of aneurysms were located in the anterior circulation. The mean follow-up was 22 months. Complete aneurysm occlusion, as assessed by intraoperative angiography, was achieved in 97.3% of aneurysms (108 of 111 patients). Among patients, 1.8% (2 of 111 patients) had a recurrence after clipping. Retreatment was required in 4.5% of patients (5 of 111) after clipping. Major complications were observed in 8% of patients and mortality in 2.7%. Ninety percent of patients had a good clinical outcome. Aneurysm size (OR 1.4, 95% CI 1.08–1.7; p = 0.009) and location in the posterior circulation were significantly associated with higher complications. All 3 patients who had coil extraction experienced a postoperative stroke. Aneurysm size (OR 1.2, 95% CI 1.02–1.45; p = 0.025) and higher number of interventions prior to clipping (OR 5.3, 95% CI 1.3–21.4; p = 0.019) were significant predictors of poor outcome. An aneurysm size > 7 mm was a significant predictor of incomplete obliteration and retreatment (p = 0.018).

CONCLUSIONS
Surgical clipping is safe and effective in treating recurrent, previously coiled cerebral aneurysms. Aneurysm size, location, and number of previous coiling procedures are important factors to consider in the management of these aneurysms.
Pediatric isolated thoracic and/or lumbar transverse and spinous process fractures
Authors: Akinpelu Babatunde J. , Zuckerman Scott L. , Gannon Stephen R. , Westrick Ashly , Shannon Chevis , Naftel Robert P. 
Published: February 2016

OBJECTIVE
Isolated transverse and spinous process fractures (TPFx and SPFx) in the thoracic and/or lumbar region have been deemed clinically insignificant in the adult population. This same rule is often applied to the pediatric population; however, little evidence exists in this younger group. The goal of this study was to describe the clinical, radiographic, and long-term data on isolated TPFx and SPFx in an exclusively pediatric population.

METHODS
A retrospective chart review at Monroe Carell Jr. Children's Hospital at Vanderbilt University identified 82 pediatric patients with isolated TPFx and/or SPFx following a traumatic event between January 2000 and December 2013. Patient demographic information, presenting symptoms, radiographic characteristics, and follow-up data were collected. Follow-up was used to determine the outcome (presence of neurological deficits) of such injuries via complete physical examination and, when available, radiographic evidence.

RESULTS
In the 82 identified patients, the mean age was 15.5 ± 3.1 years (mean is expressed ± SD throughout), with 72 injuries (87.8%) resulting from a motor vehicle, motorcycle, or all-terrain vehicle accident. There was a mean of 1.7 ± 1.0 fractured vertebral levels involved and a mean of 1.8 ± 1.1 fractures was identified per patient. Seventy-one patients (86.6%) needed bedside pain control, 7 (8.5%) were prescribed a brace, and 4 patients (4.9%) received a collar. Physical therapy was recommended for 12 patients (14.6%). A total of 84.1% had follow-up, and the mean length of follow-up was 19 ± 37 months. No patients had true neurological deficits at presentation or follow-up as a result of their isolated fractures, whereas 95.1% had other associated system injuries.

CONCLUSIONS
These data shows that there is no appreciable long-term complication associated with isolated thoracic and/or lumbar TPFx and/or SPFx in an exclusively pediatric population. Because these fractures are, however, associated with high-energy blunt trauma, they often result in associated soft-tissue or other skeletal injury. All pediatric patients in the cohort benefited from conservative management and aggressive treatment of their comorbidities.
Vertebral compression fractures after stereotactic body radiation therapy: a large, multi-institutional, multinational evaluation
Authors: Jawad Maha Saada , Fahim Daniel K. , Gerszten Peter C. , Flickinger John C. , Sahgal Arjun , Grills Inga S. , Sheehan Jason , Kersh Ronald , Shin John , Oh Kevin , Mantel Frederick , Guckenberger Matthias 
Published: February 2016

OBJECTIVE
The purpose of this study was to identify factors contributing to an increased risk for vertebral compression fracture (VCF) following stereotactic body radiation therapy (SBRT) for spinal tumors.

