bluuebunny/crossref_metadata_2025_split huggingface dataset:
Controllo delle frontiere e violazione dei diritti umani lungo la rotta balcanica
Authors: Cucchi Francesca 
Published: December 2019

This paper focuses on the possibility of conciliation between one of the main objective of recent European migration policies – the containment of migration movements – and the safeguard of immigrants dictated by European Convention of Human Rights. Furthermore the dissertation will analyze the balance between the right of every State to control their borders together with the right of the European Union to reinforce the control of external borders and the respect of fundamental human rights. In particular, after a brief analysis of the situation over the Balkan route, this paper will illustrate whether and how the guarantees provided in art. 3 ECHR can be applied in relation to the condition of immigrants and the consequent legitimacy of national and European immigration policies implemented along the route.
Patient-specific 3-dimensionally printed models for neurosurgical planning and education
Authors: Panesar Sandip S. , Magnetta Michael , Mukherjee Debraj , Abhinav Kumar , Branstetter Barton F. , Gardner Paul A. , Iv Michael , Fernandez-Miranda Juan C. 
Published: December 2019

OBJECTIVEAdvances in 3-dimensional (3D) printing technology permit the rapid creation of detailed anatomical models. Integration of this technology into neurosurgical practice is still in its nascence, however. One potential application is to create models depicting neurosurgical pathology. The goal of this study was to assess the clinical value of patient-specific 3D printed models for neurosurgical planning and education.METHODSThe authors created life-sized, patient-specific models for 4 preoperative cases. Three of the cases involved adults (2 patients with petroclival meningioma and 1 with trigeminal neuralgia) and the remaining case involved a pediatric patient with craniopharyngioma. Models were derived from routine clinical imaging sequences and manufactured using commercially available software and hardware.RESULTSLife-sized, 3D printed models depicting bony, vascular, and neural pathology relevant to each case were successfully manufactured. A variety of commercially available software and hardware were used to create and print each model from radiological sequences. The models for the adult cases were printed in separate pieces, which had to be painted by hand, and could be disassembled for detailed study, while the model for the pediatric case was printed as a single piece in separate-colored resins and could not be disassembled for study. Two of the models were used for patient education, and all were used for presurgical planning by the surgeon.CONCLUSIONSPatient-specific 3D printed models are useful to neurosurgical practice. They may be used as a visualization aid for surgeons and patients, or for education of trainees.
3D ultrasound–guided resection of low-grade gliomas: principles and clinical examples
Authors: Unsgård Geirmund , Lindseth Frank 
Published: December 2019

3D ultrasound (US) is a convenient tool for guiding the resection of low-grade gliomas, seemingly without deterioration in patients’ quality of life. This article offers an update of the intraoperative workflow and the general principles behind the 3D US acquisition of high-quality images.The authors also provide case examples illustrating the technique in two small mesial temporal lobe lesions and in one insular glioma. Due to the ease of acquiring new images for navigation, the operations can be guided by updated image volumes throughout the entire course of surgery. The high accuracy offered by 3D US systems, based on nearly real-time images, allows for precise and safe resections. This is especially useful when an operation is performed through very narrow transcortical corridors.
Primary pain generator identification by CT-SPECT in patients with degenerative spinal disease
Authors: Tender Gabriel C. , Davidson Caroline , Shields Jessica , Robichaux Jared , Park Joe , Crutcher Clifford L. , DiGiorgio Anthony M. 
Published: December 2019

OBJECTIVEAxial spinal pain generators are difficult to identify using current diagnostic modalities. Merging CT with SPECT (CT-SPECT) scans allows for accurate identification of areas with increased osteoblastic activity, which may reflect pain generators. In this study, the authors aimed to evaluate the degree of pain improvement in patients who underwent surgery, addressing primary pain generators identified by CT-SPECT.METHODSThe authors retrospectively reviewed all patients with chronic axial spine pain who underwent diagnostic CT-SPECT at their institution and analyzed pain improvement in those who underwent surgical treatment in order to determine whether CT-SPECT correctly identified the primary pain generator.RESULTSA total of 315 patients underwent diagnostic CT-SPECT between January 2014 and August 2018. Forty-eight patients underwent either cervical or lumbar fusion; there were 26 women (16 cervical, 10 lumbar) and 22 men (9 cervical, 13 lumbar). The overall axial spinal pain, as assessed through self-reporting of visual analog scale scores at 6 months postoperatively, improved from 9.04 ± 1.4 to 4.34 ± 2.3 (p = 0.026), with cervical fusion patients improving from 8.8 ± 1.8 to 3.92 ± 2.2 (p = 0.019) and lumbar fusion patients improving from 9.35 ± 0.7 to 4.87 ± 2.3 (p = 0.008).CONCLUSIONSCT-SPECT may offer a diagnostic advantage over current imaging modalities in identifying the primary pain generator in patients with axial spinal pain.
Vascular architecture mapping for early detection of glioblastoma recurrence
Authors: Stadlbauer Andreas , Eyüpoglu Ilker , Buchfelder Michael , Dörfler Arnd , Zimmermann Max , Heinz Gertraud , Oberndorfer Stefan 
Published: December 2019

