bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iterative Reconstruction for Head CT: Effects on Radiation Dose and Image Quality
Authors: Rivers-Bowerman Michael D. , Shankar Jai Jai Shiva 
Published: October 2014

AbstractBackgroundIterative reconstruction has been reported to reduce radiation dose in CT, while preserving and even improving image quality. The purpose of this study was to evaluate the effects of sinogram-affirmed iterative reconstruction (SAFIRE) on radiation dose reduction and image quality for noncontrast adult head CT and to compare SAFIRE with conventional filtered back-projection (FBP) reconstruction.MethodsInstitutional review board approval was obtained for this retrospective analysis of head CT scans reconstructed with SAFIRE and/or FBP for 107 patients. Radiation dose parameters were recorded from scanner-generated CT dose reports. Signal-to-noise and contrast-to-noise ratios (SNR, CNR) were calculated from gray and white matter (GM, WM) attenuation measurements. Image noise, artifacts, GM-WM differentiation, small structure visibility, and sharpness were graded by two readers. Statistical analysis included the independent-samples t test for quantitative data, the related samples Wilcoxon signed-rank test for qualitative data, the coefficient of repeatability for intraobserver variation, and κ statistics for interobserver agreement.ResultsMean effective dose was significantly reduced with SAFIRE from 2.0 to 1.7 mSv (p<0.0001). SAFIRE also significantly improved GM SNR, WM SNR, and GM-WM CNR (p<0.0001). Significant reductions in image noise and posterior fossa artifact as well as improvements in GM-WM differentiation, small structure visibility, and sharpness were noted with SAFIRE (P<0.005).ConclusionsSAFIRE for noncontrast adult head CT reduces patient radiation dose by 15% for the settings employed at our institution, while significantly improving multiple quantitative and qualitative measures of image quality.
Case of Multiple Sulfatase Deficiency and Ocular Albinism: A Diagnostic Odyssey
Authors: Prasad Chitra , Rupar C. Anthony , Campbell Craig , Napier Melanie , Ramsay David , Tay K.Y. , Sharan Sapna , Prasad Asuri N. 
Published: October 2014

AbstractBackgroundMultiple sulfatase deficiency (MSD) is a rare autosomal recessive inborn error of lysosomal metabolism. The clinical phenotypic spectrum encompasses overlapping features of variable severity and is suggestive of individual single sulfatase deficiencies (i.e., metachromatic leukodystrophy, mucopolysaccharidosis, and X-linked ichthyosis).Case ReportWe describe a 3-year-old male with severe hypotonia, developmental regression and progressive neurodegeneration, coarse facial features, nystagmus (from ocular albinism), and dysmyelinating motor sensory neuropathy. Ethics approval was obtained from the Western University Ontario.ResultsExtensive investigative work-up identified deficiencies of multiple sulfatases: heparan sulfate sulfamidase: 6.5 nmoles/mg/protein/17 hour (reference 25.0-75.0), iduronate-2-sulfate sulfatase: 9 nmol/mg/protein/4 hour (reference 31-110), and arylsulfatase A: 3.8 nmoles/hr/mg protein (reference 22-50). The identification of compound heterozygous pathogenic mutations in the SUMF1 gene c.836 C>T (p.A279V) and c.1045C>T (p.R349W) confirmed the diagnosis of MSD.ConclusionThe complex clinical manifestations of MSD and the unrelated coexistence of ocular albinism as in our case can delay diagnosis. Genetic counselling should be provided to all affected families.
Safety of Early Pharmacological Thromboprophylaxis after Subarachnoid Hemorrhage
Authors: de Oliveira Manoel Airton Leonardo , Turkel-Parrella David , Germans Menno , Kouzmina Ekaterina , da Silva Almendra Priscila , Marotta Thomas , Spears Julian , Abrahamson Simon 
Published: October 2014

