bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vestibular evoked myogenic potentials in evaluation of whiplash syndrome disability
Authors: Calò Lea , Liberati Luca , Fiorita Antonella , Logroscino Giandomenico , Vetrugno Giuseppe , Scarano Emanuele , Paludetti Gaetano , Picciotti Pasqualina M. 
Published: August 2014

Objective:
Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck that may result from a rear-end or side impact, predominantly in motor vehicle accidents but also from other mishaps. Vertigo and dizziness after whiplash injury are the most frequent, persistent and disabling symptoms, even in the absence of anatomical and cervical spine damage. Vestibular disturbances in whiplash patients have been widely investigated; nevertheless, physiopathology of vertigo and dizziness still remains an unsolved problem. The aim of our study was to demonstrate that cVEMPs (cervical Vestibular Evoked Myogenic Potentials) represent a valid and non-invasive technique able to investigate vestibular function, in particular the vestibulo-collic reflex and macular function.

Study design:
We examined 25 patients affected by disabling post-whiplash injury by means of audiovestibular tests: audiometric and impedance tests, nystagmus evaluation, caloric test, dynamic posturography and cervical VEMPs. Data obtained were compared with those of a normal control group.

Results:
Audiological tests, impedance tests, nystagmus evaluation, and caloric tests were normal in all patients. Comparison of dynamic posturography values obtained in whiplash patients and in the normal control group demonstrated significant differences in the Composite Equilibrium Score and Visual Component. Finally, cVEMPs were bilaterally absent in 72% of patients, unilaterally absent in 16% and present in 12%.

Conclusions:
Based upon neurophysiological evidence and our results, we can hypothesize that a concussion of the macular receptors takes place and that the maculae are more sensitive than the ampulla or cochlea receptor to this kind of injury. We conclude that cervical VEMPs represent a valid and non-invasive technique to evaluate disability after whiplash injury.
Central auditory processing functions in learning disabled children assessed by behavioural tests
Authors: Ghannoum Mohamed Tarek , Shalaby Amani Ahmed , Dabbous Abeir Osman , Abd-El-Raouf Ehab Ragaa , Abd-El-Hady Hebatallah Sherif 
Published: August 2014

Background:
There is a high prevalence of central auditory processing disorders (CAPD) in children diagnosed with learning disability (LD). It is important to identify any deficits early in order to determine appropriate management.

Objective:
To assess central auditory processing functions in children with LD through behavioural testing.

Study design:
The present study comprised 60 normal hearing children of both genders. Cases included 30 children with LD, and the controls included 30 healthy children. Each group was further subdivided into three equal number subgroups according to age: 6–8 years, > 8–10 years and > 10–12 years. All subjects were submitted to full history taking, otological examination, basic audiological evaluation and central auditory processing testing which included: low pass filtered speech test, speech-in-noise test, dichotic digit test, pitch pattern sequence test, auditory fusion test and memory tests.

Results:
This study showed that the prevalence of CAPD in children with LD was 80%, with relatively more than soft CAPD criteria used. There were statistically significant differences between cases and controls regarding the central tests included in this study, except the LPF test and, in the youngest subgroup, the SPIN test. Age significantly affected psychophysical testing, and right ear advantage was found in our subjects. However, gender had no effect on testing.

Conclusion:
Central auditory processing functions were significantly affected in children with LD compared to controls.
Hip fracture patients, Complications and Nutritional demands for Healing
Authors: Firoozabadi Mohammad Ayati 
Published: August 2014

In the population older than 60 years, fracturing of a hip is one of the main reasons for being admitted to a hospital. In 2006, the National Center for Health Statistics reported 330,000 hospital admissions for hip fracture: 293,000 (89%) occurred in patients over the age of 65; 238,000 (72%) affected women. Many of the patients operated on for a hip fracture can never return home; ultimately 19% will require long-term institutional care for the fracture, changing their life from an independent to a dependent one. Hip fracture patients also have a high mortality rate, 24% during the first postoperative year, with the expected one-year mortality rate two to three times lower in a normal population corrected for the same ages. Malnutrition is common in hip fracture patients, who appear to have a lower intake of energy, protein, calcium and vitamin D than non-fracture controls, but the effectiveness of nutritional support programs in routine clinical practice is controversial. DOI: http://dx.doi.org/10.3126/ijls.v8i4.10894
Evolutionary trends and ecological differentiation in early Cenozoic Fagaceae of western North America
Authors: Bouchal Johannes , Zetter Reinhard , Grímsson Friðgeir , Denk Thomas 
Published: August 2014

