bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seniors at Risk: The Association between the Six-Month Use of Publicly Funded Home Support Services and Quality of Life and Use of Health Services for Older People
Authors: Markle-Reid M. , Browne G. , Weir R. , Gafni A. , Roberts J. , Henderson S. 
Published: October 2008

RÉSUMÉLa présente étude évalue les caractéristiques de base et les changements dans l'état de santé et le coût des services de soins de santé utilisés en association avec les services de soutien à domicile subventionnés par l'État. l'analyse comprend 122 personnes de ≥75ans admissibles aux services de soutien à domicile. Au cours d’une période de six mois, un tiers des personnes faisant partie de l'échantillon ont utilisé des services de soutien à domicile pendant ≥1 heure par semaine. Le taux de dépression et de déficience cognitive, le degré réduit de fonctionnement physique et émotionnel, et une capacité d’adaptation moins efficace étaient plus élevés chez ces aînés que chez ceux qui utilisaient moins de services. La déficience cognitive a expliqué 17 pour cent de la variation dans l'utilisation des services de soutien à domicile. Pour la période de six mois, l'utilisation de services de soutien à domicile pendant ≥1 heure par semaine par des aînés ayant des besoins plus importants était associée à un coût plus faible d’utilisation pour les services de soins de santé et à un niveau d’amélioration plus faible de l'état de santé. Ces résultats suggèrent qu’il faut accélérer la recherche visant à déterminer des méthodes plus efficaces pour la prestation des services de soutien à domicile à ces personnes afin d’améliorer leur état de santé à l'aide des ressources disponibles.
Application of covered stent grafts for intracranial vertebral artery dissecting aneurysms
Authors: He Min , Zhang Heng , Lei Ding , Mao Bo-Yong , You Chao , Xie Xiao-Dong , Sun Hong , Ju Yan , Zhang Jia-Ming 
Published: October 2008

Object
Utilization of covered stent grafts in treating neurovascular disorders has been reported, but their efficacy and safety in vertebral artery (VA) dissecting aneurysms needs further investigation.

Methods
Six cases are presented involving VA dissecting aneurysms that were treated by positioning a covered stent graft. Two aneurysms were located distal to the posterior inferior cerebellar artery, and 4 were located proximal to the posterior inferior cerebellar artery. Aspirin as well as ticlopidine or clopidogrel were administered after the procedure to prevent stent-related thrombosis. All patients were followed up both angiographically and clinically.

Results
Five of the 6 patients underwent successful placement of a covered stent graft. The covered stent could not reach the level of the aneurysm in 1 patient with serious vasospasm who died secondary to severe subarachnoid hemorrhage that occurred 3 days later. Patient follow-up ranged from 6 to 14 months (mean 10.4 months), and demonstrated complete stabilization of the obliterated aneurysms, and no obvious intimal hyperplasia. No procedure-related complications such as stenosis or embolization occurred in the 5 patients with successful stent graft placement.

Conclusions
Although long-term follow-up studies using a greater number of patients is required for further validation of this technique, this preliminary assessment shows that covered stent graft placement is an efficient, safe, and microinvasive technique, and is a promising tool in treating intracranial VA dissecting aneurysms.
Glioma surgery using a multimodal navigation system with integrated metabolic images
Authors: Tanaka Yoji , Nariai Tadashi , Momose Toshiya , Aoyagi Masaru , Maehara Taketoshi , Tomori Toshiki , Yoshino Yoshikazu , Nagaoka Tsukasa , Ishiwata Kiichi , Ishii Kenji , Ohno Kikuo 
Published: October 2008

Object
A multimodal neuronavigation system using metabolic images with PET and anatomical images from MR images is described here for glioma surgery. The efficacy of the multimodal neuronavigation system was evaluated by comparing the results with that of the conventional navigation system, which routinely uses anatomical images from MR and CT imaging as guides.

Methods
Thirty-three patients with cerebral glioma underwent 36 operations with the aid of either a multimodal or conventional navigation system. All of the patients were preliminarily examined using PET with l-methyl-[11C] methionine (MET) for surgical planning. Seventeen of the operations were performed with the multimodal navigation system by integrating the MET-PET images with anatomical MR images. The other 19 operations were performed using a conventional navigation system based solely on MR imaging.

