bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscope-assisted repair of CSF otorrhea and temporal lobe encephaloceles via keyhole craniotomy
Authors: Roehm Pamela C. , Tint Derrick , Chan Norman , Brewster Ryan , Sukul Vishad , Erkmen Kadir 
Published: August 2017

OBJECTIVETemporal lobe encephaloceles and cerebrospinal fluid otorrhea from temporal bone defects that involve the tegmen tympani and mastoideum are generally repaired using middle fossa craniotomy, mastoidectomy, or combined approaches. Standard middle fossa craniotomy exposes patients to dural retraction, which can lead to postoperative neurological complications. Endoscopic and minimally invasive techniques have been used in other surgeries to minimize brain retraction, and so these methods were applied to repair the lateral skull base. The goal of this study was to determine if the use of endoscopic visualization through a middle fossa keyhole craniotomy could effectively repair tegmen defects.METHODSThe authors conducted a retrospective review of 6 cases of endoscope-assisted middle fossa repairs of tegmen dehiscences at a tertiary care medical center within an 18-month period.RESULTSAll cases were successfully treated using a keyhole craniotomy with endoscopic visualization and minimal retraction. Surgical times did not increase. There were no major postoperative complications, recurrences of encephaloceles, or cerebrospinal fluid otorrhea in these patients.CONCLUSIONSEndoscopic visualization allows for smaller incisions and craniotomies and less risk of brain retraction injury without compromising repair integrity during temporal encephalocele and tegmen repairs.
Volume of cerebrospinal fluid drainage as a predictor for pretreatment aneurysmal rebleeding
Authors: van Lieshout Jasper H. , Pumplün Ina , Fischer Igor , Kamp Marcel A. , Cornelius Jan F. , Steiger Hans J. , Boogaarts Hieronymus D. , Petridis Athanasios K. , Beseoglu Kerim 
Published: August 2017

OBJECTIVEInitiation of external CSF drainage has been associated with a significant increase in rebleeding probability after aneurysmal subarachnoid hemorrhage (aSAH). However, the implications for acute management are uncertain. The purpose of this study was to evaluate the role of the amount of drained CSF on aneurysmal rebleeding.METHODSConsecutive patients with aSAH were analyzed retrospectively. Radiologically confirmed cases of aneurysmal in-hospital rebleeding were identified and predictor variables for rebleeding were retrieved from hospital records. Clinical predictors were identified through multivariate analysis, and logistic regression analysis was performed to ascertain the cutoff value for the rebleeding probability.RESULTSThe study included 194 patients. Eighteen cases (9.3%) of in-hospital rebleeding could be identified. Using multivariate analysis, in-hospital rebleeding was significantly associated with initiation of CSF drainage (p = 0.001) and CSF drainage volume (63 ml [interquartile range (IQR) 55–69 ml] vs 25 ml [IQR 10–35 ml], p < 0.001). Logistic regression showed that 58 ml of CSF drainage within 6 hours results in a 50% rebleeding probability. The relative risk (RR) for rebleeding after drainage of more than 60 ml in 6 hours was 5.4 times greater compared with patients with less CSF drainage (RR 5.403, 95% CI 2.481–11.767; p < 0.001, number needed to harm = 1.687).CONCLUSIONSVolume of CSF drainage was highly correlated with the probability of in-hospital aneurysmal rebleeding. These findings suggest that the rebleeding probability can be affected in acute management should the placement of an external ventricular catheter be necessary. This finding necessitates meticulous control of the amount of drained CSF and the development of a definitive treatment protocol for this group of patients.
Predictive factors of medullary infarction after endovascular internal trapping using coils for vertebral artery dissecting aneurysms
Authors: Aihara Masanori , Naito Isao , Shimizu Tatsuya , Matsumoto Masahiro , Asakura Ken , Miyamoto Naoko , Yoshimoto Yuhei 
Published: August 2017

