bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular reconstruction of vertebral artery occlusion prior to basilar thrombectomy in a series of six patients presenting with acute symptomatic basilar thrombosis
Authors: Ecker Robert D , Tsujiura Crystiana A , Baker Christopher B , Cushing Deborah 
Published: June 2013

Introduction and purposeSymptomatic acute basilar thrombosis is associated with a high mortality rate. Aggressive endovascular management has led to survival rates of 35–50%. We report the largest series of endovascular reconstruction of occluded dominant vertebral arteries prior to basilar thrombectomy.Materials and methodsA prospective database since August 2010 of all neuroendovascular interventions was mined for patients undergoing basilar artery thrombolysis from which a group with vertebral artery reconstruction was selected. Patient charts were retrospectively reviewed for relevant clinical, technical, and outcome data.ResultsFrom August 2010 to September 2012, six patients were identified who underwent vertebral reconstruction prior to basilar thrombectomy. Patients ranged in age from 42 to 57 years (mean 51 years). Mean time from symptoms until recanalization was approximately 6 h. Angiographic Thrombolysis in Cerebral Infarction IIB reconstitution of the basilar trunk was achieved in all cases. There were no technical complications. Two patients had care withdrawn secondary to massive completed brainstem infarction and poor neurological status post intervention. Three patients are now independent at 12, 14, and 31 months, respectively. One patient, after a follow-up of only 8 months, has achieved a modified Rankin Scale score of 3.ConclusionsComplete vertebral occlusion below a basilar thrombus can be recanalized prior to thrombectomy. In this case series, 100% of the acutely occluded vertebral arteries could be opened using either anterograde or retrograde access. However, basilar thrombosis continues to be a devastating illness, with one-third of the patients in this series dying of progressive infarction despite angiographic patency of the large conduit vessels with technical complications.
Comparison of CT and fluoroscopic guidance for lumbar puncture in an obese population with prior failed unguided attempt
Authors: Brook Andrew D , Burns Judah , Dauer Edward , Schoendfeld Alan H , Miller Todd S 
Published: June 2013

Background and purposeIn the past 50 years, fluoroscopic guidance has been used to improve upon lumbar puncture (LP) technique that was unchanged for over a century. Recently, CT has seen increasing use as a guidance modality due to its ability to demonstrate soft tissue contrast and provide millimeter accuracy with needle targeting. This study compared procedure time and radiation dosages for fluoroscopic and CT guided LP.Materials and methodsThis institutional review board and Health Insurance Portability and Accountability Act (HIPAA) compliant study was a retrospective review of a consecutive cohort referred for image guided LP. For CT, 45 patients aged 49 years (range 20–78, SD 14) with body mass index (BMI) values of 33 kg/m2(range 20–50, SD 12) were included. For fluoroscopy, 100 patients aged 47 years (range 18–88, SD 17) with BMI values of 29 kg/m2(range 15–56, SD 9) were included. CT procedure time was determined using picture archiving and communication system (PACS) image time stamps. Radiation dose was determined using the CT dose report and effective dose conversion factors. Fluoroscopic procedure time was determined from nursing. Fluoroscopic radiation dose was calculated from dose–area product (DAP) and fluoroscopy times, with effective dosage calculated using simulation software.ResultsFor CT, procedure time average was 14 min (range 5–42, SD 8.5). Average dose–length product was 120 mGy×cm (range 39–211, SD 43) and average effective dose was 1.98 mSv (range 0.2–8.18, SD 4.4). For fluoroscopy, procedure time averaged 12 min (range 12–30, SD 6). Average DAP was 10 Gy×cm2(range 0.1–70, SD 11) and effective dose estimate averaged 2.9 mSv (range 0.9–9.4, SD 1.9). There were no unsuccessful taps or complications.ConclusionsBoth fluoroscopic and CT guidance may be used to perform an LP in an obese population with a short procedure time and low radiation dose.
Ultra-distal large-bore intracranial access using the hyperflexible Navien distal intracranial catheter for the treatment of cerebrovascular pathologies: a technical note
Authors: Lin Li-Mei , Colby Geoffrey P , Huang Judy , Tamargo Rafael J , Coon Alexander L 
Published: June 2013

