bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of intracranial aneurysm recurrence after microsurgical clipping based on 3D digital subtraction angiography
Authors: Marbacher Serge , Grüter Basil Erwin , Wanderer Stefan , Andereggen Lukas , Cattaneo Marco , Trost Patricia , Gruber Philipp , Diepers Michael , Remonda Luca , Steiger Hans-Jakob 
Published: August 2022

OBJECTIVE
Current knowledge of recurrence rates after intracranial aneurysm (IA) surgery relies on 2D digital subtraction angiography (DSA), which fails to detect more than 75% of small aneurysm remnants. Accordingly, the discrimination between recurrence and growth of a remnant remains challenging, and actual assessment of recurrence risk of clipped IAs could be inaccurate. The authors report, for the first time, 3D-DSA–based long-term durability and risk factor data of IA recurrence and remnant growth after microsurgical clipping.

METHODS
Prospectively collected data for 305 patients, with a total of 329 clipped IAs that underwent baseline 3D-DSA, were evaluated. The incidence of recurrent IA was described by Kaplan-Meier curves. Risk factors for IA recurrence were analyzed by multivariable Cox proportional hazards and logistic regression models.

RESULTS
The overall observed proportion of IA recurrence after clipping was 2.7% (9 of 329 IAs) at a mean follow-up of 46 months (0.7% per year). While completely obliterated IAs did not recur during follow-up, incompletely clipped aneurysms (76 of 329) demonstrated remnant growth in 11.8% (3.4% per year). Young age and large initial IA size significantly increased the risk of IA recurrence.

CONCLUSIONS
The findings support those in previous studies that hypothesized that completely clipped IAs have an extremely low risk of recurrence. Conversely, the results highlight the significant risk posed by incompletely clipped IAs. Young patients with initial large IAs and incomplete obliteration have an especially high risk for IA recurrence and therefore should be monitored more closely.
Stereotactic radiosurgery for intermediate- and high-grade arteriovenous malformations: outcomes stratified by the supplemented Spetzler-Martin grading system
Authors: Naylor Ryan M. , Graffeo Christopher S. , Nesvick Cody L. , Link Michael J. , Brown Paul D. , Stafford Scott L. , Laack Nadia N. , Pollock Bruce E. 
Published: August 2022

OBJECTIVE
The supplemented Spetzler-Martin (Supp-SM) grading system was developed to improve the predictive accuracy of surgical risk for patients with brain arteriovenous malformations (AVMs). The aim of this study was to apply the Supp-SM grading system to patients having stereotactic radiosurgery (SRS) for Spetzler-Martin (SM) intermediate- (grade III) or high-grade (grade IV–V) AVMs to enable comparison with published microsurgical series.

METHODS
In 219 patients who underwent SRS during the period from 1990 to 2016, the Supp-SM grade was calculated for SM grade III (n = 154) or SM grade IV–V (n = 65) AVMs. The Supp-SM grades in these patients were 4 (n = 14, 6%), 5 (n = 36, 16%), 6 (n = 67, 31%), 7 (n = 76, 35%), and 8–9 (n = 26, 12%). Sixty patients (27%) had deep AVMs (basal ganglia, thalamus, or brainstem). Thirty-nine patients (18%) had volume-staged SRS; 41 patients (19%) underwent repeat SRS. The median follow-up period was 69 months for SM grade III AVMs and 113 months for SM grade IV–V AVMs.

RESULTS
AVM obliteration was confirmed in 163 patients (74%) at a median of 38 months after initial SRS. The obliteration rates at 4 and 8 years were 59% and 76%, respectively. Thirty-one patients (14%) had post-SRS deficits from hemorrhage (n = 7, 3%) or radiation injury (n = 24, 11%). Six patients (3%) died after SRS (hemorrhage, n = 5; radiation injury, n = 1). The rates of neurological decline or death at 4 and 8 years were 11% and 18%, respectively. Factors predictive of nonobliteration were deep location (HR 0.57, 95% CI 0.39–0.82, p = 0.003) and increasing AVM volume (HR 0.96, 95% CI 0.93–0.99, p = 0.002). Increasing AVM volume was the only factor associated with neurological decline (HR 1.05, 95% CI 1.02–1.08, p = 0.002). The Supp-SM grading score did not correlate with either obliteration (HR 0.94, 95% CI 0.82–1.09, p = 0.43) or neurological decline (HR 1.15, 95% CI 0.84–1.56, p = 0.38).

