bluuebunny/crossref_metadata_2025_split huggingface dataset:
Misoprostol for Prevention of Postpartum Hemorrhage at Home Birth in Afghanistan: Program Expansion Experience
Authors: Haver Jaime , Ansari Nasratullah , Zainullah Partamin , Kim Young‐Mi , Tappis Hannah 
Published: February 2016

IntroductionAfghanistan has a maternal mortality ratio of 400 per 100,000 live births. Hemorrhage is the leading cause of maternal death. Two‐thirds of births occur at home. A pilot program conducted from 2005 to 2007 demonstrated the effectiveness of using community health workers for advance distribution of misoprostol to pregnant women for self‐administration immediately following birth to prevent postpartum hemorrhage. The Ministry of Public Health requested an expansion of the pilot to study implementation on a larger scale before adopting the intervention as national policy. The purpose of this before‐and‐after study was to determine the effectiveness of advance distribution of misoprostol for self‐administration across 20 districts in Afghanistan and identify any adverse events that occurred during expansion.MethodsCross‐sectional household surveys were conducted pre‐ (n = 408) and postintervention (n = 408) to assess the effect of the program on uterotonic use among women who had recently given birth. Maternal death audits and verbal autopsies were conducted to investigate peripartum maternal deaths that occurred during implementation in the 20 districts.ResultsUterotonic use among women in the sample increased from 50.3% preintervention to 74.3% postintervention. Because of a large‐scale investment in Afghanistan in training and deployment of community midwives, it was assumed that all women who gave birth in facilities received a uterotonic. A significant difference in uterotonic use at home births was observed among women who lived farthest from a health facility (> 90 minutes self‐reported travel time) compared to women who lived closer (88.5% vs 38.9%; P < .0001). All women who accepted misoprostol and gave birth at home used the drug. No maternal deaths were identified among those women who used misoprostol.DiscussionThe results of this study build on the findings of the pilot program and provide evidence on the effectiveness, primarily measured by uterotonic use, of an expansion of advance distribution of misoprostol for self‐administration.
Physical exercise as a treatment for adult and juvenile myositis
Authors: Alexanderson H. 
Published: February 2016

AbstractThere is growing evidence to support the safety and efficacy of exercise in patients with adult and juvenile idiopathic inflammatory myopathies. Five randomized controlled trials including adult patients with polymyositis and dermatomyositis (DM) and additional open studies have demonstrated reduced impairment and activity limitation as well as improved quality of life. In addition, recent studies have shown reduced disease activity assessed by consensus disease activity measures and reduced expression of genes regulating inflammation and fibrosis. Furthermore, exercise could improve muscle aerobic capacity as shown by increased mitochondrial enzyme activity. These data suggest that intensive aerobic exercise and resistance training could reduce disease activity and inflammation and improve muscle metabolism. Encouraging results have been reported from available open studies including patients with inclusion body myositis (IBM) and juvenile DM, indicating reduced impairment, activity limitation and improved quality of life also in these patients. Larger studies are needed to increase understanding of the effects of exercise in patients with active, recent‐onset polymyositis and DM as well as in patients with IBM and juvenile DM.
Phase‐Contrast Magnetic Resonance Angiography for the Determination of Cerebrovascular Reserve
Authors: Patrick James T. , Fritz Joseph V. , Adamo John M. , Dandonna Paresh 
Published: February 2016

AbstractCerebrovascular reserve (CVR) is the potential for cerebral arteriolar dilatation to occur, in response to decreased cerebral perfusion pressure, in order to maintain constant cerebral blood flow. Diminution or absence of CVR is considered a risk factor for stroke. Current methods for determining CVR include singlephoton emission computed tomography, positron emission tomography and transcranial Doppler (TCD) ultrasonography. However, significant advantages could derive from the utilization of magnetic resonance angiography (MRA) based on the concurrent acquisition of hemodynamic information (CVR and collateral flow) with phase‒contrast (PC) techniques and vascular morphology with three‒dimensional, time‒of‒flight methods. With a 1.5‒T scanner and acetazolamide (AZM), an arteriolar dilator, CVR was determined in 7 normal subjects. Mean flow velocity in the middle cerebral arteries was determined by PC MRA before and after AZM administration. For comparative purposes, mean flow velocities in the same middle cerebral arteries were determined by TCD before and after AZM administration. The mean flow velocities were as follows (mean ± standard deviation, n = 7): 40 ± 8 (PC MRA) versus 61 ±10 cm/sec (TCD) before AZM treatment and 58 ±11 (PC MRA) versus 85 ±15 cm/sec (TCD) after AZM administration. The increase in mean flow velocity (before vs after AZM), that is, the CVR, was 45 ±11 % as shown by PC MRA and 39 ± 14% as shown by TCD. Although significant differences were present between the mean flow velocities measured before and those after AZM administration, as determined by PC MRA and TCD, the CVR was not significantly different (45 vs 39%, respectively). These preliminary results suggest that PC MRA may be a method for determining CVR.
Clinical Significance of Increased Uptake of HMPAO on Brain SPECT Scans in Acute Stroke
Authors: Alexandrov Andrei V. , Ehrlich Lisa E , Bladin Christopher F. , Black Sandra E. 
Published: February 2016

