bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consideraciones quirúrgicas propias de la epilepsia en niños, comentarios sobre Perú.
Authors: Campos Manuel , Ríos Loreto , Solari Francesca , Varela Ximena , Otayza Felipe 
Published: February 2016

Las epilepsias resistentes a fármacos son aquellas donde hay persistencia de crisis pese a un tratamiento farmacológico óptimo. En niños su tratamiento es diferente al de los adultos, ya que las crisis producen daños encefálicos irrecuperables en un cerebro en desarrollo, por lo que se recomienda plantearla cirugía lo más precoz posible en casos de epilepsia refractaria y con alternativa terapeútica quirúrgica, incluso aunque las crisis lleven pocos meses de evolución. Entre el 25 al 33% de los niños presentan epilepsias resistentes a fármacos y la mitad de ellos son candidatos para iniciar un estudio prequirúrgico. En Perú aproximadamente 650 niños al año necesitarían cirugía, pero solo se operan unos pocoscasos al año, si a esto agregamos los casos rezagados de los años anteriores, significa que hay miles de niños que esperan por una cirugía de la epilepsia. Este artículo revisa el estado del arte actual
El tratamiento moral y los inicios del manicomio en el Perú.
Authors: Stucchi-Portocarrero Santiago 
Published: February 2016

El tratamiento moral se desarrolló en Europa a fines del siglo XVIII, como una ideología que planteaba un trato humanitario hacia el enfermo mental, oponiéndose a los métodos brutalmente coercitivos habituales hasta ese entonces. En el Perú fue José Casimiro Ulloa el introductor de aquellas ideas, al denunciar la deplorable situación de las loquerías de los hospitales San Andrés y Santa Ana, lo que llevó a la fundación del Hospital Civil de la Misericordia en 1859. En el nuevo establecimiento se intentó llevar a cabo una reforma de la asistencia manicomial, pero con el paso de los años el local resultó estrecho para la creciente población. La inauguración del Asilo Colonia de la Magdalena en 1918 significó una nueva esperanza para quienes seguían abogando por un buen trato hacia los enfermos mentales. Lamentablemente la historia de hacinamiento y malos tratos se repetiría en el nuevo hospital en las siguientes décadas.
Síndrome cortico-basal como una presentación clínica de una enfermedad de Creutzfeldt-Jakob esporádica.
Authors: Torres-Ramírez Luis , Sarapura-Castro Hugo , Cosentino-Esquerre Carlos , Vélez-Rojas Miriam 
Published: February 2016

La enfermedad de Creutzfeldt-Jakob (ECJ) es una enfermedad neurodegenerativa caracterizada por demencia rápidamente progresiva, mioclonías, compromiso motor y alteraciones características en los exámenes auxiliares; sin embargo existen presentaciones clínicas atípicas del cuadro. Presentamos un caso de ECJ esporádica en asociación clínica con un síndrome cortico-basal caracterizado por apraxia de extremidades, déficit sensorial cortical, fenómeno del miembro ajeno, bradicinesia y rigidez asimétricos; que es la presentación clásica de la degeneración corticobasal. Además los hallazgos en el electroencefalograma, resonancia magnética cerebral y resultado de la proteína14-3-3 en LCR fueron compatibles con ECJ esporádico probable. Este caso sugiere que el compromiso neurológico asimétrico puede asociarse a ECJ esporádico
Nivel de sobrecarga emocional en familiares cuidadores de personas con esquizofrenia en un hospital público de Lambayeque-Perú.
Authors: Li-Quiroga Mey-Ling , Alipázaga-Pérez Pedro , Osada Jorge , León-Jiménez Franco 
Published: February 2016