Results
The multimodal navigation system proved to be more useful than the conventional navigation system in determining the area to be resected by providing a clearer tumor boundary, especially in cases of recurrent tumor that had lost a normal gyral pattern. The multimodal navigation system was therefore more effective than the conventional navigation system in decreasing the mass of the tumor remnant in the resectable portion. A multivariate regression analysis revealed that the multimodal navigation system–guided surgery benefited patient survival significantly more than the conventional navigation–guided surgery (p = 0.016, odds ratio 0.52 [95% confidence interval 0.29–0.88]).

Conclusions
The authors' preliminary intrainstitutional comparison between the 2 navigation systems suggested the possible premise of multimodal navigation. The multimodal navigation system using MET-PET fusion imaging is an interesting technique that may prove to be valuable in the future.
Acute symptomatic cerebellar tonsillar herniation following intraoperative lumbar drainage
Authors: Sugrue Patrick A. , Hsieh Patrick C. , Getch Christopher C. , Batjer H. Hunt 
Published: October 2008

Complications of tonsillar herniation associated with lumbar drainage have been reported in the literature. However, acutely symptomatic tonsillar herniation after intraoperative lumbar drainage is rare. The following case illustrates the risk associated with cerebrospinal fluid (CSF) drainage in the setting of tonsillar herniation. The use of lumbar drainage during cranial surgery is a common practice for reducing intracranial pressure and enhancing exposure, but is not without complications. In addition to the complications of the insertion procedure itself, the change in pressure gradient between the intracranial and the suboccipital compartments is of key importance.
The authors present the case of a patient who underwent a subtemporal craniotomy for resection of mesial temporal cavernous malformation with intraoperative lumbar drainage. The patient had a preexisting, asymptomatic 4-mm Chiari malformation and progressive neurological deficits resulting from further cerebellar tonsillar herniation in the early postoperative period developed, which required a lumbar blood patch, decompressive suboccipital craniectomy, and C-1 laminectomy with duroplasty. After placement of the lumbar drain and subsequent CSF drainage, the change in CSF pressure gradient above and below the foramen magnum probably led to the herniation. Unfortunately, the patient has lasting neuropathic pain and cervical cord signal changes on MR images.
A mathematical model of idiopathic intracranial hypertension incorporating increased arterial inflow and variable venous outflow collapsibility
Authors: Bateman Grant A. , Stevens Scott A. , Stimpson Jesse 
Published: October 2008

Object
A collapsible segment in the venous outflow has been noted in many patients with idiopathic intracranial hypertension (IIH). Mathematical modeling has shown that these collapsible segments can account for the elevated cerebrospinal fluid (CSF) pressures associated with IIH. However, the model required an elevated outflow resistance of up to 10 times normal to predict the CSF pressures actually found clinically. Measurement of blood flow in patients with IIH has shown that inflow rates vary, with higher rates noted in patients with lesser outflow stenoses. The aim of this work was to extend a simple model of cerebral hydrodynamics to accommodate a collapsible sinus and elevations in cerebral blood flow in accordance with in vivo measurements.

Methods
Forty patients with IIH underwent MR imaging in which the degree of stenosis on MR venography was compared with the total blood inflow by using MR flow quantification. The relative outflow resistance in IIH was estimated using the CSF opening pressure. The patients were compared with 14 age-matched control individuals.

Results
Patients were divided into 3 groups based on MR venography appearances (minimal stenosis, stenosis of 40–70% and > 70% stenosis). In vivo measurements suggested a relative resistance elevation of 2.5 times normal, 4.2 times normal, and 4.8 times normal in the 3 groups, respectively. There was an increased inflow of 1.56 times normal, 1.28 times normal, and 1.19 times normal in these groups.

