bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stereoelectroencephalography Versus Subdural Strip Electrode Implantations: Feasibility, Complications, and Outcomes in 500 Intracranial Monitoring Cases for Drug-Resistant Epilepsy
Authors: Joswig Holger , Lau Jonathan C , Abdallat Mahmoud , Parrent Andrew G , MacDougall Keith W , McLachlan Richard S , Burneo Jorge G , Steven David A 
Published: March 2020

Abstract

BACKGROUND
Both stereoelectroencephalography (SEEG) and subdural strip electrodes (SSE) are used for intracranial electroencephalographic recordings in the invasive investigation of patients with drug-resistant epilepsy.

OBJECTIVE
To compare SEEG and SSE with respect to feasibility, complications, and outcome in this single-center study.

METHODS
Patient characteristics, periprocedural parameters, complications, and outcome were acquired from a pro- and retrospectively managed databank to compare SEEG and SSE cases.

RESULTS
A total of 500 intracranial electroencephalographic monitoring cases in 450 patients were analyzed (145 SEEG and 355 SSE). Both groups were of similar age, gender distribution, and duration of epilepsy. Implantation of each SEEG electrode took 13.9 ± 7.6 min (20 ± 12 min for each SSE; P < .01). Radiation exposure to the patient was 4.3 ± 7.7 s to a dose area product of 14.6 ± 27.9 rad*cm2 for SEEG and 9.4 ± 8.9 s with 21 ± 22.4 rad*cm2 for SSE (P < .01). There was no difference in the length of stay (12.2 ± 7.2 and 12 ± 6.3 d). The complication rate was low in both groups. No infections were seen in SEEG cases (2.3% after SSE). The rate of hemorrhage was 2.8% for SEEG and 1.4% for SSE. Surgical outcome was similar.

CONCLUSION
SEEG allows targeting deeply situated foci with a non-inferior safety profile to SSE and seizure outcome comparable to SSE.
Old In Vitro Antimicrobial Breakpoints Are Misleading Stewardship Efforts, Delaying Adoption of Innovative Therapies, and Harming Patients
Authors: Ambrose Paul G , Bhavnani Sujata M , Andes David R , Bradley John S , Flamm Robert K , Pogue Jason M , Jones Ronald N 
Published: March 2020

Abstract
The current antimicrobial market and old (pre-2000) in vitro antimicrobial susceptibility test interpretative criteria (STIC) are not working properly. Malfunctioning susceptibility breakpoints and antimicrobial markets have serious implications for both patients (ie, from a safety and efficacy perspective) and antibiotic-focused pharmaceutical and biotechnology company economic viability. Poorly functioning STIC fail both patients and clinicians since they do not discriminate between likely effective and ineffective antimicrobial regimens. Poor economic viability fails patients and clinicians as it decreases the industry’s ability to develop antimicrobial agents that clinicians and patients urgently require now and in the future. Herein, we review how STIC for older antimicrobial agents were determined and how their correction can impact the perceived utility of old relative to new antimicrobial agents. Moreover, we describe the data and analysis needs to systematically reevaluate older STIC values. We call for professional infectious diseases societies, government agencies, and other consensus bodies interested in the appropriate use of antimicrobial agents to join an effort to systematically evaluate and, where warranted, correct STIC for all relevant antimicrobial agents. This effort will amplify the effects of other measures designed to increase appropriate antimicrobial use (ie, good antimicrobial stewardship), development, and regulation.
Principles of Supplemental Motor Area and Cingulate Tumor Resection With Asleep Trimodal Motor Mapping: 2-Dimensional Operative Video
Authors: Magill Stephen T , Rubio Roberto Rodriguez , Berger Mitchel S 
Published: March 2020

