bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Time Course of Dexamethasone Delivery Using Iontophoresis Through Human Skin, Measured via Microdialysis
Authors: Rigby Justin H. , Draper David O. , Johnson A. Wayne , Myrer J. William , Eggett Dennis L. , Mack Gary W. 
Published: February 2015

Study Design Controlled laboratory study. Objective To determine the time course of dexamethasone sodium phosphate (Dex-P) during iontophoresis to underlying tissues using microdialysis. Background In human participants, real-time information of Dex-P transdermal delivery during iontophoresis is unknown. Methods Sixty-four healthy male participants (mean ± SD age, 24.2 ± 3.3 years; height, 181.8 ± 26.1 cm; mass, 82.4 ± 11.8 kg; subcutaneous fat thickness, 0.61 ± 0.19 cm) were randomly assigned into 1 of 6 groups: (1) 1-mA current, 1-mm probe depth; (2) 1-mA current, 4-mm probe depth; (3) 2-mA current, 1-mm probe depth; (4) 2-mA current, 4-mm probe depth; (5) in vivo retrodialysis; and (6) skin perfusion flowmetry. Microdialysis probes were used to assess the combined recovery (Dex-total) of Dex-P, dexamethasone, and its metabolite. Results There was no difference in Dex-total between current intensities (P = .99), but a greater amount of Dex-total was recovered superficially at 1 mm compared to the 4-mm depth (P<.0001). Peak concentration mean ± SD values for the 1- and 2-mA currents at 1 mm were 10.8 ± 8.1 and 7.7 ± 5.5 µg/mL, and at 4 mm were 2.0 ± 0.8 and 1.3 ± 0.9 µg/mL, respectively. Peak skin perfusion was 741.4% ± 408.7% and 711.6% ± 260.8% at baseline for 1- and 2-mA intensities, respectively. Skin perfusion returned to baseline levels earlier during 1-mA intensity at a 110 mA·min dose within the treatment, compared to 2 mA at 60 minutes posttreatment. Conclusion Transdermal delivery of Dex-P during iontophoresis was successfully measured in vivo through human skin. Measurable concentrations of Dex-total were found regardless of current intensity. Although current-induced vasodilation occurred, it did not significantly affect the tissue accumulation of Dex-total. J Orthop Sports Phys Ther 2015;45(3):190–197. doi:10.2519/jospt.2015.5308
Decreased apparent diffusion coefficient in the pituitary and correlation with hypopituitarism in patients with traumatic brain injury
Authors: Zheng Ping , He Bin , Guo Yijun , Zeng Jingsong , Tong Wusong 
Published: February 2015

OBJECT
The relationship between microstructural abnormality in patients with traumatic brain injury (TBI) and hormone-secreting status remains unknown. In this study, the authors aimed to identify the role of the apparent diffusion coefficient (ADC) using a diffusion-weighted imaging (DWI) technique and to evaluate the association of such changes with hypopituitarism in patients with TBI.

METHODS
Diffusion-weighted images were obtained in 164 consecutive patients with TBI within 2 weeks after injury to generate the pituitary ADC as a measure of microstructural change. Patients with TBI were further grouped into those with and those without hypopituitarism based on the secretion status of pituitary hormones at 6 months postinjury. Thirty healthy individuals were enrolled in the study and underwent MRI examinations for comparison. Mean ADC values were compared between this control group, the patients with TBI and hypopituitarism, and the patients with TBI without hypopituitarism; correlational studies were also performed. Neurological outcome was assessed with the Glasgow Outcome Scale (GOS) for all TBI patients 6 months postinjury.

RESULTS
In the TBI group, 84 patients had hypopituitarism and 80 had normal pituitary function. The pituitary ADC in TBI patients was significantly less than that in controls (1.83 ± 0.16 vs 4.13 ± 0.33, p < 0.01). Furthermore, the mean ADC was much lower in TBI patients with hypopituitarism than in those without pituitary dysfunction (1.32 ± 0.09 vs 2.28 ± 0.17, p < 0.05). There was also a significant difference in ADC values between patients with hyperprolactinemia and those with normal prolactin levels (p < 0.05). Additionally, the receiver operating characteristic curve analysis showed that the pituitary ADC could predict hypopituitarism with a sensitivity of 90.0% and a specificity of 90.1% at the level of 1.720 (ADC value). Finally, the ADC value was positively correlated with neurological outcome at 6 months following TBI (r = 0.602, p < 0.05).

