bluuebunny/crossref_metadata_2025_split huggingface dataset:
A microcontroller-based simulation of dural venous sinus injury for neurosurgical training
Authors: Cleary Daniel R. , Siler Dominic A. , Whitney Nathaniel , Selden Nathan R. 
Published: June 2017

OBJECTIVESurgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year.METHODSThe simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus.RESULTSTwelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course (“boot camp”) provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey.CONCLUSIONSAll trainee participants experienced tachycardia during the simulation, although the point in the simulation at which they experienced tachycardia varied. Survey results indicated that participants agreed the simulation was realistic, created stress, and was a useful tool in training neurosurgical residents. This simulator represents a novel, low-cost approach for hands-on training that effectively teaches and tests residents without risk of patient injury.
Korsakoff syndrome from retrochiasmatic suprasellar lesions: rapid reversal after relief of cerebral compression in 4 cases
Authors: Savastano Luis E. , Hollon Todd C. , Barkan Ariel L. , Sullivan Stephen E. 
Published: June 2017

Korsakoff syndrome is a chronic memory disorder caused by a severe deficiency of thiamine that is most commonly observed in alcoholics. However, some have proposed that focal structural lesions disrupting memory circuits—in particular, the mammillary bodies, the mammillothalamic tract, and the anterior thalamus—can give rise to this amnestic syndrome. Here, the authors present 4 patients with reversible Korsakoff syndromes caused by suprasellar retrochiasmatic lesions compressing the mammillary bodies and adjacent caudal hypothalamic structures.Three of the patients were found to have large pituitary macroadenomas in their workup for memory deficiency and cognitive decline with minimal visual symptoms. These tumors extended superiorly into the suprasellar region in a retrochiasmatic position and caused significant mass effect in the bilateral mammillary bodies in the base of the brain. These 3 patients had complete and rapid resolution of amnestic problems shortly after initiation of treatment, consisting of resection in 1 case of nonfunctioning pituitary adenoma or cabergoline therapy in 2 cases of prolactinoma. The fourth patient presented with bizarre and hostile behavior along with significant memory deficits and was found to have a large cystic craniopharyngioma filling the third ventricle and compressing the midline diencephalic structures. This patient underwent cyst fenestration and tumor debulking, with a rapid improvement in his mental status. The rapid and dramatic memory improvement observed in all of these cases is probably due to a reduction in the pressure imposed by the lesions on structures contiguous to the third ventricle, rather than a direct destructive effect of the tumor, and highlights the essential role of the caudal diencephalic structures—mainly the mammillary bodies—in memory function.In summary, large pituitary lesions with suprasellar retrochiasmatic extension and third ventricular craniopharyngiomas can cause severe Korsakoff-like amnestic syndromes, probably because of bilateral pressure on or damage to mammillary bodies, anterior thalamic nuclei, or their major connections. Neuropsychiatric symptoms may rapidly and completely reverse shortly after initiation of therapy via surgical decompression of tumors or pharmacological treatment of prolactinomas. Early identification of these lesions with timely treatment can lead to a favorable prognosis for this severe neuropsychiatric disorder.
Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis
Authors: Zacharia Brad E. , Kahn Sweena , Bander Evan D. , Cederquist Gustav Y. , Cope William P. , McLaughlin Lily , Hijazi Alexa , Reiner Anne S. , Laufer Ilya , Bilsky Mark 
Published: June 2017