Abstract
Resection of intra-axial tumors adjacent to the motor pathways can lead to devastating deficits; however, with an appropriate mapping technique, it can be performed safely. We present the case of a 63-yr-old woman with a diffuse glioma centered in the left supplemental motor area (SMA) and extending throughout the cingulate gyrus. In the video, we demonstrate the principles developed by the senior author for trimodal motor mapping under general anesthesia. Trimodal motor mapping includes direct stimulation of the cortex with a strip electrode, use of the bipolar stimulator for cortical and subcortical mapping, and use of the monopolar stimulator for subcortical motor mapping. We highlight technical principles required to safely resect these tumors, including the key anatomic landmarks and approach to SMA/cingulate lesions, techniques for subpial dissection, and preservation of en passage vessels. Patients with SMA tumors will almost always have a deficit after SMA resection, but if motor pathways are preserved and can be stimulated to produce movement at the end of the case, then the deficit will almost always improve, as was the case with this patient. Initially, postoperatively, she was nonverbal and hemiplegic, but by postoperative day 7 she recovered her speech significantly, was naming three of three objects, and was moving her right side. By 6 wk postoperative, she was ambulating independently and had normal speech. This case demonstrates the principles and techniques necessary for achieving maximal safe resection of tumors adjacent to the motor pathways with the patient under general anesthesia.
The patient gave written informed consent for the surgical resection of her tumor and for the publication of this video.
Growth performance of Alexandrium catenella from the Chilean fjords under different environmental drivers: plasticity as a response to a highly variable environment
Authors: Paredes-Mella Javier , Varela Daniel , Fernández Pamela , Espinoza-González Oscar 
Published: March 2020

AbstractAlexandrium catenella, the main species associated with harmful algal blooms, has progressively increased its distribution through one of the most extensive and highly variable fjord systems in the world. In order to understand this successful expansion, we evaluated the effects of different salinities, light intensity, temperatures, nitrogen (N) forms and nitrogen/phosphate (N:P) ratio levels on the growth performance, using clones isolated from different locations across its wide geographic distribution. Results showed that the growth responses were plastic and, in some cases, different reaction norms among clones were observed. Despite plasticity, the optimal growth of A. catenella (i.e. highest growth rate and highest maximal cells density) was reached within a narrow thermal range (12–15°C), while salinity (20–30 PSU) and light intensity (20–120 μmol m−2 s−1) ranges were wider. These results are partially consistent with the highest cell densities recorded in the field. Furthermore, optimal growth was reached using reduced forms of nitrogen (i.e. urea and NH4+) and in unbalanced N:P ratios (18:1 and 30:1). These characteristics likely allow A. catenella to grow in highly variable environmental conditions and might partly explain the recent expansion of this species.
Risks of solid cancers in elderly persons with osteoarthritis or ankylosing spondylitis
Authors: Ward Michael M , Alehashemi Sara 
Published: March 2020

Abstract

Objectives
Patients with osteoarthritis and ankylosing spondylitis have lower cancer-related mortality than the general population. We examined risks of solid cancers at 16 sites in elderly patients with knee or hip osteoarthritis (KHOA) or ankylosing spondylitis.

Methods
In this population-based retrospective cohort study, we used US Medicare data from 1999 to 2010 to identify cohorts of persons with KHOA or ankylosing spondylitis, and a general population group without either condition, who were followed through 2015. We compared cancer incidence among groups, adjusted for age, sex, race, socioeconomic characteristics, geographic region, smoking and comorbidities.

Results
We studied 2 701 782 beneficiaries with KHOA, 13 044 beneficiaries with ankylosing spondylitis, and 10 859 304 beneficiaries in the general population group. Beneficiaries with KHOA had lower risks of cancer of the oropharynx, oesophagus, stomach, colon/rectum, hepatobiliary tract, pancreas, larynx, lung, and ovary than the general population. However, beneficiaries with KHOA had higher risks of melanoma, renal cell cancer, and cancer of the bladder, breast, uterus and prostate. Associations were similar in ankylosing spondylitis, with lower risks of cancer of the oesophagus, stomach, and lung, and higher risks of melanoma, renal cell cancer, and cancer of the renal pelvis/ureter, bladder, breast, and prostate.

