bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microvascular Decompression using Muscle Graft for Vertebral Artery Medullary Compression Syndrome
Authors: Karki Prasanna , Shah Damber Bikram , Joshi Sumit , Poudel Prakash , Kayastha Jessica , Sharma Gopal Raman 
Published: December 2020

It is well known that brainstem dysfunction may be caused by vascular compression of the medulla oblongata. However, only a limited number of reports have found microvascular decompression surgery to be an effective treatment for symptomatic patients with medulla oblongata dysfunction.
This report describes a patient with vertebral artery compression of lateral medulla oblongata who presented with lateral medullary syndrome. Microvascular decompression surgery using the transcondylar fossa approach was effective in relieving patient symptoms.
The transcondylar fossa approach and the transposition of vertebral artery along with autologous muscle graft interposition technique is appropriate in microvascular decompression surgery to relieve vertebral artery compression of medulla oblongata.
Book Reviews
Authors: Clay J. Eugene , Bara Anna 
Published: December 2020

Aileen E. Friesen, Colonizing Russia’s Promised Land: Orthodoxy and Community on the Siberian Steppe (Toronto: University of Toronto Press, 2020), xiii + 224 pp., index, illustrations (black and white), map. $48.75 (cloth). ISBN: 978-1-4426-3719-1.Alex Oehler and Anna Varfolomeeva, eds., Multispecies Households in the Saian Mountains: Ecology at the Russia-Mongolia Border (Lanham: Lexington Books; 1 edition, 2019), 296 pages. Hardcover, $95.00. ISBN: 9781793602534.
Neurosurgery training in India during the COVID-19 pandemic: straight from the horse’s mouth
Authors: Dash Chinmaya , Venkataram Tejas , Goyal Nishant , Chaturvedi Jitender , Raheja Amol , Singla Raghav , Sardhara Jayesh , Gupta Ravi 
Published: December 2020

OBJECTIVEThe COVID-19 pandemic has forced medical professionals throughout the world to adapt to the changing medical scenario. The objective of this survey was to assess the change in neurosurgical training in India following the COVID-19 pandemic.METHODSBetween May 7, 2020, and May 16, 2020, a validated questionnaire was circulated among neurosurgical residents across India by social media, regarding changes in the department’s functioning, patient interaction, surgical exposure, changes in academics, and fears and apprehensions associated with the pandemic. The responses were kept anonymous and were analyzed for changes during the COVID-19 pandemic compared to before the pandemic.RESULTSA total of 118 residents from 29 neurosurgical training programs across 17 states/union territories of the country gave their responses to the survey questionnaire. The survey revealed that the surgical exposure of neurosurgical residents has drastically reduced since the onset of the COVID-19 pandemic, from an average of 39.86 surgeries performed/assisted per month (median 30) to 12.31 per month (median 10), representing a decrease of 67.50%. The number of academic sessions has fallen from a median of 5 per week to 2 per week. The survey uncovered the lack of universal guidelines and homogeneity regarding preoperative COVID-19 testing. The survey also reveals reluctance toward detailed patient examinations since the COVID-19 outbreak. The majority of respondents felt that the COVID-19 pandemic will hamper their operative and clinical skills. Fear of rescheduling or deferring of licensing examinations was significantly higher among those closest to the examination (p = 0.002).CONCLUSIONSThe adverse impact of the pandemic on neurosurgical training needs to be addressed. While ensuring the safety of the residents, institutes and neurosurgical societies/bodies must take it upon themselves to ensure that their residents continue to learn and develop neurosurgical skills during these difficult times.
Reconversion of neurosurgical practice in times of the SARS-CoV-2 pandemic: a narrative review of the literature and guideline implementation in a Mexican neurosurgical referral center
Authors: Díaz-Bello Sergio , Hernández-Hernández Alan , Guinto-Nishimura Gerardo Y. , Mondragón-Soto Michel G. , Lem-Carrillo Monica , González-Aguilar Alberto , Calleja-Castillo Juan M. , Leyva-Rendón Adolfo , León-Ortiz Pablo , Chávez-Piña Carmen M. , Pando-Tarín Gustavo A. , Mejía-Pérez Sonia I. , Taboada-Barajas Jesús , Zavala-Álvarez Elsa D. , Soto-Hernández José L. , Cárdenas Graciela , Gómez-Amador Juan L. 
Published: December 2020