OBJECTIVEThe authors of this study aimed to identify the incidence of and risk factors for preoperative deep venous thrombosis (DVT) in patients undergoing surgical treatment for spinal metastases.METHODSUnivariate analysis of patient age, sex, ethnicity, laboratory values, comorbidities, preoperative ambulatory status, histopathological classification, spinal level, and surgical details was performed. Factors significantly associated with DVT univariately were entered into a multivariate logistic regression model.RESULTSThe authors identified 314 patients, of whom 232 (73.9%) were screened preoperatively for a DVT. Of those screened, 22 (9.48%) were diagnosed with a DVT. The screened patients were older (median 62 vs 55 years, p = 0.0008), but otherwise similar in baseline characteristics. Nonambulatory status, previous history of DVT, lower partial thromboplastin time, and lower hemoglobin level were statistically significant and independent factors associated with positive results of screening for a DVT. Results of screening were positive in only 6.4% of ambulatory patients in contrast to 24.4% of nonambulatory patients, yielding an odds ratio of 4.73 (95% CI 1.88–11.90). All of the patients who had positive screening results underwent preoperative placement of an inferior vena cava filter.CONCLUSIONSPatients requiring surgery for spinal metastases represent a population with unique risks for venous thromboembolism. This study showed a 9.48% incidence of DVT in patients screened preoperatively. The highest rates of preoperative DVT were identified in nonambulatory patients, who were found to have a 4-fold increase in the likelihood of harboring a DVT. Understanding the preoperative thrombotic status may provide an opportunity for early intervention and risk stratification in this critically ill population.
Depression as an independent predictor of postoperative delirium in spine deformity patients undergoing elective spine surgery
Authors: Elsamadicy Aladine A. , Adogwa Owoicho , Lydon Emily , Sergesketter Amanda , Kaakati Rayan , Mehta Ankit I. , Vasquez Raul A. , Cheng Joseph , Bagley Carlos A. , Karikari Isaac O. 
Published: June 2017

OBJECTIVEDepression is the most prevalent affective disorder in the US, and patients with spinal deformity are at increased risk. Postoperative delirium has been associated with inferior surgical outcomes, including morbidity and mortality. The relationship between depression and postoperative delirium in patients undergoing spine surgery is relatively unknown. The aim of this study was to determine if depression is an independent risk factor for the development of postoperative delirium in patients undergoing decompression and fusion for deformity.METHODSThe medical records of 923 adult patients (age ≥ 18 years) undergoing elective spine surgery at a single major academic institution from 2005 through 2015 were reviewed. Of these patients, 255 (27.6%) patients had been diagnosed with depression by a board-certified psychiatrist and constituted the Depression group; the remaining 668 patients constituted the No-Depression group. Patient demographics, comorbidities, and intra- and postoperative complication rates were collected for each patient and compared between groups. The primary outcome investigated in this study was rate of postoperative delirium, according to DSM-V criteria, during initial hospital stay after surgery. The association between depression and postoperative delirium rate was assessed via multivariate logistic regression analysis.RESULTSPatient demographics and comorbidities other than depression were similar in the 2 groups. In the Depression group, 85.1% of the patients were taking an antidepressant prior to surgery. There were no significant between-group differences in intraoperative variables and rates of complications other than delirium. Postoperative complication rates were also similar between the cohorts, including rates of urinary tract infection, fever, deep and superficial surgical site infection, pulmonary embolism, deep vein thrombosis, urinary retention, and proportion of patients transferred to the intensive care unit. In total, 66 patients (7.15%) had an episode of postoperative delirium, with depressed patients experiencing approximately a 2-fold higher rate of delirium (10.59% vs 5.84%). In a multivariate logistic regression analysis, depression was an independent predictor of postoperative delirium after spine surgery in spinal deformity patients (p = 0.01).CONCLUSIONSThe results of this study suggest that depression is an independent risk factor for postoperative delirium after elective spine surgery. Further studies are necessary to understand the effects of affective disorders on postoperative delirium, in hopes to better identify patients at risk.
The effects of a calisthenics training intervention on posture, strength and body composition
Authors: Thomas E. , Bianco A. , Mancuso E.P. , Patti A. , Tabacchi G. , Paoli A. , Messina G. , Palma A. 
Published: June 2017