AbstractSingle‐photon emission computed tomography (SPECT) with 99mtechnetium‐hexamethylpropylamineoxirne (HMPAO) non‐invasively shows brain perfusion in patients after acute stroke. However, the clinical significance of the increased HMPAO uptake remains unclear. In this study, consecutive patients with hemispheric hemorrhagic and ischemic stroke admitted to the hospital were evaluated prospectively. The increased uptake of HMPAO was determined by visual analysis of SPECT images. The pathogenic mechanism of ischemic stroke was determined using the clinical and computed tomography (CT) criteria including the Toronto Embolic Scale. Of the 500 consecutive patients with acute hemispheric stroke, SPECT was performed in 458 at a mean time of 5 ± 7 days after the onset of symptoms. A strong association was found between SPECT perfusion patterns and pathogenic subtypes of stroke (p < 0.0001). Thus, in 95% of patients with intracerebral hemorrhage the focal absence of perfusion was found, and 26% of lacunar infarctions presented with a normal SPECT appearance. The mean volume of lacunar lesions that did not produce significant abnormalities on SPECT was 2.5 ± 1.2 ml. Increased HMPAO uptake was associated with a cardioembolic mechanism of stroke: High and mixed perfusion patterns were present subacutely in 29% of patients with cardioembolic stroke, compared to 15% of patients with other types of ischemic stroke (p ≤ 0.0006). The increased uptake of HMPAO on SPECT as determined by visual analysis is associated with a cardioembolic mechanism of cerebral ischemia, which could be explained by glutathione‐mediated trapping of the tracer during reperfusion and later in newly developed granulation tissue. HMPAO‐SPECT may help in early management decisions since it indicates stroke pathogenesis and evolution.
Serial Transcranial Doppler Monitoring after Transient Ischemic Attack
Authors: Eicker B. Martin , von Lorentz Johannes , Paulus Walter , Tegeler Charles H. 
Published: February 2016

AbstractThe natural course of ultrasonically detectable microembolism in patients with a symptomatic extracranial atherosclerotic lesion is not completely understood. Furthermore, the potential impact of therapeutic management on microemboli detection is anecdotal. A 58‐year‐old man who experienced a left‐hemisphere transient ischemic attack presented with an extracranial ipsilateral high‐grade carotid stenosis. He was studied 12 times in 12 months during different medical management, during which time he was symptom free, even though transcranial Doppler evidence of microemboli continued for 5 months.
Magnetic Resonance Imaging of Corticobasal Degeneration
Authors: Hauser Robert A. , Murtaugh F. Reed , Akhter Kauser , Gold Michael , Olanow C. W. 
Published: February 2016

AbstractCorticobasal degeneration (CBD) is an adult–onset, progressive parkinsonian syndrome with strikingly asymmetrical features, and signs and symptoms referable to both cerebral cortex and basal ganglia. Although once considered rare, it is now recognized with increasing frequency during life. Eight patients with clinically diagnosed CBD and 8 age– and sex–matched patients with Parkinson's disease underwent high–field–strength magnetic resonance imaging (MRI) of the brain. MRIs were graded by a blinded neuroradiologist using a semiquantitative (0–3) scale. MRI of patients with CBD revealed significantly greater T2–weighted signal hypointensity in the putamena and globi pallidi, and ventricular enlargement. When specifically sought, asymmetrical cortical atrophy was identified in 5 of 8 CBD patients. Increased T2–weighted lenticular signal hypointensity, ventricular enlargement, and asymmetrical cortical atrophy are supportive MRI findings of CBD.
Primary Diffuse Leptomeningeal Gliomatosis with Signs of Increased Intracranial Pressure and Progressive Meningeal Enhancement on MRI
Authors: Park Justin S. , Van den Noort Stanley , Kim Ronald C. , Walot Irwin , Licht Harvey 
Published: February 2016