OBJECTIVEThe first choice of treatment in cases of vertebral artery dissecting aneurysms (VADAs) is endovascular internal trapping (EIT) of the dissecting segment using coils. However, this procedure carries the risk of medullary infarction, and the risk factors for this complication are not well understood. This study investigated the risk factors causing medullary infarction.METHODSOne hundred patients who underwent EIT for VADAs were included in this study. Ninety-three patients presented with subarachnoid hemorrhage. In cases involving the posterior inferior cerebellar artery (PICA), partial internal trapping targeting the ruptured site was performed to preserve the PICA. The VADAs were classified into the distal VA stump group, proximal VA stump group, and entire VA stump group, according to the location of VA segments without adequate flow-out vessels (such as the PICA [VA stump]) at risk of delayed thrombosis. The occurrence of medullary infarction was examined in each group using diffusion-weighted MRI and/or clinical symptoms. Various measurements were performed on digital subtraction angiography, and the risk factors for medullary infarction were analyzed.RESULTSMedullary infarction occurred in 30 patients, affecting the posterolateral medulla in 27 patients and the anteromedial medulla in 3 patients. Medullary infarction occurred in 3 of 47 patients (6%) in the distal VA stump group, 10 of 19 patients (53%) in the proximal VA stump group, and 17 of 34 patients (50%) in the entire VA stump group. The length of trapping was significantly longer in the infarction group than in the noninfarction group but did not differ among the 3 groups. Total length (length of trapping plus VA stump) was a risk factor for medullary infarction in the proximal VA stumps.CONCLUSIONSThe primary risk factor for medullary infarction after EIT is not the length of trapping; rather, it is the anatomical location of the VADAs. The risk of medullary infarction is low in cases with distal VA stumps, but the symptoms are severe. Preservation of the origin of the anterior spinal artery can reduce the risk of medullary infarction. The risk of medullary infarction is high in cases with proximal VA stumps, but the symptoms are mild. A shorter length of trapping, although less likely to lead to complications, cannot prevent medullary infarction because the total length depends on the anatomical location of the PICA and not on the surgical technique. Reconstructive therapy should be indicated for patients with ruptured VADAs at high risk of severe ischemic complications (e.g., patients with hypoplasia of the contralateral VA or cases involving the PICA or anterior spinal artery, which are inappropriate for partial internal trapping) or for patients with unruptured VADAs.
Standardized method for the measurement of Grabb’s line and clival-canal angle
Authors: Martin Jonathan E. , Bookland Markus , Moote Douglas , Cebulla Catherine 
Published: August 2017

OBJECTIVEGrabb’s line—the perpendicular distance from the basion-C2 line (pB-C2)—is a widely used radiographic measurement with significant clinical implications in patients with a complex Chiari malformation. Rigorous demonstration of the reproducibility of this measurement has not previously been reported. The authors report a standardized measurement technique with excellent inter- and intrarater reliability on T1-weighted sagittal MRI.METHODSThe authors developed a standardized measurement technique that included specifications of midline slice selection, landmark and reference line definitions, and measurement technique on T1-weighted sagittal images. Twenty MR images were reviewed by 2 pediatric neurosurgeons, 1 pediatric radiologist, and 1 undergraduate student. Measurements were performed using the technique specified on 2 separate occasions. Intrarater and interrater reliabilities were calculated using the intraclass correlation coefficient.RESULTSA combined interrater reliability of 0.879 was achieved for the pB-C2, and 0.916 for the clival-canal angle, another measure of interest in patients with complex Chiari malformations. Intrarater reliability for these measurements exceeded 0.858 for all 4 reviewers.CONCLUSIONSGrabb’s line—the pB-C2—can be measured with excellent reliability using a standardized measurement protocol. Individual clinicians and collaborative databases should consider using validated measurement techniques to guide clinical decision making in patients with craniocervical junction pathology.
Development of a New Self-Reporting Instrument Measuring Benefits and Side Effects of Corticosteroids in Duchenne Muscular Dystrophy: Report from a Pilot Study
Authors: Hendriksen Ruben G.F. , Lionarons Judith M. , Hendriksen Jos G.M. , Vles Johan S.H. , McAdam Laura C. , Biggar W. Douglas 
Published: August 2017

