bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical treatment of low lumbar osteoporotic vertebral collapse: a single-institution experience
Authors: Nakajima Hideaki , Uchida Kenzo , Honjoh Kazuya , Sakamoto Takumi , Kitade Makoto , Baba Hisatoshi 
Published: September 2015

OBJECT
Low lumbar osteoporotic vertebral collapse (OVC) has not been well documented compared with OVC of the thoracolumbar spine. The differences between low lumbar and thoracolumbar lesions should be studied to provide better treatment. The aim of this study was to clarify the clinical and imaging features as well as outcomes of low lumbar OVC and to discuss the appropriate surgical treatment.

METHODS
Thirty patients (10 men; 20 women; mean age 79.3 ± 4.7 years [range 70–88 years]) with low lumbar OVC affecting levels below L-3 underwent surgical treatment. The clinical symptoms, morphological features of affected vertebra, sagittal spinopelvic alignment, neurological status before and after surgery, and surgical procedures were reviewed at a mean follow-up period of 2.4 years.

RESULTS
The main clinical symptom was radicular leg pain. Most patients had old compression fractures at the thoracolumbar level. The affected vertebra was flat-type and concave or H-shaped type, not wedge type as often found in thoracolumbar OVC. There were mismatches between pelvic incidence and lumbar lordosis on plain radiographs. On CT and MR images, foraminal stenosis was seen in 18 patients (60%) and canal stenosis in 24 patients (80%). Decompression with short fusion using a posterior approach was performed. Augmentations of vertebroplasty, posterolateral fusion, and posterior lumbar interbody fusion were performed based on the presence/absence of local kyphosis of lumbar spine, cleft formation, and/or intervertebral instability. Although the neurological and visual analog scale scores improved postoperatively, 8 patients (26.7%) developed postoperative complications mainly related to instrumentation failure. In patients with postoperative complications, lumbar spine bone mineral density was significantly low, but the spinopelvic alignment showed no correlation when compared with those without complications.

CONCLUSIONS
The main types of low lumbar OVC were flat-type and concave type, which resulted in neurological symptoms by retropulsed bony fragments generating foraminal stenosis and/or canal stenosis. For patients with low lumbar OVC, decompression of the foraminal and canal stenosis with short fusion surgery via posterior approach can improve neurological symptoms. Since these patients are elderly with poor bone quality and other complications, treatments for both OVC and osteoporosis should be provided to achieve good clinical outcome.
Incidence of hemorrhage in the pediatric population with placement and removal of external ventricular drains
Authors: Miller Catherine , Guillaume Daniel 
Published: September 2015

OBJECT
External ventricular drains (EVDs) are regularly used in pediatric neurosurgery for diagnostic and therapeutic purposes. Hemorrhage caused by placing an EVD is a common complication noted in the adult literature. In the pediatric literature, on the other hand, only a few articles have assessed the risk of hemorrhage with placement, and none have reported the occurrence of hemorrhage with removal of an EVD. The authors investigated the incidence of hemorrhage with both placement and removal of the EVD in a pediatric population.

METHODS
After obtaining institutional review board approval, a comprehensive database was created to include all pediatric patients who required EVD placement between March 2008 and June 2014 at the authors’ institution. A retrospective chart review was completed, and all imaging was reviewed for evidence of hemorrhage with placement and removal of the EVD.

RESULTS
During the designated time period, 73 EVDs were placed in 63 patients (ages 2 weeks–17 years). Indications for EVD placement were as follows: shunt infection/malfunction (21), tumor (12), hydrocephalus (18), hemorrhage (12), edema (4), trauma (1), and other (5). Hemorrhage with placement was noted in 5 of the 50 patients who underwent imaging, with a volume ranging from 0.48 cm3 to 7.7 cm3. Thirty-two patients had imaging after EVD removal, and 7 of these patients were noted to have hemorrhage (volume range 0.012 cm3 to 81.5 cm3).

CONCLUSIONS
The authors found the incidence of hemorrhage at EVD placement to be 10%, and the incidence of hemorrhage on EVD removal to be 21.9% in those patients who underwent imaging after each event. Although none of the hemorrhages were of obvious clinical significance, these data can be useful in decision making, and in discussing the risks of EVDs with the patient’s family.
Role of endoscopy in gastroesophageal reflux disease
Authors: Rai Tarun , Vennalaganti Prashanth , Sharma Prateek 
Published: September 2015