AbstractObjectiveThe recent guidelines on management of aneurysmal subarachnoid hemorrhage (aSAH) advise pharmacological thromboprophylaxis (PTP) after aneurysm obliteration. However, no study has addressed the safety of PTP in the aSAH population. Therefore, the aim of this study was to assess the safety of early PTP after aSAH.MethodsRetrospective cohort of aSAH patients admitted between January 2012 and June 2013 in a single high-volume aSAH center. Traumatic SAH and perimesencephalic hemorrhage patients were excluded. Patients were grouped according to PTP timing: early PTP group (PTP within 24 hours of aneurysm treatment), and delayed PTP group (PTP started > 24 hours).ResultsA total of 174 SAH patients (mean age 56.3±12.5 years) were admitted during the study period. Thirty-nine patients (22%) did not receive PTP, whereas 135 patients (78%) received PTP after aneurysm treatment or negative angiography. Among the patients who received PTP, 65 (48%) had an external ventricular drain. Twenty-eight patients (21%) received early PTP, and 107 (79%) received delayed PTP. No patient in the early treatment group and three patients in the delayed PTP group developed an intracerebral hemorrhagic complication. Two required neurosurgical intervention and one died. These three patients were on concomitant PTP and dual antiplatelet therapy.ConclusionsThe initiation of PTP within 24 hours may be safe after the treatment of a ruptured aneurysm or in angiogram-negative SAH patients with diffuse aneurysmal hemorrhage pattern. We suggest caution with concomitant use of PTP and dual antiplatelet agents, because it possibly increases the risk for intracerebral hemorrhage.
Cerebral Microbleeds and Functional Outcomes after Ischemic Stroke
Authors: Kim Tae-Won , Lee Seung-Jae , Koo Jaseong , Choi Hyun-Seok , Park Jeong-Wook , Lee Kwang-Soo , Kim Joong-Seok 
Published: October 2014

AbstractBackgroundWhether an association exists between cerebral microbleeds (CMBs) and functional recovery after ischemic stroke is unclear. We aimed to evaluate the association between CMBs and functional outcome after acute ischemic stroke.MethodsConsecutive patients with acute stroke were enrolled, and all patients were stratified into good and poor functional outcome groups at discharge and 6 months after ischemic stroke by using a modified Rankin Scale score. Cardiovascular risk factors, CMBs, and white matter hyperintensities were compared between these two outcome groups. Logistic regression analysis was used to estimate the risk of poor functional outcomes.ResultsA total of 225 patients were enrolled, 121 of whom were classified as having a good functional outcome at discharge and 142 as having a good 6-month functional outcome. The presence of CMBs was associated with a poor functional outcome at discharge [CMBs (+) patients in poor vs. good functional group; 48.1% vs. 30.6%; p=0.007] and 6 months [53.0% vs. 30.3%; p=0.001]. After adjustment for confounding factors, only the presence of infratentorial CMBs was associated with a poor functional outcome at discharge and 6 months. The poor functional outcome group had more CMBs than the good outcome group at 6 months.ConclusionsInfratentorial cerebral microbleeds were significantly associated with worse functional outcomes not only in the early phase of ischemic stroke but also in the chronic phase. These findings suggest that the presence of infratentorial CMBs can predict poor functional outcome after acute ischemic stroke.
Pregabalin for the Management of Cervicogenic Headache: A Double Blind Study
Authors: Boudreau Guy P. , Marchand Luc 
Published: October 2014

AbstractObjectivesThe primary objective was to evaluate the effects of pregabalin relative to placebo in patients with chronic unilateral cervicogenic headache.Primary and secondary end pointsTo assess the change from baseline in the frequency of cervicogenic headache days per 28-day period between placebo and treatment group. To assess the change from baseline in the intensity of headache, and health outcome measures.Study designThis was a double-blind, randomized, placebo-controlled, parallel-group study, evaluating the efficacy and safety of pregabalin in patients with cervicogenic headache.ProceduresThe study consisted of two phases. A baseline of -28 days and a double-blind placebo-controlled phase: with an escalation and maintenance phase, during which patients remained at their highest dose until the end of the study, at Day 86.ResultsForty one patients were randomized, predominantly females, with a mean age of 52 years old. At screening, both groups had, on average, 26 headache-days per month. By the final phase of the study, the number of headache days dropped to 16 per month for the pregabalin group while remaining stable for the placebo group (p=0.037). No serious adverse events were reported during the study.ConclusionIn this study, primary objectives were achieved with a statistically significant change of ten days in frequency of headache days; with minor side effects that were well tolerated.
Retrait de consentement et chirurgie éveillée : illustration et enjeux éthiques
Authors: Wager Michel , Du Boisgueheneuc Foucaud , Bouyer Coline , Pluchon Claudette , Stal Véronique , Gil Roger 
Published: October 2014