OBJECTIVEThe coronavirus disease 2019 (COVID-19) pandemic has forced the modification of surgical practice worldwide. Medical centers have been adapted to provide an efficient arrangement of their economic and human resources. Although neurosurgeons are not in the first line of management and treatment of COVID-19 patients, they take care of patients with neurological pathology and potential severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, the authors describe their institutional actions against the pandemic and compare these actions with those in peer-reviewed publications.METHODSThe authors conducted a search using the MEDLINE, PubMed, and Google Scholar databases from the beginning of the pandemic until July 11, 2020, using the following terms: “Neurosurgery,” “COVID-19/SARS-CoV-2,” “reconversion/modification,” “practice,” “academy,” and “teaching.” Then, they created operational guidelines tailored for their institution to maximize resource efficiency and minimize risk for the healthcare personnel.RESULTSAccording to the reviewed literature, the authors defined the following three changes that have had the greatest impact in neurosurgical practice during the COVID-19 pandemic: 1) changes in clinical practices; 2) changes in the medical care setting, including modifications of perioperative care; and 3) changes in the academic teaching methodology.CONCLUSIONSThe Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez” is one of the major referral centers for treating highly complex neurosurgical pathologies in Mexico. Its clinical and neurosurgical practices have been modified with the implementation of specific interventions against the spread of COVID-19. These practical and simple actions are remarkably relevant in the context of the pandemic and can be adopted and suited by other healthcare centers according to their available resources to better prepare for the next event.
Deep brain stimulation telemedicine programming during the COVID-19 pandemic: treatment of patients with psychiatric disorders
Authors: Lin Zhengyu , Zhang Chencheng , Zhang Yingying , Dai Lulin , Voon Valerie , Li Dianyou , Sun Bomin 
Published: December 2020

OBJECTIVEThe ongoing coronavirus disease 2019 (COVID-19) pandemic has considerably affected the delivery of postoperative care to patients who have undergone deep brain stimulation (DBS) surgery. DBS teleprogramming technology was developed and deployed in China before the COVID-19 outbreak. In this report, the authors share their experiences with telemedical DBS treatment of patients with psychiatric disorders during the COVID-19 outbreak.METHODSFour patients (2 with obsessive-compulsive disorder, 1 with major depressive disorder, and 1 with anorexia nervosa) underwent DBS surgery at Ruijin Hospital and received continuous postoperative DBS telemedicine case management from January 2020 to July 2020. DBS teleprogramming, individualized psychological support, and medical consultations were provided via the authors’ DBS telemedicine platform, which also incorporated a synchronous real-time video communication system.RESULTSForty-five DBS telemedicine sessions were conducted; there was no unexpected loss of network connection during the sessions. Of these, 28 sessions involved DBS teleprogramming. Adjustments were made to the stimulation voltage, frequency, pulse width, and contact site in 21, 12, 9, and 9 sessions, respectively. Psychological support and troubleshooting were provided during the remaining telemedicine sessions. Modest to substantial clinical improvements after DBS surgery were observed in some but not all patients, whereas stimulation-related side effects were reported by 2 patients and included reversible sleep and mood problems, headache, and a sensation of heat.CONCLUSIONSDBS telemedicine seems to offer a feasible, safe, and efficient strategy for maintaining the delivery of medical care to psychiatric patients during the COVID-19 outbreak. The authors propose that implementation of a comprehensive DBS telemedicine system, which combines DBS teleprogramming with psychological counseling, medical consultations, and medication prescriptions and delivery, could be an efficient and effective approach to manage the mental health and quality of life of patients with psychiatric disorders during future local or global public health crises.
Virtual education in neurosurgery during the COVID-19 pandemic
Authors: Lazaro Tyler , Srinivasan Visish M. , Rahman Maryam , Asthagiri Ashok , Barkhoudarian Garni , Chambless Lola B. , Kan Peter , Rao Ganesh , Nahed Brian V. , Patel Akash J. 
Published: December 2020

