bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orbitofrontal epilepsy: distinct neuronal networks underlying electroclinical subtypes and surgical outcomes
Authors: Zhao Baotian , Zhang Chao , Wang Xiu , Wang Yao , Mo Jiajie , Zheng Zhong , Ai Lin , Zhang Kai , Zhang Jianguo , Shao Xiao-qiu , Hu Wenhan 
Published: August 2020

OBJECTIVE
The aim of this study was to characterize the clinical and electrophysiological findings of epilepsy originating from the orbitofrontal cortex (OFC) as well as its surgical outcomes.

METHODS
The authors retrospectively reviewed 27 consecutive cases of patients with drug-resistant orbitofrontal epilepsy (OFE) who underwent tailored resective surgery after a detailed presurgical workup. Demographic features, seizure semiology, imaging characteristics, resection site, pathological results, and surgical outcomes were analyzed. Patients were categorized according to semiology. The underlying neural network was further explored through quantitative FDG-PET and ictal stereo-electroencephalography (SEEG) analysis at the group level. FDG-PET studies between the semiology group and the control group were compared using a voxel-based independent t-test. Ictal SEEG was quantified by calculating the energy ratio (ER) of high- and low-frequency bands. An ER comparison between the anterior cingulate cortex (ACC) and the amygdala was performed to differentiate seizure spreading patterns in groups with different semiology.

RESULTS
Scalp electroencephalography (EEG) and MRI were inconclusive to a large extent. Patients were categorized into the following 3 semiology groups: the frontal group (n = 14), which included patients with hyperactive automatisms with agitated movements; the temporal group (n = 11), which included patients with oroalimentary or manual automatisms; and the other group (n = 2), which included patients with none of the abovementioned or indistinguishable manifestations. Patients in the frontal and temporal groups (n = 23) or in the frontal group only (n = 14) demonstrated significant hypometabolism mainly across the ipsilateral OFC, ACC, and anterior insula (AI), while patients in the temporal group (n = 9) had hypometabolism only in the OFC and AI. The ER results (n = 15) suggested distinct propagation pathways that allowed us to differentiate between the frontal and temporal groups. Pathologies included focal cortical dysplasia, dysembryoplastic neuroepithelial tumor, cavernous malformation, glial scar, and nonspecific findings. At a minimum follow-up of 12 months, 19 patients (70.4%) were seizure free, and Engel class II, III, and IV outcomes were observed in 4 patients (14.8%), 3 patients (11.1%), and 1 patient (3.7%), respectively.

CONCLUSIONS
The diagnosis of OFE requires careful presurgical evaluation. Based on their electrophysiological and metabolic evidence, the authors propose that varied semiological patterns could be explained by the extent of involvement of a network that includes at least the OFC, ACC, AI, and temporal lobe. Tailored resections for OFE may lead to a good overall outcome.
Transthoracic microsurgical anterior decompression without fusion for ossification of the posterior longitudinal ligament in the thoracic spine
Authors: Ko Seokjin , Bae Junseok , Lee Sang-Ho 
Published: August 2020