RÉSUMÉContexteLe développement au cours des deniers années des interventions neurochirurgicales sous anesthésie locale, en particulier dans le champ neuro-oncologique, rend possible la question d’une éventuelle révocation per opératoire du consentement du patient à la procédure chirurgicale.ObservationLes auteurs décrivent la révocation de son consentement par un patient au cours de l’exérèse chirurgicale d’un gliome de bas grade fronto-temporo-insulaire droit.DiscussionLes aspects spécifiques aux conditions de révocation du consentement dans le contexte particulier de la chirurgie sous anesthésie locale sont discutés. La possibilité d’un pacte d’Ulysse est proposée et discutée.ConclusionsLes interventions chirurgicales en condition éveillée créent un contexte particulier en ce qu’une révocation du consentement per opératoire devient possible. Dans ces conditions, l’information préopératoire pourrait aussi aborder avec le malade la question de la conduite à tenir au cas où il serait amené à solliciter un retrait de consentement lors de son réveil per opératoire.
Nonmotor Symptoms and Cognitive Decline in de novo Parkinson’s Disease
Authors: Kwon Kyum-Yil , Kang Sung Hoon , Kim Minjik , Lee Hye Mi , Jang Ji Wan , Kim Ju Yeon , Lee Seon-Min , Koh Seong-Beom 
Published: October 2014

AbstractBackgroundCognitive impairments are common in Parkinson’s disease (PD). Despite its clinical importance, the development of dementia is still difficult to predict. In this study, we investigated the possible associations between non-motor symptoms and the risk of developing dementia within a 2-year observation period in PD.MethodsA total of 80 patients with PD participated in this study. Nonmotor symptoms (the Nonmotor Symptoms Questionnaire), PD status (Unified Parkinson’s Disease Rating Scale), depression (Geriatric d Depression Scale or Montgomery-Asberg Depression Scale), stereopsis and severity of nonmotor symptoms (Non-motor symptoms scale) were assessed. Global cognitive function (Mini-Mental State Examination) were evaluated at baseline and 2 years later.ResultsPresence of depression, vivid dreaming, REM sleep behavior disorders, hyposmia, abnormal stereopsis, non-smoking and postural instability/ gait disturbance phenotype were associated with a significantly more rapid decline of Mini-Mental State Examination. Logistic regression analyses demonstrated that depression (odds ratio=13.895), abnormal stereopsis (odds ratio=10.729), vivid dreaming (odds ratio=4.16), REM sleep behavior disorders (odds ratio=5.353) and hyposmia (odds ratio=4.911) were significant independent predictors of dementia risk within 2 years. Postural instability/ gait disturbance phenotype and age >62 years were also independent predictors of dementia risk (odd ratio=38.333, odds ratio=10.625).ConclusionWe suggest that depression, vivid dreaming, REM sleep behavior disorders, hyposmia and abnormal stereopsis are closely associated with cognitive decline, and that presence of these nonmotor symptoms predict the subsequent development of Parkinson’s disease dementia.
Carbon and nitrogen reserves in marandu palisade grass subjected to intensities of continuous stocking management
Authors: DA SILVA S. C. , PEREIRA L. E. T. , SBRISSIA A. F. , HERNANDEZ-GARAY A. 
Published: October 2014

SUMMARYPlant organic reserves and sward leaf area index (LAI) influence plant growth, persistency and herbage accumulation in grazed swards. The present study was conducted to describe patterns of variation in herbage accumulation and carbohydrate and nitrogen (N) reserves in shoot and root of marandu palisade grass subjected to intensities of continuous stocking management throughout the year. Treatments corresponded to four levels of grazing intensity – severe (S), severe/moderate (S/M), moderate (M) and lenient (L) – and were implemented in the field using bands of sward surface height (SSH – 10, 20, 30 and 40 cm ± 10%, respectively) maintained through continuous stocking and variable stocking rate. Total N concentration was higher in the shoot relative to the root compartment during autumn, early and late spring. On the other hand, the concentration of non-structural carbohydrates (NSC) and soluble N was higher in the root compartment, regardless of grazing intensity and season of the year. When taking into account the pool of C and N reserves, the shoot compartment represented the main storage organ, since it corresponded to the largest pool of NSC (averages of 0·102 ± 0·0038 and 0·201 ± 0·0088 kg/m2 for root and shoot, respectively) and soluble N (averages of 2·7 ± 0·26 and 5·3 ± 0·59 kg/m2 for root and shoot, respectively). During late spring, the time of active plant growth, there was a clear contrast in herbage accumulation and sward LAI among grazing intensities, particularly between the severe and lenient grazing treatments. The results show that even with larger pools of soluble N and NSC in the shoot compartment, herbage accumulation was limited by the reduced leaf area of swards subjected to the severe grazing treatment, indicating that under continuous stocking growth seems to be sustained by current assimilates instead of organic reserves. Therefore, targets of grazing management for maximizing herbage accumulation throughout the year should provide adequate combinations between quantity and quality of sward leaf area. This condition was obtained in the severe/moderate and moderate grazing intensities, and corresponded to sward heights between 20 and 30 cm for marandu palisade grass.
Vitamin D and obesity: current perspectives and future directions
Authors: Pourshahidi L. Kirsty 
Published: October 2014

