bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Analysis of the Use of Multichannel Microelectrode Recording During Deep Brain Stimulation Surgeries at a Single Center
Authors: Falowski Steven , Dierkes James 
Published: June 2017

Abstract

BACKGROUND
Microelectrode recording (MER) can be used to map out the target nucleus and identify ideal lead placement.

OBJECTIVE
To assess the use of multichannel MER to increase the efficiency of lead placement without compromising patient safety.

METHODS
Analysis of a single center's technique for utilizing multichannel MER with 3 consistent anterior-to-posterior simultaneous passes that include an evaluation of the location of final lead placement, patient diagnosis, target nuclei, and additional work involved for refinement of targeting. Lead revision rates and rate of hemorrhage are also assessed.

RESULTS
There were a total of 237 lead placements in 123 patients over a 4-yr period. In 4.2% of lead placements, additional planning was required, while only 2.5% required additional MER. The lead placement matched 51.3% of the time in bilateral placements and was consistent regardless of target nuclei. In 84.8% of cases, the final lead placement was within the initial 3 MER passes. An additional 11.3% could be placed without the need for an additional pass. There were 2 lead revisions and no hemorrhage or stroke complications.

CONCLUSION
This series demonstrates that our technique of multichannel MER leads to accurate and efficient lead placement maintaining its safety profile.
Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries
Authors: Ocampo Wrechelle , Cheung Amanda , Baylis Barry , Clayden Nancy , Conly John M. , Ghali William A. , Ho Chester H. , Kaufman Jaime , Stelfox Henry T. , Hogan David B. 
Published: June 2017

GENERAL PURPOSE:
To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs).

TARGET AUDIENCE:
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:
After participating in this educational activity, the participant should be better able to:
1. Identify the purpose and methods used for this study.
2. Compare costs and effectiveness related to preventative strategies for PIs.

ABSTRACT

BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective.

OBJECTIVE: The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments.

DATA SOURCES: Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic Reviews

SELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered.

DATA EXTRACTION: Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed.

DATA SYNTHESIS: The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered.

CONCLUSIONS: Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors’ review revealed a need for additional high-quality studies that adhere to commonly used standards of both currently utilized and emerging ways to prevent hospital-acquired PIs.
Hybrid Blocks for Total Knee Arthroplasty: A Technical Description
Authors: Johnston David F. , Sondekoppam Rakesh V. , Uppal Vishal , Howard James L. , Ganapathy Sugantha 
Published: June 2017

Introduction:
This narrative review article aims to examine current evidence of knee innervation in order to develop a technique of targeting pure sensory innervation of the knee joint without compromising motor function.

Methods:
A literature review of knee innervation was performed to gain an anatomic understanding of terminal sensory branches of the relevant target nerves (femoral, obturator, sciatic, and lateral femoral cutaneous).

Results:
Pure sensory block of the knee joint is challenging due to important contributions from themuscular innervation close to the joint and the variability of nerves afferents contained within and around the adductor canal.

Conclusion:
On the basis of this anatomic knowledge we describe an ultrasound-guided 3-injection hybrid technique that represents a balance between preserving adequate motor power while still providing analgesia in a simple method.
Liver X Receptor α Is Involved in Counteracting Mechanical Allodynia by Inhibiting Neuroinflammation in the Spinal Dorsal Horn
Authors: Xu Jing , Feng Yi-Wei , Liu Ling , Wang Wei , Zhong Xiong-Xiong , Wei Xu-Hong , Liu Xian-Guo 
Published: June 2017

Abstract

Background
Liver X receptors, including α and β isoforms, are ligand-activated transcription factors. Whether liver X receptor α plays a role in neuropathic pain is unknown.

Methods
A spared nerve injury model was established in adult male rats and mice. Von Frey tests were performed to evaluate the neuropathic pain behavior; Western blot and immunohistochemistry were performed to understand the underlying mechanisms.