METHODS
A total of 594 tumors were treated with spinal SBRT as primary treatment or re-irradiation at 8 different institutions as part of a multi-institutional research consortium. Patients underwent LINAC-based, image-guided SBRT to a median dose of 20 Gy (range 8–40 Gy) in a median of 1 fraction (range 1–5 fractions). Median patient age was 62 years. Seventy-one percent of tumors were osteolytic, and a preexisting vertebral compression fracture (VCF) was present in 24% of cases. Toxicity was assessed following treatment. Univariate and multivariate analyses were performed using a logistic regression method to determine parameters predictive for post-SBRT VCF.

RESULTS
At a median follow-up of 10.1 months (range 0.03–57 months), 80% of patients had local tumor control. At the time of last imaging follow-up, at a median of 8.8 months after SBRT, 3% had a new VCF, and 2.7% had a progressive VCF. For development of any (new or progressive) VCF following SBRT, the following factors were predictive for VCF on univariate analysis: short interval from primary diagnosis to SBRT (less than 36.8 days), solitary metastasis, no additional bone metastases, no prior chemotherapy, preexisting VCF, no MRI used for target delineation, tumor volume of 37.3 cm3 or larger, equivalent 2-Gy-dose (EQD2) tumor of 41.8 Gy or more, and EQD2 spinal cord Dmax of 46.1 Gy or more. Preexisting VCF, solitary metastasis, and prescription dose of 38.4 Gy or more were predictive on multivariate analysis. The following factors were predictive of a new VCF on univariate analysis: solitary metastasis, no additional bone metastases, and no MRI used for target delineation. Presence of a solitary metastasis and lack of MRI for target delineation remained significant on multivariate analysis.

CONCLUSIONS
A VCF following SBRT is more likely to occur following treatment for a solitary spinal metastasis, reflecting a more aggressive treatment approach in patients with adequately controlled systemic disease. Higher prescription dose and a preexisting VCF also put patients at increased risk for post-SBRT VCF. In these patients, pre-SBRT cement augmentation could be considered to decrease the risk of subsequent VCF.
THE EVOLUTION OF DWARF GALAXY SATELLITES WITH DIFFERENT DARK MATTER DENSITY PROFILES IN THE ERISMOD SIMULATIONS. I. THE EARLY INFALLS
Authors: Tomozeiu Mihai , Mayer Lucio , Quinn Thomas 
Published: February 2016

ABSTRACT
We present the first simulations of tidal stirring of dwarf galaxies in the Local Group carried out in a fully cosmological context. We use the ErisDARK cosmological simulation of a Milky Way (MW)-sized galaxy to identify some of the most massive subhalos (M
vir > 108
M
⊙) that fall into the main host before z = 2. Subhalos are replaced before infall with extremely high-resolution models of dwarf galaxies comprising a faint stellar disk embedded in a dark matter halo. The set of models contains cuspy halos as well as halos with “cored” profiles (with the cusp coefficient γ = 0.6) consistent with recent results of hydrodynamical simulations of dwarf galaxy formation. The simulations are then run to z = 0 with as many as 54 million particles and resolutions as small as ∼4 pc using the new parallel N-body code ChaNGa. The stellar components of all satellites are significantly affected by tidal stirring, losing stellar mass, and undergoing a morphological transformation toward a pressure supported spheroidal system. However, while some remnants with cuspy halos maintain significant rotational flattening and disk-like features, all the shallow halo models achieve v
rot/σ
⋆ < 0.5 and round shapes typical of dSph satellites of the MW and M31. Mass loss is also enhanced in the latter, and remnants can reach luminosities and velocity dispersions as low as those of ultra-faint dwarfs.
AN HST PROPER-MOTION STUDY OF THE LARGE-SCALE JET OF 3C273
Authors: Meyer Eileen T. , Sparks William B. , Georganopoulos Markos , Anderson Jay , Marel Roeland van der , Biretta John , Tony Sohn Sangmo , Chiaberge Marco , Perlman Eric , Norman Colin 
Published: February 2016