BACKGROUND: Calisthenics was a term used to define a generic set of body weight exercises. Such term is now used to define a world wide spread discipline based on body weight and gymnastics exercises. OBJECTIVE: The aim of this study was to administer a calisthenics training protocol and evaluate its effects on posture, strength and body composition in untrained individuals. METHODS: Twenty-eight male participants (24.2 [Formula: see text] 4.2 years; 67.0 [Formula: see text] 8.3 Kg; 173.3 [Formula: see text] 5.2 cm) were divided into two groups, a Calisthenics based intervention group (SG) and a control group (CG). The SG exercised for 8 weeks. Each participant underwent a body composition analysis, a postural assessment, a handgrip test, a push-up and a pull-up test. Each participant was tested at baseline and post intervention. RESULTS: The SG improved their posture (with open eyes [Formula: see text] 0.001 and with closed eyes [Formula: see text] 0.05), their strength (push-up test [Formula: see text] 0.01 with a 16.4% increase and pull up test [Formula: see text] 0.0001 with a 39.2% increase) and their body composition (Fat mass 14.8 [Formula: see text] 5.1 vs. 11.4 [Formula: see text] 5.9, [Formula: see text] 0.01). No difference was shown for the handgrip test. No significant differences were displayed in any variable of the CG between pre and post measures. CONCLUSIONS: Calisthenics training is a feasible and effective training solution to improve posture, strength and body composition without the use any major training equipment.
Research on highly sensitive optomagnetic sensor for rapid detection of inflammation
Authors: Liu Chunxiu , Cai Haoyuan , Jia Jian , Cao Tianyang , Xu Chenghua , Liu Chang 
Published: June 2017

BACKGROUND: C-reactive protein (CRP) is used to evaluate the evolution of infections and sepsis in critically ill patients. For POCT testing, biosensor-based detection techniques offer quick and convenient application. OBJECTIVE: A prototype three dimensional chip was fabricated based on a new optomagnetic method to achieve the rapid detection of CRP. METHODS: This work investigates a new technology for the quick quantitative detection of the C-reactive protein (CRP) by total internal reflection magnetic imaging (TIRMI) on a three dimensional optomagnetic sensor. Transparent glass and hydrophilic plastic film with channels were used to construct the three dimensional sensor. The magnetic nanoparticles and immunological reagent were immobilized on the reaction area of the sensor. Samples were detected using total internal reflection magnetic spot imaging (TIRMI) based on a sandwich magnetic immunoassay by one-step assay. RESULTS: The developed 3D biosensor-TIRMI method showed a wide dynamic linear range (0.2–200 ng/ml) and quick detection (5 min) with low-sample volume (10 [Formula: see text]L). CONCLUSIONS: We have presented a three dimensional optical protein chip that fulfills the demanding for point-of-care diagnostics in terms of ease-of-use (one step assay), miniaturization, assay time. This approach shows great promise for application in clinical investigations of biological samples.
A surface acoustic wave ICP sensor with good temperature stability
Authors: Zhang Bing , Hu Hong , Ye Aipeng , Zhang Peng 
Published: June 2017

BACKGROUND: Intracranial pressure (ICP) monitoring is very important for assessing and monitoring hydrocephalus, head trauma and hypertension patients, which could lead to elevated ICP or even devastating neurological damage. The mortality rate due to these diseases could be reduced through ICP monitoring, because precautions can be taken against the brain damage. OBJECTIVE: This paper presents a surface acoustic wave (SAW) pressure sensor to realize ICP monitoring, which is capable of wireless and passive transmission with antenna attached. METHODS: In order to improve the temperature stability of the sensor, two methods were adopted. First, the ST cut quartz was chosen as the sensor substrate due to its good temperature stability. Then, a differential temperature compensation method was proposed to reduce the effects of temperature. Two resonators were designed based on coupling of mode (COM) theory and the prototype was fabricated and verified using a system established for testing pressure and temperature. RESULTS: The experiment result shows that the sensor has a linearity of 2.63% and hysteresis of 1.77%. CONCLUSIONS: The temperature stability of the sensor has been greatly improved by using the differential compensation method, which validates the effectiveness of the proposed method.
Relationship Between Polymorphisms in Methotrexate Pathway Genes and Outcome of Methotrexate Treatment in a Cohort of 119 Patients with Juvenile Idiopathic Arthritis
Authors: Zajc Avramovič Mojca , Dolžan Vita , Toplak Nataša , Accetto Meta , Lusa Lara , Avčin Tadej 
Published: June 2017

