bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute subdural hematoma in the elderly: outcome analysis in a retrospective multicentric series of 213 patients
Authors: Trevisi Gianluca , Sturiale Carmelo Lucio , Scerrati Alba , Rustemi Oriela , Ricciardi Luca , Raneri Fabio , Tomatis Alberto , Piazza Amedeo , Auricchio Anna Maria , Stifano Vito , Romano Carmine , De Bonis Pasquale , Mangiola Annunziato 
Published: October 2020

OBJECTIVEThe objective of this study was to analyze the risk factors associated with the outcome of acute subdural hematoma (ASDH) in elderly patients treated either surgically or nonsurgically.METHODSThe authors performed a retrospective multicentric analysis of clinical and radiological data on patients aged ≥ 70 years who had been consecutively admitted to the neurosurgical department of 5 Italian hospitals for the management of posttraumatic ASDH in a 3-year period. Outcome was measured according to the Glasgow Outcome Scale (GOS) at discharge and at 6 months’ follow-up. A GOS score of 1–3 was defined as a poor outcome and a GOS score of 4–5 as a good outcome. Univariate and multivariate statistics were used to determine outcome predictors in the entire study population and in the surgical group.RESULTSOverall, 213 patients were admitted during the 3-year study period. Outcome was poor in 135 (63%) patients, as 65 (31%) died during their admission, 33 (15%) were in a vegetative state, and 37 (17%) had severe disability at discharge. Surgical patients had worse clinical and radiological findings on arrival or during their admission than the patients undergoing conservative treatment. Surgery was performed in 147 (69%) patients, and 114 (78%) of them had a poor outcome. In stratifying patients by their Glasgow Coma Scale (GCS) score, the authors found that surgery reduced mortality but not the frequency of a poor outcome in the patients with a moderate to severe GCS score. The GCS score and midline shift were the most significant predictors of outcome. Antiplatelet drugs were associated with better outcomes; however, patients taking such medications had a better GCS score and better radiological findings, which could have influenced the former finding. Patients with fixed pupils never had a good outcome. Age and Charlson Comorbidity Index were not associated with outcome.CONCLUSIONSTraumatic ASDH in the elderly is a severe condition, with the GCS score and midline shift the stronger outcome predictors, while age per se and comorbidities were not associated with outcome. Antithrombotic drugs do not seem to negatively influence pretreatment status or posttreatment outcome. Surgery was performed in patients with a worse clinical and radiological status, reducing the rate of death but not the frequency of a poor outcome.
Long-term pain outcomes in elderly patients with trigeminal neuralgia: comparison of first-time microvascular decompression and stereotactic radiosurgery
Authors: Raygor Kunal P. , Lee Anthony T. , Nichols Noah , Wang Doris D. , Ward Mariann M. , Barbaro Nicholas M. , Chang Edward F. 
Published: October 2020

OBJECTIVECommon surgical treatments for trigeminal neuralgia (TN) include microvascular decompression (MVD) and stereotactic radiosurgery (SRS). The use of MVD in elderly patients has been described but has yet to be prospectively compared to SRS, which is well-tolerated and noninvasive. The authors aimed to directly compare long-term pain control and adverse event rates for first-time surgical treatments for idiopathic TN in the elderly.METHODSA prospectively collected database was reviewed for TN patients who had undergone treatment between 1997 and 2017 at a single institution. Standardized collection of preoperative demographics, surgical procedure, and postoperative outcomes was performed. Data analysis was limited to patients over the age of 65 years who had undergone a first-time procedure for the treatment of idiopathic TN with at least 1 year of follow-up.RESULTSOne hundred ninety-three patients meeting the study inclusion criteria underwent surgical procedures for TN during the study period (54 MVD, 24 MVD+Rhiz, 115 SRS). In patients in whom an artery was not compressing the trigeminal nerve during MVD, a partial sensory rhizotomy (MVD+Rhiz) was performed. Patients in the SRS cohort were older than those in the MVD and MVD+Rhiz cohorts (mean ± SD, 79.2 ± 7.8 vs 72.9 ± 5.7 and 70.9 ± 4.8 years, respectively; p < 0.0001) and had a higher mean Charlson Comorbidity Index (3.8 ± 1.1 vs 3.0 ± 0.9 and 2.9 ± 1.0, respectively; p < 0.0001). Immediate or short-term postoperative pain-free rates (Barrow Neurological Institute [BNI] pain intensity score I) were 98.1% for MVD, 95.8% for MVD+Rhiz, and 78.3% for SRS (p = 0.0008). At the last follow-up, 72.2% of MVD patients had a favorable outcome (BNI score I–IIIa) compared to 54.2% and 49.6% of MVD+Rhiz and SRS patients, respectively (p = 0.02). In total, 0 (0%) SRS, 5 (9.3%) MVD, and 1 (4.2%) MVD+Rhiz patients developed any adverse event. Multivariate Cox proportional hazards analysis demonstrated that procedure type (p = 0.001) and postprocedure sensory change (p = 0.003) were statistically significantly associated with pain control.CONCLUSIONSIn this study cohort, patients who had undergone MVD had a statistically significantly longer duration of pain freedom than those who had undergone MVD+Rhiz or SRS as their first procedure. Fewer adverse events were seen after SRS, though the MVD-associated complication rate was comparable to published rates in younger patients. Overall, the results suggest that both MVD and SRS are effective options for the elderly, despite their advanced age. Treatment choice can be tailored to a patient’s unique condition and wishes.
Peripheral nerve stimulator for terminal sciatic nerve neuromas in an amputee
Authors: Daggubati Lekhaj C. , Davanzo Justin R. , Rizk Elias B. 
Published: October 2020

