bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oxygen Fraction Adjustment According to Body Surface Area during Extracorporeal Circulation
Authors: Arıtürk Cem , Özgen Serpil Ustalar , Danışan Behiç , Karabulut Hasan , Toraman Fevzi 
Published: June 2015

<p class="p1"><span class="s1"><strong>Background:</strong> The inspiratory oxygen fraction (FiO<sub>2</sub>) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO<sub>2</sub>) to reach hyperoxemic levels (&gt;180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO<sub>2</sub> levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO<sub>2</sub> levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO<sub>2</sub> during cardiac surgery.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO<sub>2</sub> adjustment strategies applied to the patients in the groups were as follows: FiO<sub>2</sub> levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Mean PaO<sub>2</sub> was significantly higher in Group I than in Group II at T2 and T3 (<em>P</em> = .0001 and <em>P</em> = .0001, respectively); in Group I than in Group III at T1 (<em>P</em> = .02); and in Group II than in Group III at T2, T3, and T4 <br /> (<em>P</em> = .0001 for all). </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>Adjustment of FiO<sub>2</sub> according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO<sub>2</sub> between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO<sub>2</sub> levels in concordance with the body temperature in the <br /> rewarming period.</span></p>
Insertion of the Intraaortic Balloon Pump via the Ascending Aorta or the Aortic Arch Using the HEARTSTRING Proximal Seal System
Authors: Lamm Peter , Juchem Gerd , Reichart Bruno , Kilian Eckehard 
Published: June 2015

<p class="p1"><span class="s1"><strong>Purpose: </strong>The HEARTSTRING Proximal Seal System is used to avoid aortic clamping to insert the intraaortic balloon pump (IABP) in the ascending aorta or the aortic arch. This technique is used when calcification or atheroma prevents side clamping of the ascending aorta or the aortic arch.</span></p><p class="p1"><span class="s1"><strong>Description:</strong> A vein graft or a small-caliber vascular prosthesis for the later insertion of the IABP is sewn to the ascending aorta or the aortic arch using the HEARTSTRING Proximal Seal System.</span></p><p class="p1"><span class="s1"><strong>Evaluation:</strong> In our department, this technique is applied whenever insertion of the IABP is not feasible via the femoral arteries. </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>The technique allows the safe insertion of the IABP via the ascending aorta or the aortic arch.</span></p>
LECUONA: CORPO E SENSAÇÃO EM MERLEAU-PONTY
Authors: Da Silva Thays Anyelle Macedo , Medeiros Rosie  Marie Do Nascimento 
Published: June 2015

Nesta pesquisa, convidamos a uma reflexão fenomenológica sobre corpo e sensação em Merleau-Ponty. Como possibilidade de leitura, escolhemos a obra “Lecuona” da Companhia de Dança Grupo Corpo. Pretende-se aproximar tal obra do discurso filosófico, principalmente dando movimento aos pensamentos fenomenológicos de Maurice Merleau-Ponty, em especial sua tese do sensível e os conhecimentos do corpo, posto que aberturas no conhecimento de modo geral, e na Filosofia moderna especificamente, permitiram, no cenário epistemológico contemporâneo, pensar-se o corpo fenomenal, atravessado por emoções, portanto estesiológico, que permite operações e expressão. Diante disso, recorremos à atitude fenomenológica de Maurice Merleau-Ponty como percurso metodológico, já que em seus estudos o filósofo lança um olhar expressivo sobre o corpo, configurando uma linguagem sensível que é expressa nos movimentos, onde aprofunda as teses da Fenomenologia num novo arranjo para o conhecimento enquanto resultado de nossa experiência no mundo vivido. As reflexões apresentadas neste pesquisa pretendem levar-nos ao espanto, ao qual muitos desafios se impõem, entre eles a compreensão do corpo e do conhecimento sensível.
Prospective Clinical Utility Study of the Use of the 21-Gene Assay in Adjuvant Clinical Decision Making in Women With Estrogen Receptor-Positive Early Invasive Breast Cancer: Results From the SWITCH Study
Authors: Gligorov Joseph , Pivot Xavier B. , Jacot William , Naman Hervé L. , Spaeth Dominique , Misset Jean-Louis , Largillier Rémy , Sautiere Jean-Loup , de Roquancourt Anne , Pomel Christophe , Rouanet Philippe , Rouzier Roman , Penault-Llorca Frederique M. ,   for The Francilian Breast Intergroup
Published: June 2015

Abstract

Background.
The 21-gene Oncotype DX Recurrence Score assay is a validated assay to help decide the appropriate treatment for estrogen receptor-positive (ER+), early-stage breast cancer (EBC) in the adjuvant setting. The choice of adjuvant treatments might vary considerably in different countries according to various treatment guidelines. This prospective multicenter study is the first to assess the impact of the Oncotype DX assay in the French clinical setting.