• Premise of the study: The early Cenozoic was a key period of evolutionary radiation in Fagaceae. The common notion is that species thriving in the modern summer‐dry climate of California originated in climates with ample summer rain during the Paleogene.• Methods: We investigated in situ and dispersed pollen of Fagaceae from the uppermost Eocene Florissant fossil beds, Colorado, United States, using a combined light and scanning electron microscopy approach.• Key results: Pollen types of Castaneoideae with affinities to modern Castanea, Lithocarpus, and Castanopsis were recognized. Pollen of the extinct genus Fagopsis represents a derived type of Castaneoideae pollen. Infrageneric groups of Quercus were well represented, including pollen of Group Protobalanus. The taxonomic diversity of Fagaceae and of the total plant assemblage indicates a mosaic of microclimates, that range from pronounced to weakly seasonal climates and depend on slope aspect and elevation. Continental climatic conditions may have triggered the evolution of sclerophyllous leaves and adaptive radiation in Quercus and other taxa thriving today under distinctly summer‐dry and winter‐dry climates.• Conclusions: Vegetation types similar to modern vegetation belts of the Coastal Ranges (chaparral, nemoral conifer forest) were established in the Front Range in the late Eocene. Coeval plant assemblages from the Coastal Ranges of California indicate distinctly subtropical, moist climates. Hence, characteristic elements found today in the summer‐dry and winter‐dry climates of Pacific North America (Quercus Group Protobalanus, Notholithocarpus) may opportunistically have dispersed into their modern ranges later in the Cenozoic. This scenario is in contrast to the evolution and migration patterns of their western Eurasian Mediterranean counterparts (Quercus Group Ilex).
Charcoal morphometry for paleoecological analysis: The effects of fuel type and transportation on morphological parameters
Authors: Crawford Alastair J. , Belcher Claire M. 
Published: August 2014

• Premise of the study: Charcoal particles preserved in sediments are used as indicators of paleowildfire. Most research focuses on abundance as an indicator of fire frequency, but charcoals also convey information about the vegetation from which they are derived. One potential source of information is their morphology, which is influenced by the parent material, the nature of the fire, and subsequent transportation and burial.• Methods: We charcoalified 26 materials from a range of plant taxa, and subjected them to simulated fluvial transport by tumbling them with water and gravel. We photographed the resulting particles, and used image analysis software to measure morphological parameters.• Results: Leaf charcoal displayed a logarithmic decrease in area, and a logarithmic increase in circularity, with transportation time. Trends were less clear for stem or wood charcoal. Grass charcoal displayed significantly higher aspect ratios than other charcoal types.• Conclusions: Leaf charcoal displays more easily definable relationships between morphological parameters and degree of breakdown than stem or wood charcoal. The aspect ratios of fossil mesocharcoal can indicate the broad botanical source of an assemblage. Coupled to estimates of charcoal abundance, this will improve understanding of the variation in flammability of ancient ecosystems.
Is HLA-B27 Increased in Patients Diagnosed with Undifferentiated Arthritis? Results from the Leiden Early Arthritis Cohort
Authors: van Gaalen Floris , van den Berg Rosaline , Verhoog Inge , Schonkeren Joris , van der Helm-van Mil Annette , Huizinga Tom , van der Heijde Désirée M. 
Published: August 2014