ABSTRACT
The radio galaxy 3C 273 hosts one of the nearest and best-studied powerful quasar jets. Having been imaged repeatedly by the Hubble Space Telescope (HST) over the past twenty years, it was chosen for an HST program to measure proper motions in the kiloparsec-scale resolved jets of nearby radio-loud active galaxies. The jet in 3C 273 is highly relativistic on sub-parsec scales, with apparent proper motions up to 15c observed by very long baseline interferometry. In contrast, we find that the kiloparsec-scale knots are compatible with being stationary, with a mean speed of −0.2 ± 0.5c over the whole jet. Assuming the knots are packets of moving plasma, an upper limit of 1c implies a bulk Lorentz factor Γ < 2.9. This suggests that the jet has either decelerated significantly by the time it reaches the kiloparsec scale, or that the knots in the jet are standing shock features. The second scenario is incompatible with the inverse Compton off the Cosmic Microwave Background (IC/CMB) model for the X-ray emission of these knots, which requires the knots to be in motion, but IC/CMB is also disfavored in the first scenario due to energetic considerations, in agreement with the recent finding of Meyer & Georganopoulos which ruled out the IC/CMB model for the X-ray emission of 3C 273 via gamma-ray upper limits.
Retrospective analysis of patients with carcinoma cervix in a rural/semi-urban setting in Western India
Authors: Singh Ranvijay , Shetty Nishitha , Naveed Maryam , Pawar Suraj , Iska Sindu , Alugubelli Navya 
Published: February 2016

Abstract
Objectives: To compare the presentation of cervical cancer and the treatment modalities received by the patients at a semi-urban/rural area of Western India with that of published literature from urban centers. Materials and Methods: We conducted a retrospective analysis of patients with cervical cancer who presented at a semi-urban/rural cancer center between 2010 and 2013. A total of 141 patients with the median age of 51 years (25-81) were studied. The demographic and clinical variables included age, annual family income, profession, comorbidities, baseline hemoglobin, prior screening, clinical stage, treatment administered, and complications. The pathological variables included tumor type and grade. Results: In our study, all patients presented with vaginal bleeding. Majority of the patients (51 patients, 37.7%) had Stage 3B disease. Since majority presented at later stages (Stage 3B), chemotherapy-radiotherapy was the most common treatment modality used in our population. On histopathology, 127 patients (90%) had squamous cell carcinoma while 14 patients (10%) had adenocarcinoma. In 96 patients (68%), the tumor grade was not known while it was a high, intermediate, and low grade in 6 (4%), 18 (13%), and 21 (15%) patients, respectively. The follow-up data of our study were not adequate; hence, the long-term survival results could not be presented. Conclusion: Patients in rural India setting present at later stages which could be improved by creating awareness, improving their personal hygiene, and adequate screening.
Gestational trophoblastic neoplasia, management as per risk stratification in a developing country
Authors: Hussain Ansar , Shiekh Aejaz , Bhat Gul , Lone A R 
Published: February 2016

Abstract
Aims: The purpose of this analysis was to address the outcome of GTN from a tertiary care centre of India. Materials and Methods: We undertook a retrospective and prospective review of GTN cases treated at our centre from 2006 to 2014. Patients of GTN were assigned to low-risk or high-risk categories as per the FIGO scoring system. The low-risk group was treated with combination of actinomycin-D and methotrexate (MTX) and the high-risk group received the EMA/CO regimen. Salvage therapy was EP/TP. Treatment was continued for 3 cycles after normalization of β-hCG level, after which the patients were kept on follow-up. Results: In total, 52 GTN patients were treated at our institution during this period; 21 were low-risk and 31 were in the high-risk category. The lung was the most common site of metastasis. All low risk patients achieved complete remission. Among high risk patients one patient died while receiving first cycle chemotherapy, one patient relapsed and 29 patients achieved complete remission. The single relapsed patient also achieved remission with 2nd line chemotherapy. Conclusion: 1. Two drug combination of Actinomycin-D and Methotrexate is a better alternative to single drug chemotherapy especially in developing countries were proper risk stratification is not always possible. 2. Patients with high disease burden should initially be treated with low dose chemotherapy to avoid life threatening visceral haemorrhage.
A report of the frequency of colorectal carcinoma and involved lymph nodes in South-West Iran
Authors: Shahbazian Hodjatollah , Nasuri Yaser , Hosseini Seyed , Arvandi Shoaleh , Razzaghi Samira 
Published: February 2016