Neuromas are a difficult-to-treat peripheral nerve pathology that can cause crippling pain. Optimal treatment is widely debated as pharmacological intervention frequently is not sufficient and surgical interventions are plagued with recurrence. The majority of amputees report severe and chronic stump pain. Avoiding complex surgery at the stump site would prevent infection or wound dehiscence. Recent advances in neuromodulation with external pulse emitters allow for pain relief with localized nerve stimulation. The authors describe the novel placement of a sciatic nerve stimulator in a 77-year-old man for painful stump neuromas of the common peroneal and tibial nerves.The video can be found here: https://youtu.be/96kKs3qjtqc
Brachial plexus avulsion neuropathic refractory pain: association of spinal cord stimulation and DREZotomy for complex pain
Authors: Marques Rômulo A. S. , Cavalcante Rodrigo A. C. , Pimenta Lucas M. C. E. 
Published: October 2020

A 52-year-old male was involved in a car accident 30 years ago. He presented with complete motor paralysis of the left upper limb. This evolved into severe neuropathic pain (mainly shocking and burning sensation) distributed from C5 to T1 dermatomes. He was first treated with spinal cord stimulation (SCS), which did not show efficacy for pain control, maintaining high visual analog scale (VAS) scores. He then received complementary treatment with left cervical DREZotomy to mitigate suffering and preserve SCS function to control “mirror pain.”The video can be found here: https://youtu.be/iTvbLAZ3odM
Belajar Melalui Musik Dengan Menerapkan Metode Orff
Authors: Ridwan  , Wulandari Hayani , Ardiyanti Dhea 
Published: October 2020

Artikel ini berfokus pada penanaman belajar melalui musik dengan menggunakan metode orff bagi guru maupun calon guru Pendidikan Anak Usia Dini (PAUD). Hubungannya pada aspek perkembangan anak, melalui metode ini dapat menumbuhkan rasa musikalitas anak dengan melalui kegiatan-kegiatan dasar seperti bernyanyi, menari, beracting dan memainkan alat musik. Bentuk memainkan alat musik disini bukan hanya memainkan alat musik yang pada umumnya, akan tetapi dapat juga memanfaatkan dari barang-barang yang ada dalam kehidupan sehari-hari. Penelitian ini menggunakan metode eksperimen dengan desain pre-eksperimen one-shot case study. Penelitian ini dilaksanakan melalui kegiatan webinar dengan peserta guru dan calon guru Pendidikan Anak Usia Dini (PAUD). Tujuan dari penelitian ini untuk memberikan gambaran dengan jelas kepada para pendidik maupun calon pendidik mengenai pelaksanaan pembelajaran melalui musik yang kreatif pada anak usia dini melalui penggunaan metode Orff. Memiliki pemahaman akan metode Orff ini sangat diperlukan baik itu secara teoritis maupun praktis sehingga guru dan calon guru tidak hanya dapat meningkatkan pengetahuan mereka, akan tetapi dapat mengaplikasikan pembelajaran yang kreatif, inovatif dan menarik pada Pendidikan Anak Usia Dini (PAUD) tentunya tetap disesuaikan dengan karakteristik anak.
Kata Kunci : Musik, Metode Orff, Anak Usia Dini
Partial Mole Coexistence with a Normal Live Fetus in Twin Pregnancy
Authors: Alkateeb Saabh I. , Alkhalidy Hala M. 
Published: October 2020