CONCLUSIONS
Use of DWI demonstrated that the pituitary ADC is correlated with hormone-secreting status in TBI patients. The authors suggest that pituitary ADC may be a useful biomarker to predict pituitary function in patients with TBI.
Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients
Authors: Sæhle Terje , Eide Per Kristian 
Published: February 2015

OBJECT
In patients with hydrocephalus and shunts, lasting symptoms such as headache and dizziness may be indicative of shunt failure, which may necessitate shunt revision. In cases of doubt, the authors monitor intracranial pressure (ICP) to determine the presence of over- or underdrainage of CSF to tailor management. In this study, the authors reviewed their experience of ICP monitoring in shunt failure. The aims of the study were to identify the complications and impact of ICP monitoring, as well as to determine the mean ICP and characteristics of the cardiac-induced ICP waves in pediatric versus adult over- and underdrainage.

METHODS
The study population included all pediatric and adult patients with hydrocephalus and shunts undergoing diagnostic ICP monitoring for tentative shunt failure during the 10-year period from 2002 to 2011. The patients were allocated into 3 groups depending on how they were managed following ICP monitoring: no drainage failure, overdrainage, or underdrainage. While patients with no drainage failure were managed conservatively without further actions, over- or underdrainage cases were managed with shunt revision or shunt valve adjustment. The ICP and ICP wave scores were determined from the continuous ICP waveforms.

RESULTS
The study population included 71 pediatric and 75 adult patients. There were no major complications related to ICP monitoring, but 1 patient was treated for a postoperative superficial wound infection and another experienced a minor bleed at the tip of the ICP sensor. Following ICP monitoring, shunt revision was performed in 74 (51%) of 146 patients, while valve adjustment was conducted in 17 (12%) and conservative measures without any actions in 55 (38%). Overdrainage was characterized by a higher percentage of episodes with negative mean ICP less than −5 to −10 mm Hg. The ICP wave scores, in particular the mean ICP wave amplitude (MWA), best differentiated underdrainage. Neither mean ICP nor MWA levels showed any significant association with age.

CONCLUSIONS
In this cohort of pediatric and adult patients with hydrocephalus and tentative shunt failure, the risk of ICP monitoring was very low, and helped the authors avoid shunt revision in 49% of the patients. Mean ICP best differentiated overdrainage, which was characterized by a higher percentage of episodes with negative mean ICP less than −5 to −10 mm Hg. Underdrainage was best characterized by elevated MWA values, indicative of impaired intracranial compliance.
Acute intracranial bleeding and recurrence after bur hole craniostomy for chronic subdural hematoma
Authors: Pang Chang Hwan , Lee Soo Eon , Kim Chang Hyeun , Kim Jeong Eun , Kang Hyun-Seung , Park Chul-Kee , Paek Sun Ha , Kim Chi Heon , Jahng Tae-Ahn , Kim Jin Wook , Kim Yong Hwy , Kim Dong Gyu , Chung Chun Kee , Jung Hee-Won , Yoo Heon 
Published: February 2015

OBJECT
There is inconsistency among the perioperative management strategies currently used for chronic subdural hematoma (cSDH). Moreover, postoperative complications such as acute intracranial bleeding and cSDH recurrence affect clinical outcome of cSDH surgery. This study evaluated the risk factors associated with acute intracranial bleeding and cSDH recurrence and identified an effective perioperative strategy for cSDH patients.

METHODS
A retrospective study of patients who underwent bur hole craniostomy for cSDH between 2008 and 2012 was performed.

RESULTS
A consecutive series of 303 cSDH patients (234 males and 69 females; mean age 67.17 years) was analyzed. Postoperative acute intracranial bleeding developed in 14 patients (4.57%) within a mean of 3.07 days and recurrence was observed in 37 patients (12.21%) within a mean of 31.69 days (range 10–104 days) after initial bur hole craniostomy. The comorbidities of hematological disease and prior shunt surgery were clinical factors associated with acute bleeding. There was a significant risk of recurrence in patients with diabetes mellitus, but recurrence did not affect the final neurological outcome (p = 0.776). Surgical details, including the number of operative bur holes, saline irrigation of the hematoma cavity, use of a drain, and type of postoperative ambulation, were not significantly associated with outcome. However, a large amount of drainage was associated with postoperative acute bleeding.