Results
Intrathecal injection of a specific liver X receptor agonist T0901317 or GW3965 could either prevent the development of mechanical allodynia or alleviate the established mechanical allodynia, both in rats and wild-type mice. GW3965 could inhibit the activation of glial cells and the expression of tumor necrosis factor-α (mean ± SD: 196 ± 48 vs. 119 ± 57; n = 6; P < 0.01) and interleukin 1β (mean ± SD: 215 ± 69 vs. 158 ± 74; n = 6; P < 0.01) and increase the expression of interleukin 10 in the spinal dorsal horn. All of the above effects of GW3965 could be abolished by liver X receptor α mutation. Moreover, more glial cells were activated, and more interleukin 1β was released in the spinal dorsal horn in liver X receptor α knockout mice than in wild-type mice after spared nerve injury. Aminoglutethimide, a neurosteroid synthesis inhibitor, blocked the inhibitory effect of T0901317 on mechanical allodynia, on the activation of glial cells, and on the expression of cytokines.

Conclusions
Activation of liver X receptor α inhibits mechanical allodynia by inhibiting the activation of glial cells and rebalancing cytokines in the spinal dorsal horn via neurosteroids.
Three-dimensional True Spine Length: A Novel Technique for Assessing the Outcomes of Scoliosis Surgery
Authors: Spurway Alan J. , Hurry Jennifer K. , Gauthier Luke , Orlik Ben , Chukwunyerenwa Chukwudi K. , Kishta Waleed E. , El-Hawary Ron 
Published: June 2017

Background:
Current assessment of spine growth for patients undergoing growth friendly surgical treatment for early-onset scoliosis (EOS) is the use of serial, 1-dimensional standard-of-care coronal vertical spine height (SoCVH) measurements. Any growth of the spine out of the coronal plane is missed by the SoCVH, which may underestimate the actual growth of the spine. This study set to validate the novel 3-dimensional true spine length (3DTSL) radiographic measurement technique for measuring growth of EOS patients.

Methods:
3DTSL measurement accuracy, reliability, and repeatability was assessed using 10 physical model configurations. In addition, interrater and intrarater reliabilities (IRRs) were assessed using interclass coefficient (ICC) analyses of 23 retrospective EOS patient clinical radiographs. 3DTSL measurements were compared with SoCVH measurements.

Results:
The model assessment showed excellent accuracy with a mean error of 1.2 mm (SD=0.9; range, 0.0 to 3.0) and mean ICC of 0.999.
IRR ICCs of the clinical radiographs averaged 0.952 for the 3DTSL and 0.975 for the vertical height whereas IRRs averaged 0.944 and 0.965, respectively (all P<0.001).
Mean clinical 3DTSL curve lengths were 193.9 mm (SD=30.0; range, 142.8 to 276.8), whereas the SoCVH averaged 156.1 mm (SD=29.7; range, 74.7 to 207.3). The mean difference between the matched 3DTSL and SoCVH measurements was 37.8 mm (SD=21.4; range, 1.3 to 95.4) and was statistically significant (P<0.0001). On average, the 3DTSL of the measured spines was 124.2% of the measured SoCVH, with a progressive difference as the Cobb or kyphosis angles increased.

Conclusions:
The novel 3DTSL measurement is accurate, repeatable, and complements the current growth assessments for EOS treatments.

Level of Evidence:
Level II—diagnostic study—development of a diagnostic criteria on basis of consecutive patients, with gold standard.
Evaluation of the Tibial Tubercle to Posterior Cruciate Ligament Distance in a Pediatric Patient Population
Authors: Clifton Blake , Richter Dustin L. , Tandberg Dan , Ferguson Matthew , Treme Gehron 
Published: June 2017

Background:
Evaluation of distal extensor mechanism alignment continues to evolve in children with patella instability. Prior studies support the use of the tibial tubercle to trochlear groove (TT-TG) distance but limitations exist for this measurement including: changes in the TT-TG distance with knee flexion, difficulty with finding the deepest part of a dysplastic trochlea, and limitations regarding identification of the site of the anatomic abnormality. The tibial tubercle-posterior cruciate ligament (TT-PCL) distance has been introduced as an alternative measure to address the shortcomings in the TT-TG distance by quantifying the position of the TT independent of the trochlea and with respect to the tibia only. The objectives of this study were to (1) confirm that TT-PCL measurements in the pediatric population are reliable and reproducible; (2) determine whether normal TT-PCL distance changes with age; and (3) compare TT-PCL distances in patients with and without patellar instability to assess its utility in the workup of pediatric patellar instability.