Conclusions
The model correctly predicted the CSF pressures noted in vivo, suggesting that high arterial inflow is required for patients with low-grade stenoses to be symptomatic.
Nimodipine in aneurysmal subarachnoid hemorrhage: a randomized study of intravenous or peroral administration
Authors: Kronvall Erik , Undrén Per , Romner Bertil , Säveland Hans , Cronqvist Mats , Nilsson Ola G. 
Published: October 2008

Object
The calcium antagonist nimodipine has been shown to reduce the incidence of ischemic complications following aneurysmal subarachnoid hemorrhage (SAH). Although most randomized studies have been focused on the effect of the peroral administration of nimodipine, intravenous infusion is an alternative and the preferred mode of treatment in many centers. It is unknown whether the route of administration is of any importance for the clinical efficacy of the drug.

Methods
One hundred six patients with acute aneurysmal SAH were randomized to receive either peroral or intravenous nimodipine treatment. The patients were monitored for at least 10 days after bleeding in terms of delayed ischemic neurological deficits (DINDs) and with daily measurements of blood flow velocities in the middle cerebral arteries by using transcranial Doppler ultrasonography. Three months after SAH, clinical outcome and new cerebral infarctions according to MR imaging studies were recorded.

Results
Baseline characteristics (age, sex distribution, clinical status on admission, radiological findings, and aneurysm treatment) did not differ between the treatment groups. There was no significant difference in the incidence of DINDs (28 vs 30% in the peroral and intravenous groups, respectively) or middle cerebral artery blood flow velocities (> 120 cm/second, 50 vs 45%, respectively). Clinical outcome according to the Glasgow Outcome Scale was the same in both groups, and there was no difference in the number of patients with new infarctions on MR imaging.

Conclusions
The results suggest that there is no clinically relevant difference in efficacy between peroral and intravenous administration of nimodipine in preventing DINDs or cerebral vasospasm following SAH.
An Umayyad Fragment of the Qur'an and its Dating
Authors: Dutton Yasin 
Published: October 2008

In the absence of clearly dated manuscripts, the problem of dating early Qur'ans has long since exercised the minds of scholars and continues to do so today. In the present paper, we investigate the dating of one early fragment of the Qur'an, which has been dated by radio-carbon dating, and can be dated by art-historical methods, to the middle of the Umayyad period, that is, the latter years of the first century and/or the first years of the second century AH. In addition to questions of dating, a study of the textual variants and the verse-numbering represented in this fragment and in two further folios from what must be the same manuscript enables us to build up a picture of the reading and the verse-numbering system represented. This leads to the conclusion that this particular manuscript was written according to the Meccan reading tradition represented in the later sources by readers such as Ibn Kathīr, Ibn Muḥayṣin and their associates and/or predecessors. A further comparison of this manuscript with other, similar manuscripts also allows us more certainty about what were otherwise provisional datings for these other manuscripts, while at the same time allowing us a clearer picture of the characteristics of the so-called ‘Kufic’ script in its earliest stages in the first and early second centuries AH, and a better understanding of its overall development.
Silica supported single‐walled carbon nanotubes as a modifier in polyethylene composites
Authors: McDaniel Neal D. , McDaniel Max P. , Balzano Leandro , Resasco Daniel E. 
Published: October 2008

AbstractComposites have been made from single‐wall carbon nanotubes in a polyethylene (PE) matrix, in which different methods of preparation were used to disperse the nanotubes. The study includes using either the refined pure nanotubes (P‐NT) as the source, or the original silica supported nanotubes (SS‐NT). SS‐NT contained nanotubes still incorporated in and around the silica as originally grown. Composites were then made by (1) coprecipitation from a suspension of P‐NT or SS‐NT in a PE solution, or (2) by forming a polymerization catalyst from the SS‐NT, and using it to polymerize ethylene, which ruptures and expands the silica as polymer builds up in the pores. Extrusion was also studied as a method of additional dispersion. Nanotubes were found to have a powerful effect on the melt rheology, increasing the low shear viscosity dramatically. Increasing the nanotube concentration also increased the flexural and tensile moduli, decreased the elongation, and increased the electrical conductivity. Consistent trends were observed from all of these diverse properties: SS‐NT had a stronger effect than P‐NT, and within the SS‐NT group the choice of silica type also had a major effect. Polymerization was generally preferred as the method of dispersing the nanotubes. The conductivity, which in some cases was quite high, was found to be pressure sensitive. Conductive NT/PE composites could be molded into films or extruded into other shapes, or comolded with other PE. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2009
Density Functional Studies on Thromboxane Biosynthesis: Mechanism and Role of the Heme‐Thiolate System
Authors: Yanai Tetsuya K. , Mori Seiji 
Published: October 2008

