bluuebunny/crossref_metadata_2025_split huggingface dataset:
The anterior hypothalamus in cluster headache
Authors: Arkink Enrico B , Schmitz Nicole , Schoonman Guus G , van Vliet Jorine A , Haan Joost , van Buchem Mark A , Ferrari Michel D , Kruit Mark C 
Published: August 2016

Objective To evaluate the presence, localization, and specificity of structural hypothalamic and whole brain changes in cluster headache and chronic paroxysmal hemicrania (CPH). Methods We compared T1-weighted magnetic resonance images of subjects with cluster headache (episodic n = 24; chronic n = 23; probable n = 14), CPH ( n = 9), migraine (with aura n = 14; without aura n = 19), and no headache ( n = 48). We applied whole brain voxel-based morphometry (VBM) using two complementary methods to analyze structural changes in the hypothalamus: region-of-interest analyses in whole brain VBM, and manual segmentation of the hypothalamus to calculate volumes. We used both conservative VBM thresholds, correcting for multiple comparisons, and less conservative thresholds for exploratory purposes. Results Using region-of-interest VBM analyses mirrored to the headache side, we found enlargement ( p < 0.05, small volume correction) in the anterior hypothalamic gray matter in subjects with chronic cluster headache compared to controls, and in all participants with episodic or chronic cluster headache taken together compared to migraineurs. After manual segmentation, hypothalamic volume (mean±SD) was larger ( p < 0.05) both in subjects with episodic (1.89 ± 0.18 ml) and chronic (1.87 ± 0.21 ml) cluster headache compared to controls (1.72 ± 0.15 ml) and migraineurs (1.68 ± 0.19 ml). Similar but non-significant trends were observed for participants with probable cluster headache (1.82 ± 0.19 ml; p = 0.07) and CPH (1.79 ± 0.20 ml; p = 0.15). Increased hypothalamic volume was primarily explained by bilateral enlargement of the anterior hypothalamus. Exploratory whole brain VBM analyses showed widespread changes in pain-modulating areas in all subjects with headache. Interpretation The anterior hypothalamus is enlarged in episodic and chronic cluster headache and possibly also in probable cluster headache or CPH, but not in migraine.
Analysis of Unplanned Intensive Care Unit Admissions in Postoperative Pediatric Patients
Authors: Landry Elizabeth K. , Gabriel Rodney A. , Beutler Sascha , Dutton Richard P. , Urman Richard D. 
Published: August 2016

Background: Currently, there are only a few retrospective, single-institution studies that have addressed the prevalence and risk factors associated with unplanned admissions to the pediatric intensive care unit (ICU) after surgery. Based on the limited amount of studies, it appears that airway and respiratory complications put a child at increased risk for unplanned ICU admission. A more extensive and diverse analysis of unplanned postoperative admissions to the ICU is needed to address risk factors that have yet to be revealed by the current literature. Aim: To establish a rate of unplanned postoperative ICU admissions in pediatric patients using a large, multi-institution data set and to further characterize the associated risk factors. Methods: Data from the National Anesthesia Clinical Outcomes Registry were analyzed. We recorded the overall risk of unplanned postoperative ICU admission in patients younger than 18 years and performed univariate and multivariate logistic regression analysis to identify the associated patient, surgical, and anesthetic-related characteristics. Results: Of the 324 818 cases analyzed, 211 reported an unexpected ICU admission. There was an increased likelihood of unplanned postoperative ICU in infants (age <1 year) and children who were classified as American Society of Anesthesiologists physical status classification of III or IV. Likewise, longer case duration and cases requiring general anesthesia were also associated with unplanned ICU admissions. Conclusion: This study establishes a rate of unplanned ICU admission following surgery in the heterogeneous pediatric population. This is the first study to utilize such a large data set encompassing a wide range of practice environments to identify risk factors leading to unplanned postoperative ICU admissions. Our study revealed that patient, surgical, and anesthetic complexity each contributed to an increased number of unplanned ICU admissions in the pediatric population.
The Correlation of Two Cerebral Saturation Monitors With Jugular Bulb Oxygen Saturation in Children Undergoing Cardiopulmonary Bypass for Congenital Heart Surgery
Authors: Naguib Aymen N. , Winch Peter D. , Sebastian Roby , Gomez Daniel , Guzman Luisa , Rice Julie , Tumin Dmitry , Galantowicz Mark , Tobias Joseph D. 
Published: August 2016