Objetivos: Describir el nivel de sobrecarga emocional en familiares cuidadores de personas con esquizofrenia atendidos en el Hospital Regional Docente Las Mercedes (HRDLM), Lambayeque-Perú, desde a octubre a diciembre del 2013. Material y Métodos: Estudio transversal descriptivo con análisis exploratorio. Se invitó a participar a todos los familiares cuidadores que tenían a cargo personas con esquizofrenia atendidas por consultorio externo durante el periodo de tiempo descrito. Se aplicó la Escala de Sobrecarga de Cuidador de Zarit, la cual fue validada por los investigadores para el presente estudio y se aplicó luego de obtener el respectivo consentimiento informado.Resultados: Se incluyeron en el estudio a 122 familiares cuidadores (principales), de los cuales 68,85% (84/122) fueron mujeres, y de ellas 40,16% (49/122) eran madres de la persona con esquizofrenia. Se encontró que una cantidad elevada de familiares cuidadores presentan sobrecarga emocional (72,95% -89/122-), entre los cuales la más frecuente es la sobrecarga leve (69,66% -62/89-). Las mayores frecuencias de sobrecarga emocional se encontraronen casos de cuidador: cónyuge (94,12% -16/17-), padre (94,44% -17/18-) y en cuidador sin instrucción (90,00%-9/10-). Conclusiones: Existen niveles altos de sobrecarga emocional en los familiares cuidadores entrevistados. Los resultados sugieren la necesidad de realizar intervenciones que permitan identificar y afrontar este problema, sobre todo enfocadas a cuidadores cónyuges, padres y con menor nivel de educación.
Astrocitoma pilocítico en niños: Reporte de un caso.
Authors: Guevara Julissa K. , Milla Luis M. , Casavilca Sandro , Vila Judith R. , Juárez Tania , Espinoza Iván O. , Guillén-Pinto Daniel 
Published: February 2016

Se reporta el caso de un niño de 10 años que se presentó con dos semanas de enfermedad caracterizada por cefalea, vómitos, marcha tambaleante y somnolencia. El examen clínico reveló bradilalia, ataxia, hiperreflexia, nistagmo horizontal y vertical, parálisis del VI nervio craneal izquierdo y signos de frontalización. En la tomografía yresonancia cerebrales se encontró hidrocefalia obstructiva por un tumor de la fosa posterior. La anatomía patológica reveló Astrocitoma Pilocítico grado I (WHO).
MELAS en el Perú: reporte de caso.
Authors: Escalante-Gavancho Carlos , Vattuone-Echevarría Jorge A. , Candia-Rivera Elizabeth , Isidro-Huarcaya Jaime , Escalante-Canorio Jorge 
Published: February 2016

El síndrome de MELAS es una rara citopatía mitocondrial de difícil diagnóstico. Reportamos el caso de una niña de 10 años, que ingresó al Instituto Nacional de Ciencias Neurológicas de Lima, Perú, quien presentó episodios bruscos similares a accidentes cerebrovasculares y crisis epilépticas. Los estudios de neuroimágenes mostraron infartos y el examen genético fue positivo para MELAS identificando la mutación más frecuente A3243G.
Enriching Rice Grain Zinc through Zinc Fertilization and Water Management
Authors: Tuyogon D.S.J. , Impa S.M. , Castillo O.B. , Larazo W. , Johnson-Beebout S. E. 
Published: February 2016

Core Ideas
Rice grain‐Zn concentration increased with more aerobic soil conditions.
Fertilizer‐Zn applied to soil had limited effect on rice grain‐Zn concentration.
Rice paddy water management affected soil redox potential and DTPA‐extractable Zn.
Combined water and Zn management are useful for agronomic Zn biofortification.
Agronomic biofortification was not sufficient to meet rice Zn nutrition targets.
Increasing rice (Oryza sativa) grain‐Zn concentration is important for achieving improved human nutrition. Our objective was to understand how agronomic management practices, including water management and fertilizer‐Zn application rate and timing, affect plant growth, grain‐Zn concentration, and yield of rice genotypes. In a series of four‐field experiments over three seasons, we tested multiple combinations of water management techniques and fertilizer‐Zn application techniques. The use of alternate wetting and drying (AWD) water management increased (p < 0.001) soil redox potential and diethylene triamine pentaacetic acid (DTPA)‐extractable soil Zn compared with continuous flooding (CF) in the 0‐ to 2‐cm soil depth, but not always in the 2‐ to 10‐cm depth. On average, AWD grain‐Zn concentration increased 9% over CF without any yield penalty. Fertilizer‐Zn application increased DTPA‐extractable Zn only in the top soil layer and only temporarily, with a corresponding increase in grain‐Zn concentration only at rates > 10 kg Zn ha−1. Different timings of fertilizer‐Zn application (from basal to flowering) had no effect on grain‐Zn concentration or yield. Overall, our results indicated that AWD had a consistent and larger positive effect than fertilizer‐Zn application on grain‐Zn concentration. However, the increase in grain‐Zn concentration due to fertilizer‐Zn or water management was small, up to 2 mg Zn kg−1 brown rice, implying that improved agronomic management alone is not sufficient to meet the target increase of at least 10 mg Zn kg−1, but is a useful complementary strategy for enhancing the performance of Zn‐enriched rice by improving soil‐Zn availability.
Determining Soil Bulk Density with Thermo‐Time Domain Reflectometry: A Thermal Conductivity‐Based Approach
Authors: Lu Yili , Liu Xiaona , Heitman Joshua , Horton Robert , Ren Tusheng 
Published: February 2016