CONCLUSIONS
Bur hole craniostomy is an effective surgical procedure for initial and recurrent cSDH. Patients with hematological disease or a history of prior shunt surgery are at risk for postoperative acute bleeding; therefore, these patients should be carefully monitored to avoid overdrainage. Surgeons should consider informing patients with diabetes mellitus that this comorbidity is associated with an increased likelihood of recurrence.
Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey
Authors: McAbee Joseph H. , Ragel Brian T. , McCartney Shirley , Jones G. Morgan , Michael L. Madison , DeCuypere Michael , Cheng Joseph S. , Boop Frederick A. , Klimo Paul 
Published: February 2015

OBJECT
The object of this study was to identify and quantify predictors of burnout and career satisfaction among US neurosurgeons.

METHODS
All US members (3247) of the American Association of Neurological Surgeons (AANS) were invited to participate in a survey between September and December 2012. Responses were evaluated through univariate analysis. Factors independently associated with burnout and career satisfaction were determined using multivariable logistic regression. Subgroup analysis of academic and nonacademic neurosurgeons was performed as well.

RESULTS
The survey response rate was 24% (783 members). The majority of respondents were male, 40–60 years old, in a stable relationship, with children, working in a group or university practice, and trained in a subspecialty. More than 80% of respondents reported being at least somewhat satisfied with their career, and 70% would choose a career in neurosurgery again; however, only 26% of neurosurgeons believed their professional lives would improve in the future, and 52% believed it would worsen. The overall burnout rate was 56.7%. Factors independently associated with both burnout and career satisfaction included achieving a balance between work and life outside the hospital (burnout OR 0.45, satisfaction OR 10.0) and anxiety over future earnings and/or health care reform (burnout OR 1.96, satisfaction OR 0.32). While the burnout rate for nonacademic neurosurgeons (62.9%) was higher than that for academic neurosurgeons (47.7%), academicians who had practiced for over 20 years were less likely to be satisfied with their careers.

CONCLUSIONS
The rates of burnout and career satisfaction were both high in this survey study of US neurosurgeons. The negative effects of burnout on the lives of surgeons, patients, and their families require further study and probably necessitate the development of interventional programs at local, regional, and even national levels.
The association between expansive arterial remodeling detected by high-resolution MRI in carotid artery stenosis and clinical presentation
Authors: Yoshida Kazumichi , Fukumitsu Ryu , Kurosaki Yoshitaka , Funaki Takeshi , Kikuchi Takayuki , Takahashi Jun C. , Takagi Yasushi , Yamagata Sen , Miyamoto Susumu 
Published: February 2015

OBJECT
The purpose of the present study was to investigate the association between carotid artery (CA) expansive remodeling (ER) and symptoms of cerebral ischemia.

METHODS
One hundred twenty-two consecutive CAs scheduled for CA endarterectomy (CEA) or CA stent placement (CAS) were retrospectively studied. After excluding 22 CAs (2 were contraindicated for MRI, 8 had near-occlusion, 6 had poor image quality, and 6 had restenosis after CEA or CAS), there were 100 CAs (100 patients) included in the final analysis. The study included 50 symptomatic patients (mean age 73.6 ± 8.9 years, 6 women, mean stenosis 68.5% ± 21.3%) and 50 asymptomatic patients (mean age 72.0 ± 5.9 years, 5 women, mean stenosis 79.4% ± 8.85%). Expansive remodeling was defined as enlargement of the internal carotid artery (ICA) with outward plaque growth. The ER ratio was calculated by dividing the maximum distance between the lumen and the outer borders of the plaque perpendicular to the axis of the ICA by the maximal luminal diameter of the distal ICA at a region unaffected by atherosclerosis using long-axis, high-resolution MRI.

RESULTS
The ER ratio of the atherosclerotic CA was significantly greater than that of normal physiological expansion (carotid bulb; p < 0.01). The ER ratio of symptomatic CA stenosis (median 1.94, interquartile range [IQR] 1.58–2.23) was significantly greater than that of asymptomatic CA stenosis (median 1.52, IQR 1.34–1.81; p = 0.0001). When the cutoff value of the ER ratio was set to 1.88, the sensitivity and specificity to detect symptoms were 0.6 and 0.78, respectively. The ER ratio of symptomatic patients was consistently high regardless of the degree of stenosis.