Background: Near-infrared spectroscopy (NIRS) is a noninvasive monitoring technique that measures regional cerebral oxygen saturation (rSO2). Objectives: The primary aim was to compare the output of 2 NIRS-based cerebral oximetry devices, FORESIGHT (CAS Medical Systems Inc, Branford, Connecticut) and INVOS (Covidien, Boulder, Colorado), to venous oxygen saturations from the jugular venous bulb at cannulation and decannulation of the superior vena cava (SVC). Secondary objectives included evaluating correlations of cerebral saturation, as measured by the NIRS devices, with mean arterial blood pressure (MAP), measured by an invasive arterial line, and end-tidal CO2 (ETCO2). Methods: Near-infrared spectroscopy, MAP, and ETCO2 data were collected at 13 defined events during each case when hemodynamic instability was expected. At SVC cannulation and decannulation, a 0.1 mL sample of blood was collected from the jugular bulb by the surgeon using a long angiocatheter. The oxygen saturation of these blood samples was measured using an AVOX device and compared with contemporaneous readings from the NIRS probes. Mixed-effects linear regression was used to correlate MAP or ETCO2 with cerebral oxygen saturation (by NIRS) at each time point. Results: Children undergoing cardiopulmonary bypass for congenital heart surgery (n = 34) were enrolled in the study. At SVC cannulation, both INVOS ( r = .78) and FORESIGHT ( r = .59) were correlated with AVOX data at P < .001, although the correlation with INVOS was significantly stronger ( P = .003). At SVC decannulation, INVOS ( r = .68; P < .001) and FORESIGHT ( r = .60; P < .001) were similarly correlated with jugular venous rSO2. Correlations of rSO2 (by NIRS) with MAP and ETCO2 levels were stronger than correlations between rSO2 change and change in MAP or ETCO2. Conclusion: INVOS correlated more strongly than FORESIGHT with the jugular bulb rSO2 at SVC cannulation but may have underestimated oxygen saturation at low rSO2 values. Data from both NIRS devices were correlated with MAP and ETCO2 over the case duration.
Ankle Fusion Combined With Calcaneal Sliding Osteotomy for Severe Arthritic Ball and Socket Ankle Deformity
Authors: Cho Byung-Ki , Park Kyoung-Jin , Choi Seung-Myung , Kang Sang-Woo , Lee Hyung-Ki 
Published: August 2016

Background: Although a ball and socket ankle deformity is usually congenital and asymptomatic, abnormal inversion and eversion mobility can result in recurrent ankle sprain and osteoarthritis. This retrospective study was performed to evaluate the clinical and radiologic outcomes of ankle fusion combined with calcaneal sliding osteotomy for severe arthritic ball and socket ankle deformity. Methods: Fourteen patients with severe arthritic ball and socket ankle deformity were followed for more than 3 years after operation. The clinical evaluation consisted of American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Ability Measure (FAAM), visual analog scale (VAS) for pain, and subjective satisfaction score. The period to fusion and union of osteotomy, the change of hindfoot alignment angle, and complications were evaluated radiologically. Results: AOFAS and FAAM scores were significantly improved from an average of 37.4 and 34.5 points to 74.6 and 78.5 points, respectively. VAS for pain with walking over 20 minutes was significantly improved from an average of 8.4 points to 1.9 points. The average satisfaction score of patients was 88.9 points. The difference in heel alignment angle (compared to contralateral side) was significantly improved from an average of 34.8 to 5.4 degrees. There were 2 cases of progressive arthritis in an adjacent joint and 1 case of failed fusion. Conclusions: Ankle fusion combined with calcaneal sliding osteotomy can be an effective operative option for ball and socket ankle deformity with advanced arthritis. In spite of increased complication rate, reliable pain relief, and restoration of gait ability through correcting hindfoot malalignment could improve the quality of life. Level of Evidence: Level IV, retrospective case series.
Endovascular treatment of aneurysms and platinum coil caliber: Study protocol of a randomized, controlled trial
Authors: Ghostine Jimmy , Khoury Naim , Cloutier Francis , Kotowski Marc , Gentric Jean-Christophe , Batista André L , Weill Alain , Roy Daniel , Darsaut Tim E , Raymond Jean 
Published: August 2016