CONCLUSIONS
The Supp-SM grading system was not predictive of outcomes after SRS of intermediate- or high-grade AVM. In a cohort that included a high percentage (47%) of "inoperable" AVMs according to Supp-SM grade (≥ 7), most patients had obliteration after SRS, although there was a high risk of neurological decline.
Neuronal dysfunction and hemodynamic disturbance due to venous congestion in dural arteriovenous fistula revealed by 123I-iomazenil SPECT
Authors: Kanemaru Kazuya , Yoshioka Hideyuki , Hashimoto Koji , Wakai Takuma , Senbokuya Nobuo , Tateoka Toru , Fukuda Norito , Umeda Takako , Onishi Hiroshi , Kinouchi Hiroyuki 
Published: August 2022

OBJECTIVE
Retrograde leptomeningeal venous drainage (RLVD) of a dural arteriovenous fistula (dAVF) is associated with neurological morbidity and unfavorable outcomes. However, the direct damage to cortical neurons by dAVF with RLVD has not been elucidated. 123I-iomazenil (123I-IMZ) SPECT can reveal cerebral blood flow and cortical neuronal damage in early and late images, respectively. This study aimed to assess the cerebral venous congestive encephalopathy caused by dAVF using 123I-IMZ SPECT.

METHODS
Based on the pre- and posttreatment MRI findings, patients were divided into three groups: a normal group, an edema group, and an infarction group. Radioactive counts in the early and late images of 123I-IMZ SPECT were investigated using the affected-to-contralateral side asymmetry ratio (ACR).

RESULTS
None of the patients in the normal group showed any symptoms related to venous congestion. In contrast, all the patients in the edema and infarction groups developed neurological symptoms. The ACR in early images in the edema group was significantly lower than that in the normal group and significantly higher than that in the infarction group. The ACR in the late images of the infarction group was significantly lower than those of the normal and edema groups. After treatment, the neurological signs disappeared in the edema group, but only partial improvement was observed in the infarction group. The ACR in early images significantly improved after treatment in the edema group, but the ACR in late images did not change in any groups.

CONCLUSIONS
123I-IMZ SPECT is useful for evaluating hemodynamic disturbances and neuronal damage in dAVFs. The reduction in early images was correlated with the severity of venous congestive encephalopathy, and the significant reduction in late images is a reliable indicator of irreversible venous infarction caused by RLVD.
Metformin and Dementia Risk: A Systematic Review with Respect to Time Related Biases
Authors: Dai Jiahui , Ports Kayleen Deanna , Corrada Maria M. , Odegaard Andrew O. , O’Connell Joan , Jiang Luohua 
Published: August 2022

Background: When studying drug effects using observational data, time-related biases may exist and result in spurious associations. Numerous observational studies have investigated metformin and dementia risk, but have reported inconsistent findings, some of which might be caused by unaddressed time-related biases. Immortal time bias biases the results toward a “protective” effect, whereas time-lag and time-window biases can lead to either a “detrimental” or “protective” effect. Objective: To conduct a systematic review examining time-related biases in the literature on metformin and dementia. Methods: The electronic databases PubMed, Web of Science, and ProQuest were searched for the terms “Metformin” AND (“dementia” OR “Alzheimer’s Disease” OR “cognitive impairment"). These databases were searched from inception through 09/24/2021. Only English language articles and human research were eligible. Results: Seventeen studies were identified: thirteen cohort studies, two case-control studies, and two nested case-control studies. Eleven (64.7%) studies reported a reduced risk of dementia associated with metformin use; two (11.8%) suggested metformin increased dementia risk, while four (23.5%) concluded no significant associations. Eight (61.5%) of thirteen cohort studies had immortal time bias or did not clearly address it. Fifteen (88.2%) of seventeen reviewed studies had time-lag bias or did not clearly address it. Two (50.0%) of four case-control studies did not explicitly address time-window bias. The studies that addressed most biases concluded no associations between metformin and dementia risk. Conclusion: None of the reviewed studies clearly addressed relevant time-related biases, illustrating time-related biases are common in observational studies investigating the impact of anti-diabetic medications on dementia risk.
Practice and reflection of participatory design in tableware design for the elderly
Authors: Wang Ching-Yi 
Published: August 2022