OBJECTIVETreatment failure and inevitable tumor recurrence are the main reasons for the poor prognosis of glioblastoma (GB). Gross-total resection at repeat craniotomy for GB recurrence improves patient overall survival but requires early and reliable detection. It is known, however, that even advanced MRI approaches have limited diagnostic performance for distinguishing tumor progression from pseudoprogression. The novel MRI technique of vascular architectural mapping (VAM) provides deeper insight into tumor microvascularity and neovascularization. In this study the authors evaluated the usefulness of VAM for the monitoring of GB patients and quantitatively analyzed the features of neovascularization of early- and progressed-stage GB recurrence.METHODSIn total, a group of 115 GB patients who received overall 374 follow-up MRI examinations after standard treatment were retrospectively evaluated in this study. The clinical routine MRI (cMRI) protocol at 3 Tesla was extended with the authors’ experimental VAM approach, requiring 2 minutes of extra time for data acquisition. Custom-made MATLAB software was used for calculation of imaging biomarker maps of macrovascular perfusion from perfusion cMRI as well as of microvascular perfusion and architecture from VAM data. Additionally, cMRI data were analyzed by two board-certified radiologists in consensus. Statistical procedures included receiver operating characteristic (ROC) analysis to determine diagnostic performances for GB recurrence detection.RESULTSOverall, cMRI showed GB recurrence in 89 patients, and in 28 of these patients recurrence was detected earlier with VAM data, by 1 (20 patients) or 2 (8 patients) follow-up examinations, than with cMRI data. The mean time difference between recurrence detection with VAM and cMRI data was 147 days. During this time period the mean tumor volume increased significantly (p < 0.001) from 9.7 to 26.8 cm3. Quantitative analysis of imaging biomarkers demonstrated microvascular but no macrovascular hyperperfusion in early GB recurrence. Therefore, ROC analysis revealed superior diagnostic performance for VAM compared with cMRI.CONCLUSIONSThis study demonstrated that the targeted assessment of microvascular features using the VAM technique provided valuable information about early neovascularization activity in recurrent GB that is complementary to perfusion cMRI and may be helpful for earlier and more precise monitoring of patients suffering from GB. This VAM approach is compatible with existing cMRI protocols. Prospective clinical trials are necessary to investigate the clinical usefulness and potential benefit of increased overall survival with the use of VAM in patients with recurrent GB.
Diffusion tensor magnetic resonance imaging of the optic nerves in pediatric hydrocephalus
Authors: Shpanskaya Katie , Quon Jennifer L. , Lober Robert M. , Nair Sid , Johnson Eli , Cheshier Samuel H. , Edwards Michael S. B. , Grant Gerald A. , Yeom Kristen W. 
Published: December 2019

