bluuebunny/crossref_metadata_2025_split huggingface dataset:
The transpalpebral approach “eyelid incision” for surgical management of intracranial tumors: A 10-years’ experience
Authors: Elnokaly Mohamed , Mao Gordon , Aziz Khaled A. 
Published: July 2020

Background:The minimally invasive approaches to the anterior skull base region through fronto-orbital craniotomy remain a highly accepted option that gains countenance and predilection over time. The transpalpebral “eyelid” incision is an under-utilized and more recent technique that offers a safe efficient corridor to manage a wide variety of lesions.Methods:We carried a retrospective study of 44 patients operated on by the fronto-orbital craniotomy through transpalpebral “eyelid” incision for intracranial tumors, in the time period from March 2007 to July 2016. The results from surgeries were analyzed; extent of tumor resection, length of hospital stay, cosmetic outcome, and complications.Results:Out of the 44 intracranial tumor cases, we had 16 male and 28 female patients with median age 54 years. We had 19 anterior skull base lesions, 8 middle skull base lesions and 8 parasellar lesions. We also operated on four frontal intraparenchymal lesions and four other various lesions. Total resection was achieved in 32 cases (72.7%), with excellent cosmetic outcome in 43 cases (97.7%). Average hospital stay was 6 days. No major complications recorded. Three cases (6.8%) had complications that varied between pseudomeningocele, wound infections, and facial pain. Follow-up average period was 23.6 months.Conclusion:The fronto-orbital approach through eyelid incision remains a reliable approach to the skull base. It provides natural anatomical dissection planes through the eyelid incision and a fronto-orbital craniotomy, creating a wide surgical corridor to manage specific lesions with consistent surgical and cosmetic outcome.
Aggressive internal and external decompression as a life-saving surgery in a deeply comatose patient with fixed dilated pupils after severe traumatic brain injury: A case report
Authors: Ebise Hiroki , Kubota Yuichi , Ohbuchi Hidenori , Arai Naoyuki , Inazuka Mayuko , Chernov Mikhail , Kasuya Hidetoshi 
Published: July 2020

Background:
To maximize control of the intracranial pressure in deeply comatose patients with malignant cerebral swelling, combination of the surgical techniques for internal and external brain decompression may be reasonable, as demonstrated in the presented case.

Case Description:
A 55-year-old man was admitted with Glasgow Coma Scale (GCS) score 4, maximally dilated pupils, and absence of the pupillary light and vestibulo-ocular reflexes. Head CT revealed massive acute subdural hematoma, prominent brain shift with subfalcine and transtentorial herniation, and diffuse subarachnoid hemorrhage. Large size decompressive craniectomy and evacuation of subdural hematoma were done, however, prominent swelling of the brain and its protrusion through the bone defect remained. Therefore, extensive temporal lobectomy and removal of the bulk of temporal muscle were additionally attained followed by lax duraplasty. Gradual recovery of the patient was noted from the 1st postoperative day, and on the 70th day, his GCS score was 4T4. Three months later, his condition corresponded to the Glasgow Outcome Scale score 3 (severe disability).

Conclusion:
Aggressive internal and external decompression with combination of large size craniectomy, extensive temporal lobectomy, removal of the bulk of temporal muscle, and lax duraplasty should be considered as possible life-saving option in cases of neurosurgical emergencies with malignant cerebral swelling.
Extremely rare case of retropharyngeal space benign plexiform schwannoma - Excised through Smith- Robinson Approach
Authors: Sakhrekar Rajendra , Peshattiwar Vishal , Jadhav Ravikant , Kulkarni Bijal , Badhwar Sanjiv , Kale Hrishikesh , Yedave Rammohan 
Published: July 2020

Background:
Approximately 25–45% of schwannomas are typically slow-growing, encapsulated, and noninvasive tumors that occur in the head-and-neck region where they rarely involve the retropharyngeal space. Here, we report deep-seated benign plexiform schwannoma located in the retropharyngeal C2-C5 region excised utilizing the Smith-Robinson approach.

Case Description:
A 30-year-old male presented with dysphagia and impaired phonation attributed to an MR documented C2-C5 retropharyngeal schwannomas. On examination, the lesion was soft, deep seated, and extended more toward the right side of the neck. Utilizing a right-sided Smith-Robinson’s approach, it was successfully removed. The histopathology confirmed the diagnosis of a plexiform schwannoma.