Abstract
Context: The colorectal cancer (CRC) is the most common malignancy between men and women. CRC has considerable morbidity and mortality, with more than 1000,000 new cases and 500,000 annual deaths. Regional lymph nodes are most common sites of metastasis from colon cancer. Lymph node involvement is an essential factor in enabling the accurate evaluation of prognosis in CRC patients. Aims: In this study, we focused on the frequency of CRC and involved lymph nodes and adequacy of lymph node dissection in patients who referred to the Oncology and Radiotherapy Department of Golestan Hospital in Ahvaz City located in South-West Iran. Setting and Design: We conducted a retrospective study among patients receiving surgical treatment for CRC in the Department of Oncology and Radiotherapy of Golestan Hospital in Ahvaz City located in South-West Iran between 2001 and 2010. Methods and Materials: All patients who underwent resection for CRC by open or laparoscopic approaches were included in the study. Data were collected from patients′ medical records. Statistical Analysis Used: Statistical data were analyzed using SPSS 21. Results: A total of 585 cases with CRC aged from16 to 89 years with mean age of 53-year-old were studied. Average number of dissected nodes was 8 lymph nodes, and lymph nodes were not found in pathology specimen of 61 cases (10.4%). In 199 patients (34.01%), number of dissected lymph nodes was 12 or more and in 386 patients (65.98%), number of dissected lymph nodes was <12. Conclusion: This study revealed a large amount of patients that had been under over treatment with radiotherapy and the following inability. Lack of removal of sufficient tissue by the surgeon during surgery or an inadequate sample check by a pathologist might lead to an inability to correct staging of the disease as well as the inability to determine the treatment program of the patients and over treatment with radiotherapy and chemotherapy.
Os sentidos de alfabetizar na pré-escola: algumas reflexões
Authors: Tomazzetti Cleonice Maria , Löffler Daliana 
Published: February 2016

Este texto é resultado de análise de dados produzidos em trabalhos circunscritos ao nível pré-escolar, desenvolvidos com duas professoras em momentos e contextos distintos. As fontes de produção e análise dos dados para esse texto foram obtidos, principalmente, dos registros da prática de estágio supervisionado na Educação Infantil e durante pesquisa de mestrado em educação. A partir desses registros propõem-se algumas reflexões acerca do processo de apropriação da língua escrita por crianças em idade pré-escolar e são explorados aspectos da infância institucionalizada, a criação, a participação e a geração de novos potenciais que se entrecruzam com dimensões propostas nas ações docentes, como de controle e repetição. Questionam-se os sentidos das práticas “alfabetizadoras” em contraponto à leitura de mundo com crianças que fazem, sonham e vivem a potência da existência humana. Tais reflexões sobre os sentidos de alfabetizar na pré-escola são desenvolvidas à luz das Diretrizes Curriculares Nacionais para a Educação Infantil e de referenciais próprios da área da alfabetização. As discussões apresentadas no presente texto consideram que a complexidade da infância permite compreender as crianças em imersão no universo da leitura e da escrita muito antes de frequentarem as escolas, encarando este momento como não exclusivo do início da vida escolar das crianças. Este processo pode ser encarado como uma iniciação ou acontecimento, em que as crianças também aprendem a ler e a escrever descobrindo os caminhos sem deixar de ser criança, visto que elas não aguardam, necessariamente, a escola para iniciarem essas aprendizagens.
Sobre a formação do professor alfabetizador: contributos para a caracterização do conhecimento de base do professor alfabetizador
Authors: Pires Pereira Íris Susana , Viana Fernanda Leopoldina , Vieira da Silva Cristina 
Published: February 2016