OBJECTIVEWhile conventional imaging can readily identify ventricular enlargement in hydrocephalus, structural changes that underlie microscopic tissue injury might be more difficult to capture. MRI-based diffusion tensor imaging (DTI) uses properties of water motion to uncover changes in the tissue microenvironment. The authors hypothesized that DTI can identify alterations in optic nerve microstructure in children with hydrocephalus.METHODSThe authors retrospectively reviewed 21 children (< 18 years old) who underwent DTI before and after neurosurgical intervention for acute obstructive hydrocephalus from posterior fossa tumors. Their optic nerve quantitative DTI metrics of mean diffusivity (MD) and fractional anisotropy (FA) were compared to those of 21 age-matched healthy controls.RESULTSPatients with hydrocephalus had increased MD and decreased FA in bilateral optic nerves, compared to controls (p < 0.001). Normalization of bilateral optic nerve MD and FA on short-term follow-up (median 1 day) after neurosurgical intervention was observed, as was near-complete recovery of MD on long-term follow-up (median 1.8 years).CONCLUSIONSDTI was used to demonstrate reversible alterations of optic nerve microstructure in children presenting acutely with obstructive hydrocephalus. Alterations in optic nerve MD and FA returned to near-normal levels on short- and long-term follow-up, suggesting that surgical intervention can restore optic nerve tissue microstructure. This technique is a safe, noninvasive imaging tool that quantifies alterations of neural tissue, with a potential role for evaluation of pediatric hydrocephalus.
Preoperative SPECT imaging as a tool for surgical planning in patients with axial neck and back pain
Authors: Brusko G. Damian , Perez-Roman Roberto J. , Tapamo Harold , Burks S. Shelby , Serafini Aldo N. , Wang Michael Y. 
Published: December 2019

OBJECTIVEHybrid SPECT with CT imaging has been used to help elucidate pain generators in patients with axial neck and back pain, identifying potential sites for treatment. Few studies have examined its role in spine surgery and most literature focuses on its use postoperatively. The authors describe the largest series to date of patients with symptomatic spondylosis who underwent preoperative SPECT imaging for surgical planning.METHODSA retrospective medical and imaging record review was conducted to identify patients who underwent SPECT or SPECT/CT studies between January 2014 and May 2018. Patients who underwent spine surgical intervention for spondylosis with primary symptoms of axial neck or back pain and who had evidence of hypermetabolic foci on spinal SPECT imaging were included. Only those patients who subsequently underwent surgery on a spinal level associated with increased radiotracer uptake were included in the analysis. Patient baseline and demographic information, and data pertaining to SPECT imaging, surgical planning, and postoperative care were collected and analyzed.RESULTSA total of 23 patients with an average age at surgery of 60.0 ± 11.0 years were included. Fifteen patients (65.2%) were male. A total of 53 spinal levels were treated, with an average of 2.30 levels treated per patient. All patients underwent fusion surgery, either lumbar (n = 14), with interbody fusion most commonly used (64.2%); or cervical (n = 9), with anterior cervical discectomy and fusion (66.6%) being the most common. The average length of hospital stay was 3.45 ± 2.32 days. One patient developed a wound infection postoperatively, requiring readmission. At the 3-month follow-up, 18 patients (78.3%) reported clinical improvement in pain. Eleven patients (47.8%) reported complete symptom resolution at the 6-month follow-up. At 1 year postoperatively, 19 patients (82.6%) reported significant relief of their symptoms following surgery.CONCLUSIONSThis is the largest series to date describing patients with axial neck and back pain who underwent preoperative SPECT imaging and subsequent surgical intervention on the affected spinal levels. The results demonstrate that SPECT imaging may be a useful adjunct to guide surgical planning, resulting in substantial clinical improvement following surgery.
Validation of the recently developed Total Disability Index: a single measure of disability in neck and back pain patients
Authors: Cruz Dana L. , Ayres Ethan W. , Spiegel Matthew A. , Day Louis M. , Hart Robert A. , Ames Christopher P. , Burton Douglas C. , Smith Justin S. , Shaffrey Christopher I. , Schwab Frank J. , Errico Thomas J. , Bess Shay , Lafage Virginie , Protopsaltis Themistocles S. 
Published: December 2019