Conclusion:
Retropharyngeal benign plexiform schwannomas are rare causes of dysphagia/impaired phonation in the cervical spine. MR studies best document the size and extent of these tumors which may be readily resected utilizing a Smith-Robinson approach.
Clinicoradiological outcomes of Goel and Harms fixation for atlantoaxial instability: An institutional experience
Authors: Sharma Jeevan Kumar , Kalidindi Kalyan Kumar Varma , Sangondimath Gururaj , Mallepally Abhinandan Reddy , Marathe Nandan , Chhabra Harvinder Singh 
Published: July 2020

Background:
Few studies have reported on the long-term outcomes of Goel and Harms C1-C2 fusions in the Asian population.

Methods:
This was a retrospective analysis of 53 patients undergoing Goel and Harms fixation (2010 –2018). Clinical outcomes were assessed utilizing the neck disability index (NDI), Japanese Orthopedic Association (JOA) score, and visual analog scale (VAS). Outcomes were then correlated with fusion rates (using dynamic X-rays), atlanto-dens interval (ADI), and space available for cord (SAC) data.

Results:
The study’s 53 patients averaged 49.98 years of age and included 42 males and 11 females. The mean preoperative versus postoperative scores on multiple outcome measures showed NDI 31.62 ± 11.05 versus decreased to 8.68 ± 3.76 post, mean JOA score (e.g., in 41 patients with myelopathy) improved from 13.20 ± 3.96 to 15.2 ± 2.17, and the mean VAS decreased from 4.85 ± 1.03 to 1.02 ± 0.87 and showed restoration of the ADI (1.96 ± 0.35 mm) and SAC (20.42 ± 0.35 mm). A 98.13% rate of C1-C2 fusion was achieved at 12 postoperative months.

Conclusion:
Goel and Harms technique for C1-C2 fusion resulted in both good clinical and radiological outcomes.
Posttraumatic thoracic epidural capillary hemangioma – A rare case report
Authors: Sudhir G. , Jayabalan Vignesh , Manohar T. H. , Gadde Saikrishna , Kumar Venkatesh , Kailash Karthik 
Published: July 2020

Background:
Capillary hemangiomas are benign vascular lesions commonly seen in subcutaneous tissues. The most common site of origin is from the vertebral body, and only a few cases of isolated lesions in thoracic epidural space, especially after trauma, have been reported in the literature.

Case Description:
We report a case of 63-year-old male with progressive bilateral lower limb weakness and exaggerated lower limb deep tendon reflexes without bowel and bladder involvement. His history revealed T7 fracture with paraparesis which was treated surgically, and implants were removed a year later. MRI showed an epidural lesion from T6-T8 extending into the right T7-8 foramen which showed hypointensity on T1, hyperintensity on T2, and homogenous enhancement in contrast images with severe cord compression. Laminectomy was done and the lesion was removed en bloc. Histopathological examination revealed it to be capillary hemangioma. The neurology came back to normal after 3 months.

Conclusion:
Although capillary hemangiomas are rare lesions, it has to be considered in the differential diagnosis of epidural space-occupying lesions which require early surgical removal to prevent a progressive and permanent neurological deficit.
A study on an optimal replacement policy for a degenerative system under partial product process
Authors: P Govindaraju , P Ashok Kumar 
Published: July 2020

In this paper, we study a degenerative reparable system with two types of failure states.Any system after repair can not be as good as new. A general monotone process model for adegenerative system under partial product process is used. We use a replacement policy N based on the failure number of the system and to determine an optimal replacement policy N*
such that the average cost rate is minimized.
REDUCING THE NUMBER OF BACTERIAL COLONIES USING ECOCID®S (POTASSIUM PEROXYSULPHATE BASED DISINFECTANT) AT SMALL ANIMAL CLINIC
Authors: Tozon Nataša , Biasizzo Majda , Ščuka Leon , Potočnik Tamara , Redek Marjeta , Prem Luka 
Published: July 2020