BackgroundSuccessful neuroendovascular treatments rely on microcatheter stability from guide catheter support. We present our experience using a new large-bore 0.058 inch or 0.072 inch inner diameter (ID) hyperflexible access catheter placed deep within the intracranial circulation during the neurointervention.MethodsWe retrospectively reviewed all neurointerventions performed by the senior author during an 18-month period to identify patients in whom the Navien intracranial catheter was placed in an ultra-distal position, defined as beyond the clinoidal internal carotid artery (ICA) or V3 segment of the vertebral artery. Procedural data collected included parent artery tortuosity, technique for Navien advancement, intraprocedural Navien position and periprocedural complications.ResultsThe Navien, either 6 F 0.072 inch ID or 5 F 0.058 inch ID, provided ultra-distal large-bore access in the following 11 intracranial interventions: anterior circulation aneurysm treatment with Pipeline embolization device (PED) (n=3); posterior circulation aneurysm single-stage stent coiling (n=5); liquid embolization of arteriovenous malformations (n=2); PED coiling of posterior circulation aneurysm (n=1). The Navien was tracked into position over a Marksman microcatheter in 10/11 cases and a Headway 27 microcatheter in one case. Intraprocedural Navien positions were as follows: supraclinoid ICA (n=2); mid M1 (n=1); V3–V4 junction (n=2) (both using 6 F Navien); distal V4 (n=3); proximal basilar (n=1); proximal-mid basilar (n=1); mid basilar (n=1). No significant catheter-related complications occurred.ConclusionsThe Navien is the newest hyperflexible access catheter that is highly trackable into ultra-distal intracranial positions. It maneuvers atraumatically, providing improved distal intracranial support for a variety of complex cerebrovascular interventions and preserves necessary ID for quality intraprocedural roadmaps and angiography.
Performance analysis of a FPGA based novel binary and DBNS multiplier
Authors: Saha Amrita , Mukherjee Manideepa , Datta Debanjana , Saha Sangita , Sinha Amitabha 
Published: June 2013

Designing high performance Software Defined Radio (SDR) with low power and flexibility is a major challenge. While the high performance DSP processors are unable to meet the speed requirements of these SDRs, System on chips (SOCs) are also not suitable because of their limited flexibility. Recently dynamically reconfigurable FPGAs have emerged as high performance programmable hardware to execute highly parallel, computationally intensive signal processing functions efficiently. Since basic intention of an SDR is to implement different modulation / demodulation schemes and basic building blocks for such schemes are signal processing functions, FPGAs have become an important component for implementing these. However, the effectiveness of such an approach with respect to cost, performance and flexibility need to be examined. Double Base Number Systems (DBNS) have been gaining attention for compute intensive applications in signal processing because of their higher performance in arithmetic operations in general and particularly multiplication.
Keeping these issues in view, this paper aims to present a new Software defined Radio. To Enhance the performance of the proposed architecture , analysis have been done employing both single index and multiple indices DBNS multipliers. Experiments and analysis on performance have also been done with its binary counterpart. Both DBNS and binary based architecture were implemented on Xilinx virtex iv FPGA using xilinx ISE 9.1 i.
Polylactic acid/polycaprolactone nanocomposite
Authors: Salehiyan Reza , Yussuf A A , Hanani Nurul Fatin , Hassan Azman , Akbari Abozar 
Published: June 2013

This article investigates the performance of polylactic acid (PLA)/polycaprolactone (PCL)/montmorillonite (MMT) nanocomposites toughened with metallocene-catalyzed linear low-density polyethylene (mLLDPE), in terms of mechanical, thermal, and morphological properties. All the results were compared and the influence of MMT and mLLDPE on the final properties was observed and reported. mLLDPE decreased the modulus and the strength of PLA/PCL and its nanocomposites due to its inherent lower rigidity compared to PLA/PCL nanocomposites. Moreover, incorporation of clay significantly increased mechanical and thermal stability of the nanocomposites. Scanning electron microscopic images confirmed that MMT acted as a compatibilizer, whereas it reduced the size of the droplets. It has been suggested that improvements in properties are related to good dispersion of clays within the matrix. However, further addition of MMT beyond 2 parts per hundred (phr) level decreases all the properties of PLA/PCL/mLLDPE/MMT nanocomposites. X-Ray diffraction patterns were used to discover the reason of reduction in the properties of PLA/PCL/mLLDPE/MMT at 4 phr. It was revealed that mLLDPE-toughened blends have intercalated structure below 4 phr MMT content as the interlayer spacing decreased at 4 phr MMT.
How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions
Authors: George Jim , Long Susannah , Vincent Charles 
Published: June 2013