Objective.Undifferentiated arthritis (UA) is a common form of arthritis. According to the Assessment of Spondyloarthritis international Society (ASAS) criteria for peripheral spondyloarthritis (pSpA), HLA-B27 can be used to help classify patients with pSpA. We tested whether HLA-B27 is increased in patients diagnosed with UA.Methods.Prevalence of HLA-B27 was compared between healthy controls and patients with UA. SpA features were compared between HLA-B27-positive and -negative UA, and SpA.Results.We found 10.1% of UA (38/375) versus 7.2% (403/5584) of controls were HLA-B27-positive (OR 1.5, 95% CI 1.0–2.1; p = 0.037). HLA-B27-positive patients with UA had more SpA features than HLA-B27-negative patients (mean 1.6, SD 1.0, and 0.9 SD 0.6; p < 0.001), but patients with SpA had significantly more SpA features (mean 4.5, SD 1.5; p < 0.001). Family history and preceding infection were features more common in HLA-B27-positive than in HLA-B27-negative UA (15.8% vs 1.3%, p = 0.04 and 15.8% vs 2.6%, p = 0.04). After HLA-B27 testing, 21 additional patients (5.6%) with UA could potentially have been classified with pSpA according to the ASAS criteria.Conclusion.HLA-B27 is more common in patients with UA than in controls. However, the yield of HLA-B27 testing in UA is low. Our results suggest that HLA-B27 testing should be reserved for patients with additional SpA features.
Tocilizumab Treatment Increases Left Ventricular Ejection Fraction and Decreases Left Ventricular Mass Index in Patients with Rheumatoid Arthritis without Cardiac Symptoms: Assessed Using 3.0 Tesla Cardiac Magnetic Resonance Imaging
Authors: Kobayashi Hitomi , Kobayashi Yasuyuki , Giles Jon T. , Yoneyama Kihei , Nakajima Yasuo , Takei Masami 
Published: August 2014

Objective.The aim of our pilot study was to prospectively evaluate the effect of inhibiting interleukin 6 on the left ventricular (LV) structure and function in patients with rheumatoid arthritis (RA) without cardiac symptoms, using cardiac magnetic resonance (CMR).Methods.Female patients with RA with active disease and healthy controls were enrolled. Cardiac symptoms were absent in all subjects. Tocilizumab (TCZ; 8 mg/kg IV every 4 weeks) was prescribed for patients with RA with an inadequate clinical response to methotrexate. All subjects underwent baseline evaluation of LV function and structure measured by CMR. We compared measures of LV geometry and function between patients with RA and patients without RA controls at baseline, and changes in the same variables between baseline and after 52 weeks of treatment among the group with RA.Results.Twenty women with RA were compared with 20 women without RA of similar mean age. In patients with RA at baseline, ejection fraction (EF) was significantly lower (−3.7%) and LV mass index (LVMI) significantly higher (+9.2%) compared with controls. TCZ treatment resulted in a significant decrease in the Simplified Disease Activity Index (SDAI) after 52 weeks of treatment, paralleling a significant increase in EF (+8.2%) and a significant decrease in LVMI (−24.4%) over the same period. The percentage change in LVMI correlated strongly with the percentage change in SDAI (r = −0.63, p = 0.0028). LV geometry in the group with RA at baseline showed eccentric hyper-trophy compared with the group without RA, a condition that normalized after TCZ treatment.Conclusion.TCZ treatment significantly increased EF and decreased LVMI associated with disease activity.
Cerebral Vasospasm in Traumatic Brain Injury: A Case Study
Authors: Nelson Alexis , Nyquist Paul A. , Razumovsky Alexander , Marshall Scott A. 
Published: August 2014

CME Educational Objectives

1.
Review the expanded differential diagnosis of mental status changes in the patient with mild to severe traumatic brain injury.

2.
Discuss the workup and monitoring for suspected cerebral vasospasm in patients with a history of traumatic subarachnoid hemorrhage.

3.
Review potential therapeutic options for mental status changes attributed to cerebral vasospasm.

An unemployed young man with a history of poly-substance abuse suffered a closed head injury as the result of a motor vehicle crash. At the scene, the patient had a prolonged period of unconsciousness and was intubated. Computed tomography (CT) of the brain upon arrival to the trauma center reveals a mild bilateral subarachnoid hemorrhage (SAH) in a nonspecific pattern. The imaging is thought to be consistent with trauma and is without a space occupying lesion.
Deep Brain Stimulation for Obsessive-Compulsive Disorder
Authors: Corse Andrew K. , Chou Tina , Arulpragasam Amanda R. , Kaur Navneet , Deckersbach Thilo , Cusin Cristina 
Published: August 2014

CME Educational Objectives

1.
Provide an overview of the history and origins of deep brain stimulation (DBS) for treatment-refractory obsessive-compulsive disorder (OCD).