Background Endovascular coil embolization of cerebral aneurysms is an effective treatment for the prevention of aneurysm rebleeding after subarachnoid hemorrhage. It is also often used in unruptured aneurysms, but it is associated with aneurysm remnants and recurrences in up to 20%–33% of patients. We hypothesized that better aneurysm occlusion rates can be achieved with coils of larger caliber. Methods The Does Embolization with Larger coils lead to better Treatment of Aneurysms (DELTA) trial is an investigator-initiated, multicenter, prospective, randomized, controlled clinical trial. To test the hypothesis that 15-caliber coiling systems are superior to 10-caliber coils, 564 patients with aneurysms measuring 4–12 mm will be randomized 1:1 to embolization with either 10-caliber coils exclusively (control group) or the highest safely achievable proportion of 15-caliber coils (intervention group). The primary efficacy endpoint of the trial is the occurrence of a major recurrence or a residual aneurysm at one year. A pilot phase of 165 patients will be conducted to verify feasibility of the coiling strategy, compliance to treatment allocation, safety of a 15-caliber platinum coil embolization strategy, recruitment rates, and the capacity to improve packing density. Discussion The DELTA trial will test the hypothesis that the use of coils of larger caliber can improve angiographic results of endovascular coiling.
‘Tubeless’ nephrectomy: Routine omission of indwelling catheters and abdominal drains and impact on patient outcomes
Authors: Hughes Paul , Chandra Lizzie , Lunawat Rahul , Cartledge Jon 
Published: August 2016

Objective: Continued refinements to the enhanced recovery after surgery (ERAS) protocols can help improve patient care. This study details the experience and outcomes of a single surgeon’s practice over a two-year period for all laparoscopic renal surgery where omitting abdominal drains and indwelling catheters, ‘tubeless nephrectomy’, was the default. Methodology: A total of 178 consecutive unselected patients underwent laparoscopic renal surgery during a 22-month period. This included laparoscopic radical, partial, live donor and benign nephrectomy cases. Demographic details and data on length of stay, complications and the need for catheterisation post-operatively and use of abdominal drains were collected prospectively. Results: Of the patient group, 142 (80%) underwent entirely ‘tubeless’ procedures. Catheterisation (indwelling catheter (IDC) or clean intermittent catheterisation (CIC)) was required in 23 (13%) patients, 11 (6%) had a drain placed at operation and two had both. The median length of stay for tubeless procedures was one day (interquartile range (IQR) 1–2, range 1–22 days). This compared to a median length of stay of three days (IQR 1–6) for those with a catheter and two days (IQR 1.5–4.5) for those with a drain post-operatively. The difference between the median length of stay for tubeless and non-tubeless procedures was statistically significant ( p=0.001). The difference in frequency of complications between the tubeless group and those who received a drain or catheter was also significant ( p=0.003). Conclusions: This change in clinical practice is safe, effective and easy to implement. When incorporated into laparoscopic nephrectomy ERAS protocols, ‘tubeless’ surgery can have a significant benefit on length of stay and patient outcomes, without a detrimental impact on complication rates.
Does regional audit improve practice in the management of urological cancers?
Authors: Dyer JE , Hartley S , Thompson A 
Published: August 2016

Objective: The effect of a regional audit is underreported and uncertain. Across the North West of England we have conducted annual regional audits of urological cancer care for over 20 years. Methods: We reviewed the data from four complete audit cycles (prostate, testis, bladder and kidney) to ascertain the change in adherence to agreed guidelines. Adherence to guidelines was pooled across cancer types and the following domains. Preoperative investigation, planning and counselling Perioperative and intraoperative care Follow-up regimen and documentation Difference in adherence to guidelines was expressed as an absolute percentage change and statistical significance was determined using Fisher’s exact test. Results: Over the four complete audit cycles 3659 case notes were reviewed totalling 20,470 observations. The four separate audits generated 42 guidelines which were equally assessable between audit cycles (prostate (nine), testis (seven), bladder (18) and kidney (eight)). Overall, adherence to guidelines between the original and follow-up audit improved from 63.4% to 73.4% ( p < 0.05). Adherence improved across all cancers; however, this was not equal across all domains. Marked improvements were seen in preoperative investigation (+13%, p < 0.05), planning and counselling and follow-up and documentation (+12%, p < 0.05). A non-significant rise of 0.1% was seen in guidelines pertaining to intraoperative care ( p = 0.95). Conclusions: A regional audit has overseen and documented an improvement in practice in urological cancer within the region studied. Although the mechanisms leading to this are likely to be complex, we suggest that the audit process per se is likely to contribute to this improvement rather than merely document it.
Brief Online Focused Attention Meditation Training: Immediate Impact
Authors: Kemper Kathi J. , Rao Nisha 
Published: August 2016