Background: There is no cure for Duchenne Muscular Dystrophy (DMD); treatment is symptomatic and corticosteroids slow the progression. Side effects of corticosteroids – especially the physical effects – have been described, however patients’ and caregivers perception on chronic corticosteroid treatment and their side effects is less well known, in particular with regards to cognition, behaviour, and emotional functioning. Objective: The primary aim of this pilot study was to (i) construct a self-report questionnaire to assess the perceived benefits and side effects of corticosteroids for patients with DMD and their parents. Furthermore we aimed to (ii) investigate the psychometric qualities of this questionnaire, (iii) whether there was a difference between parents’ and patient’s perceptions, and finally (iv) to what extent reported side effects may alter over time. Methods: A 23-item questionnaire (SIDECORT: side effect of corticosteroids) was constructed to assess the perception of these benefits and side effects in a systematic manner. Results: In total, 86 patients (aged 5 – 28 years) and 125 of their parents completed the questionnaire. Internal consistency was good. Using factor analyses on the side effect items as reported by parents, two underlying factors were found, with the first factor describing cognitive, behavioural and emotional functioning, and the second factor describing physical functioning. The potential benefits of corticosteroids were highly rated among both parents and patients, although parents rated the importance of the benefits higher than their sons ( p = 0.002). Similarly, parents rated the severity of the side effects generally higher than their sons ( p = 0.011), especially with regards to the physical side effects ( p = 0.014). Based on the parent’s perception, the neurodevelopmental side effects generally appeared to decline the longer corticosteroids were used. Conclusions: To our knowledge, this is the first explicit study on perceived cognitive-, behavioural-, and emotional side effects and the allocation of benefits to corticosteroids in DMD. On the basis of our research we suggest a short form questionnaire, which proves to be reliable and valid for research- and clinical practice. This questionnaire could provide useful insights for the care of boys and men with DMD.
Sustained Virological Response by Direct Antiviral Agents in HCV Leads to an Early and Significant Improvement of Liver Fibrosis
Authors: Persico Marcello , Rosato Valerio , Aglitti Andrea , Precone Davide , Corrado Mariano , Luna Antonio De , Morisco Filomena , Camera Silvia , Federico Alessandro , Dallio Marcello , Claar Ernesto , Caporaso Nicola , Masarone Mario 
Published: August 2017

Background Direct antiviral agents (DAA) demonstrated high efficacy among HCV-infected patients in registered trials. Nevertheless, the impact of these therapies on liver stiffness measurement (LSM) and liver functionality in ‘real-life’ is not well-known. The aim of the present study was to evaluate the sustained virological response (SVR) impact on LSM and clinical parameters of DAA-therapy on a real-life population of HCV patients with F3/F4 fibrosis. Methods A total of 749 HCV genotype 1–4 patients with F3/F4 hepatitis undergoing antiviral therapy were consecutively enrolled in four centres of hepatology in Italy. Clinical, biochemical and imaging data were collected at the baseline (T0), at the end of treatment (EoT) and after 12 weeks (SVR12). Results Out of 749 patients, 69.7% were F4 and 30.3% were F3. SVR12 was reached in 97.5%. LSM significantly decreased from T0 to EoT ( P<0.001), whereas, it did not from EoT to SVR12 ( P= not significant). Moreover, in F4 no significant differences were found in Child and MELD between T0, EoT and SVR12 ( P= not significant). At the univariate analysis of clinical and liver parameters, baseline high glucose ( P<0.005), type 2 diabetes ( P<0.001), low alanine aminotransferase (ALT; P<0.001), low platelets ( P<0.005), and the presence of esophageal varices (EV; P<0.001) were found to be associated with a lack of a significant EoT LSM improvement. At multiple regression, ALT ( P<0.05), diabetes ( P<0.005) and EV ( P<0.05) were inversely associated with significant LSM reduction. Conclusions Virological response to DAA is associated with fibrosis regression and recovery of liver functionality and this can be detected as early as EoT. HCV eradication is associated with a rapid and significant clinical improvement that lasts over time and seems to be negatively influenced by diabetes and EV.
Fatores Essenciais de Risco de Uso de Drogas por Adolescentes: Utilizando Modelagem de Equações Estruturais
Authors: Costa Giovani Glaucio 
Published: August 2017