BACKGROUND: In the past, the designers used to dominate and conduct user-centered design and research. The findings of such surveys might not reflect the user needs and produce the best design solutions. OBJECTIVE: This project aimed to use PD to introduce the design curriculum to break through the previous user-centered design thinking, as the designer and the user design together, with the user given the right to lead the entire design process. METHODS: The theme of this research design is tableware; 55 students and 11 elderly (over the age of 65) were invited to participate in this study. Questionnaires divided into the beginning, middle and final stages tested the teaching effectiveness of PD. RESULTS: The results showed that PD effectively improves five points: (1) design concepts and attitudes, (2) design methods, (3) problem solving and communication skills, (4) implementing design concepts, and (5) responding to the variety of user needs. CONCLUSION: This PD teaching model employs a well-established practical process to form an effective teaching routine, which is expected to be universally applied to other related design courses.
Biodegradabilidade de filmes baseados em biopolímero e óleo essencial de erva-doce
Authors: Santos Bruna dos , Costa Fabíola Medeiros da , Rodrigues Thais Fátima , Jahno Vanusca Dalosto , Aouada Fauze Ahmad , Aouada Marcia Regina de Moura 
Published: August 2022

O processo de embalagem de alimentos é de imensa importância quando se trata de preservação de alimentos frescos ou processados. A maioria desses materiais são fabricados com plásticos sintéticos e sua eliminação representa um problema ambiental. Este estudo teve como objetivo preparar e caracterizar filmes compostos de biopolímeros, alginato de sódio (AS) e carboximetilcelulose (CMC), com adição de goma arábica e óleo essencial de erva doce. A análise de ângulo de contato mostra que os filmes são hidrofílicos. A superfície dos filmes apresentou estrutura firme, densa e coesa, porém com algumas rugosidades. Nas micrografias das amostras de filme contendo óleo essencial de erva doce nota-se estruturas parecidas com cristais sobre a matriz polimérica de CMC e AS. A umidade dos filmes foi, no geral, baixa (média de 14 %). Os menores percentuais de umidade apresentados foram para os filmes com de óleo essencial. Os filmes são biodegradáveis, esse processo ocorre, pois, as macromoléculas naturais, como proteínas, polissacarídeos, celulose e goma geralmente são degradáveis em sistemas biológicos pela hidrólise seguida de oxidação. Portanto, foi satisfatório a formação de embalagem comestível contendo polissacarídeos e emulsão de óleo essencial de erva-doce.
Complicações decorrentes do levantamento do seio maxilar
Authors: Nascimento Viviane Oliveira do , Cronemberger Maura Pimentel Costa , Cavalcante Adriana de Araújo Fortes , Silva Marcelo Lopes , Sousa Alex Paulo Sérvio de , Matos Luanne Mara Rodrigues de 
Published: August 2022

De forma reabilitadora e estética, a ciência da implantodontia tem se aprimorado com o intuito de solucionar alguns incômodos relatados por pacientes. Dentre essas queixas, as zonas edêntulas devem ser meticulosamente avaliadas para um adequado planejamento clínico. Assim sendo, quando é diagnosticado o quadro de maxila atrófica, na maioria dos casos o seio maxilar acaba pneumatizando e técnicas operacionais são analisadas para possibilitar a acomodação dos implantes. Por essa razão, o objetivo deste trabalho é de relatar as principais complicações decorrentes do procedimento de levantamento do seio maxilar. Para a elaboração da pesquisa, foi realizado levantamento bibliográfico, utilizando as bases de dados Scientific Electronic Library Online (Scielo) e Medical Literature Analysis and Retrieval System Online (Medline). Descritores específicos como levantamento do assoalho do seio maxilar, complicações intraoperatórias e maxila, foram utilizados como método de busca. Nessa pesquisa, os artigos foram selecionados por critérios adequados relevantes à temática, todos publicados entre o período de 2016 a 2022, nos idiomas inglês e português. Na literatura vigente, muitos são os estudos nessa área que comprovam grande índice de sucesso nas cirurgias de levantamento do seio maxilar, no entanto, assim como qualquer intervenção cirúrgica, riscos operacionais podem ser presentes. Nesse aspecto, quando algumas questões são somadas como bom conhecimento científico sobre o assunto, destreza manual do operador e respeito às conformidades de cada indivíduo, a probabilidade de complicações da cirurgia diminui.
Padrão de consumo alimentar e estado nutricional em diabetes mellitus gestacional
Authors: Silva Julianne Cibele Rodrigues da , Martins Mayhanne Cockles de Oliveira , Dias Fernanda Dayana da Silva , Silva Taciana Iracema da , Lima Thalita Chistina da Costa , Burgos Maria Goretti Pessoa de Araújo 
Published: August 2022