Maintaining patient safety in acute hospitals is a global health challenge. Traditionally, patient safety measures have been concentrated on critical care and surgical patients. In this review the medical literature was reviewed over the last ten years on aspects of patient safety specifically related to patients with dementia. Patients with dementia do badly in hospital with frequent adverse events resulting in the geriatric syndromes of falls, delirium and loss of function with increased length of stay and increased mortality. Contributory factors include inadequate assessment and treatment, inappropriate intervention, discrimination, low staff levels and lack of staff training. Unfortunately there is no one simple solution to this problem, but what is needed is a multifactorial, multilevel approach at the seven levels of care – patient, task, staff, team, environment, organisation and institution. Improving safety and quality of care for patients with dementia in acute hospitals will benefit all patients and is an urgent priority for the NHS.
Using patient-reported outcome measures to estimate cost-effectiveness of hip replacements in English hospitals
Authors: Appleby John , Poteliakhoff Emmi , Shah Koonal , Devlin Nancy 
Published: June 2013

Objective To estimate the average cost per quality adjusted life year (QALY) gained from hip surgery, and to examine the variation in that between hospitals. Design The transformation of patient-reported outcome measures (EQ-5D data) into QALYs, covering 25,463 NHS patient episodes between April 2009 and August 2010 from hospitals in England, using a model of future health change arising from a hip operation compared to a counterfactual of no operation. Hospital-level costs for hip procedures from the National Reference Costs data-set was used to calculate the hospitals' cost per QALY. Setting English hospitals treating NHS-funded patients undergoing hip replacement. Participants NHS-funded patients undergoing primary hip replacement. Main outcome measure Cost per QALY. Results Assuming some degradation in patients’ health over the lifetime of the hip prosthesis, average health gain arising from a hip operation was 2.77 QALYs. For procedures paid for by the NHS but carried out in the independent sector the average gain was 2.97 QALYs. Average NHS hospital hip procedure costs were estimated to be £5844. The unweighted average cost per QALY for NHS hospitals was £2128. There were significant variations in cost per QALY between hospitals; most of this variation appears to be driven by variations in cost, not QALYs. Conclusions Using the new patient-assessed health-related quality of life data combined with routine hospital-level cost data it is possible to estimate a procedure-based measure of efficiency for hospitals. The fact that variations in cost per QALY are strongly driven by variations in cost suggests that further work is needed to investigate the causes of cost variations per se – especially the quality of routine NHS cost data.
Classification of High‐Resolution Manometry Data According to Videofluoroscopic Parameters Using Pattern Recognition
Authors: Hoffman Matthew R. , Jones Corinne A. , Geng Zhixian , Abelhalim Suzan M. , Walczak Chelsea C. , Mitchell Alyssa R. , Jiang Jack J. , McCulloch Timothy M. 
Published: June 2013

