bluuebunny/crossref_metadata_2025_split huggingface dataset:
Buovo d’Antona fra originale veneziano e suo adattamento yiddish: la narrazione cavalleresca veicolo delle ideologie
Authors: Artico Davide 
Published: October 2020

The paper contains some partial findings of a comparative research on the chivalry romance Buovo d’Antona as printed in Bologna and in Venice in the 1480s in a number of different, yet quite similar one to another, incunables; and its ottava rima adaptation in yiddish-taytsh, made by Elye Bokher (Elia Levita) in Padua around 1507, and then published as Bovo-Buch in Isny, Württemberg, as late as 1541. Respectively, the narratives implicitly deliver two different ideologies, meant as consequent sets of socially shared convictions about the good living. In particular, the place of women in society and the family, or better said, the male representation thereof, substantially differs in the Yiddish adaptation compared to the Venetian original.
AS CRIPTOMOEDAS E A INVESTIGAÇÃO POLICIAL: Desafios e Soluções
Authors: Montenegro Guilherme Augusto de Oliveira 
Published: October 2020

As criptomoedas atualmente possuem um papel crescente no mercado de transações financeiras, gerando fortes impactos econômicos e sociais, e, como toda nova tecnologia possuem aspectos positivos, como segurança e privacidade. Por outro lado, também podem ser associadas a aspectos negativos, como sendo potenciais facilitadores de atividades criminosas, uma vez que a regulamentação ainda incipiente pode permitir que sejam menos detectáveis as transações através delas realizadas, bem como dificultar a identificação de seus autores. No entanto, como demonstrado através de pesquisas teóricas e do estudo de casos práticos, através dos princípios que regem essa tecnologia e do histórico de investigações criminais, verifica-se que, apesar das dificuldades, é possível, sim, reprimir a prática de atos delituosos instrumentalizados pelas criptomoedas. Nesse sentido, percebe-se que há necessidade de se manter uma cooperação entre diversos órgãos de controle, uma preparação e capacitação dos policiais em investigar esse tipo de delito, sem abandonar os métodos tradicionais de investigação que complementam os recursos tecnológicos no rastreamento das transações e localização dos autores. Palavras-Chave: Criptomoedas. Lavagem de dinheiro. Investigação Policial. Rastreabilidade das transações.
MÉTODOS DE IDENTIFICAÇÃO POST MORTEM EM NECROPAPILOSCOPIA FORENSE: revisão de literatura
Authors: Delgado Simone Mariana , Mariotti Kristiane de Cassia 
Published: October 2020

A Necropapiloscopia Forense é uma área pericial que trata da identificação humana post mortem por meio de impressões digitais. Para a realização da perícia necropapiloscópica os papiloscopistas utilizam métodos convencionais preconizados pela literatura e previstos em manuais e POP’s (procedimentos operacionais padrão). Porém, fenômenos cadavéricos e condições de morte como putrefação, mumificação, carbonização, saponificação e maceração, podem dificultar e até mesmo inviabilizar a obtenção de impressões digitais com qualidade suficiente para exame, o que faz com que muitos cadáveres permaneçam sem identificação. Diante disso, este artigo pretende fazer levantamento e discussão de trabalhos científicos que ofereçam propostas de técnicas de identificação humana post mortem na área de Necropapiloscopia Forense, caracterizando-as, descrevendo-as e avaliando-as, para que possam ser direcionadas à prática forense, fundamentada em conhecimento científico. A revisão integrativa foi eleita como metodologia de pesquisa. Buscou-se publicações completas sobre a temática no período de janeiro/2002 a março/2019, nas bases de dados Scopus, Pubmed e Google Scholar, nos idiomas português e inglês. 17 publicações enquadraram-se no critério de inclusão. As técnicas recomendadas incluem desde procedimentos manuais, relativamente simples, como técnica do pó e técnica da moldagem; à procedimentos mais complexos, como as técnicas de maceração química que exigem excisão de falanges e tratamento com reagentes químicos. As novas tendências apontam o uso da tecnologia como câmeras fotográficas, smartphones, scanners agregados a softwares para captura digital de impressões digitais e compartilhamento em tempo real das imagens, bem como, dos fatores de correção do sistema AFIS, uma vez que resolvem problemas como encolhimento e colapso das estruturas dos dedos. Os resultados encontrados neste estudo apontam que: métodos de identificação post mortem em Necropapiloscopia é uma área ainda pouco explorada pela literatura forense, principalmente aqui no Brasil; há necessidade de desenvolvimento de estudos científicos que preencham lacunas na área; as técnicas recomendadas na literatura devem ter continuidade na prática forense, para que possam ser devidamente aplicadas, aprimoradas, difundidas e incluídas em protocolos e POP’s da área, visando a melhoria significativa nos resultados que envolvam identificação humana de cadáveres em diferentes estágios e condições de morte.
To drill or not to drill, that is the question: nonsurgical treatment of chronic subdural hematoma in the elderly. A systematic review
Authors: Scerrati Alba , Visani Jacopo , Ricciardi Luca , Dones Flavia , Rustemi Oriela , Cavallo Michele Alessandro , De Bonis Pasquale 
Published: October 2020