Methods.
A total of 100 patients with ER+, human epidermal growth factor receptor 2-negative EBC, and node-negative (pN0) disease or micrometastases in up to 3 lymph nodes (pN1mi) were enrolled. Treatment recommendations, physicians’ confidence before and after knowing the Recurrence Score value, and physicians’ perception of the assay were recorded.

Results.
Of the 100 patients, 95 were evaluable (83 pN0, 12 pN1mi). Treatment recommendations changed in 37% of patients, predominantly from chemoendocrine to endocrine treatment alone. The proportion of patients recommended chemotherapy decreased from 52% pretest to 25% post-test. Of patients originally recommended chemotherapy, 61% were recommended endocrine treatment alone after receiving the Recurrence Score result. For both pN0 and pN1mi patients, post-test recommendations appeared to follow the Recurrence Score result for low and high values. Physicians’ confidence improved significantly.

Conclusion.
These are the first prospective data on the impact of the Oncotype DX assay on adjuvant treatment decisions in France. Using the assay was associated with a significant change in treatment decisions and an overall reduction in chemotherapy use. These data are consistent with those presented from European and non-European studies.

Implications for Practice:
This study shows that in estrogen receptor-positive, human epidermal growth factor receptor 2-negative early breast cancer (either node-negative or with micrometastases in up to 3 lymph nodes), Oncotype DX testing is associated with a treatment recommendation change in more than a third of patients (primarily from chemoendocrine treatment to endocrine treatment alone but also in the opposite direction) and an overall reduction in chemotherapy use. These results are consistent with those from other decision impact studies worldwide and further emphasize the role of Oncotype DX testing in management of early breast cancer, as reflected in international treatment guidelines.
Aboveground vertebrate and invertebrate herbivore impact on net N mineralization in subalpine grasslands
Authors: Risch Anita C. , Schütz Martin , Vandegehuchte Martijn L. , van der Putten Wim H. , Duyts Henk , Raschein Ursina , Gwiazdowicz Dariusz J. , Busse Matt D. , Page-Dumroese Deborah S. , Zimmermann Stephan 
Published: June 2015

Aboveground herbivores have strong effects on grassland nitrogen (N) cycling. They can accelerate or slow down soil net N mineralization depending on ecosystem productivity and grazing intensity. Yet, most studies only consider either ungulates or invertebrate herbivores, but not the combined effect of several functionally different vertebrate and invertebrate herbivore species or guilds. We assessed how a diverse herbivore community affects net N mineralization in subalpine grasslands. By using size‐selective fences, we progressively excluded large, medium, and small mammals, as well as invertebrates from two vegetation types, and assessed how the exclosure types (ET) affected net N mineralization. The two vegetation types differed in long‐term management (centuries), forage quality, and grazing history and intensity. To gain a more mechanistic understanding of how herbivores affect net N mineralization, we linked mineralization to soil abiotic (temperature; moisture; NO3−, NH4+, and total inorganic N concentrations/pools; C, N, P concentrations; pH; bulk density), soil biotic (microbial biomass; abundance of collembolans, mites, and nematodes) and plant (shoot and root biomass; consumption; plant C, N, and fiber content; plant N pool) properties.Net N mineralization differed between ET, but not between vegetation types. Thus, short‐term changes in herbivore community composition and, therefore, in grazing intensity had a stronger effect on net N mineralization than long‐term management and grazing history. We found highest N mineralization values when only invertebrates were present, suggesting that mammals had a negative effect on net N mineralization. Of the variables included in our analyses, only mite abundance and aboveground plant biomass explained variation in net N mineralization among ET. Abundances of both mites and leaf‐sucking invertebrates were positively correlated with aboveground plant biomass, and biomass increased with progressive exclusion. The negative impact of mammals on net N mineralization may be related partially to (1) differences in the amount of plant material (litter) returned to the belowground subsystem, which induced a positive bottom‐up effect on mite abundance, and (2) alterations in the amount and/or distribution of dung, urine, and food waste. Thus, our results clearly show that short‐term alterations of the aboveground herbivore community can strongly impact nutrient cycling within ecosystems independent of long‐term management and grazing history.
Responsiveness and Minimal Clinically Important Change: A Comparison Between 2 Shoulder Outcome Measures
Authors: Christiansen David Høyrup , Frost Poul , Falla Deborah , Haahr Jens Peder , Frich Lars Henrik , Svendsen Susanne Wulff 
Published: June 2015