Conclusion
Lower risks of highly prevalent cancers, including colorectal and lung cancer, may explain lower cancer-related mortality in patients with KHOA or ankylosing spondylitis. Similarities in cancer risks between KHOA and AS implicate a common risk factor, possibly chronic NSAID use.
Monitoring in emotion regulation: behavioral decisions and neural consequences
Authors: Dorman Ilan Shirel , Shafir Roni , Birk Jeffrey L , Bonanno George A , Sheppes Gal 
Published: March 2020

AbstractMonitoring and deciding how to adjust an active regulatory strategy in order to maximize adaptive outcomes is an integral element of emotion regulation, yet existing evidence remains scarce. Filling this gap, the present study examined core factors that determine behavioral regulatory monitoring decisions and the neuro-affective consequences of these decisions. Using a novel paradigm, the initial implementation of central downregulation strategies (distraction, reappraisal) and the emotional intensity (high, low) were manipulated, prior to making a behavioral decision to maintain the initial implemented strategy or switch from it. Neuro-affective consequences of these behavioral decisions were evaluated using the Late Positive Potential (LPP), an electro-cortical measure of regulatory success. Confirming predictions, initial implementation of reappraisal in high intensity and distraction in low intensity (Strategy × Intensity combinations that were established in prior studies as non-preferred by individuals), resulted in increased behavioral switching frequency. Neurally, we expected and found that in high (but not low) emotional intensity, where distraction was more effective than reappraisal, maintaining distraction (relative to switching to reappraisal) and switching to distraction (relative to maintaining reappraisal) resulted in larger LPP modulation. These findings suggest that monitoring decisions are consistent with previously established regulatory preferences and are associated with adaptive short-term neural consequences.
The influence of relationship closeness on default-mode network connectivity during social interactions
Authors: Fareri Dominic S , Smith David V , Delgado Mauricio R 
Published: March 2020

Abstract
Reciprocated trust plays a critical role in forming and maintaining relationships, and has consistently been shown to implicate neural circuits involved in reward-related processing and social cognition. Less is known about neural network connectivity during social interactions involving trust, however, particularly as a function of closeness between an investor and a trustee. We examined network reactivity and connectivity in participants who played an economic trust game with close friends, strangers and a computer. Network reactivity analyses showed enhanced activation of the default-mode network (DMN) to social relative to non-social outcomes. A novel network psychophysiological interaction (nPPI) analysis revealed enhanced connectivity between the DMN and the superior frontal gyrus and superior parietal lobule when experiencing reciprocated vs violated trust from friends relative to strangers. Such connectivity tracked with differences in self-reported social closeness with these partners. Interestingly, reactivity of the executive control network (ECN), involved in decision processes, demonstrated no social vs non-social preference, and ECN-ventral striatum connectivity did not track social closeness. Taken together, these novel findings suggest that DMN interacts with components of attention and control networks to signal the relative importance of positive experiences with close others vs strangers.
Beyond the Core: Who Has Larger Social Networks?
Authors: Hofstra Bas , Corten Rense , van Tubergen Frank 
Published: March 2020

Abstract
The sociological literature on social networks overwhelmingly considers the number of core social contacts. Social networks, however, reach far beyond this small number of social ties. We know little about individual variation in the size of such extended social networks. In this study, we move beyond core networks and explain individual variation in the extended social network size among youth. We use survey data of Dutch adolescents (N = 5,921) and use two state-of-the-art measurements to compute extended network sizes: network scale-up methods through Bayesian modeling and the observed number of contacts on Facebook. Among both measurements, we find that extended networks are larger among ethnic majority members, girls, and those who often engage in social foci. This highlights a crucial role for preferences and opportunity in the genesis of extended networks. Additionally, we find that differences between both network sizes (scale-up and Facebook) are smaller for girls and higher educated. We discuss the implications of these findings and suggest directions for future research.
Acculturating Into Nursing for Hispanic/Latinx Baccalaureate Nursing Students: A Secondary Data Analysis
Authors: Woodley Lisa K. , Lewallen Lynne P. 
Published: March 2020

Abstract

BACKGROUND
This is a secondary data analysis of an original study describing the lived experiences of Hispanic/Latinx nursing students as they acculturate into the profession of nursing.

METHOD
The original study described the experiences of 11 Hispanic/Latinx new graduates from three baccalaureate nursing programs in the southeastern United States. A secondary data analysis using a theoretical thematic analytical approach with data gathered in the original study was done to determine the utility of the theory of cultural marginality in understanding these student experiences.