AbstractReaction mechanisms for the isomerization of prostaglandin H2to thromboxane A2, and degradation to 12‐L‐hydroxy‐5,8,10‐heptadecatrienoic acid (HHT) and malondialdehyde (MDA), catalyzed by thromboxane synthase, were investigated using the unrestricted Becke‐three‐parameter plus Lee–Yang–Parr (UB3LYP) density functional level theory. In addition to the reaction pathway through FeIV‐porphyrin intermediates, a new reaction pathway through FeIII‐porphyrin π‐cation radical intermediates was found. Both reactions proceed with the homolytic cleavage of endoperoxide OO to give an alkoxy radical. This intermediate converts into an allyl radical intermediate by a CC homolytic cleavage, followed by the formation of thromboxane A2having a 6‐membered ring through a one electron transfer, or the degradation into HHT and MDA. The proposed mechanism shows that an iron(III)‐containing system having electron acceptor ability is essential for the 6‐membered ring formation leading to thromboxane A2. Our results suggest that the step of the endoperoxide OO homolytic bond cleavage has the highest activation energy following the binding of prostaglandin H2to thromboxane synthase.
Kinetic Evidence for the Influence of Subsurface Oxygen on Palladium Surfaces Towards CO Oxidation at High Temperatures
Authors: Gopinath Chinnakonda S. , Thirunavukkarasu Kandasamy , Nagarajan Sankaranarayanan 
Published: October 2008

AbstractTransient state kinetics of the catalytic oxidation of CO with O2 on Pd‐surfaces has been measured under isothermal conditions by using a molecular beam approach. Systematic studies were carried out as a function of reaction temperature and CO+O2 composition. With sufficient kinetic evidence, we have demonstrated the positive influence of subsurface oxygen towards CO‐adsorption and oxidation to CO2 at high temperatures (600–900 K) on Pd‐surfaces, and the likely electronic nature of the surface changes with oxygen in the subsurface. These studies also provide a direct proof for CO‐adsorption with a significantly reactive sticking coefficient at high temperatures on Pd‐surfaces exhibiting a significant subsurface O‐coverage.
Randomized clinical trial of botulinum toxin injection for pain relief in patients with thrombosed external haemorrhoids
Authors: Patti R , Arcara M , Bonventre S , Sammartano S , Sparacello M , Vitello G , Di Vita G 
Published: October 2008

Abstract

Background
Thrombosed external haemorrhoids are one of the most frequent anorectal emergencies. They are associated with swelling and intense pain. Internal sphincter hypertonicity plays a role in the aetiology of the pain. This study evaluated the efficacy and safety of an intrasphincteric injection of botulinum toxin for pain relief in patients with thrombosed external haemorrhoids.

Methods
Thirty patients with thrombosed external haemorrhoids who refused surgical operation were randomized into two groups. Patients received an intrasphincteric injection of either 0·6 ml saline or 0·6 ml of a solution containing 30 units botulinum toxin. Anorectal manometry was performed before treatment and 5 days afterwards.

Results
After 5 days of treatment, the maximum resting pressure fell in both groups, but was significantly lower in the botulinum toxin group (P = 0·004). Pain intensity was significantly reduced within 24 h of botulinum toxin treatment (P &lt; 0·001), but only after 1 week in the placebo group (P = 0·019).

Conclusion
A single injection of botulinum toxin into the anal sphincter seems to be effective in rapidly controlling the pain associated with thrombosed external haemorrhoids, and could represent an effective conservative treatment for this condition. Registration number: NCT00717782 (http://www.clinicaltrials.gov).
Case–control comparison of laparoscopic and open washout for peritoneal dialysis-associated peritonitis
Authors: Barlow A D , Yates P J , Hosgood S A , Nicholson M L 
Published: October 2008

Abstract

Background
Peritonitis is the major complication of peritoneal dialysis (PD). Some 25–40 per cent of patients require surgical intervention, traditionally laparotomy, washout and removal of the PD catheter. The aim was to compare this open procedure with laparoscopic washout and catheter removal.