OBJECTIVEThe authors aimed to analyze outcomes following transthoracic microsurgical anterior decompression of thoracic ossification of the posterior longitudinal ligament (T-OPLL), which was causing myelopathy, and determine the predictive factors for surgical outcomes.METHODSPatients who underwent transthoracic microsurgical anterior decompression without fusion for the treatment of T-OPLL from December 2014 to May 2019 were included. Demographic, radiological, and perioperative data and clinical outcomes of 35 patients were analyzed. The modified Japanese Orthopaedic Association (mJOA) score and recovery rate were used to evaluate functional outcomes.RESULTSA total of 35 consecutive patients (8 men and 27 women; mean age 52.2 ± 10.8 years) were enrolled in this study, and the mean follow-up period was 65.5 ± 51.9 months. The mean mJOA score significantly improved after surgery (5.9 ± 1.8 vs 8.3 ± 1.5, p < 0.001), with a mean recovery rate of 47.7% ± 24.5%. The visual analog scale (VAS) score significantly improved after surgery (7.3 ± 1.3 vs 4.3 ± 0.7, p < 0.001). The outcome was excellent in 4 patients (11.4%), good in 21 patients (60.0%), fair in 4 patients (11.4%), unchanged in 5 patients (14.3%), and worsened in 1 patient (2.9%). There were 12 cases of CSF leakage, 1 case of epidural hematoma, 1 case of pleural effusion, and 1 case of pneumothorax. Age, preoperative kyphotic angle, anteroposterior length of T-OPLL at the maximally affected level, and mass occupying rate were identified as predictors associated with postoperative outcome. A multivariate regression analysis revealed that age and preoperative kyphotic angle were independent risk factors for postoperative outcomes.CONCLUSIONSTransthoracic microsurgical anterior decompression without fusion achieved favorable clinical and radiological outcomes for treating T-OPLL with myelopathy. Patient age and preoperative kyphotic angle were independent risk factors for lower recovery rate.
The Institute for Healthcare Improvement–NeuroPoint Alliance collaboration to decrease length of stay and readmission after lumbar spine fusion: using national registries to design quality improvement protocols
Authors: Zuckerman Scott L. , Devin Clinton J. , Rossi Vincent , Chotai Silky , Dyer E. Hunter , Knightly John J. , Potts Eric A. , Foley Kevin T. , Bisson Erica F. , Glassman Steven D. , Mummaneni Praveen V. , Bydon Mohamad , Asher Anthony L. 
Published: August 2020

OBJECTIVENational databases collect large amounts of clinical information, yet application of these data can be challenging. The authors present the NeuroPoint Alliance and Institute for Healthcare Improvement (NPA-IHI) program as a novel attempt to create a quality improvement (QI) tool informed through registry data to improve the quality of care delivered. Reducing the length of stay (LOS) and readmission after elective lumbar fusion was chosen as the pilot module.METHODSThe NPA-IHI program prospectively enrolled patients undergoing elective 1- to 3-level lumbar fusions across 8 institutions. A three-pronged approach was taken that included the following phases: 1) Research Phase, 2) Development Phase, and 3) Implementation Phase. Primary outcomes were LOS and readmission. From January to June 2017, a learning system was created utilizing monthly conference calls, weekly data submission, and continuous refinement of the proposed QI tool. Nonparametric tests were used to assess the impact of the QI intervention.RESULTSThe novel QI tool included the following three areas of intervention: 1) preoperative discharge assessment (location, date, and instructions), 2) inpatient changes (LOS rounding checklist, daily huddle, and pain assessments), and 3) postdischarge calls (pain, primary care follow-up, and satisfaction). A total of 209 patients were enrolled, and the most common procedure was a posterior laminectomy/fusion (60.2%). Seven patients (3.3%) were readmitted during the study period. Preoperative discharge planning was completed for 129 patients (61.7%). A shorter median LOS was seen in those with a known preoperative discharge date (67 vs 80 hours, p = 0.018) and clear discharge instructions (71 vs 81 hours, p = 0.030). Patients with a known preoperative discharge plan also reported significantly increased satisfaction (8.0 vs 7.0, p = 0.028), and patients with increased discharge readiness (scale 0–10) also reported higher satisfaction (r = 0.474, p < 0.001). Those receiving postdischarge calls (76%) had a significantly shorter LOS than those without postdischarge calls (75 vs 99 hours, p = 0.020), although no significant relationship was seen between postdischarge calls and readmission (p = 0.342).CONCLUSIONSThe NPA-IHI program showed that preoperative discharge planning and postdischarge calls have the potential to reduce LOS and improve satisfaction after elective lumbar fusion. It is our hope that neurosurgical providers can recognize how registries can be used to both develop and implement a QI tool and appreciate the importance of QI implementation as a separate process from data collection/analysis.
Neurological events due to pedicle screw malpositioning with lateral fluoroscopy–guided pedicle screw insertion
Authors: Caelers Inge J. M. H. , Rijkers Kim , van Kuijk Sander M. J. , van Santbrink Henk , de Bie Rob A. , van Hemert Wouter L. W. 
Published: August 2020