OBJECTIVEChronic subdural hematoma (CSDH) is one of the most common neurosurgical pathologies, typically affecting the elderly. Its incidence is expected to grow along with the aging population. Surgical drainage represents the treatment of choice; however, postoperative complications and the rate of recurrence are not negligible. For this reason, nonsurgical alternatives (such as middle meningeal artery embolization, steroids, or tranexamic acid administration) are gaining popularity worldwide and need to be carefully evaluated, especially in the elderly population.METHODSThe authors performed a systematic review according to PRISMA criteria of the studies analyzing the nonsurgical strategies for CSDHs. They collected all papers in the English language published between 1990 and 2019 by searching different medical databases. The chosen keywords were “chronic subdural hematoma,” “conservative treatment/management,” “pharmacological treatment,” “non-surgical,” “tranexamic acid,” “dexamethasone,” “corticosteroid,” “glucocorticoid,” “middle meningeal artery,” “endovascular treatment,” and “embolization.”RESULTSThe authors ultimately collected 15 articles regarding the pharmacological management of CSDHs matching the criteria, and 14 papers included the endovascular treatment.CONCLUSIONSThe results showed that surgery still represents the mainstay in cases of symptomatic patients with large CSDHs; however, adjuvant and alternative therapies can be effective and safe in a carefully selected population. Their inclusion in new guidelines is advisable.
Is age an additional factor in the treatment of elderly patients with glioblastoma? A new stratification model: an Italian Multicenter Study
Authors: Ius Tamara , Somma Teresa , Altieri Roberto , Angileri Filippo Flavio , Barbagallo Giuseppe Maria , Cappabianca Paolo , Certo Francesco , Cofano Fabio , D’Elia Alessandro , Della Pepa Giuseppe Maria , Esposito Vincenzo , Fontanella Marco Maria , Germanò Antonino , Garbossa Diego , Isola Miriam , La Rocca Giuseppe , Maiuri Francesco , Olivi Alessandro , Panciani Pier Paolo , Pignotti Fabrizio , Skrap Miran , Spena Giannantonio , Sabatino Giovanni 
Published: October 2020

OBJECTIVEApproximately half of glioblastoma (GBM) cases develop in geriatric patients, and this trend is destined to increase with the aging of the population. The optimal strategy for management of GBM in elderly patients remains controversial. The aim of this study was to assess the role of surgery in the elderly (≥ 65 years old) based on clinical, molecular, and imaging data routinely available in neurosurgical departments and to assess a prognostic survival score that could be helpful in stratifying the prognosis for elderly GBM patients.METHODSClinical, radiological, surgical, and molecular data were retrospectively analyzed in 322 patients with GBM from 9 neurosurgical centers. Univariate and multivariate analyses were performed to identify predictors of survival. A random forest approach (classification and regression tree [CART] analysis) was utilized to create the prognostic survival score.RESULTSSurvival analysis showed that overall survival (OS) was influenced by age as a continuous variable (p = 0.018), MGMT (p = 0.012), extent of resection (EOR; p = 0.002), and preoperative tumor growth pattern (evaluated with the preoperative T1/T2 MRI index; p = 0.002). CART analysis was used to create the prognostic survival score, forming six different survival groups on the basis of tumor volumetric, surgical, and molecular features. Terminal nodes with similar hazard ratios were grouped together to form a final diagram composed of five classes with different OSs (p < 0.0001). EOR was the most robust influencing factor in the algorithm hierarchy, while age appeared at the third node of the CART algorithm. The ability of the prognostic survival score to predict death was determined by a Harrell’s c-index of 0.75 (95% CI 0.76–0.81).CONCLUSIONSThe CART algorithm provided a promising, thorough, and new clinical prognostic survival score for elderly surgical patients with GBM. The prognostic survival score can be useful to stratify survival risk in elderly GBM patients with different surgical, radiological, and molecular profiles, thus assisting physicians in daily clinical management. The preliminary model, however, requires validation with future prospective investigations. Practical recommendations for clinicians/surgeons would strengthen the quality of the study; e.g., surgery can be considered as a first therapeutic option in the workflow of elderly patients with GBM, especially when the preoperative estimated EOR is greater than 80%.
The role of frailty in geriatric cranial neurosurgery for primary central nervous system neoplasms
Authors: Shahrestani Shane , Lehrich Brandon M. , Tafreshi Ali R. , Brown Nolan J. , Lien Brian V. , Ransom Seth , Ransom Ryan C. , Ballatori Alexander M. , Ton Andy , Chen Xiao T. , Sahyouni Ronald 
Published: October 2020