2.
Describe the various neuroanatomic targets of DBS implant for OCD as well as the neurocircuitry involved.

3.
Explain the effects of DBS for OCD, both intended and unintended, as well as the promise the treatment holds for select treatment-resistant OCD patients.

Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder that affects approximately 2% to 3% of the population.
1
OCD is characterized by persistent, intrusive, and distressing thoughts (obsessions) and ritualistic behaviors (compulsions), such as counting, organizing, or cleaning, which are used to lessen anxiety caused by the obsessive thoughts. The symptoms of OCD generally manifest in childhood or adolescence and may result in significant impairment in everyday functioning. The etiology of OCD is hypothesized to involve a combination of genetic and environmental factors.
Addiction in Chronic Pain Patients: Evidence-Based Approaches for Monitoring Chronic Opioid Therapy
Authors: Patel Alkesh N. 
Published: August 2014

CME Educational Objectives

1.
Appreciate the clinical interface between pain and addiction as it relates to the general neurobiological mechanisms of disease, analgesic effects of drugs of abuse, and genetic underpinnings.

2.
Understand the controversies surrounding chronic opioid therapy for the treatment of chronic noncancer pain and identify patients at risk of prescription opioid misuse.

3.
Appreciate how urine toxicology testing is used in monitoring chronic pain patients and outline the potential benefits and limitations of its use in clinical practice.

Pain and addiction share several common pathways that interface on neuroanatomic and neurobiological grounds. The clinical interaction between pain and addiction is often complex. Drugs of abuse often have analgesic effects, and the dysregulation of mood and behavior seen with addiction complicates the perception of pain. Genetic data suggest that chronic pain, opioid analgesia, and opioid addiction share similar patterns of gene expression.
1
Medical professions have increasingly been prescribing opioids to treat chronic pain. Randomized controlled trials show a lack of strong evidence supporting sustainable analgesic efficacy and improved function with chronic opioid therapy (COT).
Comorbidities in Schizophrenia: Challenges for Researchers and Clinicians
Authors: Opler Lewis A. , Hwang Michael Y. , Opler Mark G. 
Published: August 2014

CME Educational Objectives

1.
Provide strategies for combining psychotropics in treating persons with schizophrenia plus other psychiatric disorders.

2.
Provide an understanding of the need to combine psychiatric genetics with epidemiology, neurobiology, and clinical experience in developing psychiatric nosologies.

3.
Indicate the importance of combining categorical and dimensional approaches in the diagnosis and treatment of psychiatric disorders.

In 1993, Hwang and Hollander
1
described the co-occurrence of schizophrenic and obsessive-compulsive symptoms in their article “Schizo-Obsessive Disorders.” Subsequently, Hwang et al
2–4
have continued to study both theoretic and treatment approaches relevant to schizophrenia with comorbidity. The publication of the
Diagnostic and Statistical Manual for Mental Disorders, 5th edition
(
DSM-5
)
5
is appropriately leading to many articles and even more discussions regarding psychiatric diagnoses. In this article, we update our conceptualization of and treatment recommendations for schizophrenia with comorbidity and offer our perspective regarding impact of developments in
DSM-5
.
Substance Use Comorbidity in Patients with Schizophrenia
Authors: Vitacco Michael J. , Buckley Peter F. 
Published: August 2014

CME Educational Objectives1.Be mindful of the association between the onset of schizophrenia and substance use.2.Understand and utilize the guidelines for clinical care of patients with schizophrenia and comorbid substance use.3.Consider the need for antipsychotic medications that will effectively treat schizophrenia without supporting addiction.Comorbid substance use is common in people with schizophrenia and other psychotic disorders. Although there are discrepancies between studies reporting on the prevalence of this comorbidity, the most typical number reported is that approximately 50% of patients diagnosed with schizophrenia will have a substance use diagnosis at some point in their lives, and up to 25% of those people diagnosed with schizophrenia at any given time may be actively engaged in substance use.1,2The importance for understanding this dual diagnosis is clear when one considers that the combination of substance use and psychotic disorders leads to higher levels of violence and more severe psychopathology.3Various studies have addressed substance use as it relates to the etiology, pathogenesis, and treatment of schizophrenia, and yet fundamental questions remain. For instance, is substance use, on its own accord, a putative risk factor for schizophrenia? How does the presence of substance use impact the treatment of a person with schizophrenia? This article aims to provide an overview of recent empirical research on two notable areas influencing clinicians and researchers. First, we discuss explanatory models that aim to improve our understanding of the high prevalence between substance use and schizophrenia. Second, we review implications for the treatment of substance use comorbidity in people with schizophrenia and complications that stem from substance use in these patients.
Group Psychotherapy in Schizophrenia with Obesity and Eating Disorders: A Pilot Study
Authors: Yum Sun Young , Hwang Michael Y. 
Published: August 2014