OBJECTIVEThe risk of novel postoperative neurological events due to pedicle screw malpositioning in lumbar fusion surgery is minimized by using one of the several image-guided techniques for pedicle screw insertion. These techniques for guided screw insertion range from intraoperative fluoroscopy to intraoperative navigation. A practical technique consists of anatomical identification of the screw entry point followed by lateral fluoroscopy used for guidance during insertion of the screw. This technique is available in most clinics and is less expensive than intraoperative navigation. However, the safety of lateral fluoroscopy–guided pedicle screw placement with regard to novel postoperative neurological events due to screw malposition has been addressed only rarely in the literature. In this study the authors aimed to determine the rate of novel postoperative neurological events due to intraoperative and postoperatively established screw malpositioning during lateral fluoroscopy–assisted screw insertion.METHODSIncluded patients underwent lateral fluoroscopy–assisted lumbosacral screw insertion between January 2012 and August 2017. The occurrence of novel postoperative neurological events was analyzed from patient files. In case of an event, surgical reports were screened for the occurrence of intraoperative screw malposition. Furthermore, postoperative CT scans were analyzed to identify and describe possible screw malposition.RESULTSIn total, 246 patients with 1079 screws were included. Novel postoperative neurological events were present in 36 patients (14.6%). In 8 of these 36 patients (3.25% of the total study population), the neurological events could be directly attributed to screw malposition. Screw malpositioning was caused either by problematic screw insertion with immediate screw correction (4 patients) or by malpositioned screws for which the malposition was established postoperatively using CT scans (4 patients). Three patients with screw malposition underwent revision surgery without subsequent symptom relief.CONCLUSIONSLateral fluoroscopy–assisted lumbosacral screw placement results in low rates of novel postoperative neurological events caused by screw malposition. In the majority of patients suffering from novel postoperative neurological events, these events could not be attributed to screw malpositioning, but rather were due to postoperative neurapraxia of peripheral nerves, neuropathy, or intraoperative traction of nerve roots.
A short-segment fusion strategy using a wide-foot-plate expandable cage for vertebral pseudarthrosis after an osteoporotic vertebral fracture
Authors: Taiji Ryo , Takami Masanari , Yukawa Yasutsugu , Hashizume Hiroshi , Minamide Akihito , Nakagawa Yukihiro , Nishi Hideto , Iwasaki Hiroshi , Tsutsui Shunji , Okada Motohiro , Okada Sae , Teraguchi Masatoshi , Murata Shizumasa , Kozaki Takuhei , Yamada Hiroshi 
Published: August 2020

