bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic significance of histomolecular subgroups of adult anaplastic (WHO Grade III) gliomas: applying the ‘integrated’ diagnosis approach
Authors: Rajmohan K S , Sugur Harsha S , Shwetha S D , Ramesh Arvind , Thennarasu Kandavel , Pandey Paritosh , Arivazhagan Arimappamagan , Santosh Vani 
Published: January 2016

AimsAnaplastic gliomas (AGs; WHO Grade III) include anaplastic astrocytoma (AA), anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA) and are known to have variable prognosis. Since biomarkers have a major impact on prognosis of gliomas, we compared the prognostic significance of the established biomarkers of AGs and the ‘histomolecular’ subgroups based on the proposed International Society of Neuropathology-Haarlem (‘ISN-Haarlem’) guidelines, with the current WHO 2007 classification.MethodsThe study was carried out on formalin-fixed paraffin-embedded (FFPE) tissues from 91 adult patients with AG. Clinical, histological and molecular parameters, including 1p/19q codeletion, isocitrate dehydrogenase gene (IDH1)-R132H positivity, α thalassemia/mental retardation syndrome X-linked gene (ATRX) expression and O6-methylguanine-DNA-methyltransferase gene (MGMT) promoter methylation (mMGMT), were correlated with overall survival (OS) and recurrence-free survival (RFS). Subsequently, following sequencing for rareIDHmutations, we derived three ‘histomolecular’ subgroups based on the ‘integrated’ diagnosis approach proposed by ‘ISN-Haarlem’ guidelines and correlated this with clinical outcome.ResultsGross tumour resection, administration of radiochemotherapy, 1p/19q codeletion,IDH1-R132H positivity and mMGMTwere associated with favourable OS and RFS (p≤0.001), while the WHO histological subgroups were prognostically not significant. The ISN ‘histomolecular’ subgroups prognosticated best with AOs (IDHmut, 1p/19q codeleted,ATRXpredominantly retained) having the best survival, followed by the AAs (IDHmut,ATRXloss or retained, 1p19q non-codeleted) and AAIDHwild type group having the worst OS and RFS (p=<0.001 for OS).ConclusionsOur study reiterates the prognostic significance of biomarkers, 1p/19q codeletion,IDH1-R132H positivity and mMGMTin AGs. Importantly, we show that the ‘histomolecular’ subgroups of AGs based on the ‘integrated’ diagnosis has a prognostic value, superior to the WHO histological classification.
Risk Analysis of Unruptured Intracranial Aneurysms
Authors: Murayama Yuichi , Takao Hiroyuki , Ishibashi Toshihiro , Saguchi Takayuki , Ebara Masaki , Yuki Ichiro , Arakawa Hideki , Irie Koreaki , Urashima Mitsuyoshi , Molyneux Andrew J. 
Published: January 2016

Background and Purpose—
The natural history of unruptured intracranial aneurysms remains unclear, and management strategy is not well defined.

Methods—
From January 2003 to December 2012, we enrolled patients with aneurysm in our institution. In total, 2252 patients with 2897 aneurysms were eligible for analysis, and 1960 eligible aneurysms were conservatively managed. Precise 3-dimensional evaluation was conducted using computed tomography angiography, digital subtraction angiography, or magnetic resonance angiography. We then assessed the risk of aneurysm rupture, mortality, and morbidity associated with aneurysm characteristics, demographics, and known health/lifestyle risk factors.

Results—
The mean follow-up duration was 7388 aneurysm-years. During observation, 56 aneurysms ruptured, resulting in an overall rupture rate per year of 0.76% (95% confidence interval, 0.58–0.98). The mean initial visit to rupture interval was 547 days. Aneurysm size, location, daughter sac, and history of subarachnoid hemorrhage were significant independent predictors for aneurysm rupture. Aneurysms that were ≥5 mm were associated with a significantly increased risk of rupture when compared with 2- to 4-mm aneurysms (unadjusted hazard ratio, 12.24; 95% confidence interval, 7.15–20.93). Of 56 patients who experienced hemorrhage, 29 (52 %) died or were rendered severely disabled. Of the patients who had large or giant aneurysms, none recovered without deficits, and the mortality rate after rupture was 69%. For aneurysms sized <5 mm, the mortality rate was 18%.