A clinical study has been conducted to test the efficacy of Ecocid® S, a biocidal agent. The active substance is potassium peroxysulphate and is used in clinical practice after the mechanical cleaning of various surfaces that act as potential sources of infection transmission. We determined 29 swabbing points, from which 87 samples were collected with cotton swabs. Swabs were submitted for microbiological testing to evaluate microbial contamination before cleaning, and before and after disinfection with Ecocid® S. We submitted 63 swabs from 21 swabbing points for further statistical analysis. Five swabs were excluded because the presence of bacteria in the swabs before disinfection had not been determined. The clinical study on the efficacy of Ecocid® S disinfectant showed that it is effective with an average reduction in contamination of 95.75%. The disinfectant was also active with a significantly reduced time of action: it was removed with dry paper towels from all sampling points, except the floor scales, only 5 to 10 minutes after application. The time required for the proper preparation of examination tables and other equipment in clinical practice is of vital importance for a smooth workflow.Key words: animals; disinfection; potassium peroxysulphate; Ecocid® S ZMANJŠANJE ŠTEVILA BAKTERIJ PO UPORABI RAZKUŽILA ECOCID®S (RAZKUŽILO NA OSNOVI KALIJEVEGA PEROKSISULFATA) V PROSTORIH KLINIKE ZA MALE ŽIVALIPovzetek: S klinično študijo smo želeli ugotoviti učinkovitosti biocidnega razkužila ECOCID®S. Aktivna snov v razkužilu je kalijev peroksisulfat, ki se na klinikah uporablja za razkuževanje različnih površin, ki predstavljajo ključna mesta za prenos okužb, po njihovem mehaničnem čiščenju. Določili smo 29 vzorčnih mest, na katerih smo z uporabo bombažnih brisov odvzeli 87 vzorcev. Z mikrobiološkim testiranjem smo ugotavljali stopnjo kontaminacije pred čiščenjem, ter pred in po razkuževanju z ECOCID®S. Za statistično obdelavo smo uporabili 63 rezultatov z 21 vzorčnih mest. Pet rezultatov je bilo izločenih iz obdelave, ker je bila že pred razkuževanjem stopnja kontaminacije pod mejo detekcije uporabljene metode. S klinično študijo učinkovitosti razkužila Ecocid®S smo ugotovili povprečno 95,75 % zmanjšanje števila kontaminantov po uporabi razkužila. Razkužilo je bilo učinkovito tudi ob skrajšanem času delovanja le 5 do 10 minut po nanosu. Zaradi zagotavljanja tekočega dela na kliniki je izredno pomemben čas, ki je potreben za ustrezno pripravo površin in druge opreme za pregled živali, zato je razkužilo Ecocid® S primerno za uporabo na veterinarskih klinikah, saj hitro in učinkovito zmanjša bakterijsko kontaminacijo.Ključne besede: živali; dezinfekcija; kalijev peroksisulfat; Ecocid® S
Performance and Management of Cost in the Construction Industry
Authors: Shaikh Fazal Ali , Odhano Nasurullah , Kaliannan Suaathi 
Published: July 2020

In the arena of cost baselines and project budgets, the construction industry is always famed and controversial. Owing to the paucity of funds or maladministration at various levels, there is 90 percent of project delay is fully stranded. While being a major contributor to a country's Gross Domestic Product, its sufficient potentiality has never been tapped. Maybe this dismaying climate is created by the cold-hearted, reckless and unscrupulous attitudes of construction industry stakeholders. The main objectives of this research is to determine the genesis of exceeded budget/cost in construction projects that affect cost management and to suggest appropriate measures to harness the construction industry's full potential. The key drivers that have positive or negative repercussions on the cost aspect of the projects are the administration, pundits and consumers or holders. For assessing the most common causative factors of exceeded cost in construction projects, the authors organized interactive discussions with construction industry pundits, designers, architects, schematic experts, and manufacturers. Moreover, the incumbent concerns in the construction industry were analyzed and examined to examine important factors. To underscore the key motives that drive the projects, directly and indirectly, a questionnaire was dispensed between the participants on the analysis in the cost of undergoing projects. Results of the study are the key interpretations which were drawn from this research paper are fraud, weak political engrossment, poor site management, hampering of site deployment, consultants inflexible approach, gold plating, faulty safety and healthcare management system. To remove these hurdles, I have recommended appropriate guidelines for preventing, reducing or mitigating the effects of these factors.
Compressive Strength of Concrete using Fly Ash and Rice Husk Ash: A Review
Authors: Sam Joel 
Published: July 2020