Methods:
All knee magnetic resonance imaging performed for patients from birth to 15.9 years of age at our institution between December 2004 and February 2012 were retrospectively collected (total 566). Eighty-two patients had patellar instability and 484 patients did not have patellar instability. Two magnetic resonance imaging reviewers measured TT-PCL distance on T2-weighted axial images in a blinded manner. Intraobserver and interobserver agreement was measured. Correlation between TT-PCL distance and age as well as group differences between mean TT-PCL distances was evaluated.

Results:
Intraobserver and interobserver agreement was excellent (0.93) and very good (0.80), respectively. The mean TT-PCL distance was 20.1 mm with a range of 5.8 to 32.1 mm. The mean age was 12.6 years with a range of 0.8 to 15.9 years. The average TT-PCL distance was 21 mm for the instability group and 19.9 mm for the control group. TT-PCL distance increased significantly as subject age increased; however, there was no significant measurement difference shown between the patellar instability group and the control group.

Conclusions:
TT-PCL distance increased with age in the pediatric population but did not correlate with recurrent patella instability in this pediatric cohort.

Level of Evidence:
Level III—diagnostic.
Clinical Outcomes of Cervical Spinal Surgery for Cervical Myelopathic Patients With Coexisting Lumbar Spinal Canal Stenosis (Tandem Spinal Stenosis)
Authors: Yamada Tsuyoshi , Yoshii Toshitaka , Yamamoto Naoki , Hirai Takashi , Inose Hiroyuki , Kato Tsuyoshi , Kawabata Shigenori , Okawa Atsushi 
Published: June 2017

Study Design.
A retrospective observational study.

Objective.
We evaluated the prevalence and clinical characteristics of tandem spinal stenosis (TSS) in patients with cervical myelopathy including ossification of the posterior longitudinal ligament of the cervical spine (C-OPLL).

Summary of Background Data.
Concurrent cervical and lumbar spinal canal stenosis is generally reported as TSS. Most previous studies have used magnetic resonance imaging to evaluate spinal stenosis in the cervical and lumbar spine.

Methods.
The authors performed a retrospective analysis of the outcomes of 297 myelography and cervical surgeries performed in myelopathic patients. We compared the non-TSS group (n = 125) with the TSS group (n = 172) in terms of multiple clinical parameters. In each group, we compared the cervical non-OPLL cases with the cervical OPLL cases. Moreover, we investigated the ratio and clinical outcomes of additional lumbar surgeries performed for TSS patients.

Results.
One hundred seventy-two cases (57.9%) were considered TSS. Forty-one patients (13.8%) underwent a lumbar operation during the follow-up period. The TSS group included a greater number of OPLL patients, elderly patients, diabetes mellitus, hypertension, and non-smokers than the non-TSS group. The postoperative C-JOA score and the C-JOA recovery rate in the TSS group were significantly lower than the non-TSS group. In the TSS group, the non-C-OPLL patients were significantly older than the C-OPLL patients. The C-OPLL patients had higher postoperative C-JOA scores than the non-C-OPLL patients in both the TSS and non-TSS groups. The additional lumbar surgery effectively improved both the C-JOA and L-JOA scores in TSS patients.

Conclusion.
The prognosis for TSS patients with myelopathy was worse than that for patients with isolated cervical lesions. Younger C-OPLL patients, even those with TSS, showed higher recovery rates than non-C-OPLL patients. Aging and coexistent lumbar lesions may influence the recovery process following surgery for cervical myelopathy.