Conclusions—
Larger aneurysms are at greater risk for rupture and poor outcome. Ethnic factors may play a role in the risk of rupture.
Preexisting Heart Disease Underlies Newly Diagnosed Atrial Fibrillation After Acute Ischemic Stroke
Authors: Rizos Timolaos , Horstmann Solveig , Dittgen Felix , Täger Tobias , Jenetzky Ekkehart , Heuschmann Peter , Veltkamp Roland 
Published: January 2016

Background and Purpose—
Whether newly diagnosed atrial fibrillation (nAF) after stroke reflects underlying heart disease and represents an increased risk of cardioembolic stroke, or whether it is triggered by neurogenic mechanisms remains uncertain. We investigated, whether cardiovascular risk factors and echocardiographic parameters in patients with nAF are similar to patients with known AF (kAF) and differ from patients without AF.

Methods—
Consecutive acute ischemic stroke patients were enrolled into a prospective stroke database. All patients with echocardiography were included and univariable and multivariable testing was applied to compare clinical characteristics and echocardiographic findings among patients with nAF, kAF, and no AF.

Results—

A total of 1397 patients were included (male, 62.3%; median age, 71 years). AF was present in 320 (22.9%) patients. Of those, nAF was present in 36.2% (116/320) and kAF in 63.8% (204/320). No clinical or echocardiographic factor was independently associated with detection of nAF compared with kAF but a trend toward larger left atrial diameters in patients with kAF was observed (
P
=0.070). In contrast, patients with nAF were more often female (
P
<0.001), older (
P
<0.001) and had a larger left atrial diameters (
P
<0.001) compared with patients without AF. While stroke severity in patients with nAF and kAF was similar, patients without AF had less severe strokes.

Conclusions—
Stroke patients with nAF and with kAF share common cardiovascular risk factors, have similar echocardiographic findings and suffer equally severe strokes. We conclude that preexisting heart disease is the major cause of AF that is first diagnosed after stroke.
Enhanced Effective Connectivity Between Primary Motor Cortex and Intraparietal Sulcus in Well-Recovered Stroke Patients
Authors: Schulz Robert , Buchholz Anika , Frey Benedikt M. , Bönstrup Marlene , Cheng Bastian , Thomalla Götz , Hummel Friedhelm C. , Gerloff Christian 
Published: January 2016

Background and Purpose—
Ischemic strokes with motor deficits lead to widespread changes in neural activity and interregional coupling between primary and secondary motor areas. Compared with frontal circuits, the knowledge is still limited to what extent parietal cortices and their interactions with frontal motor areas undergo plastic changes and might contribute to residual motor functioning after stroke.

Methods—
Fifteen well-recovered patients were evaluated 3 months after stroke by means of functional magnetic resonance imaging while performing visually guided hand grips with their paretic hand. Dynamic causal modeling was used to investigate task-related effective connectivity between ipsilesional posterior parietal regions along the intraparietal sulcus and frontal key motor areas, such as the primary motor cortex, the ventral premotor cortex, and the supplementary motor area.

Results—
Compared with healthy controls of similar age and sex, we observed significantly enhanced reciprocal facilitatory connectivity between the primary motor cortex and the anterior intraparietal sulcus of the ipsilesional hemisphere. Beyond that and as a fingerprint of excellent recovery, the coupling pattern of the parietofrontal network was near-normal. An association between coupling parameters and clinical scores was not detected.

Conclusions—
The present analysis further adds to the understanding of the parietofrontal network of the ipsilesional hemisphere as a prominent circuit involved in plastic changes after stroke.
Risk of Stroke After the
International Classification of Diseases
-Ninth Revision Discharge Code Diagnosis of Hypertensive Encephalopathy
Authors: Lerario Michael P. , Merkler Alexander E. , Gialdini Gino , Parikh Neal S. , Navi Babak B. , Kamel Hooman 
Published: January 2016

Background and Purpose—
Although chronic hypertension is a well-established risk factor for stroke, little is known about stroke risk after hypertensive encephalopathy (HE), when neurologic sequelae of hypertension become evident. Therefore, we evaluated the risk of stroke after a diagnosis of HE.