OBJECTIVENeck and back pain are highly prevalent conditions that account for major disability. The Neck Disability Index (NDI) and Oswestry Disability Index (ODI) are the two most common functional status measures for neck and back pain. However, no single instrument exists to evaluate patients with concurrent neck and back pain. The recently developed Total Disability Index (TDI) combines overlapping elements from the ODI and NDI with the unique items from each. This study aimed to prospectively validate the TDI in patients with spinal deformity, back pain, and/or neck pain.METHODSThis study is a retrospective review of prospectively collected data from a single center. The 14-item TDI, derived from ODI and NDI domains, was administered to consecutive patients presenting to a spine practice. Patients were assessed using the ODI, NDI, and EQ-5D. Validation of internal consistency, test-retest reproducibility, and validity of reconstructed NDI and ODI scores derived from TDI were assessed.RESULTSA total of 252 patients (mean age 55 years, 56% female) completed initial assessments (back pain, n = 115; neck pain, n = 52; back and neck pain, n = 55; spinal deformity, n = 55; and no pain/deformity, n = 29). Of these patients, 155 completed retests within 14 days. Patients represented a wide range of disability (mean ODI score: 36.3 ± 21.6; NDI score: 30.8 ± 21.8; and TDI score: 34.1 ± 20.0). TDI demonstrated excellent internal consistency (Cronbach’s alpha = 0.922) and test-retest reliability (intraclass correlation coefficient = 0.96). Differences between actual and reconstructed scores were not clinically significant. Subanalyses demonstrated TDI’s ability to quantify the degree of disability due to back or neck pain in patients complaining of pain in both regions.CONCLUSIONSThe TDI is a valid and reliable disability measure in patients with back and/or neck pain and can capture each spine region’s contribution to total disability. The TDI could be a valuable method for total spine assessment in a clinical setting, and its completion is less time consuming than that for both the ODI and NDI.
Sifat Mekanik Paving Block Komposit Sebagai Lapis Perkerasan Bebas Genangan Air (Permeable Pavement)
Authors: Iqbal Maulia  , Ismeddiyanto  , Suryanita Reni 
Published: December 2019

Penggunaan beton sebagai lapis perkerasan jalan dan pemukiman akan mempengaruhi proses infiltrasi sehingga mengakibatkan terjadi genangan atau banjir ketika musim hujan. Adapun alternatif untuk mengatasi masalah tersebut yaitu digunakan inovasi perkerasan paving block komposit. Paving block komposit merupakan penggabungan paving block dan beton porous. Penelitian ini bertujuan meningkatkan kuat tekan beton porous namun tidak mengurangi kemampuannya untuk meloloskan air dan mengkaji sifat mekanik yaitu kuat tekan. Pada penelitian ini beton porous diisi pada bagian tengah paving block dengan variasi diameter beton porous yang dibuat adalah 1 ½”, 2”, 2 ½”, dan 3”. Pengujian kuat tekan dilakukan pada umur 28 hari. Pada pengujian kuat tekan, nilai tertinggi didapat dari masing-masing variasi berturut-turut adalah 39,260 MPa, 3,864 MPa, 21,747 MPa, dan 15,204 MPa. Klasifikasi paving block berdasarkan mutu kuat tekan didapat bahwa variasi 1 ½” dan 2” termasuk kedalam mutu B, variasi 2 ½” termasuk kedalam mutu C dan variasi 3” termasuk kedalam mutu D. Sehingga dapat disimpulkan nilai optimum kuat tekan inovasi paving block komposit yaitu sebesar 20,80 MPa dengan laju infiltrasi 2,78 mm/s. Nilai optimum tersebut termasuk kedalam mutu B yaitu pada variasi diameter 2” dan 2½”. Paving block komposit diameter 2” dan 2½” ini dapat digunakan sebagai lahan parkir atau trotoar pejalan kaki dan mampu mengatasi banjir ataupun genangan air.
Cisplatin Ineligibility for Patients With Metastatic Urothelial Carcinoma: A Survey of Clinical Practice Perspectives Among US Oncologists
Authors: Galsky Matthew D. , Ma Esprit , Shah-Manek Bijal , Mills Rosalina , Ha Long , Krebsbach Craig , Blouin Eric , Tayama Darren , Ogale Sarika 
Published: December 2019

BACKGROUND: Cisplatin-based chemotherapy is the first-line (1L) treatment for eligible patients with locally advanced/metastatic urothelial carcinoma (mUC). However, many patients with mUC are ineligible for cisplatin-based therapy due to age- or disease-related factors. Specific criteria used by practicing physicians to determine cisplatin ineligibility have not been well characterized. OBJECTIVE: To understand US oncologists’ perspectives and self-reported treatment preferences related to cisplatin-ineligible patients with mUC. METHODS: An electronic survey was administered (November-December 2017) to a random sample from a panel of US oncologists who had agreed to participate in periodic surveys. Eligible participants were required to have ≥2 years of clinical experience, have experience treating ≥5 patients with mUC in the past year, and be board certified and/or eligible. In addition to providing demographic information, clinical preferences, and self-reported practices, participants identified and ranked criteria and reasons for determining cisplatin ineligibility. Descriptive statistics were used to analyze all demographics and responses. RESULTS: From the 301 respondents, the most commonly identified clinical factors for cisplatin ineligibility were renal dysfunction (78%) and poor performance status (77%), followed by neuropathy (47%), solitary kidney (43%), hearing loss (43%), advanced age (43%), and cardiovascular dysfunction (41%). Patients were typically deemed ineligible for cisplatin at diagnosis (58%) or on initiation of 1L metastatic therapy (61%). The preferred non-cisplatin 1L treatments were checkpoint inhibitors (75%), followed by carboplatin-based chemotherapy (19%). CONCLUSIONS: This survey of US oncologists provides insights into clinical perspectives on cisplatin ineligibility in the context of the evolving treatment landscape for patients with mUC.
Salvage Hyperthermic Gemcitabine and Docetaxel Combination Chemotherapy After BCG Failure in Non-Muscle Invasive Bladder Cancer Patients
Authors: Rao Mounica Y. , Kang Paul , Tarajkowski Jamaka C. , Mobley Debra L. , Lamm Donald L. 
Published: December 2019