Level of Evidence: 4
Injectable DaxibotulinumtoxinA for the Treatment of Glabellar Lines: A Phase 2, Randomized, Dose-Ranging, Double-Blind, Multicenter Comparison With OnabotulinumtoxinA and Placebo
Authors: Carruthers Jean , Solish Nowell , Humphrey Shannon , Rosen Nathan , Muhn Channy , Bertucci Vince , Swift Arthur , Metelitsa Andrei , Rubio Roman G. , Waugh Jacob , Quiring John , Shears Gill , Carruthers Alastair 
Published: June 2017

BACKGROUND
Injectable daxibotulinumtoxinA (RT002) is an investigational botulinum toxin Type A in clinical development. It is formulated with a proprietary peptide and offers the potential of a longer acting neurotoxin therapy.

OBJECTIVE
To compare the safety, efficacy, and duration of response of daxibotulinumtoxinA with onabotulinumtoxinA and placebo [www.clinicaltrials.gov NCT02303002].

METHODS
In this Phase 2, randomized, dose-ranging, parallel-group, double-blind, multicenter study, subjects with moderate or severe glabellar lines at maximum frown were randomly assigned to 20U, 40U, or 60U daxibotulinumtoxinA, 20U onabotulinumtoxinA, or placebo. Glabellar line severity was evaluated by investigators and subjects at least every 4 weeks, for at least 24 weeks.

RESULTS
Overall, 268 subjects enrolled. Statistical and clinical superiority were observed for 40U and 60U daxibotulinumtoxinA over 20U onabotulinumtoxinA for a range of efficacy outcomes despite the study not being powered to detect statistically significant differences between these active treatment groups.

CONCLUSION
The 40U dose of daxibotulinumtoxinA was well tolerated (e.g., absence of ptosis) and had the most favorable risk: benefit profile. Compared with 20U onabotulinumtoxinA, it exhibited a significantly greater response rate and a significantly longer duration of response (median of 24 weeks vs 19 weeks; p = .030).
Multiple Free Flap Reconstructions of Head and Neck Defects Due to Oral Cancer
Authors: Mochizuki Yumi , Harada Hiroyuki , Shimamoto Hiroaki , Tomioka Hirofumi , Hirai Hideaki 
Published: June 2017

Objective:
We studied complications following multiple free flap reconstructions in the head and neck.

Methods:
In this cohort, 26 patients (14 men and 12 women) who underwent multiple microvascular free flap reconstructions were included in the study. The reasons for secondary reconstruction were recurrence of tumor (12 cases), necrosis of transferred skin and/or bone (6 cases), reconstruction plate fracture or exposure (4 cases), and others (4 cases). A third reconstruction in 4 cases and a fourth reconstruction in 1 case were performed.

Results:
No flap necrosis occurred. Postsurgical infections occurred at only secondary reconstructions in 7 patients. Although 4 cases with a history of external radiation therapy were anastomosed at contralateral side, those 4 cases suffered from severe pre-and postsurgical infection of the ipsilateral side. Postsurgical infection occurred in 2 cases with anastomoses at the ipsilateral side of the neck and required drainage after secondary surgery.

Conclusions:
A history of external radiation therapy and the existence of severe preoperative infection affected complications after multiple reconstructions.
Versatility of the Latissimus Dorsi Free Flap during the Treatment of Complex Postcraniotomy Surgical Site Infections
Authors: Yoshioka Nobutaka 
Published: June 2017