Decreasing our over-reliance on cement as an ingredient in the making of concrete due to its contribution to the CO2 emissions has led to numerous researches been conducted to find suitable replacement for cement in concrete mixes. Materials like fly ash, ground granulated blast furnace slag, silica fume, rice husk ash and metakaolin among others have been identified as materials that can at the very least be used as a replacement for cement in concrete mix. These materials are referred to as supplementary cementitious materials (SCMs). This paper reviewed the work that has been done on the use of fly ash and rice husk ash as partial replacements for concrete, its chemical composition and its effect on the compressive strength of concrete. Charts, tables and figures were employed as tools to study the various chemical compounds of fly ash and rice husk ash. It was seen that depending on how the coal or rice husk was initially processed the percentage of some of the minor compounds like Sodium oxide (Na2O), Titanium oxide (TiO2) and Phosphorus pentoxide (P2O5) were sometimes very low or not recorded as part of the final product. The data on the compressive strength of concrete after fly ash and rice husk ash had been added in percentage increments of 0%, 10%, 20%, 30%, 40%, 50% and 0%, 5%, 7.5%, 10%, 12.5%, 15% respectively analysed over a minimum period of 7 days and a maximum period of 28 days found out that the optimal percentage partial replacement of fly ash and rice husk ash for a strong compressive concrete strength is 30% of fly ash and 7.5% of rice husk ash.
Factors determining an unfavorable one-year prognosis of myocardial infarction complicated by left ventricular failure and associated with chronic cerebral ischemia
Authors: Lebedeva N. B. , Chesnokova L. Yu. , Tarasov N. I. 
Published: July 2020

Aim. To evaluate factors of unfavorable annual prognosis of myocardial infarction (MI) complicated by heart failure (HF) with reduced ejection fraction (HFrEF) and associated with chronic cerebral ischemia (CCI).Material and Methods. A total of 182 patients with Q wave myocardial infarction complicated by the left ventricular dysfunction concomitant with CCI were included in the study. Of them, 149 (81.9%) patients were men and 33 (18.1%) were women. The mean age was 60.4 (53; 69) years. All patients underwent echocardiography, color duplex scanning of the carotid arteries and examination by an interventional neurologist. Hard endpoints were collected within one year.Results. The majority of the patients included in the study suffered from grade 2 CCI. Atherosclerotic plaques in the brachiocephalic arteries were found in 37.4% of patients; the degree of stenosis did not exceed 50% in all cases. 77 (46.1%) patients achieved hard endpoints within one year. Multivariate logistic regression showed that the most unfavorable predictor of poor 1-year survival was the presence of the positive history of ACVA [RR 7.33 (95% CI 1.97–27.32), p = 0.003], and the most unfavorable predictors of risk of adverse cardiovascular events included prior stroke [RR = 1.92 (95% CI 1.09–3.38), p = 0.025] and carotid atherosclerotic plaques [RR = 2.12 (95% CI 1.34–3.37), p = 0.001].Conclusion. The presence of carotid atherosclerotic plaques and prior stroke affected the long-term prognosis in patients with myocardial infarction complicated by heart failure and chronic cerebral ischemia.
Pulmonary embolism in the presence of chronic heart failure syndrome: A structural-functional state of the cardiovascular system
Authors: Statkevich T. V. , Mitkovskaya N. P. , Balysh A. M. , Rambalskaya A. R. , Petrova K. B. , Moklaya A. V. , Levkovich I. E. 
Published: July 2020

Aim. To identify the features of the structural-functional state of the cardiovascular system in patients with pulmonary embolism (PE) in the presence of chronic heart failure (CHF) syndrome.Material and Methods. The study included 231 patients diagnosed with PE at admission to the hospital. Patients were further divided into subgroups depending on the verification of the diagnosis by computed tomography and the presence of CHF syndrome.Results and discussion. An increase in pressure in the pulmonary artery system contributed to the formation and aggravation of right ventricular systolic dysfunction, which acquired a greater prevalence and severity in the presence of CHF. This was confirmed by the echocardiographic signs of dysfunction of the right heart including increased linear dimensions of right cardiac chambers, right atrium volume index of 32.3 (29.4–37.9) mL/m2 versus 29.1 (26.6–32.3) mL/m2 (U = 1583.00, p < 0.001); greater prevalence of hemodynamic instability (proportion of patients with fainting or presyncope at hospital admission was 32% in the presence of CHF versus 16.7% without CHF; χ2 = 4,49, p < 0.05); and more significant increases in the laboratory markers of right ventricular dysfunction and injury included in the prediction model of adverse PE outcome [brain natriuretic peptide of 395 (204–789) pg/mL versus 104.2 (38.9–212) pg/mL (U = 1162.00, p < 0.001), high-sensitive troponin of 212 (194.5–297.6) ng/mL versus 184.8 (168.0–194.8) ng/mL (U = 279.50, p < 0.01), myocardial fatty acid-binding protein of 0.37 (0.18–1.2) ng/mL versus 0.2 (0.08–0.3) ng/mL (U = 530.00, p < 0.001), copeptin of 0.2 (0.05–0.92) ng/mL versus 0.09 (0.04–0.15) ng/mL (U = 563.00, p < 0.01), and reduced renal function].
Integrative respiratory and skeletal musculature training in patients with functional class II–IV chronic heart failure and low or intermediate left ventricular ejection fraction: Design and rationale
Authors: Begrambekova J. L. , Karanadze N. A. , Mareev V. Yu. , Kolesnikova E. A. , Orlova Ya. A. 
Published: July 2020