A questão da identificação dos fatores que facilitam o uso de drogas por adolescentes é alvo de muitos estudos de autores que o pesquisam. Os fatores individuais de risco que ocasionam o uso de drogas por adolescentes, se combinados entre si, poderão atingir a mais de setenta possibilidades. Os pesquisadores ainda estão estudando as inter-relações entre os vários fatores já conhecidos, com a finalidade de se chegar a um provável consenso sobre o uso de drogas pelos jovens. Este artigo visou contribuir para a corroboração a cerca de fatores gerais consensuais que facilitam o uso de drogas por adolescentes. O objetivo deste estudo foi identificar quais os conceitos essenciais ou básicos, constructos, não observados diretamente, que pudessem resumir os fatores de risco diretos que aumentam, em diferentes intensidades, a probabilidade do jovem vir a consumir drogas. O artigo realizou uma pesquisa de percepção junto a uma amostra não probabilística de 124 psicólogos e assistentes sociais. A pesquisa questionava, numa escala de 0 a 10, a intensidade em que 20 fatores de risco individuais diretos aumentariam a probabilidade de um adolescente vir a usar drogas.A análise de dados consistiu de uma análise de confiabilidade, de uma análise fatorial exploratória e de uma modelagem de equações estruturais, para verificar a existência de conceitos abstratos, identificá-los e confirmá-los. Os constructos, não medidos diretamente, seriam os fatores causais que explicariam e resumiriam os facilitadores diretos do consumo de drogas por menores de idade.“Fator de Risco Natural”, “Fator Evento e Experiência de Vida” e “Fator Social”, nesta ordem, provavelmente seriam os fatores latentes, os conceitos abstratos, o resumo teórico conceitual do que se percepção como fatores de risco facilitadores diretos do consumo de drogas não lícitas por adolescentes. Estes novos eixos temáticos sumarizam em 94,5% a variação das opiniões auferidas pelos pesquisados no estudo. A investigação é meramente preliminar, o ideal seria uma amostra com maior representatividade, mas abre caminhos para estudos mais generalizáveis sobre a temática estudada.
FTIR Characterization and Release of Bovine Serum Albumin from Bioactive Glasses
Authors: Liu Wai-Ching , Ballenger Blake , Algarni Amnah , Velez Mariano , Chu Tien-Min G. 
Published: August 2017

Background Bioactive glass has attracted substantial interest in orthopedics, but it has been less explored as a drug carrier. This study investigated the bovine serum albumin (BSA) release from bioactive 13–93B0 and 13–93B3 glasses. Methods Glass disks (13–93B0 and 13–93B3; n = 5) were loaded with 4 mg of BSA and coated under different chitosan-coating conditions. The amount of BSA released in phosphate-buffered saline (PBS) was evaluated, and a degradation study was performed to find out the weight loss and pH of PBS. Secondary structures of BSA on 13–93B0 were characterized by Fourier transform infrared (FTIR) spectroscopy. Results One hundred percent protein release occurred by 24 hours for all 13–93B3 groups. However, chitosan coating delayed 100% release up to 72 hours in 13–93B0 groups. The 13–93B3 glass showed higher degradation rates than 13–93B0 regardless of chitosan-coating status. Multilayer and sandwich chitosan coatings further delayed BSA release from 13–93B0. FTIR analysis revealed that α-helical structure was the highest among all groups and significantly higher in the 2% sandwich chitosan coating group (32.0% ± 2.1%), compared with uncoated and 4% chitosan groups. Conclusions Chitosan coating can delay the burst release of BSA from 13–93B0 glass and be a potential coating on bioactive glass for drug delivery purposes.
Utility of Anteroposterior Diameter Ratio of Tumor and Abdomen for Laparoscopic Approach for Radical Nephrectomy in Large Renal Masses
Authors: Yadav Priyank , Srivastava Devarshi , Arakere Sachin , Gupta Shashikant , Aga Pallavi , Mandhani Anil 
Published: August 2017