In recent years, new functional roles of vitamin D beyond its traditional role in calcium homoeostasis and bone metabolism have emerged linking the fat-soluble vitamin to various non-communicable diseases. Vitamin D deficiency (25-hydroxyvitamin D (25(OH)D) < 25–30 nmol/l) and sub-optimal status (25(OH)D < 50–100 nmol/l) are increasingly associated with unfavourable metabolic phenotypes, including insulin resistance, type 2 diabetes and CVD; conditions also commonly linked with overweight and obesity. Early studies reported poor vitamin D status in the morbidly obese. More recently, it has been observed that a graded relationship between vitamin D status and BMI, or specifically adiposity, exists in the general population. A number of hypotheses have been proposed to explain the potential mechanisms whereby alterations in the vitamin D endocrine system occur in the obese state. Plausible explanations include sequestration in adipose tissue, volumetric dilution or negative feedback mechanisms from increased circulating 1,25-dihydroxyvitamin D3. Others hypothesise that heavier individuals may partake in less outdoor activity, may also cover-up and wear more clothing than leaner individuals, thus decreasing sun exposure and limiting endogenous production of cholecalciferol in the skin. Moreover, in some but not all studies, BMI and adiposity have been negatively associated with the change in vitamin D status following vitamin D supplementation. It therefore remains unclear if body size and/or adiposity should be taken into account when determining the dietary requirements for vitamin D. This review will evaluate the current evidence linking vitamin D status and supplementation to overweight and obesity, and discuss the implications for setting dietary requirements.
China's Economic Engagement in North Korea
Authors: Reilly James 
Published: October 2014

AbstractSince 2005, central Chinese leaders have successfully encouraged local governments and commercial actors to expand their economic interactions with North Korea. However, the resulting expansion in commercial actors and economic interactions has intensified a principal-agent dilemma for Chinese leaders, exacerbating diplomatic tensions, eroding border security, and undermining popular support for Beijing's engagement strategy. In comparison with China's other neighbours, North Korea presents both a difficult case for stimulating economic engagement and a relatively easy case for enforcement. These dynamics are even more likely to emerge across China's 13 other land neighbours.
Syphilis: antibiotic treatment and resistance
Authors: STAMM L. V. 
Published: October 2014

SUMMARYSyphilis is a chronic, multi-stage infectious disease that is usually transmitted sexually by contact with an active lesion of a partner or congenitally from an infected pregnant woman to her fetus. Although syphilis is still endemic in many developing countries, it has re-emerged in several developed countries. The resurgence of syphilis is a major concern to global public health, particularly since the lesions of early syphilis increase the risk of acquisition and transmission of infection with human immunodeficiency virus (HIV). Because there is no vaccine to prevent syphilis, control is mainly dependent on the identification and treatment of infected individuals and their contacts with penicillin G, the first-line drug for all stages of syphilis. The emergence of clinically significant azithromycin resistance inTreponema pallidumsubsp.pallidum, the syphilis agent, has resulted in treatment failures, thus precluding the routine use of this second-line drug. Information is presented here on the diagnosis and recommended antibiotic treatment of syphilis and the challenge of macrolide-resistantT. pallidum.
Prognosis and survival of 128 patients with severe avian influenza A(H7N9) infection in Zhejiang province, China
Authors: XIAO Y. Y. , CAI J. , WANG X. Y. , LI F. D. , SHANG X. P. , WANG X. X. , LIN J. F. , HE F. 
Published: October 2014