Methods
In a case–control comparison, 20 patients who had laparoscopic washout for PD-associated peritonitis were matched by age and causative organism with 20 patients who had open washout.

Results
The groups were well matched for age, sex, causative organism, preoperative C-reactive protein level, white cell count and presence of bowel wall sclerosis. Laparoscopic surgery was quicker than open operation (mean(s.d.) 49(13) versus 73(30) min; P = 0·006) and postoperative morphine requirements were significantly lower (median 0 versus 27 mg; P &lt; 0·001). Bowel function recovered more quickly in the laparoscopic group, as measured by time to first passage of flatus (mean(s.d.) 2(1) versus 5(4) days; P = 0·004) and resumption of free fluids (median 2 versus 4 days; P = 0·044). Reoperation rates and 30-day mortality were identical in the two groups.

Conclusion
This study suggests that laparoscopic washout for PD peritonitis is as effective as open washout, but is quicker and less painful with earlier return of bowel function.
Fast-track recovery programme after pancreatico- duodenectomy reduces delayed gastric emptying
Authors: Balzano G , Zerbi A , Braga M , Rocchetti S , Beneduce A A , Di Carlo V 
Published: October 2008

Abstract

Background
Data on enhanced recovery programmes after pancreatic surgery are sparse. This retrospective cohort study, using historical controls, aimed to evaluate the impact of a fast-track programme after pancreaticoduodenectomy (PD).

Methods
Between 2004 and 2007, 252 patients undergoing PD were treated by a fast-track programme that included earlier postoperative feeding and mobilization. The patients were compared with an equally sized control group that received a traditional programme from 2000 to 2004. Outcome measures were morbidity, length of stay and readmission rate.

Results
The rates of pancreatic fistula and other intra-abdominal complications were similar in the two groups. Delayed gastric emptying (DGE) was significantly reduced in the fast-track group (13·9 versus 24·6 per cent; P = 0·004). The independent effect of the fast-track protocol in reducing DGE was confirmed by the multiple regression analysis (adjusted odds ratio 0·477, P = 0·005). Length of stay was reduced with the fast-track protocol (median 13 versus 15 days; P &lt; 0·001), without increasing the readmission rate (7·1 versus 6·3 per cent; P = 0·865).

Conclusion
A fast-track programme after PD improves gastric emptying and reduces postoperative stay.
Importance of extrasphincteric mechanisms in the pathophysiology of faecal incontinence in adults with a history of anorectal anomaly
Authors: Athanasakos E P , Ward H C , Williams N S , Scott S M 
Published: October 2008

Abstract

Background
Although surgery for congenital anorectal anomalies (ARAs) aims to preserve anorectal function, faecal incontinence and constipation often result. Apart from the anal sphincters, continence is dependent on multiple anatomical and physiological factors. The aim of this study was to evaluate adults with a history of ARA to determine the role of such factors in functional outcome.

Methods
The study included 20 consecutive adult patients with faecal incontinence who had undergone anorectal surgery as infants. Comprehensive testing included anal manometry, endoanal ultrasonography, tests of pudendal nerve function and rectal sensory function, evacuation proctography and colonic transit studies.

Results
Anal resting tone and squeeze increments were both attenuated in 15 of 19 patients. Integrity of the internal and external anal sphincters was compromised in 16 and 15 of 18 patients respectively. Eleven of 13 had evidence of pudendal neuropathy. Rectal sensation was abnormal in 14 of 18 patients, of whom ten were hypersensitive and four hyposensitive. Rectal evacuation was abnormal in nine of 14. Colonic transit was delayed in five of eight patients with constipation.

Conclusion
Faecal incontinence in adult patients with ARA is related to various pathophysiologies. Structural integrity of the anal sphincters is a major factor, but extrasphincteric mechanisms, notably rectal sensory function, may be as important.