We present a case of dizygotic diamiontic twin pregnancy in which one fetus was normal with normal placenta, the 2nd fetus was normal appearing with partial molar placenta. All required investigation and clinical assessments were carried out and revealing partial molar pregnancy in one fetus and normal placenta of the other one. Maternal BhCG was high for gestational age.The patient was a 31-year-old presented to Central Private Hospital; her gestational age was 22 weeks +5 days following IVF (after 10 years of primary infertility) of diazygotic diamiontic twin pregnancy as a case of vaginal bleeding from 8 weeks of gestation with uterine contractions.
The patient had gestational DM & hyperthyroidism. Appropriate treatment regarding her conditions was implemented
All appropriate management was implemented. The patient continued to bleed. Within few days of admission she had premature uncomplicated labor with normal vaginal delivery (gestational age was23 Wks +3 days), both babies appeared normal, one placenta morphologically &histologically typical of H.mole. The other one completely was normal.
Monitoring of serum BhCG and follow up transvaginal US was done until BhCG level returned to normal after 3 months of delivery without chemotherapy.
Close monitoring of pregnancy from early stages and discussing the possible complications to mother and baby (such as baby may be chromosomally abnormal &may not survive) with parents is important to manage such complications.
It is also necessary to have post-natal close follow up for maternal BhCG levels to assess any possibility of invasive mole or choriocarcinoma.
Attitude of Medical Students University of Baghdad toward Psychiatry:Clinical significance and as future career
Authors: Younis Maha S. , Mahdi Abbas alrubayee Fadhil 
Published: October 2020

Background: Psychiatry is an important branch of medicine and has been an integral part of the academic curriculum in Baghdad College of Medicine since its establishment. Medical students have a different attitude towards it as a medical profession like other specialties of medicine and as future medical career.
Objectives: This study aims to explore the attitudes of medical students towards psychiatry in general and as a future career after their course of clerkship in the Department of Psychiatry in Baghdad Teaching Hospital.
Patients and Methods: During the year 2016, 158 male and female students of fifth and sixth years participated in a brief five-question survey derived from the international questionnaire-Attitude towards Mental Illness (AMI) assessing their perspectives toward importance of psychiatry as medical discipline to study and as their future career choice.
Results: The female to male ratio was 2:1. Of all the respondents, 86.6% indicated the clinical significance of psychiatry as a profession. Only 23% said that they would choose psychiatry as their future career. Nearly half of them attributed improvement of their attitudes to the positive effect of tutoring. Generally, there were no prominent gender differences in the responses
Conclusion: The vast majority of the students had a positive attitude towards psychiatry in general yet it wasn’t preferred as their future career. It is thought that education and training of psychiatry may ameliorate the negative attitude towards the clinical importance but it may not affect their career aspiration.
Etiological factors of cholestasis ininfancy andearly childhood in Children Welfare Teaching Hospital
Authors: Ibraheem Mohammad Fadhil , Mahmood Adnan Y. , Salih Jasim M. 
Published: October 2020

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Background: Neonatal cholestasis is defined as prolonged elevation of the serum level of conjugated
bilirubin beyond the first 14 days of life. There are many causes of neonatal cholestasis which must be identified because early intervention may result in a better outcome , such as surgical intervention in biliary atresia within two months from birth , or effective dietary management in metabolic disorders like galactosemia.
Objective:To determine the causes of early childhood cholestasis in children attending the Children Welfare
Teaching Hospital in Baghdad and to study some of associated factors in infancy and early childhood cholestasis.
Patient and method: This is a cross sectional descriptive study conducted on 48 patients attending the Children Welfare Teaching Hospital in Baghdad for the period of 1Novembe r 2015 to 15 January 2016. These cases were evaluated by thorough history, examination and investigations. Results:O the 48 patients enrolled in this study, 30 (62.5%) lived in Baghdad, and the remaining 37.5% were referred from other governorates . the mean age of the patients was 11.1 ± 12.4 months, with 20 females (41.7%) and 28 males (58.3%). The Results revealed that 11(22.9%)were the result of congenital infections , 9 (18.8%) were idiopathic in origin, 8
(16.7%) were caused by biliary atresia, 8 (16.7%) of unknown origin, 5 (10.4%) were caused by sepsis (mainly
staphylococcus, streptococcus species, E coli, staphylococcus aureus) , 2 (4.2%) were caused by progressive
familial intrahepatic cholestasis and 1 (2.1%) case was caused by each of the following causes: Alagille snyndrome, Choledochal cyst, Galactosemia, hypothyroidism and Tyrosinemia.
Conclusion: Congenital infections were the most common cause in this study, of which the most common is cytomegalovirus ( CMV ). Clay color stool and high alkaline phosphatase levels were found mostly in biliary atresia. No method by itself is sufficient to diagnose the cause of neonatal cholestasis. D iagnosis can only be established using all available methods.
Ultrasound Findings of MammographicallyDense Breasts in a Sample of Iraqi Female PatientsDOI:https
Authors: Mohson Khaleel , Kareem Tara F. , Awn Anas K. 
Published: October 2020