ObjectiveTo determine if pattern recognition techniques applied to high‐resolution manometry (HRM) spatiotemporal plots of the pharyngeal swallow can identify features of disordered swallowing reported on the Modified Barium Swallow Impairment Profile (MBSImP).Study DesignCase series evaluating new method of data analysis.SettingUniversity hospital.Subjects and MethodsSimultaneous HRM and videofluoroscopy was performed on 30 subjects (335 swallows) with dysphagia. Videofluoroscopic studies were scored according to the MBSImP guidelines while HRM plots were analyzed using a novel program. Pattern recognition using a multilayer perceptron artificial neural network (ANN) was performed to determine if 7 pharyngeal components of the MBSImP as well as penetration/aspiration status could be identified from the HRM plot alone. Receiver operating characteristic (ROC) analysis was also performed.ResultsMBSImP parameters were identified correctly as normal or disordered at an average rate of approximately 91% (area under the ROC curve ranged from 0.902 to 0.981). Classifications incorporating two MBSImP parameters resulted in classification accuracies over 93% (area under the ROC curve ranged from 0.963 to 0.989).ConclusionPattern recognition coupled with multiparameter quantitative analysis of HRM spatiotemporal plots can be used to identify swallowing abnormalities, which are currently assessed using videofluoroscopy. The ability to provide quantitative, functional data at the bedside while avoiding radiation exposure makes HRM an appealing tool to supplement and, at times, replace traditional videofluoroscopic studies.
Prescription of compression stockings in France in primary care
Authors: Benigni J-P , Ansolabehere X , Saudez X , Toussi M , Branchoux S , Taieb C 
Published: June 2013

Objectives Recent French data describing real-life compression stocking use are lacking. This study aimed to describe the actual situation for patients who were prescribed compression stockings by their general practitioner and to assess annual treatment costs from a societal perspective. Methods A retrospective analysis using Disease Analyzer database data from 6349 adults with at least one compression stocking prescription between July 2009 and June 2010. Results Mean patient age was 58 years, and 72.3% of patients were women. Seven out of 10 patients received only a single compression stocking prescription over one year. The estimated mean annual per patient cost was 152.2 ± 100.7 Euros. Conclusion Most patients received only a single compression stocking prescription during one year. General practitioners prescribing compression stockings more often may have a better understanding of venous disease and may manage their patients differently. Although more expensive, this approach may be one which should be accepted more widely.
Evolution by selection, recombination, and gene duplication in MHC class I genes of two Rhacophoridae species
Authors: Zhao Mian , Wang Yongzhen , Shen Hang , Li Chenliang , Chen Cheng , Luo Zhenhua , Wu Hua 
Published: June 2013

AbstractBackgroundComparison of major histocompatibility complex (MHC) genes across vertebrate species can reveal molecular mechanisms underlying the evolution of adaptive immunity-related proteins. As the first terrestrial tetrapods, amphibians deserve special attention because of their exposure to probably increased spectrum of microorganisms compared with ancestral aquatic fishes. Knowledge regarding the evolutionary patterns and mechanisms associated with amphibian MHC genes remains limited. The goal of the present study was to isolate MHC class I genes from two Rhacophoridae species (Rhacophorus omeimontisandPolypedates megacephalus) and examine their evolution.ResultsWe identified 27 MHC class I alleles spanning the region from exon 2 to 4 in 38 tree frogs. The available evidence suggests that these 27 sequences all belong to classical MHC class I (MHC Ia) genes. Although several anuran species only display one MHC class Ia locus, at least two or three loci were observed inP. megacephalusandR. omeimontis,indicating that the number of MHC class Ia loci varies among anuran species. Recombination events, which mainly involve the entire exons, played an important role in shaping the genetic diversity of the 27 MHC class Ia alleles. In addition, signals of positive selection were found in Rhacophoridae MHC class Ia genes. Amino acid sites strongly suggested by program to be under positive selection basically accorded with the putative antigen binding sites deduced from crystal structure of human HLA. Phylogenetic relationships among MHC class I alleles revealed the presence of trans-species polymorphisms.ConclusionsIn the two Rhacophoridae species (1) there are two or three MHC class Ia loci; (2) recombination mainly occurs between the entire exons of MHC class Ia genes; (3) balancing selection, gene duplication and recombination all contribute to the diversity of MHC class Ia genes. These findings broaden our knowledge on the evolution of amphibian MHC systems.
Distinct transcriptome profiles identified in normal human bronchial epithelial cells after exposure to γ-rays and different elemental particles of high Z and energy
Authors: Ding Liang-Hao , Park Seongmi , Peyton Michael , Girard Luc , Xie Yang , Minna John D , Story Michael D 
Published: June 2013