Study Design A prospective cohort study nested in a randomized controlled trial. Objectives To determine and compare responsiveness and minimal clinically important change of the modified Constant score (CS) and the Oxford Shoulder Score (OSS). Background The OSS and the CS are commonly used to assess shoulder outcomes. However, few studies have evaluated the measurement properties of the OSS and CS in terms of responsiveness and minimal clinically important change. Methods The study included 126 patients who reported having difficulty returning to usual activities 8 to 12 weeks after arthroscopic decompression surgery for subacromial impingement syndrome. The assessment at baseline and at 3 months included the OSS, the CS, and the European Quality of Life-5 Dimensions-3 Level (EQ-5D-3L) index. Responsiveness was assessed as follows: by correlation analysis between the change scores of the OSS, CS, and EQ-5D-3L index, and the Patient Global Impression of Change (PGIC) scale; by receiver-operating-characteristic (ROC) curve analysis using the PGIC scale as an external anchor; and by effect-size statistics. Results At 3 months, a follow-up assessment of 112 patients (89%) was conducted. The change scores of the CS and the OSS were more strongly correlated with the external anchor (PGIC scale) than the change score of the EQ-5D-3L index. The areas under the ROC curves exceeded 0.80 for both shoulder scores, with no significant differences between them, and comparable effect-size estimates were observed for the CS and the OSS. Minimal clinically important change ROC values were 6 points for the OSS and 11 points for the CS, with upper 95% cutoff limits of 12 and 22 points, respectively. Conclusion The CS and the OSS were both suitable for assessing improvement after decompression surgery. J Orthop Sports Phys Ther 2015;45(8):620–625. Epub 25 Jun 2015. doi:10.2519/jospt.2015.5760
Baseline Examination Factors Associated With Clinical Improvement After Dry Needling in Individuals With Low Back Pain
Authors: Koppenhaver Shane L. , Walker Michael J. , Smith Ryan W. , Booker Jacquelynn M. , Walkup Isaac D. , Su Jonathan , Hebert Jeffrey J. , Flynn Timothy 
Published: June 2015

Study Design Quasi-experimental. Objectives To explore for associations between demographic, patient history, and physical examination variables and short-term improvement in self-reported disability following dry needling therapy performed on individuals with low back pain (LBP). Background Dry needling is an intervention used with increasing frequency in patients with LBP; however, the characteristics of patients who are most likely to respond are not known. Methods Seventy-two volunteers with mechanical LBP participated in the study. Potential prognostic factors were collected from baseline questionnaires, patient history, and physical examination tests. Treatment consisted of dry needling to the lumbar multifidus muscles bilaterally, administered during a single treatment session. Improvement was based on percent change on the Oswestry Disability Index at 1 week. The univariate and multivariate associations between 33 potential prognostic factors and improved disability were assessed with correlation coefficients and multivariate linear regression. Results Increased LBP with the multifidus lift test (rpb = 0.31, P = .01) or during passive hip flexion performed with the patient supine (rpb = 0.23, P = .06), as well as positive beliefs about acupuncture/dry needling (rho = 0.22, P = .07), demonstrated univariate associations with Oswestry Disability Index improvement. Aggravation of LBP with standing (rpb = −0.27, P = .03), presence of leg pain (rpb = −0.29, P = .02), and any perception of hypermobility in the lumbar spine (rpb = −0.21, P = .09) were associated with less improvement. The multivariate model identified 2 predictors of improved disability with dry needling: pain with the multifidus lift test and no aggravation with standing (R2 = 0.16, P = .01). Conclusion Increased LBP with the multifidus lift test was the strongest predictor of improved disability after dry needling, suggesting that the finding of pain during muscle contraction should be studied in future dry needling studies. Level of Evidence Prognosis, level 1b. J Orthop Sports Phys Ther 2015;45(8):604–612. Epub 25 Jun 2015. doi:10.2519/jospt.2015.5801
Atrophy of the Quadriceps Is Not Isolated to the Vastus Medialis Oblique in Individuals With Patellofemoral Pain
Authors: Giles Lachlan S. , Webster Kate E. , McClelland Jodie A. , Cook Jill 
Published: June 2015