Methods—

We identified all patients discharged from California, New York, and Florida emergency departments and acute care hospitals between 2005 and 2012 with a primary
International Classification of Diseases
, Ninth Edition, Clinical Modification discharge diagnosis of HE (437.2). Patients discharged with a primary diagnosis of seizure (345.x) served as negative controls, whereas patients with a primary diagnosis of transient ischemic attack (435.x) were positive controls. Our primary outcome was the composite of subsequent ischemic stroke or intracerebral hemorrhage. Kaplan–Meier survival statistics were used to calculate cumulative outcome rates, and Cox proportional hazard analysis was used to examine the association between index disease types and outcomes while adjusting for vascular risk factors.

Results—
We identified 8233 patients with HE, 191 091 with seizure, and 308 680 with transient ischemic attack. The 1-year cumulative rate of ischemic stroke or intracerebral hemorrhage after HE was 4.90% (95% confidence interval [CI], 4.45–5.40) when compared with 0.92% (95% CI, 0.88–0.97) after seizure and 4.49% (95% CI, 4.42–4.57) after transient ischemic attack. The risk of intracerebral hemorrhage was significantly elevated in those with HE (hazard ratio, 2.0; 95% CI, 1.7–2.5) but not in those with transient ischemic attack (hazard ratio, 1.0; 95% CI, 0.9–1.1), when compared with seizure patients.

Conclusions—
Patients discharged with a diagnosis of HE face a high risk of future cerebrovascular events, particularly intracerebral hemorrhage.
Cluster Analysis of Tropical Cyclone Tracks over the Western North Pacific Using a Self-Organizing Map
Authors: Kim Han-Kyoung , Seo Kyong-Hwan 
Published: January 2016

AbstractTropical cyclone (TC) tracks over the western North Pacific (WNP) in 1979–2013 are classified by a self-organizing map technique. A false detection rate method identifies five optimal TC clusters. Physical mechanisms of the intraseasonal and interannual variations in the TC genesis frequency are investigated for each cluster. The five clusters are separated by genesis location, from the westernmost area (east of the Philippines, C1) to the easternmost (~150°E, C5) onset area over the WNP. The intraseasonal Madden–Julian oscillation (MJO) significantly affects the genesis frequency for all clusters except for C5. In particular, MJO phases 5 and 6 (1 and 2) provide significantly favorable (unfavorable) large-scale conditions for TC genesis. Two types of El Niño–Southern Oscillation influence the interannual variation of the genesis frequency for only C2 (generated over the western Philippine Sea and East China Sea) and C4 (formed near the eastern Philippine Sea). Enhanced eastern Pacific sea surface temperature (SST) anomalies lead to a ~40% decrease in the C2 TC frequency through a reversed Walker circulation with downward motion over the WNP. Conversely, increased central Pacific SST anomalies generate a cyclonic Rossby wave northwest of the forcing, inducing a significant increase (~50%) in the C4 TC frequency. The interannual variability for the C5 TCs is strongly controlled by the variation of the western Pacific subtropical high (WPSH). A positive WPSH variation reduces the C5 TC genesis frequency by 66%, while negative WPSH anomalies enhance the frequency by 50%. A prediction scheme using information from the first four 6-h TC locations demonstrates a skillful determination of TC clusters.
Pectus excavatum repair using Prolene polypropylene mesh
Authors: Rasihashemi Seyed Ziaeddin , Ramouz Ali 
Published: January 2016