OBJECTIVEFrailty is a clinical state of increased vulnerability due to age-associated decline and has been well established as a perioperative risk factor. Geriatric patients have a higher risk of frailty, higher incidence of brain cancer, and increased postoperative complication rates compared to nongeriatric patients. Yet, literature describing the effects of frailty on short- and long-term complications in geriatric patients is limited. In this study, the authors evaluate the effects of frailty in geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm.METHODSThe authors conducted a retrospective cohort study of geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm between 2010 and 2017 by using the Nationwide Readmission Database. Demographics and frailty were queried at primary admission, and readmissions were analyzed at 30-, 90-, and 180-day intervals. Complications of interest included infection, anemia, infarction, kidney injury, CSF leak, urinary tract infection, and mortality. Nearest-neighbor propensity score matching for demographics was implemented to identify nonfrail control patients with similar diagnoses and procedures. The analysis used Welch two-sample t-tests for continuous variables and chi-square test with odds ratios.RESULTSA total of 6713 frail patients and 6629 nonfrail patients were identified at primary admission. At primary admission, frail geriatric patients undergoing cranial neurosurgery had increased odds of developing acute posthemorrhagic anemia (OR 1.56, 95% CI 1.23–1.98; p = 0.00020); acute infection (OR 3.16, 95% CI 1.70–6.36; p = 0.00022); acute kidney injury (OR 1.32, 95% CI 1.07–1.62; p = 0.0088); urinary tract infection prior to discharge (OR 1.97, 95% CI 1.71–2.29; p < 0.0001); acute postoperative cerebral infarction (OR 1.57, 95% CI 1.17–2.11; p = 0.0026); and mortality (OR 1.64, 95% CI 1.22–2.24; p = 0.0012) compared to nonfrail geriatric patients receiving the same procedure. In addition, frail patients had a significantly increased inpatient length of stay (p < 0.0001) and all-payer hospital cost (p < 0.0001) compared to nonfrail patients at the time of primary admission. However, no significant difference was found between frail and nonfrail patients with regard to rates of infection, thromboembolism, CSF leak, dural tear, cerebral infarction, acute kidney injury, and mortality at all readmission time points.CONCLUSIONSFrailty may significantly increase the risks of short-term acute complications in geriatric patients receiving cranial neurosurgery for a primary CNS neoplasm. Long-term analysis revealed no significant difference in complications between frail and nonfrail patients. Further research is warranted to understand the effects and timeline of frailty in geriatric patients.
Morbidity and mortality in elderly patients undergoing evacuation of acute traumatic subdural hematoma
Authors: Kerezoudis Panagiotis , Goyal Anshit , Puffer Ross C. , Parney Ian F. , Meyer Fredric B. , Bydon Mohamad 
Published: October 2020