OBJECTIVENeurosurgical education in the US has changed significantly as a consequence of the novel coronavirus (COVID-19) pandemic. Institutional social distancing requirements have resulted in many neurosurgical programs utilizing video conferencing for educational activities. However, it is unclear how or if these practices should continue after the pandemic. The objective of this study was to characterize virtual education in neurosurgery and understand how it should be utilized after COVID-19.METHODSA 24-question, 3-part online survey was administered anonymously to all 117 US neurosurgical residency programs from May 15, 2020, to June 15, 2020. Questions pertained to the current use of virtual conferencing, preferences over traditional conferences, and future inclinations. The Likert scale (1 = strongly disagree, 3 = neutral, 5 = strongly agree) was used. Comparisons were calculated using the Mann-Whitney U-test. Statistical significance was set at 0.05.RESULTSOne-hundred eight responses were recorded. Overall, 38 respondents (35.2%) were attendings and 70 (64.8%) were trainees. Forty-one respondents (38.0%) indicated attending 5–6 conferences per week and 70 (64.8%) attend national virtual conferences. When considering different conference types, there was no overall preference (scores < 3) for virtual conferences over traditional conferences. In regard to future use, respondents strongly agreed that they would continue the practice at some capacity after the pandemic (median score 5). Overall, respondents agreed that virtual conferences would partially replace traditional conferences (median score 4), whereas they strongly disagreed with the complete replacement of traditional conferences (median score 1). The most common choices for the partial replacement of tradition conferences were case conferences (59/108, 55%) and board preparation (64/108, 59%). Lastly, there was a significant difference in scores for continued use of virtual conferencing in those who attend nationally sponsored conferences (median score 5, n = 70) and those who do not (median score 4, n = 38; U = 1762.50, z = 2.97, r = 0.29, p = 0.003).CONCLUSIONSVirtual conferences will likely remain an integral part of neurosurgical education after the COVID-19 pandemic has abated. Across the country, residents and faculty report a preference for continued use of virtual conferencing, especially virtual case conferences and board preparation. Some traditional conferences may even be replaced with virtual conferences, in particular those that are more didactic. Furthermore, nationally sponsored virtual conferences have a positive effect on the preferences for continued use of virtual conferences.
Anxiety in neurosurgical patients undergoing nonurgent surgery during the COVID-19 pandemic
Authors: Doglietto Francesco , Vezzoli Marika , Biroli Antonio , Saraceno Giorgio , Zanin Luca , Pertichetti Marta , Calza Stefano , Agosti Edoardo , Aliaga Arias Jahard Mijail , Assietti Roberto , Bellocchi Silvio , Bernucci Claudio , Bistazzoni Simona , Bongetta Daniele , Fanti Andrea , Fioravanti Antonio , Fiorindi Alessandro , Franzin Alberto , Locatelli Davide , Pugliese Raffaelino , Roca Elena , Sicuri Giovanni Marco , Stefini Roberto , Venturini Martina , Vivaldi Oscar , Zattra Costanza , Zoia Cesare , Fontanella Marco Maria 
Published: December 2020

OBJECTIVEThe COVID-19 pandemic has forced many countries into lockdown and has led to the postponement of nonurgent neurosurgical procedures. Although stress has been investigated during this pandemic, there are no reports on anxiety in neurosurgical patients undergoing nonurgent surgical procedures.METHODSNeurosurgical patients admitted to hospitals in eastern Lombardy for nonurgent surgery after the lockdown prospectively completed a pre- and postoperative structured questionnaire. Recorded data included demographics, pathology, time on surgical waiting list, anxiety related to COVID-19, primary pathology and surgery, safety perception during hospital admission before and after surgery, and surgical outcomes. Anxiety was measured with the State-Trait Anxiety Inventory. Descriptive statistics were computed on the different variables and data were stratified according to pathology (oncological vs nononcological). Three different models were used to investigate which variables had the greatest impact on anxiety, oncological patients, and safety perception, respectively. Because the variables (Xs) were of a different nature (qualitative and quantitative), mostly asymmetrical, and related to outcome (Y) by nonlinear relationships, a machine learning approach composed of three steps (1, random forest growing; 2, relative variable importance measure; and 3, partial dependence plots) was chosen.RESULTSOne hundred twenty-three patients from 10 different hospitals were included in the study. None of the patients developed COVID-19 after surgery. State and trait anxiety were reported by 30.3% and 18.9% of patients, respectively. Higher values of state anxiety were documented in oncological compared to nononcological patients (46.7% vs 25%; p = 0.055). Anxiety was strongly associated with worry about primary pathology, surgery, disease worsening, and with stress during waiting time, as expected. Worry about positivity to SARS-CoV-2, however, was the strongest factor associated with anxiety, even though none of the patients were infected. Neuro-oncological disease was associated with state anxiety and with worry about surgery and COVID-19. Increased bed distance and availability of hand sanitizer were associated with a feeling of safety.CONCLUSIONSThese data underline the importance of psychological support, especially for neuro-oncological patients, during a pandemic.
The adjustment of neurosurgical procedures during the COVID-19 pandemic: a case study at Dr. Sardjito General Hospital as a part of an academic health system
Authors: Pramusinto Handoyo , Tamba Daniel Agriva , Subagio Yoyok , Numberi Tommy J. , Pramujo Bangun , Sinanu Franklin L. , Ariasthapuri Gheanita , Bismantara Haryo , Meliala Andreasta 
Published: December 2020