Objetivo: Investigar o consumo alimentar, variáveis obstétricas, clínicas, antropométricas, controle glicêmico e de estilo de vida em gestantes com Diabetes Mellitus Gestacional (DMG). Métodos: Trata-se de um estudo descritivo, de natureza quantitativa, realizado de março a agosto de 2018, no Hospital das Clínicas da UFPE. Foram estudadas variáveis sociodemográficas, antropométricas, estilo de vida, controle glicêmico e consumo alimentar gestacional. Para análise estatística foram usados os testes de Mann-Whitney, Kruskal-Wallis e Shapiro-Wilk, com margem de erro de 5%. Resultados: Foram avaliadas 65 gestantes com idade > 19 anos. O excesso de peso pré-gestacional ocorreu em 73,8% da amostra, enquanto na gestação evoluiu para 84,6%; a glicemia de jejum foi mais elevada nas gestantes com excesso ponderal e naquelas sedentárias. O consumo de alimentos de risco glicêmico, foi associado positivamente com IMC pré-gestacional. A prática de atividade física foi realizada por 9,2% do grupo, sem associações com outros parâmetros de estilo de vida. Conclusão: Gestantes com DMG apresentaram excesso de peso e glicemia de jejum elevada em sua maioria, foi observada associação entre o consumo de alimentos de risco com excesso de peso e a maior parte da amostra era sedentária.
DEVELOPMENT AND INNOVATION OF SENDANG BATIK DESIGN AND MOTIVATION DURING THE NEW NORMAL TIME WITH SIWALAN LEAF AND FRUIT MOTIF
Authors: Ruswaji Ruswaji , Sulaeman Moh. Muklis , Febrian A. Bimbie 
Published: August 2022

Batik art is a local cultural heritage that stores knowledge and local wisdom of high value. In other words batik is a craft that has high artistic value and has long been a part of Indonesian culture. Therefore Sendang Lamongan batik is one of the cultural heritage that needs to be preserved, protected and supported by its development. This devotion tries to develop the design of Batik Sendang Lamongan motif as a result of cultural acculturation of its people, so that it can be an asset for cultural heritage. The focus and priority of design development motifs depart from the problem is still limited variety of existing ornaments. The purpose of this program is to improve the quality of batik products through the development of batik motif designs based on local wisdom. Second, expanding the market segment, not only in lamongan area but also other regions including outside east Java province. This program method is a discussion and observation conducted to identify problems, conduct activities, training workshops on the development of batik motifs based on local wisdom, followed by mentoring, monitoring and evaluation. This program produces new batik motifs based on local wisdom from flora natural sources, namely with The Leaves and Fruits of Borassus.
The Role of Hydrogeological Monitoring in a Multidisciplinary Context for the Preservation of the Critical Zone in the Natural Reserve of Castelporziano Estate
Authors: Sbarbati Chiara , Lacchini Alessandro , Petitta Marco 
Published: August 2022

Critical Zone (CZ) science has developed in recent years, involving different disciplines that vary depending on the specific research focus. This multidisciplinary approach highlights the relevance of the Underground component of the Critical Zone (UCZ) in regulating the water cycle, which can influence the complex equilibrium of the whole CZ. In this study, we analyze evolution during the time of different parameters, characterizing the saturated and unsaturated parts of the UCZ of the Castelporziano Estate, a natural reserve located in a coastal area close to Rome. The purposes of these activities are to monitor the potential depletion of groundwater resources and understand the recharge mechanism processes characterizing the aquifer in the framework of occurring climate changes, net of anthropogenic pressure. The long-term analyses of water table variations carried out over the last 25 years, allowed us to preliminarily identify four different ranges of the slope coefficient of the water table, characterizing different areas of the Estate. Specifically, the Northern, Central, and Coastal areas have shown a general depletion trend in piezometric levels, while in the Eastern area, a positive trend has been recognized. Additional long-term analysis of piezometric level variations allowed us to confirm the presence of the four recharge areas and compare annual recharge and water table levels to assess the relationship between the saturated UCZ and meteoric recharge in the identified areas. To evaluate the role of the unsaturated UCZ in recharge mechanisms, the water content in the first meter of soil has also been analyzed, showing different responses of outcropping sediments in capturing rainfall during different periods of the year and under different rainfall input conditions, highlighting the pivotal role of rainfall for the Castelporziano UCZ, both for deep recharge of the water table and for feeding the forest roots. Stable isotopes confirm that Castelporziano UCZ feeding is strongly dependent on local meteoric recharge, also highlighting that evaporation processes are active in a limited way. The obtained results assess that the monitoring of UCZ has a crucial role in the correct preservation of more complex environmental systems, which include groundwater resources and the coastal Mediterranean forest.
The role of obesity, type 2 diabetes, and metabolic factors in gout: A Mendelian randomization study
Authors: Yang Yang , Xian Wei , Wu Dide , Huo Zijun , Hong Shubin , Li Yanbing , Xiao Haipeng 
Published: August 2022