OBJECTIVEAcute traumatic subdural hematoma (atSDH) can be a life-threatening neurosurgical emergency that necessitates immediate evacuation. The elderly population can be particularly vulnerable to tearing bridging veins. The aim of this study was to evaluate inpatient morbidity and mortality, as well as predictors of inpatient mortality, in a national trauma database.METHODSThe authors queried the 2016–2017 National Trauma Data Bank registry for patients aged 65 years and older who had undergone evacuation of atSDH. Patients were categorized into three age groups: 65–74, 75–84, and 85+ years. A multivariable logistic regression model was fitted for inpatient mortality adjusting for age group, sex, race, presenting Glasgow Coma Scale (GCS) category (3–8, 9–12, and 13–15), Injury Severity Score, presence of coagulopathy, presence of additional hemorrhages (epidural hematoma [EDH], intraparenchymal hematoma [IPH], and subarachnoid hemorrhage [SAH]), presence of midline shift > 5 mm, and pupillary reactivity (both, one, or none).RESULTSA total of 2508 patients (35% females) were analyzed. Age distribution was as follows: 990 patients at 65–74 years, 1096 at 75–84, and 422 at 85+. Midline shift > 5 mm was present in 72% of cases. With regard to additional hemorrhages, SAH was present in 21%, IPH in 10%, and EDH in 2%. Bilaterally reactive pupils were noted in 90% of patients. A major complication was observed in 14.4% of patients, and the overall mortality rate was 18.3%. In the multivariable analysis, the presenting GCS category was found to be the strongest predictor of postoperative inpatient mortality (3–8 vs 13–15: OR 3.63, 95% CI 2.68–4.92, p < 0.001; 9–12 vs 13–15: OR 2.64, 95% CI 1.79–3.90, p < 0.001; 30% of overall variation), followed by the presence of SAH (OR 2.86, 95% CI 2.21–3.70, p < 0.001; 25% of overall variation) and the presence of midline shift > 5 mm (OR 2.40, 95% CI 1.74–3.32, p < 0.001; 11% of overall variation). Model discrimination was excellent (c-index 0.81). Broken down by age decile group, mortality increased from 8.0% to 15.4% for GCS 13–15 to around 36% for GCS 9–12 to almost as high as 60% for GCS 3–8, particularly in those aged 85 years and older.CONCLUSIONSThe present results from a national trauma database will, the authors hope, assist surgeons in preoperative discussions with patients and their families with regard to expected postoperative outcomes following surgical evacuation of an atSDH.
Magnetic resonance–guided laser interstitial thermal therapy for brain tumors in geriatric patients
Authors: Ginalis Elizabeth E. , Danish Shabbar F. 
Published: October 2020

OBJECTIVEThere is a paucity of studies assessing the use of MR-guided laser interstitial thermal therapy (LITT), specifically in the elderly population. The aim of this study was to evaluate the safety of LITT for brain tumors in geriatric patients.METHODSGeriatric patients (≥ 65 years of age) treated with LITT for intracranial tumors at a single institution between January 2011 and November 2019 were retrospectively identified. The authors grouped patients into two distinct age cohorts: 65–74 years (group 1) and 75 years or older (group 2). Baseline characteristics, operative parameters, postoperative course, and morbidity were recorded for each patient.RESULTSFifty-five geriatric patients underwent 64 distinct LITT procedures for brain tumors. The majority of lesions (40 [62.5%]) treated were recurrent brain metastases or radiation necrosis. The median modified frailty index was 0.1 (low frailty; range 0–0.4) for patients in group 1 and 0.2 (intermediate frailty; range 0–0.4) for patients in group 2 (p > 0.05). The median hospital length of stay (LOS) was 1 day (IQR 1–2 days); there was no significant difference in LOS between the age groups. The hospital stay was significantly longer in patients who presented with a neurological symptom and in those who experienced a postoperative complication. The majority of patients (43 [68.3%] of 63 cases) were fit for discharge to their preoperative accommodation following LITT. The rate of discharge to home was not significantly different between the age groups. Those discharged to rehabilitation facilities were more likely to have presented with a neurological symptom. Nine patients (14.1% of cases) were found to have acute neurological complications following LITT, with nearly all patients showing complete or partial recovery at follow-up. The 30-day postoperative mortality rate was 1.6% (1 case). The complication and 30-day postoperative mortality rates were not significantly different between the two age groups.CONCLUSIONSLITT can be considered a minimally invasive and safe neurosurgical procedure for the treatment of intracranial tumors in geriatric patients. Careful preoperative preparation and postoperative care is essential as LITT is not without risk. Appropriate patient selection for cranial surgery is essential, because neurosurgeons are treating an increasing number of elderly patients, but advanced age alone should not exclude patients from LITT without considering frailty and comorbidities.
Risk factors, comorbidities, quality of life, and complications after surgery in idiopathic normal pressure hydrocephalus: review of the INPH-CRasH study
Authors: Israelsson Hanna , Larsson Jenny , Eklund Anders , Malm Jan 
Published: October 2020