OBJECTIVEThe recent COVID-19 outbreak has forced notable adjustments to surgical procedure preparation, including neurosurgical services. However, due to the uniqueness of the recent situation, neurosurgical centers, especially those located in low-resource settings, are facing several challenges such as a lack of coordination, poor equipment, and shortage of medical personnel. Therefore, several guidelines from local authorities and international neurosurgical bodies have been published to help clinicians manage their patients. In addition, the academic health system (AHS), which is an integrated system containing a medical institution, universities, and a teaching hospital, may play some role in the management of patients during COVID-19. The objective of this study was to describe how each hospital in the authors’ network adjusted their neurosurgical practice and how the AHS of the Universitas Gadjah Mada (UGM) played its role in the adaptation process during the pandemic.METHODSThe authors gathered both local and national data about the number of COVID-19 infections from the government’s database. To assess the contribution of the AHS to the efforts of each hospital to address the pandemic, questionnaires were given to 6 neurosurgeons, 1 resident, and 2 general surgeons about the management of neurosurgical cases during the pandemic in their hospitals.RESULTSThe data illustrate various strategies to manage neurosurgical cases by hospitals within the authors’ networks. The hospitals were grouped into three categories based on the transmission risk in each region. Most of these hospitals stated that UGM AHS had a positive impact on the changes in their strategies. In the early phase of the outbreak, some hospitals faced a lack of coordination between hospitals and related stakeholders, inadequate amount of personal protective equipment (PPE), and unclear regulations. As the nation enters a new phase, almost all hospitals had performed routine screening tests, had a sufficient amount of PPE for the medical personnel, and followed both national and international guidelines in caring for their neurosurgical patients.CONCLUSIONSThe management of neurosurgical procedures during the outbreak has been a challenging task and a role of the AHS in improving patient care has been experienced by most hospitals in the authors’ network. In the future, the authors expect to develop a better collaboration for the next possible pandemic.
The Controlling Nutritional Status (CONUT) Score is a Prognostic Biomarker in Advanced Urothelial Carcinoma Patients Treated with First-Line Platinum-Based Chemotherapy
Authors: Suzuki Hiroaki , Ito Masaya , Takemura Kosuke , Kobayashi Shuichiro , Kataoka Madoka , Iida Noriyuki , Sekiya Ken , Matsumoto Takuya , Koga Fumitaka 
Published: December 2020