Respiratory system remodeling plays an important role in the progression of congestive heart failure (CHF). Decreased oxygenation of the respiratory muscles during intense physical exertion in patients with CHF may aggravate respiratory failure and provoke hyperactivation of the inspiratory metaborefl ex, thereby aggravating exercise intolerance due to a decrease in muscular system perfusion. Respiratory muscle training can minimize the eff ects of inspiration metaborefl ex activation and prolong the duration of exercise.Trial design. This is a prospective randomized trial with a sham control. The trial will include 40 adult patients of both genders with NYHA II-III CHF and with ejection fraction (EF) ≤ 49%. Patients will be randomized in a 1:1 ratio to either Active or Control group. Active group will receive four-week guided respiratory muscles training followed by 12-week guided aerobic training (treadmill walking). Control group will receive four-week sham respiratory muscles training (THRESHOLD® IMT breathing trainer with level slightly above 0), followed by 12 weeks guided aerobic training (treadmill walking). The primary aim is to compare the eff ect of diff erent training modalities on functional capacity (peak VO2 ). Secondary outcome measures include changes in respiratory muscle strength, serum biomarkers (NT-proBNP and ST2) and Angiotensin II. Health-related quality of life (MLwHFQ.23) and psycho-emotional state of patients also will be assessed.The study also planned an additional analysis with a suitable group of patients who were screened but refused to participate in the study.Conclusion. Heart failure patients often give up exercise due to symptoms of shortness of breath and muscle weakness. We suggest that the training technique based on the inclusion of respiratory muscle training as the fi rst stage of cardiac rehabilitation will positively aff ect the eff ectiveness of subsequent aerobic training in patients with heart failure, by reducing the activity of RAAS and SAS and increasing respiratory effi ciency.
Preoperative contrast-enhanced magnetic resonance imaging in ischemic cardiomyopathy patients undergoing surgical left ventricular reconstruction
Authors: Pryakhin A. S. , Shipulin V. M. , Andreev S. L. , Aleksandrova E. A. , Shipulin V. V. , Garganeeva A. A. , Kuzheleva E. A. , Ussov W. Y. 
Published: July 2020

Purpose. The aim of this study was to identify the signifi cance of myocardial viability indicators calculated based on cardiac magnetic resonance imaging (MRI) with delayed contrast, as predictors of the adverse course of postoperative period in the surgical treatment of patients with ischemic cardiomyopathy.Material and Methods. A total of 178 patients underwent surgical treatment for ischemic cardiomyopathy from March, 2013 to December, 2017. All patients underwent preoperative cardiac MRI scan with paramagnetic contrast.Results. The logistic regression analysis showed that the left ventricular volumetric indicators and the amount of residual viable myocardium, calculated using delayed contrast-enhanced MRI, were the essential predictors of favorable and complicated course of postoperative period in ischemic cardiomyopathy patients. In patients with a residual viable left ventricular myocardium amount over 64.5%, surgical ventricular reconstruction procedure may be performed with a low risk of early postoperative complications (OR 8.25, 95% CI 1.45-46.8, p = 0.017).Conclusion. Cardiac MRI with delayed paramagnetic contrasting is a valuable method contributing to the preoperative identifi cation of a cohort of ischemic cardiomyopathy patients who can benefi t the most from surgical left ventricular reconstruction.