Objective.To identify clinical and pharmacogenetic determinants of efficacy and toxicity of methotrexate (MTX) in juvenile idiopathic arthritis (JIA) over time.Methods.A cohort of 119 consecutive patients with JIA treated with MTX was reviewed. The Juvenile Arthritis Disease Activity Score including 71 joints was used to measure disease activity. Nonresponders were patients who did not reach a minimum of 30% improvement after 6 months of treatment or were switched to biologic drugs in the first 6 months because of inefficacy. All adverse events (AE) were noted. Genotyping of single-nucleotide polymorphisms (SNP) in the genes coding for MTX transporters, folate pathway, and adenosine pathway was performed using real-time PCR methods. Univariate and multivariable penalized logistic and Cox regression were used to analyze data.Results.Thirty patients (25.8%) were defined as nonresponders and 55 (47.2%) were switched to biologics during the followup. Sixty-five patients (54.5%) reported AE in a total of 405 patient-years, and 10 patients (8.4%) discontinued MTX because of AE. AMPD1 rs17602729 and MTHFD1 rs2236225 were associated with gastrointestinal AE while the latter together with MTRR rs1801394 also demonstrated associations with developing hepatoxicity. MTHFR rs1801131, ABCG2 rs2231137, wild-type of MTR rs1805087, and wild-type of ABCC2 rs2273697 were identified as potential markers for discontinuing MTX treatment because of AE. MTHFR rs1801133, MTRR rs1801394, and ABCC2 rs2273697 were associated with switching to biologics.Conclusion.SNP in different MTX metabolic pathways influence treatment with MTX. Genetic variability is a better marker for toxicity than efficacy.
Cellular Automata as an Example for Advanced Beginners’ Level Coding Exercises in a MOOC on Test Driven Development
Authors: Staubitz Thomas , Teusner Ralf , Meinel Christoph , Prakash Nishanth 
Published: June 2017

Programming tasks are an important part of teaching computer programming as they foster students to develop essential programming skills and techniques through practice. The design of educational problems plays a crucial role in the extent to which the experiential knowledge is imparted to the learner both in terms of quality and quantity. Badly designed tasks have been known to put-off students from practicing programming. Hence, there is a need for carefully designed problems. Cellular Automata programming lends itself as a very suitable candidate among problems designed for programming practice. In this paper, we describe how various types of problems can be designed using concepts from Cellular Automata and discuss the features which make them good practice problems with regard to instructional pedagogy. We also present a case study on a Cellular Automata programming exercise used in a MOOC on Test Driven Development using JUnit, and discuss the automated evaluation of code submissions and the feedback about the reception of this exercise by participants in this course. Finally, we suggest two ideas to facilitate an easier approach of creating such programming exercises.
The effects of macroeconomic instability and inflation on sustainable real growth in South African firms
Authors: Beaumont-Smith M , Murray LW , N’Cho-Oguie C , Blakley DL 
Published: June 2017

This empirical study is an investigation of the impact that inflation and other factors have had on the growth of business firms in South Africa. Using the model of sustainable growth, an empirical multivariate model is developed to test a variety of assumed relationships and to isolate the impact of inflation. A data set of South African firms’ financial statements during the period 1983- 1996 was assembled to permit a detailed examination of these firms’ financial performance during South Africa’s period of isolation. Utilising both direct and indirect measures of inflation, we determine that inflation affects growth in a negative manner. By combing firm-level and macro data issues relating to the endogeneity of inflation, we argue that macroeconomic instability is the true factor adversely affecting firm growth during this period of time.
Dissemination of annual report information on the internet by South African companies
Authors: Naudé F , Du Toit A 
Published: June 2017