CONCLUSIONS
There was a significant correlation between ER ratio and ischemic symptoms. The ER ratio might be a potential indicator of vulnerable plaque, which requires further validation by prospective observational study of asymptomatic patients.
Alternative method for the reconstruction of meningomyelocele defects: V-Y rotation and advancement flap
Authors: Kankaya Yüksel , Sungur Nezih , Aslan Özlem Çolak , Ozer Kadri , Ulusoy Mustafa Gürhan , Karatay Mete , Oruç Melike , Gürsoy Koray , Karaaslan Önder , Koçer Uğur 
Published: February 2015

OBJECT
Skin grafts, skin flaps, fasciocutaneous flaps, muscle flaps, and musculocutaneous flaps have been used for closure of large meningomyelocele (MMC) defects that cannot be closed primarily. The V-Y rotation advancement flap technique has been used successfully for the reconstruction of defects in different areas of the body. In the present study, the authors report on their novel use of this technique in both a binary and a quadruple (butterfly) flap manner for closure of large MMC defects. They also present an algorithm that they developed for the evaluation of MMC defects.

METHODS
Between January 2011 and November 2013, 17 patients (13 girls and 4 boys) with extremely large MMC defects that could not be repaired by direct primary closure underwent reconstruction of the defects with binary and quadruple V-Y rotation and advancement flaps. With the patient prone, the axillary apices, the most craniad point of the intergluteal sulcus, and the posterior axillary lines were marked, and a rectangular area on the back was designed. Edges of the rectangular area and the transverse and longitudinal diameters of the defect were measured and the presence of kyphosis was noted. These measurements and their proportions were used to develop an algorithm for patient assessment. While binary flaps were planned over the transverse diameter of the defects, quadruple flaps were planned over the bisectors of the defects, which were closed by elevating fasciocutaneous flaps.

RESULTS
For patients whose defect diameter to back width ratio was between 0.30 and 0.50 and whose mean ratio of defect area to donor area was between 0.09 and 0.15, binary V-Y rotation and advancement flaps were used. When these values were in the range of 0.50–0.66 and 0.16–0.35, respectively, quadruple V-Y rotation and advancement flaps were preferred. The mean duration of postoperative follow-up was 10.4 months. With the exception of minor complications, such as partial necrosis of 0.5 × 0.5 cm in a quadruple flap, all the flaps healed uneventfully.

CONCLUSIONS
With this study, closure of MMC defects with V-Y rotation and advancement flaps has been defined for the first time in the literature. The use of this technique with multiple flaps is an effective alternative to other flap options for the closure of large MMC defects. The algorithm developed in the course of this study should facilitate evaluation and reconstruction planning for patients with MMC defects.
Practical clinical interventions for diet, physical activity, and weight control in cancer survivors
Authors: Demark‐Wahnefried Wendy , Rogers Laura Q. , Alfano Catherine M. , Thomson Cynthia A. , Courneya Kerry S. , Meyerhardt Jeffrey A. , Stout Nicole L. , Kvale Elizabeth , Ganzer Heidi , Ligibel Jennifer A. 
Published: February 2015

Answer questions and earn CME/CNEThe importance of expanding cancer treatment to include the promotion of overall long‐term health is emphasized in the Institute of Medicine report on delivering quality oncology care. Weight management, physical activity, and a healthy diet are key components of tertiary prevention but may be areas in which the oncologist and/or the oncology care team may be less familiar. This article reviews current diet and physical activity guidelines, the evidence supporting those recommendations, and provides an overview of practical interventions that have resulted in favorable improvements in lifestyle behavior change in cancer survivors. It also describes current lifestyle practices among cancer survivors and the role of the oncologist in helping cancer patients and survivors embark upon changes in lifestyle behaviors, and it calls for the development of partnerships between oncology providers, primary care providers, and experts in nutrition, exercise science, and behavior change to help positively orient cancer patients toward longer and healthier lives. CA Cancer J Clin 2015;65: 167–189. © 2015 American Cancer Society.
Ernst Schröder on pasigraphy
Authors: Peckhaus Volker 
Published: February 2015

La compréhension chez Ernst Schröder du rôle de la logique dans le projet de fonder les mathématiques a été profondément influencée par son analyse de la logique des relatifs telle que présentée par Charles Peirce. L’algèbre ou logique des relatifs est devenue la clé pasigraphique de la création d’un langage universel de nature scientifique, étant déjà esquissée de façon programmatique dans les premières publications de Schröder sur la sémiotique. Elle est devenue l’outil d’élaboration d’une « algèbre absolue », une théorie générale des connexions. Les écrits logiques de Schröder datant des années 1895-1901 ne traitent donc pas principalement de l’application des méthodes mathématiques à l’analyse de la logique, mais plutôt, en accord avec la thèse fondamentale du logicisme, de la description et de l’analyse des mathématiques au moyen de la logique. On trouve des indices de la conversion de Schröder au logicisme dans sa correspondance avec Paul Carus et Felix Klein.
« Que les principes de la logique ne sont pas fiables » : Nouvelle traduction française annotée et commentée de l'article de 1908 de L. E. J. Brouwer
Authors: Van Atten Mark , Sundholm Göran , Bourdeau Michel , Van Atten Vanessa 
Published: February 2015