CME Educational Objectives

1.
Develop individualized treatment methods for patients with metabolic illness and schizophrenia.

2.
Anticipate the importance of body image, body weight and self-esteem in patients with stabilized schizophrenia.

3.
Incorporate psychotherapy in treatment regimens.

Despite an abundance of data on metabolic illnesses in patients with schizophrenia, their management is relatively less studied. In the few treatment studies, the goal is even less clear. Are we aiming to reduce weight? Why? Or are we aiming to reduce morbidities associated with obesity and, ultimately, cardiovascular mortality? If it is the latter, then weight is just one surrogate marker. We still do not know what weight is a surrogate of in patients with schizophrenia.
The CHILD 1 Diet: From Strategy to Practicality
Authors: Regis Adrienne 
Published: August 2014

As described by the Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents report, the Cardiovascular Health Integrated Lifestyle Diet (CHILD 1) is the first-step diet for all children with elevated cardiovascular risk. Although the diet is specifically designed for cardiovascular disease risk reduction, it can also be used for the promotion of healthy dietary habits for children (older than the age of 2 years) and adolescents while still continuing to provide adequate nutrition for optimal growth and development. The diet provides guidance on caloric distribution, offers appropriate beverage and snack choices, and highlights the importance of adequate fruit and vegetable intake. Although the guidelines presented in the CHILD 1 diet provide a framework on which a healthy diet can be built, it can be challenging for some patients and families to put the recommendations into practice. This article focuses on explaining the key nutrition messages within the CHILD 1 diet and includes practical suggestions for meal planning.

CME Educational Objectives

1.
Understand the key components of the Cardiovascular Health Integrated Lifestyle Diet (CHILD 1).

2.
Determine food choices that make for a successful CHILD 1 diet.

3.
Identify strategies to help educate families to prepare foods consistent with a successful CHILD 1 diet.
Hyperinsulinism in a Neonate
Authors: Blanco Michelle , Khan Owais , Stanley Katherine , Hageman Joseph R. , Greeley Siri Atma W. 
Published: August 2014

A male patient was born small for gestational age (SGA) at 33 weeks with a birth weight of 1,663 grams (< 10th percentile) and length 43 cm (10th percentile) to a 38-year-old G5P4 mother by cesarean section due to non-reassuring fetal heart tones. Prior to delivery, his mother experienced decreased fetal movement and decelerations. At birth, he was initially well-appearing and vigorous, with Apgar scores of 7 and 8 at 1 and 5 minutes, respectively. The physical examination was unremarkable — no skin findings, no facial anomalies, good tone, and the anterior fontanelle was soft and flat. The placenta, although noted to be healthy in appearance on prenatal ultrasounds, was atrophic and calcified by gross examination.
The patient developed respiratory distress 1 hour after birth and was found to have a blood glucose level of 24 mg/dL. Following an intravenous (IV) bolus of 10% dextrose in water (D10W) of 2 mL/kg, his glucose was 20 mg/dL. He was started on IV fluids with a glucose infusion rate (GIR) of 7.3 mg/kg/minute, with a subsequent rise in blood glucose to 46 mg/dL. Due to prematurity, respiratory distress, and persistent hypoglycemia, a diagnostic evaluation was initiated for possible sepsis, including a complete blood count with differential and platelet count and blood cultures. The patient was started empirically on IV ampicillin and gentamicin. The patient was subsequently found to have thrombocytopenia, hypomagnesemia, and hyponatremia on laboratory evaluation and was transferred to our neonatal intensive care unit (NICU) for further care.