Core IdeasA method for monitoring soil bulk density from thermal conductivity and water content is provided.The new approach provides reliable bulk density data in both laboratory and field conditions.The new approach performs better than the heat capacity‐based method.The bulk density (ρb) of a tilled soil layer usually varies with depth and time. It is difficult to measure in situ ρbwith available instruments. Here we present a new approach that is capable of monitoring in situ ρbbased on thermal conductivity (λ) measurements. The proposed approach relies on an empirical model that relates λ to soil particle‐size distribution, ρb, and volumetric water content (θ). The thermo‐time domain reflectometry (thermo‐TDR) sensor measures λ and θ simultaneously, and knowing soil texture a priori, ρbis estimated using the empirical model. The approach was tested using datasets obtained on repacked and intact soil samples with a wide range of ρband θ. Further evaluations were made using in situ ρbmeasurements with thermo‐TDR sensors in four tillage treatments. The laboratory results showed that the λ‐based thermo‐TDR method was able to provide reliable ρbwith root mean square errors (RMSE) within 0.17 g cm‐3. Under field conditions, the λ‐based thermo‐TDR method also provided accurate ρbestimates with relative error generally within 10%. Under both laboratory and field conditions, the λ‐based thermo‐TDR method performed better than the heat capacity (C)‐based thermo‐TDR method. Differences were attributed mainly to C errors resulting from probe deflections, while λ measurements with the thermo‐TDR method were not affected by probe deflections. The λ‐based approach provides a way to obtain nondestructive, repeated, and in situ ρbestimates with the thermo‐TDR method both in laboratory and field settings.
The Selected Aspects of Application of Monetary Policy in the Economic and Monetary Union Pre-and-Post 2008
Authors: Vojtaššák Marek 
Published: February 2016

Abstract

Purpose of the article is to present in two parts the selected aspects of application of monetary policy in the euro area pre and post 2008 as well as insitutional adaptations brought by the EU legislator.

Methodology/methods In order to better explain these points, the article relies partially on a comparison with the framework and application of the monetary policy by the Federal Reserve as well as on a historic method when outlining the influence of definition of financial stability from the ECB/Eurosystem towards other prominent central banks.

Scientific aim The article presents selected aspects of the monetary policy in the part of the EU where single currency was introduced in order to outline state of the art governance structure as well as a certain institutional creativity in application of powers conferred upon the central banks by the Treaty on the Functioning of the European Union and Protocol on the Statute of the European System of Central Banks and of the European Central Bank. The goal is to prove (i) the hypothesis of robustness of the framework and (ii) present the limits that can only be pushed further by the legislative power.

The conclusions confirm on the one hand that the framework of monetary policy based on strong institutional safeguards such as legislative power and independence is very resilient and can prove efficient and creative enough to stabilise an innovative monetary system, however, on the other hand, validate the hypothesis that certain adaptations can only be performed on the basis of a legislative adaptations.
Preliminary Evaluation of a Modified STarT Back Screening Tool Across Different Musculoskeletal Pain Conditions
Authors: Butera Katie A. , Lentz Trevor A. , Beneciuk Jason M. , George Steven Z. 
Published: February 2016

Abstract

Background
The STarT Back Screening Tool is a validated multidimensional screening measure and risk stratification tool for people with low back pain.

Objective
The study objective was to compare relationships between a modified STarT Back Screening Tool (mSBT) and clinical and psychological measures in people with low back, neck, shoulder, and knee pain. The hypothesis was that the relationships between mSBT scores and clinical and psychological measure scores would be similar across the included musculoskeletal pain conditions.

Design
A cross-sectional, secondary analysis was done in this study.