Objective We aimed to assess the clinical outcomes of our surgical technique for repair of pectus excavatum using Prolene polypropylene mesh. Methods Among 29 patients with pectus excavatum, the major complaint was cosmetic dissatisfaction, and the main symptom was exercise dyspnea in 15 patients. The Haller index used to assess pectus excavatum severity; it was significant in 22 patients. In all patients, a 2-layer sheet of Prolene polypropylene mesh was placed behind the sternum. Results No serious complication was observed postoperatively, and all patients were satisfied with the cosmetic result. Mitral valve prolapse improved in all cases after 3 months. Spirometry revealed improved pulmonary function after surgery. Conclusion With due attention to the advantages of Prolene polypropylene mesh, such as remaining permanently in place, adapting to various stresses encountered in the body, resisting degradation by tissue enzymes, and trimming without unraveling, we concluded that this mesh is suitable for use as posterior sternal support in pectus excavatum patients.
The Journey through a Barren Landscape to Practising Music Therapist
Authors: Lunt Helen 
Published: January 2016

In this article I describe my personal journey through mental illness to practising music therapist, which spans some 30 years. The bleak and barren landscape of the hospitals in which I was an acute patient has now been transformed into a colourful milieu where I practise as a music therapist. The parallel paths of my own illness and my professional training are growing into an integration of my inner and outer life, which is reflected in my music therapy work with people with mental health problems. The names of all people have been changed to safeguard anonymity. I have used the third person when discussing my own story, also providing additional perspective by using the pseudonym ‘Jane’. The article is in two main sections.
Singing in Therapy: Monitoring Disease Process in Chronic Degenerative Illness
Authors: Magee Wendy L. , Davidson Jane W. 
Published: January 2016

Music therapy in the treatment of chronic neurological illness typically focuses on the use of music to address the emotional and psychosocial impact of loss and change stemming from pathology. A range of clinical techniques is described in anecdotal accounts spanning instrumental improvisation, song composition and singing. However, there is scant reference to the musical and emotional experience of singing as a clinical technique with individuals living with chronic degenerative illness. Drawing on the results of an empirical investigation into the effects of music therapy with clients with chronic neurological illness, this paper reveals how singing may be used by clients to monitor their physical disease process. Grounded theory research with this population has revealed that music therapy elicits processes in which individuals monitor the physical changes caused by their disease process (Magee and Davidson 2004). Based upon these research findings, this paper illustrates that individuals living with illnesses which cause loss of voice function may find the act of singing a highly physical experience. As such, singing may be used to monitor subtle changes which have occurred due to the disease process. Individuals living with degenerative illness may use singing within therapy as a way to defy their illness process and as an expression of life's breath running through the body. Singing and voice work within clinical music therapy is therefore not only a vehicle for emotional expression, but also an invaluable tool in gaining an understanding of the client's experience, offering a boundaried environment for exploration of loss and degeneration. Finally, the paper provides a theoretical framework for the emotional experience of singing songs of personal meaning in therapy.
Steering a Path through Change: Observations on the Process of Training
Authors: Watson Tessa 
Published: January 2016

There are very few papers or articles that focus upon either learning and teaching, or student change, in the music therapy training experience. This paper considers the process of change during training. The student perspective is considered by using quotations from trainee music therapists. These quotations have been gathered over several years through small research projects studying learning and teaching. These quotations from students will be used to illustrate the author's thoughts about change and the process of training. Theories of learning and teaching are used to further illuminate the author's conceptualisation of student training. The author would like to thank those students who completed questionnaires.
Early Intervention Music Therapy for Adolescent Mothers and Their Children
Authors: Abad Vicky , Williams Kate 
Published: January 2016

Adolescence is a unique and challenging period of growth, change and possible turmoil as a young person transitions towards adulthood. The capacity to provide quality parenting at this time is likely to be compromised because the teenage mother simultaneously experiences the challenges of adolescence and first time parenthood. Research suggests that teenage mothers are significantly less supportive, more detached, more intrusive, and more negative / hostile, when compared to older mothers, and may be less able to provide a stimulating learning environment. Sing & Grow is a national early intervention music therapy project provided by Playgroup Associations and funded by the Commonwealth Government of Australia. The project provides 10 weekly group music therapy sessions to parent and child (aged 0 to 3 years) dyads from families in communities identified as marginal as a result of various circumstances, including adolescent and young parenthood. Outcomes of clinical programmes conducted to date show that the central provision of music has been successful in promoting a range of non-musical parenting outcomes for adolescent and young mothers. This includes observed increases in their repertory of skills in relating to and interacting with their child in more gentle and nurturing ways.
From Performer to Container
Authors: Inada Masami 
Published: January 2016