Study Design Cross-sectional. Objectives To determine if quadriceps atrophy was present in people with patellofemoral pain (PFP), and whether the vastus medialis oblique (VMO) was selectively involved. Background Despite the lack of research investigating individual quadriceps muscle size in individuals with PFP, it has been suggested that selective atrophy of the VMO relative to the vastus lateralis could be associated with PFP. Methods The quadriceps muscle sizes of 35 participants with PFP (22 with unilateral and 13 with bilateral symptoms) and 35 asymptomatic control participants matched for age and sex were measured using real-time ultrasound. The thicknesses of the VMO, vastus lateralis, vastus medialis, rectus femoris, and vastus intermedius were measured. Paired-samples t tests were used to compare muscle thickness between limbs in those with unilateral PFP, and independent t tests were used to compare muscle thickness between groups with and without PFP. Results In those with unilateral PFP, the thickness of all portions of the quadriceps muscle was statistically smaller in the symptomatic compared to the asymptomatic limb: VMO (P = .038), vastus medialis (P<.001), vastus lateralis (P = .005), vastus intermedius (P = .013), and rectus femoris (P = .045). No difference was found in thickness of any of the portions of the quadriceps on the affected side of people with PFP compared to asymptomatic controls: VMO (P = .148), vastus medialis (P = .474), vastus lateralis (P = .122), vastus intermedius (P = .466), and rectus femoris (P = .508). Conclusion Atrophy of all portions of the quadriceps muscles is present in the affected limb of people with unilateral PFP. There was no atrophy of the quadriceps in individuals with PFP compared to those without pathology. Selective atrophy of the VMO relative to the vastus lateralis was not identified in people with PFP. J Orthop Sports Phys Ther 2015;45(8):613–619. Epub 25 Jun 2015. doi:10.2519/jospt.2015.5852
Virtual Sensorimotor Balance Training for Children With Fetal Alcohol Spectrum Disorders: Feasibility Study
Authors: McCoy Sarah Westcott , Jirikowic Tracy , Price Robert , Ciol Marcia A. , Hsu Lin-Ya , Dellon Brian , Kartin Deborah 
Published: June 2015

BackgroundDiminished sensory adaptation has been associated with poor balance control for children with fetal alcohol spectrum disorders (FASD). A virtual reality system, Sensorimotor Training to Affect Balance, Engagement and Learning (STABEL), was developed to train sensory control for balance.ObjectivesThe purpose of this study was to examine the STABEL system in children with FASD and children with typical development (TD) to (1) determine the feasibility of the STABEL system and (2) explore the immediate effects of the STABEL system on sensory attention and postural control.DesignThis is a technical report with observational study data.MethodsEleven children with FASD and 11 children with TD, aged 8 to 16 years, completed 30 minutes of STABEL training. The children answered questions about their experience using STABEL. Sensory attention and postural control were measured pre- and post-STABEL training with the Multimodal Balance Entrainment Response system and compared using repeated-measures analysis of variance.ResultsAll children engaged in game play and tolerated controlled sensory input during the STABEL protocol. Immediate effects post-STABEL training in both groups were increased postural sway velocity and some changes in entrainment gain. Children with FASD showed higher entrainment gain to vestibular stimuli. There were no significant changes in sensory attention fractions.LimitationsThe small sample size, dose of STABEL training, and exploratory statistical analyses are study limitations, but findings warrant larger systematic study to examine therapeutic effects.ConclusionsChildren completed the training protocol, demonstrating the feasibility of the STABEL system. Differences in postural sway velocity post-STABEL training may have been affected by fatigue, warranting further investigation. Limited immediate effects suggest more practice is needed to affect sensory attention; however, entrainment gain changes suggest the STABEL system provoked vestibular responses during balance practice.
Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater
Authors: Takai Keisuke , Komori Takashi , Taniguchi Makoto 
Published: June 2015

OBJECT
The microvascular anatomy of spinal dural arteriovenous fistulas (AVFs), especially the relationships of the vessels with the dura mater, has yet to be angiographically demonstrated in detail and proven histologically.