Abstract

Background
Ionizing radiation composed of accelerated ions of high atomic number (Z) and energy (HZE) deposits energy and creates damage in cells in a discrete manner as compared to the random deposition of energy and damage seen with low energy radiations such as γ- or x-rays. Such radiations can be highly effective at cell killing, transformation, and oncogenesis, all of which are concerns for the manned space program and for the burgeoning field of HZE particle radiotherapy for cancer. Furthermore, there are differences in the extent to which cells or tissues respond to such exposures that may be unrelated to absorbed dose. Therefore, we asked whether the energy deposition patterns produced by different radiation types would cause different molecular responses. We performed transcriptome profiling using human bronchial epithelial cells (HBECs) after exposure to γ-rays and to two different HZE particles (28Si and 56Fe) with different energy transfer properties to characterize the molecular response to HZE particles and γ-rays as a function of dose, energy deposition pattern, and time post-irradiation.

Results
Clonogenic assay indicated that the relative biological effectiveness (RBE) for 56Fe was 3.91 and for 28Si was 1.38 at 34% cell survival. Unsupervised clustering analysis of gene expression segregated samples according to the radiation species followed by the time after irradiation, whereas dose was not a significant parameter for segregation of radiation response. While a subset of genes associated with p53-signaling, such as CDKN1A, TRIM22 and BTG2 showed very similar responses to all radiation qualities, distinct expression changes were associated with the different radiation species. Gene enrichment analysis categorized the differentially expressed genes into functional groups related to cell death and cell cycle regulation for all radiation types, while gene pathway analysis revealed that the pro-inflammatory Acute Phase Response Signaling was specifically induced after HZE particle irradiation. A 73 gene signature capable of predicting with 96% accuracy the radiation species to which cells were exposed, was developed.

Conclusions
These data suggest that the molecular response to the radiation species used here is a function of the energy deposition characteristics of the radiation species. This novel molecular response to HZE particles may have implications for radiotherapy including particle selection for therapy and risk for second cancers, risk for cancers from diagnostic radiation exposures, as well as NASA’s efforts to develop more accurate lung cancer risk estimates for astronaut safety. Lastly, irrespective of the source of radiation, the gene expression changes observed set the stage for functional studies of initiation or progression of radiation-induced lung carcinogenesis.
The genome and transcriptome of the pine saprophyte Ophiostoma piceae, and a comparison with the bark beetle-associated pine pathogen Grosmannia clavigera
Authors: Haridas Sajeet , Wang Ye , Lim Lynette , Massoumi Alamouti Sepideh , Jackman Shaun , Docking Rod , Robertson Gordon , Birol Inanc , Bohlmann Jörg , Breuil Colette 
Published: June 2013

Abstract

Background

Ophiostoma piceae is a wood-staining fungus that grows in the sapwood of conifer logs and lumber. We sequenced its genome and analyzed its transcriptomes under a range of growth conditions. A comparison with the genome and transcriptomes of the mountain pine beetle-associated pathogen Grosmannia clavigera highlights differences between a pathogen that colonizes and kills living pine trees and a saprophyte that colonizes wood and the inner bark of dead trees.

Results
We assembled a 33 Mbp genome in 45 scaffolds, and predicted approximately 8,884 genes. The genome size and gene content were similar to those of other ascomycetes. Despite having similar ecological niches, O. piceae and G. clavigera showed no large-scale synteny. We identified O. piceae genes involved in the biosynthesis of melanin, which causes wood discoloration and reduces the commercial value of wood products. We also identified genes and pathways involved in growth on simple carbon sources and in sapwood, O. piceae’s natural substrate. Like the pathogen, the saprophyte is able to tolerate terpenes, which are a major class of pine tree defense compounds; unlike the pathogen, it cannot utilize monoterpenes as a carbon source.

Conclusions
This work makes available the second annotated genome of a softwood ophiostomatoid fungus, and suggests that O. piceae’s tolerance to terpenes may be due in part to these chemicals being removed from the cells by an ABC transporter that is highly induced by terpenes. The data generated will provide the research community with resources for work on host-vector-fungus interactions for wood-inhabiting, beetle-associated saprophytes and pathogens.