This article explores the case of a musically accomplished client for whom an indirect therapeutic intervention involving musical improvisation was provided within the context of a psychiatric music therapy group. In making music in a group, musically accomplished clients can dominate the music making with their strong musical skills. Their means of participating in group improvisational play often reflects a self-protective narrowing down of awareness. The case considered here demonstrates that ‘performers' in such groups can learn to relax their defensive stance and play supportive music when the therapist facilitates the development of the group by modelling collaborative improvisation, rather than by intervening directly. An example of this kind of therapeutic intervention is described from a psychoanalytic perspective, focusing on the improvisational playing of the client and group in different phases of the case.
An Investigation into Time Relationships in Co-Improvisation with Children Having Epileptic Fits
Authors: Eugster Mario 
Published: January 2016

This qualitative research project investigates aspects of time and timing in co-improvisation with children suffering from epilepsy. Recently, a growing interest in time and timing has emerged in the field of music therapy. However, the impact of epilepsy on time relationships in music therapy has not been systematically explored to date. Using both video recordings of sessions and interviews with therapists experienced in working with epileptic children as data, the impact of epilepsy on musical time relationships is explored. Time relationships are understood to include not only the relationship between the therapist's and client's timings, expressed in timing of musical activity and body movements, but also the subjective experiences of time a therapist has whilst working with epileptic children, especially when they have a seizure. The findings of this study support and complexify previous theoretical writings on time and timing in the music therapy literature. The impact of an epileptic seizure on the timing between client and therapist is analysed. The complex relationships between timing and psycho-physiological changes are explored, including possible effects of the therapist's emotional responses on timing. The findings of the study suggest that music therapists share certain experiences of time in work with epileptic children. Finally, there is a discussion of music-therapeutic strategies used by therapists when time relationships are affected by an epileptic episode.
Music Therapy with Children and Adolescents in Mainstream Schools: A Systematic Review
Authors: Carr Catherine , Wigram Tony 
Published: January 2016

This article identifies existing research and clinical activity utilising music therapy with mainstream children, as well as a potential need for music therapy with this client group. A systematic review was undertaken of music therapy literature relating to work with children in mainstream schools: 60 papers were identified, 12 of which were outcome studies. Statistical and government data provide a background to the current status and needs of children in the UK. The emotional and social wellbeing needs of children have been identified as a priority to be addressed by the UK government. However, further research, service-planning and reorganisation is required. There is evidence that music therapy is used with children in mainstream schools both in the UK and abroad. Current literature suggests that music therapy is an effective intervention. The review demonstrates that further research is required if music therapy is to be considered an effective intervention to address the needs of mainstream schoolchildren.
In Search of the Face—An Approach to Mental Handicap
Authors: Zallik Stephanie 
Published: January 2016

The article puts forward a case for using music therapy with handicapped people in a way which allows them to overcome the difficulties they have in expressing their needs. The idea of therapy with the mentally ill being more profound in nature than with the mentally handicapped, is discussed and argued against. The article pursues this theme by considering the relationship between what a handicapped person first presents in the therapy session and what is beneath. The aim of music therapy is therefore to reach those aspects lying beneath the surface. A brief case study is given in order to further illustrate these ideas.
Vibroacoustic Therapy: The Therapeutic Effect of Low Frequency Sound on Specific Physical Disorders and Disabilities
Authors: Skille Olav , Wigram Tony , Weekes Lyn 
Published: January 2016

This article traces the early development of vibroacoustic therapy, and some of the theoretical basis for its use in a treatment procedure. It describes some of the initial work in the Scandinavian countries, gives examples of the type of problems that low frequency sound and music have been particularly effective in treating, and puts into perspective the use of music and sound as a physically effective means of treating people in comparison with the interactive forms of intervention commonly used by music therapists. Much of the case material described in the article (Norwegian and English) is anecdotal. In the latter section of this paper, current research is described.