Methods
Participants with low back (n=118), neck (n=92), shoulder (n=106), or knee (n=111) pain were recruited, and an mSBT was developed for use across the pain conditions. Separate hierarchical linear regression models were developed, with clinical (health status, pain intensity, and disability) and psychological (kinesiophobia, catastrophizing, fear avoidance, anxiety, depressive symptoms, and self-efficacy) measures as dependent variables. Demographic and pain region variables were entered in the first step, mSBT scores were entered in the second step, and pain region × mSBT interactions were entered in the last step.

Results
In the final models, no interactions were identified, suggesting that dependent measure scores did not differ by pain region. The strongest contributor for all dependent variables was mSBT scores (β=|0.32|–|0.68|); higher mSBT scores were associated with poorer health status and self-efficacy and with higher levels of pain intensity, disability, kinesiophobia, catastrophizing, fear avoidance, anxiety, and depressive symptoms.

Limitations
Generalizability was restricted to physical therapy outpatients with the included pain conditions. The mSBT used in this study is not ready for clinical implementation.

Conclusions
The results of this study support the feasibility of using a single measure for concise risk assessment across different musculoskeletal pain conditions. Further longitudinal studies are needed to better direct the clinical use of an mSBT in people with low back, neck, shoulder, and knee pain.
Outcome of hospital discharge on postoperative Day 1 following uncomplicated tethered spinal cord release
Authors: Poonia Seerat , Graber Sarah , Corbett Wilkinson C. , O'neill Brent R. , Handler Michael H. , Hankinson Todd C. 
Published: February 2016

OBJECTIVE
Postoperative management following the release of simple spinal cord–tethering lesions is highly variable. As a quality improvement initiative, the authors aimed to determine whether an institutional protocol of discharging patients on postoperative day (POD) 1 was associated with a higher rate of postoperative CSF leaks than the prior protocol of discharge on POD 2.

METHODS
This was a single-center retrospective review of all children who underwent release of a spinal cord–tethering lesion that was not associated with a substantial fascial or dural defect (i.e., simple spinal cord detethering) during 2 epochs: prior to and following the institution of a protocol for discharge on POD 1. Outcomes included the need for and timing of nonroutine care of the surgical site, including return to the operating room, wound suturing, and nonsurgical evaluation and management.

RESULTS
Of 169 patients identified, none presented with CSF-related complications prior to discharge. In the preintervention group (n = 113), the postoperative CSF leak rate was 4.4% (5/113). The mean length of stay was 2.3 days. In the postintervention group, the postoperative CSF leak rate was 1.9% (1/53) in the patients with postdischarge follow-up. The mean length of stay in that group was 1.3 days.

CONCLUSIONS
At a single academic children's hospital, a protocol of discharging patients on POD 1 following uncomplicated release of a simple spinal cord–tethering lesion was not associated with an increased rate of postoperative CSF leaks, relative to the previous protocol. The rates identified are consistent with the existing literature. The authors' practice has changed to discharge on POD 1 in most cases.
Anterior cervical discectomy and fusion in the outpatient ambulatory surgery setting compared with the inpatient hospital setting: analysis of 1000 consecutive cases
Authors: Adamson Tim , Godil Saniya S. , Mehrlich Melissa , Mendenhall Stephen , Asher Anthony L. , McGirt Matthew J. 
Published: February 2016

OBJECTIVE
In an era of escalating health care costs and pressure to improve efficiency and cost of care, ambulatory surgery centers (ASCs) have emerged as lower-cost options for many surgical therapies. Anterior cervical discectomy and fusion (ACDF) is one of the most prevalent spine surgeries performed, and the frequency of its performance is rapidly increasing as the aging population grows. Although ASCs offer significant cost advantages over hospital-based surgical centers, concern over the safety of outpatient ACDF has slowed its adoption. The authors intended to 1) determine the safety of the first 1000 consecutive ACDF surgeries performed in their outpatient ASC, and 2) compare the safety of these outpatient ACDFs with that of consecutive ACDFs performed during the same time period in the hospital setting.

METHODS
A total of 1000 consecutive patients who underwent ACDF in an ACS (outpatient ACDF) and 484 consecutive patients who underwent ACDF at Vanderbilt University Hospital (inpatient ACDF) from 2006 to 2013 were included in this retrospective study of patients' medical records. Data were collected on patient demographics, comorbidities, operative details, and perioperative and 90-day morbidity. Perioperative morbidity and hospital readmission were compared between the outpatient and inpatient ACDF groups.