Dans son article majeur « Que les principes de la logique ne sont pas fiables » de 1908, L. E. J. Brouwer tire pour la première fois les conséquences révisionnistes de la vue générale de la logique présentée dans sa thèse de doctorat de 1907, en rejetant le principe du tiers exclu. Nous présentons ici une nouvelle traduction française et une introduction philosophique et historique.
Femur Fractures in Professional Athletes: A Case Series
Authors: Sikka Robby , Fetzer Gary , Hunkele Thomas , Sugarman Eric , Boyd Joel 
Published: February 2015

Objective
To discuss return to play after femur fractures in several professional athletes.

Background
Femur fractures are rare injuries and can be associated with significant morbidity and mortality. No reports exist, to our knowledge, on return to play after treatment of isolated femur fractures in professional athletes. Return to play is expected in patients with femur fractures, but recovery can take more than 1 year, with an expected decrease in performance.

Treatment
Four professional athletes sustained isolated femur fractures during regular-season games. Two athletes played hockey, 1 played football, and 1 played baseball. Three players were treated with anterograde intramedullary nails, and 1 was treated with retrograde nailing. All players missed the remainder of the season. At an average of 9.5 months (range, 7–13 months) from the time of injury, all athletes were able to return to play. One player required the removal of painful hardware, which delayed his return to sport. Final radiographs revealed that all fractures were well healed. No athletes had subjective complaints or concerns that performance was affected by the injury at an average final follow-up of 25 months (range, 22–29 months).

Uniqueness
As the size and speed of players increase, on-field trauma may result in significant injury. All players returned to previous levels of performance or exceeded previous statistical performance levels.

Conclusions
In professional athletes, return to play from isolated femur fractures treated with either an anterograde or retrograde intramedullary nail is possible within 1 year. Return to the previous level of performance is possible, and it is important to develop management protocols, including rehabilitation guidelines, for such injuries. However, return to play may be delayed by subsequent procedures, including hardware removal.
La cobertura periodística del cambio climático y del calentamiento global en El País, El Mundo y La Vanguardia
Authors: Fernández-Reyes Rogelio , Piñuel-Raigada José Luis , Vicente-Mariño Miguel 
Published: February 2015

Este artículo aborda la cobertura mediática del cambio climático y del calentamiento global en España a través del seguimiento de la presencia de estos términos en El País, El Mundo y La Vanguardia desde enero de 2000 hasta noviembre de 2014. Metodología. A partir de datos de la Universidad de Colorado y de Google Trends, se completa un análisis comparativo de las agendas mediática y ciudadana. Resultados. La cobertura en España presenta una tendencia similar a la prensa internacional occidental, si bien existen episodios particulares que las diferencian. Los hitos más importantes remiten a eventos políticos internacionales, acuerdos internacionales, informes científicos del Panel Intergubernamental sobre Cambio Climático y al documental An Inconvenient Truth. Discusión y conclusiones. La agenda internacional condiciona la agenda nacional, si bien el contexto general evidencia una pérdida de presencia del cambio climático en medios impresos, a pesar de la creciente acumulación de la creciente evidencia empírica acerca del riesgo medioambiental.
Propuesta teórico metodológica para el análisis de las competencias profesionales y su impacto en la empleabilidad
Authors: Jiménez Rebeca Almanza , Vargas-Hernández José Guadalupe 
Published: February 2015

El objetivo del presente artículo es analizar el nivel de empleabilidad de los Ingenieros en Gestión Empresarial Egresados del Instituto tecnológico de Lázaro Cárdenas en función de sus competencias profesionales partiendo de la hipótesis inicial. Las competencias profesionales tienen una relación directa positiva en la empleabilidad lo que a través de la aplicación del método de encuesta en escala tipo Likert aplicada a ambos conglomerados, se realizó el análisis de los hallazgos los cuales evidencian el impacto de las competencias profesionales en la empleabilidad, la existencia de una correlación directa positiva de ambas y la oportunidad para desarrollar la creatividad e innovación mediante el emprendedurismo.