BACKGROUND: Bacillus Calmette-Guerin (BCG) is the recommended therapy for high and intermediate risk non-muscle invasive bladder cancer (NMIBC), but treatment failure is common. While a radical cystectomy is recommended after BCG failure, some patients desire bladder preservation and others are poor surgical candidates. Salvage chemotherapy treatments may be offered to this subgroup of patients. OBJECTIVE: To assess if combination, hyperthermic Gemcitabine and Docetaxel chemotherapy (GEM/DOCE) is a safe and effective salvage option for treating NMIBC. METHODS: Sixty patients who received our GEM/DOCE protocol between 2007–2017 were identified (51 BCG failures, 9 BCG naïve). This study measured overall treatment success, defined as no recurrence, progression, cystectomy, nor death due to bladder cancer. Kaplan-Meier curves were used to ascertain probability of treatment success. The log-rank test was used to identify factors associated with treatment success. RESULTS: Sixty patients received treatment with a median follow-up of 14.9 months. All patients completed the induction course with no significant adverse effects. Overall treatment success was 83% at first surveillance, 69% at 1 year, and 55% at 2 years in the entire cohort, and 90% at first surveillance, 74% at 1 year, and 56% at 2 years in the BCG-failure patients. All-cause and bladder-cancer-specific survival were both 97.9% at 1 year, 85.9% and 94.6% respectively at 2 years. Three patients underwent cystectomy at a median of 10.2 months, two of these were secondary to recurrences. Three patients had progression of their disease. CONCLUSIONS: Hyperthermic GEM/DOCE seems to be a well-tolerated salvage regimen that demonstrates a reasonable efficacy and warrants further investigation.
On the expressiveness and semantics of information flow types
Authors: Rajani Vineet , Garg Deepak 
Published: December 2019

Information Flow Control (IFC) is a form of dependence analysis that tracks and prohibits dependence of public outputs on secret inputs. Such a dependence analysis is often carried out using a type system. IFC type systems can track dependence (via confidentiality labels) at varying levels of granularity. On one extreme, there are fine-grained type systems that track dependence at the level of individual values. They label individual values. On the other extreme, there are coarse-grained type systems that track dependence at the level of entire computations. These type systems do not label individual values but instead label entire sub-computations. An important foundational question is one of the relative expressiveness of these two classes of IFC type systems. In this paper we show that, despite the glaring differences in how they track dependence, the two classes of type systems are actually equally expressive. We do this by showing translations from FG, a fine-grained IFC type system derived from SLAM (In Proceedings of the ACM SIGPLAN-SIGACT Symposium on Principles of Programming Languages (POPL) (1998)), to [Formula: see text], a coarse-grained IFC type system derived from HLIO (In Proceedings of the ACM SIGPLAN International Conference on Functional Programming (ICFP) (2015)), and vice-versa. The translation from [Formula: see text] to FG is straightforward since FG tracks dependence at a granularity finer than [Formula: see text] does. However, the translation from FG to [Formula: see text] is quite involved and relies extensively on label quantification. We further examine the reason for this complexity using a slight variant of [Formula: see text], called CG, to which FG can be translated more easily. As a separate, more foundational contribution we show how to extend logical relation models of information flow to languages with higher-order state. Specifically, we build world-indexed (Kripke) logical relations for FG, [Formula: see text] and CG, which we use to prove these type systems sound and also to prove the translations between them correct.