RESULTS
Of the first 1000 outpatient ACDF cases performed in the authors' ASC, 629 (62.9%) were 1-level and 365 (36.5%) were 2-level ACDFs. Mean patient age was 49.5 ± 8.6, and 484 (48.4%) were males. All patients were observed postoperatively at the ASC postanesthesia care unit (PACU) for 4 hours before being discharged home. Eight patients (0.8%) were transferred from the surgery center to the hospital postoperatively (for pain control [n = 3], chest pain and electrocardiogram changes [n = 2], intraoperative CSF leak [n = 1], postoperative hematoma [n = 1], and profound postoperative weakness and surgical reexploration [n = 1]). No perioperative deaths occurred. The 30-day hospital readmission rate was 2.2%. All 90-day surgical morbidity was similar between outpatient and inpatient cohorts for both 1-level and 2-level ACDFs.

CONCLUSIONS
An analysis of 1000 consecutive patients who underwent ACDF in an outpatient setting demonstrates that surgical complications occur at a low rate (1%) and can be appropriately diagnosed and managed in a 4-hour ASC PACU window. Comparison with an inpatient ACDF surgery cohort demonstrated similar results, highlighting that ACDF can be safely performed in the outpatient ambulatory surgery setting without compromising surgical safety. In an effort to decrease costs of care, surgeons can safely perform 1- and 2-level ACDFs in an ASC environment.
Sequence Mining of Comorbid Neurodevelopmental Disorders Using the SPADE Algorithm
Authors: Pimus Inna , Schertz Mitchell , Peleg Mor 
Published: February 2016

SummaryObjectives: Understanding the progression of comorbid neurodevelopmental disorders (NDD) during different critical time periods may contribute to our comprehension of the underlying pathophysiology of NDDs. The objective of our study was to identify frequent temporal sequences of developmental diagnoses in noisy patient data.Methods: We used a data set of 2810 patients, documenting NDD diagnoses given to them by an NDD expert at a child developmental center during multiple visits at different ages. Extensive preprocessing steps were developed in order to allow the data set to be processed by an efficient sequence mining algorithm (SPADE).Results: The discovered sequences were validated by cross validation for 10 iterations; all correlation coefficients for support, con -fidence and lift measures were above 0.75 and their proportions were similar. No significant differences between the distributions of sequences were found using KolmogorovSmirnov test.Conclusions: We have demonstrated the feasibility of using the SPADE algorithm for discovery of valid temporal sequences of co-morbid disorders in children with NDDs. The identification of such sequences would be beneficial from clinical and research perspectives. Moreover, these sequences could serve as features for developing a full-fledged temporal predictive model.
Evaluation of a Veress needle for the fluid egress system of stifle arthroscopy in toy dog breeds
Authors: Cha Jae-Gwan , Beom Lee Hae , Cheong Hye-Yeon , Heo Su-Young , Ragetly Guillaume 
Published: February 2016

SummaryObjectives: The aim of this study was to evaluate the use of a Veress needle as a fluid egress system for stifle arthroscopy in toy dog breeds.Methods: Cadaveric canine stifle joints (n = 32) were prepared to induce an artificial intra-articular haemorrhagic effect, followed by stifle arthroscopy. The stifles were randomly assigned to one of three groups, and a fluid egress portal was established using a Veress needle (VN), a standard egress cannula (SE), or an intravenous catheter stylet (CS). Time to establish the egress portal, arthroscopic visibility, and egress portal performance were evaluated during the arthroscopy. After the arthroscopic examinations, iatrogenic cartilage lesions were identified and analysed using the percentage area of cartilage damage (%ACD).Results: The overall arthroscopic visibility and egress portal performance were not significantly different among the groups. The egress portal establishment was faster for the VN (33 sec) and the CS (34 sec) groups than for the SE (43 sec) group (p = 0.001). On gross joint examination, no iatrogenic laceration was found in the VN group, whereas four out of 10 of the SE and two out of 10 of the CS specimens had linear cartilage excoriation on the stifle joints. The %ACD score of the VN group was lower than those of the SE group (p = 0.009) and the CS group (p = 0.001).Clinical significance: The Veress needle method used in this study was useful to establish a fluid egress system and limit iatrogenic cartilage excoriations. This technique could become the method of choice for stifle arthroscopy, especially in smaller dogs.