OBJECTIVEVarious surgical treatments have been reported for vertebral pseudarthrosis after osteoporotic vertebral fracture (OVF). However, the outcomes are not always good. The authors now have some experience with combined anterior-posterior short-segment spinal fusion (1 level above and 1 level below the fracture) using a wide-foot-plate expandable cage. Here, they report their surgical outcomes with this procedure.METHODSBetween June 2016 and August 2018, 16 consecutive patients (4 male and 12 female; mean age 75.1 years) underwent short-segment spinal fusion for vertebral pseudarthrosis or delayed collapse after OVF. The mean observation period was 20.1 months. The level of the fractured vertebra was T12 in 4 patients, L1 in 3, L2 in 4, L3 in 3, and L4 in 2. Clinical outcomes were assessed using the lumbar Japanese Orthopaedic Association (JOA) scale and 100-mm visual analog scale for low-back pain. Local kyphotic angle, intervertebral height, bone union rate, and instrumentation-related adverse events were investigated as imaging outcomes. The data were analyzed using the Wilcoxon signed-rank test.RESULTSThe mean operating time was 334.3 minutes (range 256–517 minutes), and the mean blood loss was 424.9 ml (range 30–1320 ml). The only perioperative complication was a superficial infection of the posterior wound that was cured by irrigation. The lumbar JOA score and visual analog scale value improved from 11.2 and 58.8 mm preoperatively to 20.6 and 18.6 mm postoperatively, respectively. The mean local kyphotic angle and mean intervertebral height were 22.6° and 28.0 mm, respectively, before surgery, −1.5° and 40.5 mm immediately after surgery, and 7.0° and 37.1 mm at the final observation. Significant improvement was observed in both parameters immediately after surgery and at the final observation when compared with the preoperative values. Intraoperative endplate injury occurred in 8 cases, and progression of cage subsidence of 5 mm or more was observed in 2 of these cases. Proximal junctional kyphosis was observed in 2 cases. There were no cases of screw loosening. No cases required reoperation due to instrument-related adverse events. Bone union was observed in all 14 cases that had CT evaluation.CONCLUSIONSThis short-segment fusion procedure is relatively minimally invasive, and local reconstruction and bone fusion have been achieved. This procedure is considered to be attempted for the surgical treatment of osteoporotic vertebral pseudarthrosis after OVF.
Dickkopf-1 Overexpression in vitro Nominates Candidate Blood Biomarkers Relating to Alzheimer’s Disease Pathology
Authors: Shi Liu , Winchester Laura M. , Liu Benjamine Y. , Killick Richard , Ribe Elena M. , Westwood Sarah , Baird Alison L. , Buckley Noel J. , Hong Shengjun , Dobricic Valerija , Kilpert Fabian , Franke Andre , Kiddle Steven , Sattlecker Martina , Dobson Richard , Cuadrado Antonio , Hye Abdul , Ashton Nicholas J. , Morgan Angharad R. , Bos Isabelle , Vos Stephanie J.B. , ten Kate Mara , Scheltens Philip , Vandenberghe Rik , Gabel Silvy , Meersmans Karen , Engelborghs Sebastiaan , De Roeck Ellen E. , Sleegers Kristel , Frisoni Giovanni B. , Blin Olivier , Richardson Jill C. , Bordet Régis , Molinuevo José L. , Rami Lorena , Wallin Anders , Kettunen Petronella , Tsolaki Magda , Verhey Frans , Lleó Alberto , Alcolea Daniel , Popp Julius , Peyratout Gwendoline , Martinez-Lage Pablo , Tainta Mikel , Johannsen Peter , Teunissen Charlotte E. , Freund-Levi Yvonne , Frölich Lutz , Legido-Quigley Cristina , Barkhof Frederik , Blennow Kaj , Rasmussen Katrine Laura , Nordestgaard Børge Grønne , Frikke-Schmidt Ruth , Nielsen Sune Fallgaard , Soininen Hilkka , Vellas Bruno , Kloszewska Iwona , Mecocci Patrizia , Zetterberg Henrik , Morgan B. Paul , Streffer Johannes , Visser Pieter Jelle , Bertram Lars , Nevado-Holgado Alejo J. , Lovestone Simon 
Published: August 2020