RESULTS
Findings support aspects of the theory, including marginal living, cross-cultural conflict recognition, and adjustment responses of poise and integration. Personal and contextual influences also impact the acculturation process for these nursing students.

CONCLUSION
The theory of cultural marginality is valuable and provides important context for understanding the process that Hispanic/Latinx nursing students experience as they acculturate into nursing.
Cephalic Elevation Device for Second-Stage Cesarean Delivery
Authors: Lassey Sarah C. , Little Sarah E. , Saadeh Michael , Patton Nicole , Farber Michaela K. , Bateman Brian T. , Robinson Julian N. 
Published: March 2020

OBJECTIVE:
A cephalic elevation device is an inflatable device that elevates the fetal head. We sought to evaluate whether such a device reduces time to delivery after hysterotomy and lowers morbidity in cesarean deliveries during the second stage of labor.

METHODS:
We conducted a double-blind randomized controlled trial among nulliparous, term women aged 18–50 years with vertex singleton pregnancies. Women were eligible if they were to undergo cesarean delivery in the second stage of labor. All participating women had the cephalic elevation device inserted by the delivering provider and were randomly allocated to inflation or noninflation of the device. Inflation was performed in a blinded fashion. The primary outcome was time from hysterotomy to delivery. A sample size of 30 per group (N=60 participants) was planned to detect a 50% decrease in time to delivery after hysterotomy with cephalic elevation device inflation.

RESULTS:
From January 2018 through July 2019, 60 women who underwent cesarean delivery in the second stage were randomized. Analysis was by intention to treat. Women in the inflation group were older (33 vs 30.5 years), but the groups were otherwise similar. In both groups, most women had a low-transverse hysterotomy (93%). The median time from hysterotomy to delivery was significantly shorter in the inflation group (31 vs 54 seconds; P<.01). There was no significant difference in neonatal outcomes.

CONCLUSION:
Use of the cephalic elevation device during second-stage cesarean delivery led to a 23-second reduction time from hysterotomy to delivery.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03342508.

FUNDING SOURCE:
The cephalic elevation devices used in this study were donated by Safe Obstetrics Systems.
Management of hip fractures among elderly patients at Jordan University Hospital: A cross-sectional study
Authors: Alisi Mohammed S. , Al-Alajlouni Jihad , Hammad Yazan , Mousa Khaled , Elifranji Zuhdi , Alaqrabawi Ihab , Al-Saber Munther , Alsousi Ahmed , Elessi Khamis 
Published: March 2020

Background:
This study compared the practice of elderly hip fractures management at Jordan University Hospital against the practice recommended by American Academy of Orthopaedic Surgeons (AAOS).

Methods:
Medical records between Oct 1, 2017, and Oct 31, 2018, were reviewed retrospectively. Inclusion criteria included patients over the age of 65 yr who were admitted from the emergency department. Patients excluded from the study were involved in motor vehicle accidents, had pathological fractures, or were transferred from other hospitals. One hundred and thirteen patients were included.

Results:
All patients received venous thromboembolism prophylaxis, and none had preoperative traction. Surgery was done within 48 hr in 83% (94/113) of patients. All patients with unstable femoral neck fractures underwent arthroplasty. Sliding hip screws were used in 93.5% (29/31) of stable intertrochanteric fractures, but cephalomedullary devices were used in 86.7% of unstable fractures (46 patients). Rehabilitation was done for a majority of patients. Unfortunately, preoperative regional analgesia was not used at all. Bipolar heads were used in a majority of hemiarthroplasty cases. A blood transfusion threshold of no higher than 8 g/dL was only followed in 16 cases. Only 23.9% of patients continued physical therapy at home. Fewer than one-third of the patients underwent nutritional assessment or support. Only 15 patients received a secondary mode of analgesia postoperatively. Vitamin D and calcium were prescribed for less than 50% of patients. Only 10.6% were evaluated for osteoporosis after fracture.

Conclusions:
Compliance with AAOS guidelines is reasonable, and it can be increased by following recommendations regarding: preoperative analgesia, femoral head type, blood transfusion threshold, home physical therapy, nutritional assessment, pain management, vitamin D and calcium supplementation, and osteoporosis treatment.