Introduction Laparoscopic radical nephrectomy (LRN) is now increasingly done for tumors larger than 10 cm. Despite selection of favorable cases, LRN may not be successful due to lack of adequate working space with large tumors. We describe a new feature on Contrast Enhanced Computed Tomography (CECT) abdomen to predict feasibility of LRN for large renal masses between 10 and 15 cm. Methods From January 2005 to December 2015, renal tumors between 10 and 15 cm were selected retrospectively for LRN. Patients with retroperitoneal lymphadenopathy, Inferior vena cava (IVC) thrombus and involvement of adjacent organs were excluded. Anteroposterior (AP) diameter ratio of renal tumor and abdomen (APROTA) was calculated by dividing the maximum AP diameter of tumor along with normal renal parenchyma, by the AP diameter of abdomen on CECT. The patients were stratified into two groups: Group A (successful LRN) and Group B (conversion to open surgery) and outcomes were compared. The reasons for conversion were also noted. Results Of 29 patients, 16 (55.2%) had successful LRN (Group A), while 13 (44.8%) had conversion to open surgery (group B). The median tumor size in Group A was 11.3 ± 1.8 cm and in Group B was 13.6 ± 1.26 cm. Eleven of 13 patients had conversion due to large tumor size causing failure to progress. Two conversions were due to bleeding and injury to the colon each. There was a significant difference in the APROTA in group A and B [0.43 ± 0.09 in group A and 0.64 ± 0.14 in group B (p = 0.0001)]. Conclusions Patients with APROTA of more than 0.65 are unlikely to have successful outcome with LRN.
Teach First Norway - who joins and what are their initial motivations for teaching?
Authors: Nesje Katrine 
Published: August 2017

Motivasjon for å undervise er et tema som er mye diskutert i offentlige debatter og i forskningslitteraturen. Grunnen til dette er at læreres profesjonelle motivasjon har vist seg å påvirke elevenes motivasjon, læreres tilfredshet i jobben, fravær og turnover i læreryrket, samt rekruttering av nye lærere. Alternative lærerutdanninger som tilbyr en raskere vei inn i læreryrket har i de senere årene blitt etablert, både i Norge og internasjonalt. Denne studien undersøker om den profesjonelle motivasjonen til kandidater som rekrutteres til disse programmene har spesielle kjennetegn. Artikkelen undersøker både motivasjon for undervisning og motivasjon for å delta i det alternative lederopplærings- og lærerutdanningsprogrammet Teach First Norway. Datamaterialet består av spørreskjemadata og intervjudata fra ett kull (N=13) Teach First Norway-kandidater. Basert på spørreskjemadata ble det utført en klyngeanalyse som fant tre motivasjonsprofiler: “Lav altruistisk motivasjon”, “Interesse for undervisning” og “Høy altruistisk motivasjon”. Ved hjelp av kvalitative intervjuer ble motivasjonsprofilene utdypet. Resultatene viser at samspillet mellom deltakernes ulike motivasjonsfaktorer er kompleks og unik. Det stereotype bildet av en Teach First Norway-kandidat som bruker programmet som et springbrett inn i lederstillinger i næringslivet nyanseres som følge av funnene.Nøkkelord: alternativ lærerutdanning, motivasjon for å undervise, karriere, Teach First NorwayAbstractTeacher motivation is a widely discussed topic in public debates and educational research literature. Prior research has found that teachers’ professional motivation impacts students’ motivation, teachers’ professional satisfaction, teacher absenteeism and turnover, as well as the recruitment of new teachers. Recently, the introduction of alternative teacher education programmes has provided a faster way into the teaching profession. This study investigates specific characteristics of the professional motivations of candidates recruited to these programmes. The article reports both the motivations for teaching and reasons for attending the alternative teacher education programme Teach First Norway (TFN). For descriptive purposes a cluster analysis was performed based on survey data from one cohort (N=13) of TFN candidates. Three motivational profiles emerged: ‘low altruistic motivation’, ‘high interest in teaching’ and ‘predominant altruistic motivation’. The profiles were further explored through qualitative interviews. The results show that the interplay between participants’ motivations is complex and unique. The stereotypical image of a TFN candidate that uses the programme as a springboard into management positions in businesses becomes more nuanced as a result of these findings.Keywords: alternative teacher education, motivations to teach, careers, Teach First