Background:Some intractable cases of postcraniotomy infection, which can involve compromised skin, an open frontal air sinus, and residual epidural dead space, have been reported. In such cases, reconstructing the scalp and skull is challenging.Methods:Between 2009 and 2016, the author treated 12 patients with recalcitrant postcraniotomy surgical site infections with latissimus dorsi (LD) free flaps. The patients’ ages ranged from 37 to 79 years (mean, 63.5 years), and their underlying diseases included subarachnoid hemorrhaging (n = 5), brain tumors (n = 4), and cerebral arteriovenous malformations (n = 3).Results:The LD free flap was used for scalp reconstruction in 3 cases, scalp reconstruction and separation of the intracranial and nasal cavities in 5 cases, and the obliteration of epidural dead space in 4 cases. Debridement followed by staged cranial reconstruction was carried out in 8 cases, and single-stage cranial reconstruction was conducted in 2 cases. The bone defects of the other 2 cases, which were small, were filled with LD musculo-adipose free flaps. The postoperative local appearance of the wounds was acceptable in every case, and no complications occurred.Conclusions:The LD free flap is a versatile tool for the treatment of complex postcraniotomy surgical site infections. This vascularized muscle flap is useful for controlling local infections because of its abundant vascularity. Moreover, its variety of uses means that it can resolve several problems in cases involving complex cranial wounds.
Relationship between Keloid Formation and YAP/TAZ Signaling
Authors: Aramaki-Hattori Noriko , Okabe Keisuke , Hamada Mariko , Takato Tamae , Kishi Kazuo 
Published: June 2017

Summary:
YAP (yes-associated protein) and TAZ (transcriptional coactivator with PDZ-binding motif) are part of a classical pathway that controls contact inhibition in the Hippo pathway. YAP and TAZ were recently reported to act as nuclear relays of mechanical signals that communicate extracellular matrix rigidity and cell shape. However, the role of YAP/TAZ signaling in keloid formation is unclear. Here, we used immunohistochemistry to investigate YAP/TAZ expression in keloid and nonaffected lesions. YAP/TAZ expression in keloid fibroblasts had a greater tendency to localize to the nucleus relative to that seen in fibroblasts from unaffected tissues. Meanwhile, keratinocytes or endothelial cells from either keloid or unaffected tissues showed no significant differences in YAP/TAZ expression patterns. These results suggest that YAP/TAZ nuclear localization in keloid fibroblasts might activate Hippo signaling and may play an important role in gene expression that affects keloid formation and stiffness.
Tc-99m-Human Serum Albumin Transit Time as a Measure of Arm Breast Cancer-Related Lymphedema
Authors: Toyserkani Navid M. , Hvidsten Svend , Tabatabaeifar Siavosh , Simonsen Jane A. , Høilund-Carlsen Poul F. , Sørensen Jens A. 
Published: June 2017

Background:
Lymphoscintigraphy has often been used for evaluating arm lymphatic dysfunction, but no optimal approach for quantification has so far emerged. We propose a quantifiable measure of lymphatic function that we applied in patients treated for breast cancer.

Methods:
Eleven patients, aged 34–68 years, with unilateral arm lymphedema following breast cancer treatment underwent bilateral lymphoscintigraphy using intradermal injection in both hands of technetium-99m–labeled human serum albumin and sequential 5 min imaging for 5 hours. The mean transit time (MTT) in the arms was calculated based on time activity curves generated from injection site and arm regions. Visual lymphedema scoring was performed based on dermal backflow and lymph node presence. Excess arm volume was calculated from circumference measurements.

Results:
The MTT (mean ± SD) was significantly longer in the lymphedema arm than in the normal arm: 60.1 ± 27.7 versus 5.4 ± 2.5 minutes (mean difference, 54.7 minutes; 95% confidence interval, 36.5–72.9 minutes; P < 0.0001). Patients with previous erysipelas infection had significantly longer MTT than other patients (mean difference, 43.7 minutes; 95% confidence interval, 18.6–68.7 minutes; P < 0.001). There was a positive correlation between MTT and excess arm volume (r = 0.64; P = 0.04) and number of lymph nodes removed (r = 0.65; P = 0.03) but no correlation between visual score and MTT.

Conclusion:
Measurements of MTT were able to discriminate lymphedema from healthy arm and MTT correlated with relevant markers for lymphedema severity. We encourage further research using the MTT approach for monitoring lymphedema and evaluation of treatment response.