BACKGROUND: The controlling nutritional status (CONUT) score is an objective indicator of general condition from the aspect of nutritional status, calculated from serum albumin, total cholesterol, and total lymphocyte count. The CONUT score is also considered to reflect the degree of tumor-derived chronic inflammation and the host immune status in patients with advanced cancer. OBJECTIVE: To examine the prognostic role of the CONUT score in patients with advanced urothelial carcinoma (aUC) treated with first-line platinum-based chemotherapy. METHODS: Associations of the CONUT score with clinical parameters and overall survival (OS) were investigated retrospectively in 147 patients with aUC receiving first-line platinum-based chemotherapy at a single cancer center from February 2003 to April 2019. RESULTS: The median (range) CONUT score was 1 (0–7). A higher CONUT score was associated with lower hemoglobin ( P < 0.001) and higher C-reactive protein levels ( P = 0.023) but not with chemotherapy response ( P = 0.432). The median OS for patients with CONUT scores 0–1, 2–3, and ≥4 were 23.3, 14.9, and 9.4 months, respectively ( P < 0.001). In the multivariable analysis, a higher CONUT score was independently associated with shorter OS (scores 2–3 vs 0–1, HR 1.58, P = 0.048; scores ≥4 vs 0–1, HR 2.63, P = 0.008) along with poorer performance status (HR 4.79, P < 0.001), primary tumor site of the upper urinary tract (HR 1.70, P = 0.016), higher LDH (HR 3.85, P = 0.036), higher alkaline phosphatase (HR 3.06, P = 0.028), and non-responders to chemotherapy (HR 2.07, P < 0.001). CONCLUSIONS: The CONUT score is a prognostic biomarker in patients with aUC receiving first-line platinum-based chemotherapy.
Well-being and Perceptions of Supportive Resources among Caregivers of Patients with Bladder Cancer
Authors: Jung Ahrang , Song Lixin , Snyder Elizabeth , Louwers Renata K. , Sachse Karen , Chisolm Stephanie , Gore John L. , Smith Angela B. 
Published: December 2020

BACKGROUND: The unique burden of treatment and survivorship of patients with bladder cancer can negatively impact caregiver experience and their use of supportive care resources. OBJECTIVE: To assess caregivers’ well-being and their perception of potential supportive resources. METHODS: In this cross-sectional survey, caregivers of patients with bladder cancer (N = 630) were recruited through the nationwide Bladder Cancer Advocacy Network Patient Survey Network. We used stakeholder-developed questionnaires to examine caregiver well-being (i.e., physical well-being, tiredness, fear, worry, sadness), the perceived helpfulness of potential resources (i.e., web-based and print-based information, specialized support, personal stories of other caregivers, phone-call and online chat with other caregivers), and influencing factors. RESULTS: Caregivers more frequently reported emotional well-being as a moderate to serious problem (67% for fear, 78% for worry, 66% for sadness) compared with physical well-being (30%) and tiredness (47%). Decreased well-being was associated with female gender of the caregiver, higher than high school education, or caring for a patient with advanced (versus non-invasive) bladder cancer. Of six potential resources, “web-based information” was perceived as “very helpful” among 79% of respondents, followed by “personal stories from other caregivers” (62%). Caregiver preferences for “web-based information” was not associated with any specific demographic or clinical factors. CONCLUSIONS: Caregivers reported moderate to serious problems with emotional and physical well-being. Web-based platforms were perceived as beneficial supportive resources for bladder cancer caregivers. Future intervention research should target the influencing factors identified in this study to optimize the health outcomes of caregivers and enhance the supportive care resources for improving their well-being.
Quadriceps activation during maximal isometric and isokinetic contractions: The minimal real difference and its implications
Authors: Catino Luigi , Malloggi Chiara , Scarano Stefano , Cerina Valeria , Rota Viviana , Tesio Luigi 
Published: December 2020

BACKGROUND: A method of measurement of voluntary activation (VA, percent of full muscle recruitment) during isometric and isokinetic concentric contractions of the quadriceps femoris (QF) at 60[Formula: see text]/s and 120[Formula: see text]/s was previously validated. OBJECTIVE: This study aimed to quantify the test-retest minimal real difference (MRD) of VA during isometric (ISOM) and isokinetic concentric contractions of QF (100[Formula: see text]/s, ISOK) in a sample of healthy individuals. METHODS: VA was measured through the interpolated twitch technique. Pairs of electrical stimuli were delivered to the QF at 40[Formula: see text] of knee flexion during maximal voluntary contractions. Twenty-five healthy participants (20–38 years, 12 women, 13 men) completed two testing sessions with a 14-day interval. VA values were linearized through logit transformation (VA[Formula: see text]). The MRD was estimated from intraclass correlation coefficients (model 2.1). RESULTS: The VA (median, range) was 84.20% (38.2–99.9%) in ISOM and 94.22% (33.8–100%) in ISOK. MRD was 0.78 and 1.12 logit for ISOM and ISOK, respectively. As an example, in terms of percent VA these values correspond to a change from 76% to 95% and from 79% to 98% in ISOM and in ISOK, respectively. CONCLUSIONS: The provided MRD values allow to detect significant individual changes in VA, as expected after training and rehabilitation programs.