Background: Previous studies suggest that Dickkopf-1 (DKK1), an inhibitor of Wnt signaling, plays a role in amyloid-induced toxicity and hence Alzheimer’s disease (AD). However, the effect of DKK1 expression on protein expression, and whether such proteins are altered in disease, is unknown. Objective: We aim to test whether DKK1 induced protein signature obtained in vitro were associated with markers of AD pathology as used in the amyloid/tau/neurodegeneration (ATN) framework as well as with clinical outcomes. Methods: We first overexpressed DKK1 in HEK293A cells and quantified 1,128 proteins in cell lysates using aptamer capture arrays (SomaScan) to obtain a protein signature induced by DKK1. We then used the same assay to measure the DKK1-signature proteins in human plasma in two large cohorts, EMIF ( n = 785) and ANM ( n = 677). Results: We identified a 100-protein signature induced by DKK1 in vitro. Subsets of proteins, along with age and apolipoprotein E ɛ4 genotype distinguished amyloid pathology (A + T–N–, A+T+N–, A+T–N+, and A+T+N+) from no AD pathology (A–T–N–) with an area under the curve of 0.72, 0.81, 0.88, and 0.85, respectively. Furthermore, we found that some signature proteins (e.g., Complement C3 and albumin) were associated with cognitive score and AD diagnosis in both cohorts. Conclusions: Our results add further evidence for a role of DKK regulation of Wnt signaling in AD and suggest that DKK1 induced signature proteins obtained in vitro could reflect theATNframework as well as predict disease severity and progression in vivo.
ENTRETANTOS:
Authors: Dos Santos Leonardo Camila , Barboza da Silva Dagualberto , Pereira Barros João Paulo , Sampaio de Sousa Ingrid , Bezerra Saraiva Rodrigo , Celestino Lemos Furtado Gondim Gabriella 
Published: August 2020

Objetiva-se relatar experiências do projeto EntreTantos, entre 2017 e 2018, em Fortaleza. Referenciadas nos diálogos da Psicologia Social com estudos pós-estruturalistas e críticos à colonialidade, as ações do projeto intentaram mapear micropolíticas de resistência juvenis e criar espaços de ampliação de problematizações acerca de violências contra jovens nas margens urbanas, a partir de intercessões entre universidade, movimentos sociais e organizações que atuam com juventudes. Metodologicamente, o projeto se organiza em duas frentes, uma que enfoca a potencialização de redes entre movimentos, coletivos e organizações da sociedade civil, e outra voltada à criação de rodas de conversações com coletivos e grupos em contextos marginalizados. Os resultados e discussões apontam a participação da equipe extensionista em fóruns e movimentos que pautam segurança pública, prevenção e enfrentamento da violência letal contra segmentos infantojuvenis, bem como expõem a realização de rodas de conversações na região do Jangurussu.
CONDIÇÕES DE SAÚDE BUCAL EM IDOSOS INSTITUCIONALIZADOS E NÃO INSTITUCIONALIZADOS DE FORTALEZA, CEARÁ.
Authors: Sousa Jessica Soares de , Mendes Gemakson Mikael , Silva Raul Anderson Domingues Alves da , Moura Walda Viana Brigido de , Teixeira Ana Karine Macedo , Regis Rômulo Rocha 
Published: August 2020

O presente artigo tem como objetivo comparar as condições de saúde bucal de idosos residentes em uma Instituição de Longa Permanência para Idosos no município de Fortaleza, Ceará (G1), com idosos não institucionalizados (G2). Foram obtidos dados sociodemográficos e realizados exames intrabucais para avaliar as condições: cárie dentária, doença periodontal, edentulismo e uso/necessidade de próteses dentárias. Os dados foram analisados através do software SPSS (Statistical Package for Social Sciences), versão 22.0 através de testes estatísticos apropriados. Diferença significativa foi observada no índice CPO-D, cuja média foi de 28,4 entre o G1 e 24,1 entre o G2 (P=0,02). A ocorrência de cálculo dentário, sangramento gengival e bolsa periodontal foi semelhante entre os grupos. A porcentagem de indivíduos desdentados totais foi de 33,3%, sendo em sua maioria do G1. Já em relação ao uso e necessidade de próteses dentárias, o G1 utilizava mais e necessitava mais de uma nova prótese total. Já entre o G2, a maior necessidade foi de uma reabilitação oral parcial, mas em contrapartida, o uso de próteses foi menor. Conclui-se que G1 teve uma saúde bucal mais precária em comparação a G2, caracterizada por maior número de dentes perdidos, carecendo de medidas de promoção e recuperação de saúde bucal.
PENGARUH PRODUK ATRIBUT PADA PERILAKU PELANGGAN ORGANISASI PADA PUTUSAN PEMBELIAN JASA PAKET MEETING (MICE) DI HOTEL MALYA-BANDUNG
Authors: Halim Hasniati 
Published: August 2020