SUMMARYNo published studies have discussed details of the prognosis and survival of patients with severe avian influenza A(H7N9) infection. In this study we analysed 128 laboratory-confirmed cases of severe H7N9 infection in Zhejiang province, the most affected region during the H7N9 epidemic in mainland China. We found that an increase in patient age by 5 years was associated with a 1·41 [95% confidence interval (CI) 1·19–1·67] times odds ratio for fatality. In addition, the time interval between the first clinical visit after symptom onset and hospital admission was inversely associated with survival time since admission. Of the 47 patients who died of the disease, when the time interval between the first clinical visit and hospital admission increased by 1 day, the duration of survival was 0·78 times (95% CI 0·62–0·98) as long. Our results suggest that patients with severe influenza H7N9 infection at older ages were at a higher risk of fatality, and that a delay in hospital admission was associated with more rapid death. More studies are required to corroborate our major findings.
High prevalence of West Nile virus in equines from the two provinces of Pakistan
Authors: ZOHAIB A. , SAQIB M. , BECK C. , HUSSAIN M. H. , LOWENSKI S. , LECOLLINET S. , SIAL A. , ASI M. N. , MANSOOR M. K. , SAQALEIN M. , SAJID M. S. , ASHFAQ K. , MUHAMMAD G. , CAO S. 
Published: October 2014

SUMMARYThis study describes the first large-scale serosurvey on West Nile virus (WNV) conducted in the equine population in Pakistan. Sera were collected from 449 equids from two provinces of Pakistan during 2012–2013. Equine serum samples were screened using a commercial ELISA kit detecting antibodies against WNV and related flaviviruses. ELISA-positive samples were further investigated using virus-specific microneutralization tests (MNTs) to identify infections with Japanese encephalitis virus (JEV), WNV and tick-borne encephalitis virus (TBEV). Anti-WNV antibodies were detected in 292 samples by ELISA (seroprevalence 65·0%) and WNV infections were confirmed in 249 animals by MNT. However, there was no animal found infected by JEV or TBEV. The detection of WNV-seropositive equines in Pakistan strongly suggests a widespread circulation of WNV in Pakistan.
Evaluating Cold, Wind, and Moisture Protection of Different Coverings for Prehospital Maritime Transportation–A Thermal Manikin and Human Study
Authors: Jussila Kirsi , Rissanen Sirkka , Parkkola Kai , Anttonen Hannu 
Published: October 2014

AbstractIntroductionPrehospital maritime transportation in northern areas sets high demands on hypothermia prevention. To prevent body cooling and hypothermia of seriously-ill or injured casualties during transportation, casualty coverings must provide adequate thermal insulation and protection against cold, wind, moisture, and water splashes.ObjectiveThe aim of this study was to determine the thermal protective properties of different types of casualty coverings and to evaluate which would be adequate for use under difficult maritime conditions (cold, high wind speed, and water splashes). In addition, the study evaluated the need for thermal protection of a casualty and verified the optimum system for maritime casualty transportation.MethodsThe study consisted of two parts: (1) the definition and comparison of the thermal protective properties of different casualty coverings in a laboratory; and (2) the evaluation of the chosen optimum protective covering for maritime prehospital transportation. The thermal insulations of ten different casualty coverings were measured according to the European standard for sleeping bags (EN 13537) using a thermal manikin in a climate chamber (-5°C) with wind speeds of 0.3 m/s and 4.0 m/s, and during moisture simulations. The second phase consisted of measurements of skin and core temperatures, air temperature, and relative humidity inside the clothing of four male test subjects during authentic maritime prehospital transportation in a partially-covered motor boat.ResultsWind (4 m/s) decreased the total thermal insulation of coverings by 11%-45%. The decrement of thermal insulation due to the added moisture inside the coverings was the lowest (approximately 22%-29%) when a waterproof reflective sheet inside blankets or bubble wrap was used, whereas vapor-tight rescue bags and bubble wrap provide the most protection against external water splashes. During authentic maritime transportation lasting 30 minutes, mean skin temperature decreased on average by 0.5°C when a windproof and water-resistant rescue bag was used over layered winter clothing.ConclusionThe selected optimum rescue bag consisted of insulating and water-resistant layers providing sufficient protection against cold, wind, and water splashes during prehospital transportation lasting 30 minutes in the uncovered portion of a motor boat. The minimum thermal insulation for safe maritime transportation (30 minutes) is 0.46 m2K/W at a temperature of -5°C and a wind speed of 10 m/s.JussilaK, RissanenS, ParkkolaK, AnttonenH. Evaluating cold, wind, and moisture protection of different coverings for prehospital maritime transportation–a thermal manikin and human study. Prehosp Disaster Med. 2014;29(6):1-9.