AbstractGastroesophageal reflux disease is a condition due to reflux of stomach content in the esophagus causing trouble symptoms or complications or both. GERD is a clinical diagnosis and typically presents with a heartburn and/or regurgitation and a positive response to antacid secretory medications. GERD is the leading outpatient diagnosis among all gastrointestinal disorders in the United States. Approximately 40% of population report occasional symptoms of GERD whereas 10-20% of patients will have symptoms at least once in a week. Recent guidelines from gastrointestinal societies such as American College of Gastroenterology, American Society for Gastrointestinal Endoscopy and American College of Physicians have laid out specific indications regarding role of esophagogastroduodenoscopy in GERD. Despite these recommendations, studies have revealed that one-fifth to two-fifth EGDs may not be clinically indicated, especially where open access endoscopy referral system is used. Traditionally, GERD has been thought to be a disease of the western world. Prevalence rates had been estimated to be lower in Asia when compared to that of the Western Countries. Few recent epidemiological studies in India showed the prevalence of reflux disease in India to be between 8-24%, which is comparable to the western world. The use of EGDs becomes more critical for developing countries such as India where prevalence of GERD and BE is comparable to the western countries but have limited resources. In addition to direct cost for an EGD, it burdens economy with indirect costs such as time off from the work, transportation and any procedural complications. Risk stratifying patients with GERD may therefore prevent unnecessary procedures, harms and costs. The aim of this paper is to review the existing evidence on the role of endoscopy in GERD.
Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study
Authors: Dar Imtiyaz Ahmad , Dar Waseem Raja , Khan Mushtaq Ahmad , Kasana Basharat Ahmad , Sofi Najeeb Ullah , Hussain Moomin , Arshad Faheem , Wani Manzoor Ahmad , Latief Muzamil , Sodhi Jaswinder Singh 
Published: September 2015

Abstract
Introduction: Lower gastrointestinal bleeding (LGIB) is one of the leading causes for hospital admissions in gastroenterology wards all over the world. Patients usually present with hematochezia or bloody diarrhea. Colonoscopy is usually the initial diagnostic intervention followed by other more sophisticated tests. Bleeding may stop spontaneously, but evaluation is important because patients may harbor a sinister lesion like cancer. Aim of the Study: To determine the various etiologies, clinical presentations, a diagnostic test used and treatments received by LGIB patients admitted in our department. Materials and Methods: A total of 300 cases were studied which included 180 retrospective cases and 120 prospective cases. For retrospective cases, all the information was obtained by analyzing their case records while as prospective patients were managed as per a predefined protocol and details of various investigations and treatments documented. Results: Most commonly affected was elderly population (>60 years), constituting 40% (120/300) of studied population. Males constituted 59% (177/300) and females 41% (123/300). The most common clinical presentation of LGIB in our patients was hematochezia (63.6%, 191/300). Growth/polyp was the most common finding on colonoscopic examination seen in 29.3% (n = 88) patients. Inflammatory lesions were seen in 77 out of 239 (25.7%) patients. Wireless capsule endoscopy was positive in 13 out of 24 patients (54%). Computed tomography (CT) enterography showed positive results in 6 out of 25 (24%) cases. Red blood cell scan was done in seven patients while as CT angiography in in four patients. Therapeutic endoscopy was successful in 115 out of 239 patients with positive colonoscopy, polypectomy was the commonest procedure performed. Medical management was carried out in 34.6% patients. Surgical treatment was offered to 21% patients. Conclusion: Colonoscopy is the initial and most common investigation used in the evaluation of GI bleed. A polyp is the most common diagnosis while as polypectomy the most common therapeutic procedure.
Yield of colonoscopy with special reference to lower gastrointestinal bleeding in a tertiary referral center in Eastern India
Authors: Ray Gautam 
Published: September 2015

Abstract
Background: Little data exist on the yield of colonoscopy in its different indications, especially gastrointestinal (GI) bleeding. Furthermore, there are no formal guidelines regarding the timing of its performance in the work up for lower GI bleeding. Methods: In a retrospective study, spanning from January 2007 to December 2013, the clinical data of all the patients undergoing colonoscopy were retrieved from the hospital records including the predominant symptom which mandated colonoscopy and results of the other tests done before colonoscopy including upper GI endoscopy (esophagogastroduodenoscopy [EGD]). The type of GI bleed (overt or occult) along with the presence or absence of iron deficiency anemia (IDA) was noted. The yield of EGD in the corresponding years in those having a presentation with lower GI bleed and/or IDA was also noted for comparison. Results: Overall yield of colonoscopy was low (25.7%) like for all its indications except lower GI bleed where its yield was highest (45.2%). 81.2% of the cases with a diagnosis presented with lower GI bleed, highest for colon cancer (90%), and polyps (86.1%). Cases of occult bleed more often had a positive diagnosis than overt bleed (P = 0.02). EGD yielded positive findings in more cases (43.2%, P = 0.00) than colonoscopy (except piles). Colonic cancers and polyps were presented with hematochezia when compared to gastric cancer which presented more often with occult bleed and other clinical symptoms. Conclusion: EGD should be done first in lower GI bleeding to exclude upper GI source and select subsequent colonoscopy. For hematochezia and occult bleed, colonoscopy is important whether IDA is present or not.
Cytomegalovirus infection in gastrointestinal tract: A case series of three patients and review of literature
Authors: Ranjan Piyush , Gupta Varun , Goyal Mohan , Dhawan Shashi , Gupta Pallav , Kumar Mandhir , Sachdeva Munish 
Published: September 2015