BackgroundSeveral epidemiological studies have reported a possible correlation between risk of gout and metabolic disorders including type 2 diabetes, insulin resistance, obesity, dyslipidemia, and hypertension. However, it is unclear if this association is causal.MethodsWe used Mendelian randomization (MR) to evaluate the causal relation between metabolic conditions and gout or serum urate concentration by inverse-variance-weighted (conventional) and weighted median methods. Furthermore, MR-Egger regression and MR-pleiotropy residual sum and outlier (PRESSO) method were used to explore pleiotropy. Genetic instruments for metabolic disorders and outcome (gout and serum urate) were obtained from several genome-wide association studies on individuals of mainly European ancestry.ResultsConventional MR analysis showed a robust causal association of increasing obesity measured by body mass index (BMI), high-density lipoprotein cholesterol (HDL), and systolic blood pressure (SBP) with risk of gout. A causal relationship between fasting insulin, BMI, HDL, triglycerides (TG), SBP, alanine aminotransferase (ALT), and serum urate was also observed. These results were consistent in weighted median method and MR-PRESSO after removing outliers identified. Our analysis also indicated that HDL and serum urate as well as gout have a bidirectional causal effect on each other.ConclusionsOur study suggested causal effects between glycemic traits, obesity, dyslipidemia, blood pressure, liver function, and serum urate as well as gout, which implies that metabolic factors contribute to the development of gout via serum urate, as well as potential benefit of sound management of increased serum urate in patients with obesity, dyslipidemia, hypertension, and liver dysfunction.
Hyperglycemia aggravates ischemic brain damage via ERK1/2 activated cell autophagy and mitochondrial fission
Authors: Liu Ping , Yang Xiao , Niu Jianguo , Hei Changchun 
Published: August 2022

BackgroundHyperglycemia is one of the major risk factors for stroke and stroke recurrence, leading to aggravated neuronal damage after cerebral ischemia/reperfusion (I/R). ERK1/2 signaling pathway plays a vital role in cerebral ischemic injury. However, the role of the ERK1/2 pathway in hyperglycemia-aggravated ischemic brain damage is not clear.MethodsStreptozotocin (STZ; 50 mg/kg)-induced diabetes (blood glucose ≥12 mmol/L) or control groups in adult Sprague-Dawley rats were further subdivided into I/R (carotid artery/vein clamping), I/R + PD98059 (I/R plus ERK1/2 inhibitor), and Sham-operated groups (n = 10 each). Neurobehavioral status (Neurological behavior scores) and the volume of the cerebral infarction (TTC staining); brain mitochondrial potential (JCI ratio test) and cell apoptosis (TUNEL assay); RAS protein expression, phosphorylated/total ERK1/2 and Drp-1 (Dynamic-related protein 1) protein levels (Western blotting); mitochondrial fusion-related proteins mitofusin-1/2 (Mfn1/2), optic atrophy (OPA-1) and mitochondrial fission 1 (Fis1), and autophagy-associated proteins Beclin-1, LC3-I/II and P62 (Western blotting and immunohistochemistry) were analyzed.ResultsThe I/R + PD98059 group demonstrated better neurobehavior on the 1st (p &lt; 0.05) and the 3rd day (p &lt; 0.01) than the I/R group. Compared to the Sham group, cerebral ischemia/reperfusion brought about neuronal damage in the I/R group (p &lt;0.01). However, treatment with PD98059 showed an improved situation with faster recovery of mitochondrial potential and less apoptosis of neuronal cells in the I/R + PD98059 group (p &lt; 0.01). The I/R group had a higher-level expression of RAS and phosphorylated ERK1/2 and Drp-1 than the diabetes mellitus (DM) group (p &lt; 0.01). The PD98059 treated group showed decreased expression of p-ERK1/2, p-Drp-1, Fis1, and Beclin-1, LC3-I/II and P62, but increased Mfn1/2 and OPA-1 than the I/R group (p &lt; 0.01).ConclusionHyperglycemia worsens cerebral ischemia/reperfusion-induced neuronal damage via ERK1/2 activated cell autophagy and mitochondrial fission.