OBJECTIVEIdiopathic normal pressure hydrocephalus (INPH) is a dementia treatable by insertion of a shunt that drains CSF. The cause of the disease is unknown, but a vascular pathway has been suggested. The INPH-CRasH (Comorbidities and Risk Factors Associated with Hydrocephalus) study was a modern epidemiological case-control study designed to prospectively assess parameters regarding comorbidities and vascular risk factors (VRFs) for INPH, quality of life (QOL), and adverse events in patients with shunted INPH. The objective of this review was to summarize the findings of the INPH-CRasH study.METHODSVRFs, comorbidities, QOL, and adverse events were analyzed in consecutive patients with INPH who underwent shunt placement between 2008 and 2010 in 5 of 6 neurosurgical centers in Sweden. Patients (n = 176, within the age span of 60–85 years and not having dementia) were compared to population-based age- and gender-matched controls (n = 368, same inclusion criteria as for the patients with INPH). Assessed parameters were as follows: hypertension; diabetes; obesity; hyperlipidemia; psychosocial factors (stress and depression); smoking status; alcohol intake; physical activity; dietary pattern; cerebrovascular, cardiovascular, or peripheral vascular disease; epilepsy; abdominal pain; headache; and clinical parameters before and after surgery. Parameters were assessed through questionnaires, clinical examinations, measurements, ECG studies, and blood samples.RESULTSFour VRFs were independently associated with INPH: hyperlipidemia, diabetes, obesity, and psychosocial factors. Physical inactivity and hypertension were also associated with INPH, although not independently from the other risk factors. The population attributable risk percent for a model containing all of the VRFs associated with INPH was 24%. Depression was overrepresented in patients with INPH treated with shunts compared to the controls (46% vs 13%, p < 0.001) and the main predictor for low QOL was a coexisting depression (p < 0.001). Shunting improved QOL on a long-term basis. Epilepsy, headache, and abdominal pain remained common for a mean follow-up time of 21 months in INPH patients who received shunts.CONCLUSIONSThe results of the INPH-CRasH study are consistent with a vascular pathophysiological component of INPH. In clinical care and research, a complete risk factor analysis as well as screening for depression and a measurement for QOL should probably be included in the workup of patients with INPH. The effect of targeted interventions against modifiable VRFs and antidepressant treatment in INPH patients should be evaluated. Seizures, headache, and abdominal pain should be inquired about at postoperative follow-up examinations.
Impact of frailty on surgery for glioblastoma: a critical evaluation of patient outcomes and caregivers’ perceptions in a developing country
Authors: Katiyar Varidh , Sharma Ravi , Tandon Vivek , Goda Revanth , Ganeshkumar Akshay , Suri Ashish , Chandra P. Sarat , Kale Shashank S. 
Published: October 2020

OBJECTIVEThe authors aimed to evaluate the impact of age and frailty on the surgical outcomes of patients with glioblastoma (GBM) and to assess caregivers’ perceptions regarding postdischarge care and challenges faced in the developing country of India.METHODSThis was a retrospective study of patients with histopathologically proven GBM from 2009 to 2018. Data regarding the clinical and radiological characteristics as well as surgical outcomes were collected from the institute’s electronic database. Taking Indian demographics into account, the authors used the cutoff age of 60 years to define patients as elderly. Frailty was estimated using the 11-point modified frailty index (mFI-11). Patients were divided into three groups: robust, with an mFI score of 0; moderately frail, with an mFI score of 1 or 2; and severely frail, with an mFI score ≥ 3. A questionnaire-based survey was done to assess caregivers’ perceptions about postdischarge care.RESULTSOf the 276 patients, there were 93 (33.7%) elderly patients and 183 (66.3%) young or middle-aged patients. The proportion of severely frail patients was significantly more in the elderly group (38.7%) than in the young or middle-aged group (28.4%) (p < 0.001). The authors performed univariate and multivariate analysis of associations of different short-term outcomes with age, sex, frailty, and Charlson Comorbidity Index. On the multivariate analysis, only frailty was found to be a significant predictor for in-hospital mortality, postoperative complications, and length of hospital and ICU stay (p < 0.001). On Cox regression analysis, the severely frail group was found to have a significantly lower overall survival rate compared with the moderately frail (p = 0.001) and robust groups (p < 0.001). With the increase in frailty, there was a concomitant increase in the requirement for readmissions (p = 0.003), postdischarge specialist care (p = 0.001), and help from extrafamilial sources (p < 0.001). Greater dissatisfaction with psychosocial and financial support among the caregivers of severely frail patients was seen as they found themselves ill-equipped to provide postdischarge care at home (p < 0.001).CONCLUSIONSFrailty is a better predictor of poorer surgical outcomes than chronological age in terms of duration of hospital and ICU stay, postoperative complications, and in-hospital mortality. It also adds to the psychosocial and financial burdens of the caregivers, making postdischarge care challenging.