Level of Evidence:
Level III.
Indications and associated outcomes for platelet-rich plasma injections performed in an academic orthopaedic-specific hospital: A patient satisfaction survey
Authors: Melbourne Craig S. , Smith Conor A. , Patel Jaykumar , Platt Brooks , Cook James L. 
Published: March 2020

Background:
Platelet-rich plasma (PRP) is an autologous biologic product that has become widely used in orthopaedic centers and at so-called “regenerative medicine” or “pain” clinics. Although food Drug Administration (FDA)-approved indications for use of PRP in orthopaedics are for applications in which it is mixed with autograft or allograft bone, attention and clinical research have focused on its off-label uses for treatment of osteoarthritis, musculotendinous disorders, or joint pain. The present study aimed to document indications for PRP used by orthopaedic surgery faculty in an academic orthopaedic-specific hospital between 2011 and 2016, characterize demographics of patients receiving these injections, and assess associated 1-year or greater outcomes for these patients.

Methods:
With institutional review board approval, this study retrospectively identified 148 patients with osteoarthritis, augmentation surgical treatments, tendon or ligament pathology, and sacroiliac joint pain as indications for PRP treatment.

Results:
For respondents (n=60), 78.3% (47 of 60) reported PRP-related improvement in symptoms, with mean duration of effect of 800 days and an overall level of satisfaction with their PRP treatment of 67.9% (range, 1-100%). Factors that negatively influenced successful outcomes in the present study included patient age older than 45 yr and use of leukocyte-rich PRP, while degree of improvement and return to full activity positively influenced patient satisfaction with PRP treatment.

Conclusions:
The results of the present study suggest that PRP can be used to treat a variety of musculoskeletal conditions commonly diagnosed at an academic orthopaedic-specific hospital, with expectations for 78% of patients reporting improvement and an overall patient satisfaction level of 68%.

Level of Evidence:
Level IV.
A Multicenter Trial Demonstrating Presence or Absence of Bacterial Contamination at the Screw-Bone Interface Owing to Absence or Presence of Pedicle Screw Guard, Respectively, During Spinal Fusion
Authors: Agarwal Aakash , Lin Boren , Agarwal Ashish G. , Elgafy Hossein , Schultz Christian , Agarwal Anand K. , Goel Vijay K. , Sigler Von , Karas Chris , Gidvani Sandeep , Wang Jeffrey C. , Anand Neel , Garfin Steve R. 
Published: March 2020

Study Design:
A prospective multicenter study.

Objective:
The objective of this study was to assess bacterial contamination in current practices of pedicle screw handling and comparing it to a novel method of using an intraoperative, sterile implant guard for screws.

Summary of Background Data:
Postoperative infections occur at the higher end of 2%–13%, as cited in the literature, and are underestimated due to various reasons in such publications. Despite concerns associated with vancomycin application immediately before closure, it is theoretically impossible to irrigate the screw-bone interface postimplantation. Consequently, any contamination of pedicle screw before implantation is permanent, and has the potential to cause deep-bone infection, or hardware loosening due to encapsulation of biofilm between the bone and the screw. Therefore, continued vigilance and effective preventive measures should be undertaken if available.

Materials and Methods:
Two groups of presterile individually-packaged pedicle screws, one incased in a sterile, protective guard (group 1: G) and the other without such a guard (group 2: NG), 31 samples in each group were distributed over 28 spinal fusion surgeries at 5 independent hospitals groups. Each were loaded onto the insertion device by the scrub tech and left on the sterile table. Twenty minutes later, the lead surgeon who had just finished preparing the surgical site, handles the pedicle screw, to check the fit with the insertion device. Then, instead of implantation, it was transferred to a sterile container using fresh sterile gloves for bacterial analysis.

Results:
The standard unguarded pedicle screws presented bioburden in the range of 105 to 107 colonies forming units per screw, whereas the guarded pedicle screws showed no bioburden.

Conclusion:
Standard, current, handling of pedicle screws leads to bacterial contamination, which can be avoided if the screws are sterilely prepackaged with an intraoperative guard (preinstalled).