Background. There is increasing interest in brief, online training in mind-body skills to improve resilience in health professionals. Methods. We analyzed data from an online training program in focused attention meditation. Resilience, relaxation, stress, positive and negative affect, and flourishing were measured before and after training using standardized scales. Results. The 379 participants included nurses (31%), physicians (21%), social workers and psychologists (10%), and others (38%). At baseline, participants reported high levels of stress (mean 16.7 compared with population norms of 12-14). Completing modules was associated with small but significant improvements in relaxation, resilience, stress, positive and negative affect, and flourishing ( P <. 01 for all) Conclusion. Online focused attention meditation training reaches diverse health professionals and is associated with improvements in relaxation, resilience, stress, affect, and flourishing. Additional research is warranted to compare the long-term cost-effectiveness of different amounts and types of mind-body training on clinician burnout and quality of care.
Safeguarding Bagan: Endeavours, Challenges and Strategies
Authors: Weise Kai 
Published: August 2016

Bagan Archaeological Area and Monuments is a cultural landscape spreading over an area of over 100 km2 on a bend in the Ayeyarwady River in the central dry zone of Myanmar. The remains of over 2,500 monuments along with archaeological vestiges of ancient palaces, water management systems and fortifications are testimony to the highly evolved and significant Bagan period from the tenth to the thirteenth centuries CE. Exceptional architectural and artistic achievements are manifested in the exquisite ensembles of monuments with their intricate ornamentation and outstanding mural paintings. Till today, many of these Buddhist monuments are revered. The living traditions are manifested by the festivals, celebrations and rituals performed by the locals, pilgrims and the monks from the numerous monasteries. In 1997, the World Heritage Committee referred the nomination of Bagan, which was followed by two decades of uncontrolled development. Since 2012, there have been renewed efforts to inscribe Bagan on the World Heritage List. This has, however, required detailed assessments of the present status of the heritage site and the establishment of an integrated management system. This article explains the threats the heritage site is facing and how these are being addressed through the ongoing preparation of the management system.
Hyperfibrinolysis increases blood–brain barrier permeability by a plasmin- and bradykinin-dependent mechanism
Authors: Marcos-Contreras Oscar A. , Martinez de Lizarrondo Sara , Bardou Isabelle , Orset Cyrille , Pruvost Mathilde , Anfray Antoine , Frigout Yvann , Hommet Yannick , Lebouvier Laurent , Montaner Joan , Vivien Denis , Gauberti Maxime 
Published: August 2016

Key Points
Hydrodynamic transfection of plasmids encoding for plasminogen activators leads to a hyperfibrinolytic state in mice. Hyperfibrinolysis increases BBB permeability via a plasmin- and bradykinin-dependent mechanism.
Therapeutic interactions between mesenchymal stem cells for healing medication-related osteonecrosis of the jaw
Authors: Matsuura Yuri , Atsuta Ikiru , Ayukawa Yasunori , Yamaza Takayoshi , Kondo Ryosuke , Takahashi Akira , Ueda Nobuyuki , Oshiro Wakana , Tsukiyama Yoshihiro , Koyano Kiyoshi 
Published: August 2016

Abstract
Background
Mesenchymal stem cells (MSCs) have been isolated from a variety of tissues, including bone marrow, adipose, and mucosa. MSCs have the capacity for self-renewal and differentiation. Reports have been published on the systemic administration of MSCs leading to functional improvements by engraftment and differentiation, thus providing a new strategy to regenerate damaged tissues. Recently, it has become clear that MSCs possess immunomodulatory properties and can therefore be used to treat diseases. However, the therapeutic effect mechanisms of MSCs are yet to be determined. Here, we investigated these mechanisms using a medication-related osteonecrosis of the jaw (MRONJ)-like mouse model.

Methods
To generate MRONJ-like characteristics, mice received intravenous zoledronate and dexamethasone two times a week. At 1 week after intravenous injection, maxillary first molars were extracted, and at 1 week after tooth extraction, MSCs were isolated from the bone marrow of the mice femurs and tibias. To compare “diseased MSCs” from MRONJ-like mice (d-MSCs) with “control MSCs” from untreated mice (c-MSCs), the isolated MSCs were analyzed by differentiation and colony-forming unit-fibroblast (CFU-F) assays and systemic transplantation of either d-MSCs or c-MSCs into MRONJ-like mice. Furthermore, we observed the exchange of cell contents among d-MSCs and c-MSCs during coculture with all combinations of each MSC type.