ABSTRAK Manajemen Hotel Malya saat ini melakukan repositioning dengan menambah segmen market baru yaitu MICE business (Meeting, Incentive, Convention and Exhibition), sehingga diperlukan suatu upaya untuk memahami karakteristik pelangggan MICE tersebut dengan cara mengetahui besarnya pengaruh atribut produk terhadap sikap pelanggan corporate meeting di Hotel Malya Bandung. Analisis kuantitatif berupa analisis jalur dipergunakan untuk menghitung besarnya pengaruh atribut produk terhadap sikap pembelian pelanggan. Teknik pengumpulan data menggunakan teknik sensus dengan alat bantu kuestioner disebarkan kepada 50 perusahaan yang telah menyelenggarakan corporate meeting di hotel Malya pada periode tertentu, dengan menggunakan teknik judgment sampling. Hasil penelitian dan pengujian hipotesis pengaruh atribut produk terhadap sikap pembelian pelanggan dapat disimpulkan bahwa hanya People (X3) yang berpengaruh signifikan secara langsung terhadap sikap pembelian yaitu sebesar 35,40%. Pengaruh Physical Evidence (X1) dan Process (X2) tidak berpengaruh signifikan terhadap sikap pembelian, namun berpengaruh tidak langsung melalui People (X3) yaitu sebesar 24.14%. Sedangkan pengaruh lain terhadap sikap pelanggan yang tidak dipergunakan dalam penelitian ini yaitu sebesar 40,46%. Dapat disimpulkan pula bahwa setiap perusahaan memiliki Unit Buying Center yang terbentuk secara informal tidak terstruktur dan sangat dinamis karena peran masing-masing orang dalam buying center berubah-ubah, hal ini menyebabkan pemasar perlu membuat strategi promosi yang efektif melalui aktifitas sales call (personal selling) yang tepat, sehingga manajemen perlu mengetahui aturan main yang diberlakukan ke masing-masing konsumen perusahaan untuk menggunakan pendekatan yang tepat. Kata Kunci : sikap pelanggan organisasi, atribut produk, physical evidence, proses, orang, afektif, kepuasan
PREVALENCE OF OBESITY RELATED TO STRESS IN POLICE WORKERS- A CROSS-SECTIONAL STUDY
Authors: Raju Somesh , Kumari Rina , Tiwari Sunita , Verma NS 
Published: August 2020

Background: Despite the prevalence of obesity and its increases in associated diseases such as diabetes and cardiovascular disease, no studies have addressed the spread of obesity among police officers working in stressful environment. Therefore, the present study conducted to access the prevalence of work related stress in police personnel.
Aims and Objective: To access the prevalence of obesity and stress burden among police workers and to see association of stress burden of police workers with their obesity.

Material and Method: This cross-sectional observational study done on 245 police workers in PAC, Sitapur, India. Subjects having more than ten years of working experience were included in study. Anthropometric measurements of subject recorded by following standard protocol. Standardized stress scale was used to access the degree of stress in police workers. Available data analyze and expressed in percentage, mean with SD and chi square test to see the significance of association.

Results: According to result of body mass index 77.14% of subjects were obese and 9.8% of subject was overweight. According to waist circumference 82.04% of subjects were obese. Result of stress score showed that 31.84% of subjects having mild stress and 16.73% of subjects having moderate stress. 30.35% of subjects having abdominal obesity were suffered from mild stress and there association was highly significant (p=0.02).

Conclusion: The study recommends health education programs to combat obesity and overweight. Regular counseling should be conducted to alleviate work related stress.