The Internet is a cost-effective and efficient way of distributing information to all stakeholders in a transparent, globalised business environment. The aim of this study was to determine the current state and level of adoption of the Internet as a delivery and communication mechanism for disseminating online/digital annual reports in the largest listed companies in South Africa. The population selected for the survey was the 2001 Financial Mail top 300 (SA Giants) companies. The research was conducted by analysing the corporate websites of the selected companies, to establish the existence of a corporate website and whether the full annual report was available electronically. The study also investigated the relationship between digital annual reports and company characteristics. The investigation revealed that those companies with websites and digital annual reports are profitable companies.
A case of nonconvulsive status epilepticus presenting as dissociative fugue
Authors: Erol Almila , Yigit Ayla , Dogan Gozde , Ozer Behiye 
Published: June 2017

<p><span>Nonconvulsive status epilepticus is characterised by changes in behaviour, memory, affect or level of consciousness. We report a case of nonconvulsive status epilepticus precipitated by carbamazepine that presented as dissociative fugue. The patient was a 49-year-old man. He first experienced a tonic-clonic seizure nine years previously and was diagnosed with <em>grand mal</em> epilepsy. He had been using carbamazepine 800 mg daily for the last eight years. He had not had any tonic-clonic seizures since carbamazepine was introduced but began to display behavioural disturbances periodically. He also left home many times, and remembered nothing about the period he had been away after he returned. He was hospitalised with a preliminary diagnosis of dissociative fugue. He had recurrent episodes with dissociative symptoms during his stay in the hospital. An electroencephalogram (EEG) and a 24-hour video EEG revealed nothing abnormal. An EEG recording taken during an episode indicated complex partial status epilepticus. Carbamazepine was substituted with valproate, and the patient was discharged in remission. </span></p>
Contributions from the South African Society of Psychiatrists (SASOP) to the National Mental Health Action Plan
Authors: Janse van Rensburg Albert Bernard 
Published: June 2017

<p>The national Mental Health Action Plan (MHAP) flowed from the Ekurhuleni Declaration, adopted at the National Mental Health Summit (NMHS) in April 2012. The final draft of the MHAP included eight national objectives, with key activities which were believed to be ‘catalytic.’ These objectives include: district-based mental health service; institutional capacity; surveillance, research and innovation; infrastructure and capacity; mental health technology, equipment and medicines; inter-sectoral collaboration; human resources; and advocacy, mental health promotion and prevention of illness. A representative group of regional State Employed Special Interest Group (SESIG) delegates met during April 2013, to: operationalise the 12 South African Society of Psychiatrists (SASOP)/SESIG position statements of the previous year; review SASOP’s position statements in the context of the proposed national MHAP; and to identify SASOP’s role and responsibilities accordingly. This paper describes the contextual events in the drafting of the MHAP, as well as the appraisal of the MHAP during the 2013 SASOP/SESIG meeting, and SASOP’S envisaged role and responsibilities according to the national MHAP. </p>
Reserpine for the treatment of refractory mania
Authors: Eloff Ingrid Geeske , Esterhuysen Willem 
Published: June 2017

<p>We report a case of refractory mania treated successfully with reserpine. The patient was a 26-year-old man with bipolar I disorder, who had recurrent hospital admissions for manic episodes that failed to respond to multiple mood stabilisers and antipsychotics. The patient also suffered from hypertension. His manic symptoms improved markedly with the addition of reserpine to the treatment regimen. Reserpine is a centrally acting antihypertensive with anti-adrenergic properties. It has been found to reduce the duration of a manic episode rapidly in a small group of studies. This proved to be the case with this patient. Reserpine used in conjunction with other psychotropic medication may be considered in the treatment of refractory mania, but controlled trials are necessary to support our finding more generally.</p>