Results
d-MSCs were inferior to c-MSCs in differentiation and CFU-F assays. Moreover, the d-MSC-treated group did not show earlier healing in MRONJ-like mice. In cocultures with any combination, MSC pairs formed cell–cell contacts and exchanged cell contents. Interestingly, the exchange among c-MSCs and d-MSCs was more frequently observed than other pairs, and d-MSCs were distinguishable from c-MSCs.

Conclusions
The interaction of c-MSCs and d-MSCs, including exchange of cell contents, contributes to the treatment potential of d-MSCs. This cellular behavior might be one therapeutic mechanism used by MSCs for MRONJ.
Serial changes in the proliferation and differentiation of adipose-derived stem cells after ionizing radiation
Authors: Jeong Woonhyeok , Yang Xiao , Lee Jeongmi , Ryoo Youngwook , Kim Jinhee , Oh Youngkee , Kwon Sunyoung , Liu Dalie , Son Daegu 
Published: August 2016

Abstract
Background
Adipose-derived stem cells (ASCs) are important to homeostasis and the regeneration of subcutaneous fat. Hence, we examined the proliferation and differentiation capacity of irradiated ASCs over time.

Methods
Two female pigs received a single 18 Gy dose of ionizing radiation to an 18 × 8 cm area on the dorsal body skin via a 6 MeV electron beam. After irradiation, the ASCs were cultured from adipose tissue harvested from a non-irradiated area and an irradiated area at 2, 4, and 6 weeks. The proliferation capacity of ASCs was evaluated by a colony-forming units–fibroblasts (CFUs-Fs) assay, a cholecystokinin (CCK) test with 10 % fetal bovine serum (FBS), and a 1 % FBS culture test. The senescence of ASCs was evaluated through morphological examination, immunophenotyping, and β-galactosidase activity, and the multipotent differentiation potential of ASCs was evaluated in adipogenic, osteogenic, and chondrogenic differentiation media.

Results
Irradiated ASCs demonstrated significantly decreased proliferative capacity 6 weeks after irradiation. As well, the cells underwent senescence, which was confirmed by blunted morphology, weak mesenchymal cell surface marker expression, and elevated β-galactosidase activity. Irradiated ASCs also exhibited significant losses in the capacity for adipocyte and chondrocyte differentiation. In contrast, osteogenic differentiation was preserved in irradiated ASCs.

Conclusions
We observed decreased proliferation and senescence of irradiated ASCs compared to non-irradiated ASCs 6 weeks after irradiation. Furthermore, irradiated ASCs demonstrated impaired adipocyte and chondrocyte differentiation but retained their osteogenic differentiation capacity. Our results could shed light on additional pathogenic effects of late irradiation, including subcutaneous fibrosis and calcinosis.
“It is hard to mesh all this”: Invoking attitude, persona and argument organisation
Authors: Don Alexanne 
Published: August 2016

AbstractThis paper focuses on the nature of invoked attitude as part of the Appraisal framework under Systemic Functional Linguistics, offering an amended set of diagnostic tools for tracking the ways that attitude may be invoked or implied in written discourse. Under the appraisal framework, categories of attitude are located in a system network, suggesting that there are a set of features that can determine whether wordings belong to one or another category. However, in the many cases where such attitudes are invoked, rather than being directly activated through the use of highly stable lexical items, such categorisation becomes problematic. Categorisation of attitude is dependent almost entirely on discourse semantic features of text and on interpretive probabilities, even in the case of explicit or ‘inscribed’ Attitudes, since the value (negative or positive) of many lexical items can be ‘flipped’ in the co-text in which such wordings appear. This paper presents what is termed a Spectrum of potential invoked attitudinal activators, arguing that these textual devices and resources provide a more fine-grained approach to analyses where invoked attitudes have been identified in texts. The paper argues that intertextuality, in its broadest sense, needs to be taken into account when making claims that attitudinal values have been identified in texts. As such, the paper presents a somewhat different theoretical approach to that offered by Martin and White (2005). The proposals offered are illustrated with excerpts from a study based on a close analysis of a corpus of texts of written interaction comprising over 80,000 running words, texts in which invoked attitude was more frequent than inscribed attitudes.