AbstractA 21‐year‐old woman presented with a 5‐month history of meningeal signs and evidence of intracranial hypertension and, as shown by magnetic resonance imaging (MRI), progressively more extensive meningeal enhancement, particularly within the spinal canal. Autopsy disclosed the presence of primary diffuse leptomeningeal gliomatosis with spinal cord predominance, possibly arising within heterotopic leptomeningeal glial tissue in the cervical region. No parenchymal primary lesion was identified. MRI with gadolinium appears to be the imaging modality of choice for the early detection of primary diffuse leptomeningeal neoplasia.
Stenting: A New Approach to Carotid Dissection
Authors: DeOcampo Jose , Brillman Jon , Levy David I. 
Published: February 2016

AbstractA patient with bilaterally occluded internal carotid arteries had a right hemispheric stroke followed by a left cerebral infarction, secondary to dissection from fibro–muscular dysplasia, seen also in the vertebral arteries. The occluded left carotid was reopened and stents placed, with apparent reestablishment of left hemispheric blood flow. The speech and other deficits resolved. Although its use is under investigation, percutaneous balloon angioplasty with stents may be an appropriate intervention when other measures do not prevent progressive ischemic events.
Degeneration of the Pyramidal Tracts in Patients with Amyotrophic Lateral Sclerosis
Authors: Abe, Kazuo , Fujimura, Harutoshi , Kobayashi, Yasuo , Fujita, Norihiko , Yanagihara, Takehiko 
Published: February 2016

AbstractTo investigate focal hyperintensity in the internal capsule (1C) on magnetic resonance images (MRIs) and its clinical significance, 80 patients with amyotrophic lateral sclerosis (ALS) and 80 sex‐ and age‐matched normal control subjects were studied. On T2‐weighted images, hyperintense foci were found in the posterior part of the posterior limb (PL) of the 1C in 41 (51 %) of 80 control subjects. However, no subject showed increased signal intensities on proton density‐weighted images. Hyperintense foci were also observed in the posterior part of the PL of the IC on T2‐weighted images in 52 (65%) of 80 ALS patients and on proton density‐weighted images in 26 (65%) of 40 ALS patients; the abnormally intense foci were seen at the same anatomical location in the IC as those in the normal control subjects. On postmortem MRI, the abnormally intense foci were found in the posterior part of the PL of the IC in the formalin‐ fixed brains from 9 ALS patients. Three normal control subjects did not show signal intensity changes on postmortem MRI. On histological examination of 9 ALS brains, distinct myelin pallor and gliosis were found in the posterior third of the PL of the IC. Proton density‐weighted images appear to be useful to distinguish neuropathological changes in the corticospinal tract of ALS patients.
Transcranial Doppler in 178 Patients Before, During, and After Carotid Endarterectomy
Authors: Gossetti Bruno , Martinelli Ombretta , Guerricchio Renato , lrace Luigi , Benedetti-Valentini Fabrizio 
Published: February 2016

AbstractFrom July 1991 to March 1995, 178 patients who underwent 198 carotid surgical repairs were investigated preoperatively, intraoperatively, and postoperatively by transcranial Doppler sonography (TCD). Preoperative TCD evaluation showed stenosis of the middle cerebral artery (MCA) in 4 patients (2.2%), siphon stenosis in 3 (1.6%), incomplete circle of Willis in 23 (12.9%), a decrease of mean blood flow velocity more than 70% of the basal value during digital common carotid compression in 31 (17.9%), and a critical reduction of vasomotor reactivity (no significant increase of mean blood flow velocity in the MCA during breath–holding test) in 34 (19.1%). Nine patients (5%) had surgery without preoperative angiography. In those patients the indication for surgery was based on color Doppler imaging and TCD investigations. Ninety surgical procedures were carried out under general anesthesia and 108 under locoregional anesthesia. In 37 surgeries (31.7%) a shunt was inserted: The use of a shunt was based on a decrease of mean blood flow velocity in the MCA below 50% of the basal value under general anesthesia or loss of consciousness combined with a decrease of mean blood flow velocity in the MCA higher than 70% of the basal value when locoregional anesthesia was employed. lntraoperative TCD monitoring showed a decrease of mean blood flow velocity in the MCA due to shunt malfunction in (8.3%) of 36 surgeries, turbulence of blood flow during declamping in 79 procedures (39.8%), and microembolic events in 10 patients (5%) that were related to one transient and one permanent neurological deficit. Another permanent deficit occurred in a patient without TCD signs. After surgery, TCD reliably detected an early asymptomatic occlusion of the carotid artery, hyperperfusion syndrome in 12 (6.0%), and an increase of vasomotor reactivity in 10 (29.4%) of 34 surgeries.
Extensive Reversible Brain Magnetic Resonance Lesions in a Patient with HELLP Syndrome
Authors: Feske Steven K. , Sperling Reisa A. , Schwartz Richard B. 
Published: February 2016