Neste texto recuperamos o quadro teórico proposto por Lee S. Shulman para dar resposta à seguinte questão: Qual o conhecimento de base do professor alfabetizador? A partir desta questão, entende-se que o ensino da alfabetização implica a convocação e a operacionalização de conhecimentos de diferentes naturezas, alguns dos quais subinvestigados e, por isso mesmo, ainda dependentes das intuições e práticas não sistematizadas e dificilmente passíveis de aprendizagem nos contextos de formação académica. Argumenta-se que é pela mesma ordem de razões que a tarefa pedagógica de ensinar a ler se torna difícil de conceber para os jovens professores. Defende-se que o modelo do conhecimento do professor alfabetizador que apresentamos se configura como basilar na concepção da formação do professor alfabetizador no atual contexto formativo português, que também é brevemente caracterizado.
Women’s leadership in local government in the Caribbean
Authors: Sam Kizzann Lee 
Published: February 2016

Women and men are traditionally cast in different roles, with males being leaders in the workplace, home and government. In contrast, communities promote women as caregivers who support male leaders and shape future generations as mothers, mentors and teachers. In recognition of this societal view of women that often led to inequality and inequity, the UNDP listed Gender Equality and empowering women as one of eight Millennium Development Goals. The post-2015 Sustainable Development Goals, adopted by the United Nations in autumn 2015, also included gender equality and empowering women as Goal 5.In its work in the Caribbean, the Caribbean Local Economic Development Project (CARILED) examined gender as it relates to micro, small and medium enterprise (MSME) development in six Caribbean countries. The findings of this study showed gender gaps for both male and female entrepreneurs in different areas of development. Traditionally gendered roles for MSME sectors, access to financing and lack of adequate guidance or community support were some areas that affected men and women differently in the region. The study outlines ways in which male and female leaders can address traditional gender roles by identifying priority areas for development, creating an enabling environment for start-ups and expansion, and fostering a policy and legislative base that facilitates ease of doing business. The recommendations further describe the public–private partnerships needed to successfully meet gender gaps, and the importance of both elected officials and technocrats in inter alia community engagement and advocacy towards local economic development.The importance of gender equality among elected officials and technocrats, and the influence gender has on determining priority areas of focus within local government strategic plans for communities are also set out within this paper.
Clinical and Pathologic Predictors of Clinical Outcome of Malignant Pleural Mesothelioma
Authors: Berardi Rossana , Fiordoliva Ilaria , De Lisa Mariagrazia , Ballatore Zelmira , Caramanti Miriam , Morgese Francesca , Savini Agnese , Rinaldi Silvia , Torniai Mariangela , Tiberi Michela , Ferrini Consuelo , Onofri Azzurra , Cascinu Stefano 
Published: February 2016

Aims and background Although worldwide use of asbestos has decreased, the incidence of malignant pleural mesothelioma (MPM) is expected to increase over the next few decades. A number of scoring systems has been proposed to assess clinicopathologic features and to predict the prognosis. We assessed the relationship between patients’ features and disease evolution in order to choose the best treatment able to prolong overall survival (OS) and progression-free survival (PFS). Methods We retrospectively analyzed patients with locally advanced or metastatic MPM, treated at the Department of Medical Oncology, Università Politecnica Marche, Italy, from January 2003 to September 2013. Data on age, sex, smoking history, asbestos exposure, performance status, tumor stage, histology, type of treatment, and routine laboratory tests including complete blood count panel, date of death, or censored status were collected. The OS and PFS were estimated using Kaplan-Meier method and Cox analysis was performed to analyze the prognostic relevance of clinical parameters. Results We enrolled a total of 62 patients. Univariate analysis showed that histologic type, performance status, response to first-line therapy, pretreatment hemoglobin levels, and plasmatic Ca125 were significant prognostic factors. Conversely, no significant correlation was found between age, sex, smoking history, reported exposure to asbestos, stages at diagnosis, treatments, and OS and PFS. Conclusions Our results showed that anemia and increased Ca125 might be considered negative prognostic parameters in MPM patients and confirmed the prognostic role of histotype, performance status, and response to first-line chemotherapy.