AbstractCytomegalovirus disease can involve any site of gastrointestinal tract from oral cavity to rectum. CMV disease most frequently occurs in patients’ with immune deficiency, such as the acquired immunodeficiency syndrome, after organ transplantation, after cancer chemotherapy and in patients on immunosuppressive medications. The number of patients with immune deficiency has increased in recent years and has lead to a substantial increase in incidence of opportunistic CMV virus. Gastrointestinal CMV infection has also been reported in immunocompetent adults. Symptoms and signs depend on part of the gastrointestinal tract involved. Diagnosis depends either on a positive mucosal biopsy or by serology, quantitative PCR or CMV antigenemia. We report three cases of CMV infection in patients with three different underlying conditions and discuss the clinical features, diagnostic approach and treatment. All patients had positive serology with high viral load on PCR. Histology with immunohistochemistry was positive for CMV in two of the three cases. Ganciclovir response was seen in all patients in respect to clinical improvement, endoscopic resolution of lesions and clearing of the virus load.
Endoscopic ultrasound guided emergency coil and glue for actively bleeding duodenal varix after failed endoscopy
Authors: Choudhary Narendra S. , Rai Rahul , Rajesh Puri , Randhir Sud 
Published: September 2015

AbstractManagement of ectopic variceal bleed may be difficult at times due to anatomical location or presence of collaterals. We present a case of an elderly cirrhotic male with acute upper gastrointestinal bleed due to a large duodenal varix successfully managed by endoscopic ultrasound guided coil placement along with glue (N-butyl-2-cyanoacrylate) injection.
Evaluation of Microstructural Effects on the Degree of Sensitization (DOS) of a UNS S31803 Duplex Stainless Steel Aged at 475°C
Authors: de Melo Evelin Barbosa , Magnabosco Rodrigo 
Published: September 2015

In this study, microstructural and electrochemical behavior of a UNS S31803 duplex stainless steel aged at 475°C were investigated. Hardness values increased with aging at 475°C and evidence of alpha prime (α′) phase formation was confirmed by transmission electron microscopy analysis. Double loop electrochemical potentiokinetic reactivation measurements in a 2 M H2SO4 + 0.5 M NaCl + 0.01 M KSCN solution showed an increase in the degree of sensitization values, mainly for the sample aged for 360 h at 475°C. Moreover, the results suggest that α′ phase formation occurred via spinodal decomposition mechanism.
An Exploration of Three Peer Tutoring Cases in the School Orchestra Program
Authors: Webb Richard S. 
Published: September 2015

AbstractThe purpose of this multiple case study was to explore the choices, thought processes, and evidence of knowledge construction of high school string players in their role as peer tutors. Three high school students served as participants and were observed and video-recorded while teaching private lessons to sixth grade students from within their district’s orchestra program. Lesson data were supplemented by pre- and postlesson interviews with, and written reflections by, each of the participants. After a cross-case analysis of the data, four themes emerged: (a) choices from experiences, (b) reorganization and communication, (c) enjoyment and value, and (d) perception of roles. Interviews with the participants suggested that the act of teaching younger peers might contribute to an increased motivational interest for learning on the part of the tutors. Student-centered learning experiences such as peer tutoring may also foster an increased sense of ownership, both of the music program in which the tutors participate and of the tutors’ own learning. Findings supported the results of prior studies in the areas of communication, responsibility, altruism, selfconfidence, self-efficacy, and other cognitive-affective aspects of tutoring. Implications for informing music education practice, and suggestions for further research into peer teaching and learning in the music classroom, are offered.
Barriers and facilitators adolescent females living with HIV face in accessing contraceptive services: a qualitative assessment of providers’ perceptions in western Kenya
Authors: Hagey Jill M , Akama Eliud , Ayieko James , Bukusi Elizabeth A , Cohen Craig R , Patel Rena C 
Published: September 2015