AbstractA severe form of toxemia of pregnancy with microangiopathic hemolytic anemia, elevated /iver enzymes, and /ow platelets has been called the HELLP syndrome. A patient with the HELLP syndrome developed a severe, reversible encephalopathy. Brain computed tomography and magnetic resonance imaging showed abnormalities consistent with edema limited to the posterior circulation territory. The location of the lesions and their occurrence in the HELLP syndrome support suggestions that the vulnerability of posterior structures in eclamptic encephalopathy is due to a vascular susceptibility of the posterior circulation and that endothelial cell dysfunction plays an important role in the pathogenesis of eclamptic encephalopathy.
Clinical Significance of Intraplaque Hemorrhage in Carotid Artery Disease
Authors: Sillesen Henrik , Nielsen Tina 
Published: February 2016

AbstractPrevious research has indicated that intraplaque hemorrhage is a significant pathogenetic factor in carotid artery disease. The present study was undertaken to evaluate whether the clinical presentation of patients with carotid artery disease could be correlated to quantitative histologic analysis of surgically removed carotid specimens. Two–hundred–seventy patients undergoing carotid endarterectomy comprised the material Symptomatology was assessed preoperatively. After removal, the carotid plaques were analyzed histologically for relative volume content of hemorrhage, fatty tissue, fibrous tissue, and calcification. There was no difference between asymptomatic and symptom atic patients. However, when the time interval between onset of symptoms and surg~ ry was considered, plaques from patients with recent symptoms contained more hemorrhage compared with plaques from asymptomatic patients (p = 0.0045). The paper supports the theory of intraplaque hemorrhage being related to clinical events in carotid artery disease.
The Clinical Relevance of Cerebral Microemboli Detection by Transcranial Doppler Ultrasound
Authors: Zuilen, Erik V. , Van Gijn, Jan , Ackerstaff, Rob G. A. 
Published: February 2016

AbstractThis article reviews the studies on the detection of microemboli by transcranial Doppler ultrasound and the insight these studies have provided into the role of microemboli in the pathogenesis of symptomatic cerebral ischemia.
Multiple Cerebral Pseudoaneurysms and Hemorrhages: The Expanding Spectrum of Metastatic Cerebral Choriocarcinoma
Authors: Kalafut Mary , Vinuela Fernando , Saver Jeffrey L. , Martin Neil , Vespa Paul , Verity M. Anthony 
Published: February 2016

AbstractCerebral metastases occur in 10–20% of patients with choriocarcinoma. Although single oncotic and pseudoaneurysms have been reported, multiple pseudoaneurysms and hemorrhages are rare. A 33–year–old woman developed 10 intracerebral hemorrhages over a 30–day period. Angiogram showed multiple focal areas of delayed contrast washout in distal vessels. Autopsy revealed intravascular choriocarcinoma without true aneurysm formation. A diagnosis of choriocarcinoma should be considered for women of childbearing age presenting with cerebrovascular syndromes, especially those found to have cerebral aneurysm, pseudoaneurysm, and/or hemorrhage.
Quantitative Cerebral Perfusion SPECT in Systemic Lupus Erythematosus with Severe Central Nervous Involvement—Before and After Methylprednisolone Pulse Therapy
Authors: You Dong-Ling , Tzen Kai-Yuan , Kao Pan-Fu , Tsai Ming-Fong 
Published: February 2016