METHODS
From January 2012 through April 2014, a total of 7 patients with spinal dural AVFs in the thoracic region underwent open microsurgical obliteration at Tokyo Metropolitan Neurological Hospital. The microvascular anatomy of spinal dural AVFs was comprehensively assessed by using advanced microangiography, including 3D computer graphics and intraoperative indocyanine green video angiography, and by histological findings.

RESULTS
The 2 microangiography techniques revealed the spatial course and in vivo blood flow of the meningeal vessels and their relationships with the dura mater in sufficient detail. The meningeal branch of the intercostal artery split into multiple meningeal vessels on the outer dural surface adjacent to the root sleeve. After crossing the dura mater to the inner dural surface, these vessels gathered and joined a single intradural draining vessel. On the inner dural surface, the single draining vessel was fed by the surrounding multiple meningeal vessels, which appeared to be caput medusae.
Histological findings revealed that the structure of the meningeal branch of the intercostal artery corresponded to that of a normal artery. The structure of intradural draining vessels corresponded to that of a vein modified by retrograde arterial inflow. On the inner dural surface, more than 1 meningeal artery gathered and joined with the proximal radiculomedullary vein.

CONCLUSIONS
Spinal dural AVFs are located on the inner dural surface, where multiple direct AV connections between more than 1 meningeal feeding artery and a single proximal radiculomedullary vein occur at the site where the vein connects to the dura mater.
Skull base chondrosarcoma radiosurgery: report of the North American Gamma Knife Consortium
Authors: Kano Hideyuki , Sheehan Jason , Sneed Penny K. , McBride Heyoung L. , Young Byron , Duma Christopher , Mathieu David , Seymour Zachary , McDermott Michael W. , Kondziolka Douglas , Iyer Aditya , Lunsford L. Dade 
Published: June 2015

OBJECT
Stereotactic radiosurgery (SRS) is a potentially important option for patients with skull base chondrosarcomas. The object of this study was to analyze the outcomes of SRS for chondrosarcoma patients who underwent this treatment as a part of multimodality management.

METHODS
Seven participating centers of the North American Gamma Knife Consortium (NAGKC) identified 46 patients who underwent SRS for skull base chondrosarcomas. Thirty-six patients had previously undergone tumor resections and 5 had been treated with fractionated radiation therapy (RT). The median tumor volume was 8.0 cm3 (range 0.9–28.2 cm3), and the median margin dose was 15 Gy (range 10.5–20 Gy). Kaplan-Meier analysis was used to calculate progression-free and overall survival rates.

RESULTS
At a median follow-up of 75 months after SRS, 8 patients were dead. The actuarial overall survival after SRS was 89% at 3 years, 86% at 5 years, and 76% at 10 years. Local tumor progression occurred in 10 patients. The rate of progression-free survival (PFS) after SRS was 88% at 3 years, 85% at 5 years, and 70% at 10 years. Prior RT was significantly associated with shorter PFS. Eight patients required salvage resection, and 3 patients (7%) developed adverse radiation effects. Cranial nerve deficits improved in 22 (56%) of the 39 patients who deficits before SRS. Clinical improvement after SRS was noted in patients with abducens nerve paralysis (61%), oculomotor nerve paralysis (50%), lower cranial nerve dysfunction (50%), optic neuropathy (43%), facial neuropathy (38%), trochlear nerve paralysis (33%), trigeminal neuropathy (12%), and hearing loss (10%).

CONCLUSIONS
Stereotactic radiosurgery for skull base chondrosarcomas is an important adjuvant option for the treatment of these rare tumors, as part of a team approach that includes initial surgical removal of symptomatic larger tumors.