IntroductionAvoiding unintended pregnancies is important for the health of adolescents living with HIV and has the additional benefit of preventing potential vertical HIV transmission. Health facility providers represent an untapped resource in understanding the barriers and facilitators adolescents living with HIV face when accessing contraception. By understanding these barriers and facilitators to contraceptive use among adolescent females living with HIV, this study aimed to understand how best to promote contraception within this marginalized population.MethodsWe conducted structured in‐depth interviews with 40 providers at 21 Family AIDS Care & Education Services ‐ supported clinics in Homabay, Kisumu and Migori counties in western Kenya from July to August 2014. Our interview guide explored the providers’ perspectives on contraceptive service provision to adolescent females living with HIV with the following specific domains: contraception screening and counselling, service provision, commodity security and clinic structure. Transcripts from the interviews were analyzed using inductive content analysis.ResultsAccording to providers, interpersonal factors dominated the barriers adolescent females living with HIV face in accessing contraception. Providers felt that adolescent females fear disclosing their sexual activity to parents, peers and providers, because of repercussions of perceived promiscuity. Furthermore, providers mentioned that adolescents find seeking contraceptive services without a male partner challenging, because some providers and community members view adolescents unaccompanied by their partners as not being serious about their relationships or having multiple concurrent relationships. On the other hand, providers noted that institutional factors best facilitated contraception for these adolescents. Integration of contraception and HIV care allows easier access to contraceptives by removing the stigma of coming to a clinic solely for contraceptive services. Youth‐friendly services, including serving youth on days separate from adults, also create a more comfortable setting for adolescents seeking contraceptive services.ConclusionsProviders at these facilities identified attitudes of equating seeking contraceptive services with promiscuity by parents, peers and providers as barriers preventing adolescent females living with HIV from accessing contraceptive services. Health facilities should provide services for adolescent females in a youth‐friendly manner and integrate HIV and contraceptive services.
Program allocation process improvement by an assignment model
Authors: IŞIK Okay , BİLGE Muhammet , KILIÇARSLAN Yıldırım 
Published: September 2015

AbstractAs the only source of jet pilot candidates for Turkish Air Force, Air Force Academy (TuAFA) applies several screening processes in order to acquire an average group of 150 cadets from civilian high school graduates each year. Besides the nationwide examinations (YGS-LYS), there are several others such as medical, flight, athletics evaluations and etc. Because the number of criteria for screening is large, the spread of the distribution of YGS-LYS scores of the candidates, which is assumed to be the aptitude towards college education, is a lot wider than those of other universities. Although admission to faculty for civilian high school students is regulated by the YGS-LYS score; in order to provide a balance distribution among different programs in terms of YGS-LYS score, placement to aerospace, electronics, computer and Industrial engineering programs of the Faculty is governed by a special directive. Although the directive considers candidates’ preferences, the ultimate goal of the algorithm in the directive is to keep the balance of academic success among different programs in the allocation process. In this study, we propose an alternative assignment model which tries to minimize the deviations from students’ preferences while maintaining the balance of the distribution among programs. Through simulation from different preference distributions with different number of students, it has been showed that regardless of the number of students and distribution of preferences,first choice allocation performance of the proposed model is significantly better than the directive’s algorithm.
Vertical Movements, Behavior and Habitat Utilization of Adult Yellowfin Tuna (Thunnus albacares) Tagged in West Philippine Sea, Mindoro Island, Philippines
Authors: Macusi Edison D. , Babaran Ricardo P. , Ingles Jose T. 
Published: September 2015

This paper describes the vertical movements, behavior and habitat utilization of an electronically tagged adult yellowfin tuna (Thunnus albacares) after 17 days of liberty in the Philippines based on analyses of 23,845 datapoints recorded from a recovered electronic popup tag. The exhaustive set provides a way to describe the vertical movement as well as a range of behaviors exhibited by the fish. We used the daily time records of depth and temperature from the vertical dives of the fish at different times of the day (nocturnal, dawn, diurnal, dusk) to describe fish behavior and to characterize its three deep dives. The fish stayed 23% and 24% of its time at warmer waters of 28 0C and 30 0C. It also spent 15% of its time at 26 0C and 10% of its time at colder waters of 20 0C and 22 0C. The daily differences in temperatures fluctuated from 12.10C to 30.1 0C with the daily average temperature of 24.2 0C. Swimming speeds determined show the maximum vertical ascent speed that the fish registered reached 1.53m/s swimming from a depth of 195m to 104m during a dusk. The maximum vertical descent speed reached 1.38m/s from a depth of 78m down to 161m. The deepest dive of the fish started from a U-shaped diving profile that lasted for almost 32 minutes and then followed by another U-shaped dive for 12 minutes before a deep dive and fast vertical ascent. The total duration of its dives differ with water depth: 0-50m (1.89 hours), 50-75m (4.78 hours), 75-100m (3.35 hours), 100-125m (1.69 hours), 125-150m (1.69 hours). Such swimming behavior provides valuable information on the vulnerability of tunas particularly the juvenile fishery. Keywords - Archival tag, fish aggregating device (FAD), Mindoro Island, West Philippine Sea, Yellowfin tuna, Philippines