AbstractSevere cerebral involvement may occur in patients with systemic lupus erythematosus. Methylprednisolone pulse therapy is a management choice for those with severe cerebral involvement. However, its effectiveness is uncertain. This article describes Tc‐99m HMPAO cerebral perfusion singlephoton emission computerized tomography to document the restoration of cerebral perfusion after methylprednisolone pulse therapy in a case of systemic lupus erythromatosus with severe cerebral manifestations.
Three‐Dimensional Bioprinting Materials with Potential Application in Preprosthetic Surgery
Authors: Fahmy Mina D. , Jazayeri Hossein E. , Razavi Mehdi , Masri Radi , Tayebi Lobat 
Published: February 2016

AbstractCurrent methods in handling maxillofacial defects are not robust and are highly dependent on the surgeon's skills and the inherent potential in the patients’ bodies for regenerating lost tissues. Employing custom‐designed 3D printed scaffolds that securely and effectively reconstruct the defects by using tissue engineering and regenerative medicine techniques can revolutionize preprosthetic surgeries. Various polymers, ceramics, natural and synthetic bioplastics, proteins, biomolecules, living cells, and growth factors as well as their hybrid structures can be used in 3D printing of scaffolds, which are still under development by scientists. These scaffolds not only are beneficial due to their patient‐specific design, but also may be able to prevent micromobility, make tension free soft tissue closure, and improve vascularity. In this manuscript, a review of materials employed in 3D bioprinting including bioceramics, biopolymers, composites, and metals is conducted. A discussion of the relevance of 3D bioprinting using these materials for craniofacial interventions is included as well as their potential to create analogs to craniofacial tissues, their benefits, limitations, and their application.
The History of Articulators: The Contributions of Rudolph L. Hanau and His Company—Part II
Authors: Engelmeier Robert L. , Belles Donald M. , Starcke Edgar N. 
Published: February 2016

AbstractThis article is an historical overview of the Hanau Engineering Company from the time of Rudolph Hanau's death in 1930 to the present. It explores the development of many articulators intended both for removable and fixed prosthodontic restorations. The article is divided into the eras of the company's corporate history, and it reviews articulator designs and major improvements made during each of those periods.
Application of An Eating Motivation Survey to Study Eating Occasions
Authors: Phan Uyen T.X. , Chambers Edgar 
Published: February 2016

AbstractThis pilot study applied an eating motivation survey to explore motivations behind eating occasions by looking at specific choices of foods and beverages people consumed at various meal times. This study was conducted online with 198 people. The survey included questions about demographics, the most recent meal including specific food choices and an eating motivation questionnaire which contained 50 subscales to measure 17 motivations using Check‐All‐That‐Apply procedures. Data were analyzed by Correspondence Analysis. Liking was the strongest motivation that drove people to select certain foods, regardless of eating occasions. Need and Hunger, Habits, Price and Convenience were the main motivations for breakfast, lunch and dinner while Health and Weight Control were found to be the main driving factors for daytime snacking. Late‐night snacks were linked to Pleasure and Visual appeal. For dinner, people were additionally motivated by Variety Seeking and Traditional Eating.Practical ApplicationsDaily food choice is a complex decision influenced by various factors and eating context is one of those. Food selection and the motivations of those selections are dependent on liking, but other motivators differed across eating occasions. This suggests that the intended meal time is a key factor that should be considered when testing food and beverage products.
Evaluating the suitability of maggot meal as a partial substitute of soya bean on the productive traits, digestibility indices and organoleptic properties of broiler meat
Authors: Khan S. , Khan R. U. , Sultan A. , Khan M. , Hayat S. U. , Shahid M.S. 
Published: February 2016

SummaryThis study was conducted to replace soya bean meal with maggot meal at difference percentages. A total of 120 one‐day‐old broiler chicks were divided into four groups. Four diets were formulated with maggot meal to replace soya bean meal at the rate of 0%, 10%, 20% and 30% designated as A, B, C and D respectively. Feed and water were offered ad libitum during the study which lasted for 28 days. Feed intake decreased significantly in treated groups while body weight, Feed conversion ratio and dressing percentage increased significantly in group D. Apparent metabolizable energy increased significantly in the group fed 30% maggot meal; however, no significant difference was found in dry matter, crude protein, crude fibre, ether extract, ash and nitrogen free extract between the control and treated groups. The result of sensory evaluation revealed that tenderness and juiciness increased significantly in group C and B respectively. The colour and flavour were most accepted in group B and C. The results indicate that replacement of soya bean meal at the rate of 30% in broiler feed produced most favourable results.