Background: Breast problems including breast cancer have been increasing in Iraq during the recent years. Yet, early detection and screening programs using mammography mainly with complementary ultrasound had dramatically decreased the mortality rates from this emerging disease.
Objective: To assess the dense breast detected by mammography for the presence of any hidden
suspicious lesion by using ultrasound.
Patients and methods: this is a cross - sectional study on 53 female patients who came for breast cancer
screening or attended the Breast Clinic in the Oncology Teaching Hospital of the Medical City Complex in Baghdad –Iraq. The study was conducted from January to October 2018. Two -view mammography was done for each breast, and those with dense breasts underwent further ultrasound assessment done by a board-
certified radiologist.
Results: The mean age for the 53 patients included in the study was 48 years. Mammographic findings
showed that heterogeneous fibroglandular tissue density was present in (89%) of the study population.
Suspicious or clearly defined mass(es) by mammograph were seen in 16 (30%) of the patients, while no
mass was identified in (22%). Ultrasound findings we re as follows: Suspicious mass in (75%) of the cases
and benign lesions such as simple cysts or fibroadenoma in (9%). The results showed that ultrasound has
upgraded 12 cases that were diagnosed as BI -RADS I/II to BI-RADS IV/V and this represented (23%) of
the cases. On the other hand, the mammogram and the ultrasound were in concordance for BI RADS
IV/V in 28 cases (54%). The positive predictive value of the ultrasound and the mammogram for BI -
RADS IV and V breast lesions is 72% for BI - RADS IV and 95% for BI - RADS V for ultrasound and that of mammograph is 83% for BI - RADS IV 80% for BI- RADS V, while the negative predictive value of mammograph is 55% for BI - RADS I/II 25% for BI - RADS III.
Conclusion: Dense breast is still an important problematic issue in mammographic screening as it may
obscure small lesions, for which, ultrasound is proved to be a complementary and essential targeting tool
in the assessment process.
Risk factors of hearing defects and their relationship to the outcome of hearing screening among neonates
Authors: Hameed Numan Nafie , Malih Mokhalad Ghazi 
Published: October 2020

Background: Increased exposure to risk factors of hearing loss leads to a high susceptibility to deafness
among neonates admitted to neonatal care units in developing countries.
Objective: This article aims to study the prevalence of risk factors for neonatal hearing defect and determine their effect on the result of transient evoked otoacoustic emissions hearing test ( TEOAE). Methods: A longitudinal study was carried out for a period of one year from 1st October, 2016 to 30 th September, 2017 in the CWTH, Medical city, Baghdad, Iraq Demographic characteristics and certain risk factors were recorded for screened neonates. TEOAE test was done and if they failed to pass two steps, they were referred to
autom ated auditory brainstem - response (AABR).
Results: Out of 400 neonates, 342 (85.5%) passed from step 1TEOAE, while 58 (14.5%) were referred to step 2. From 58, 26 (44.8%) have passed step 2 and 32 (55.2%) not pass step 2 and were referred to AABR. From those 32 neonates with suspected hearing defect, NICU stay >7 days, ototoxic drugs >7days, use of ventilator >7 days, birth weight <1500gm, and craniofacial malformations were the main risk factors for hearing defects occurring in (90.6%), (90.6%), (59.4%), (40.6%), and (21.9%) respectively.
Conclusions: Low birth weight , long intensive care stay, mechanical ventilation, drugs ototoxicity and
craniofacial malformation of neonates are the main risk factors for failed TEOAE test
The Prevalence of Physical Disability in Elderly SAMPLE in Primary Health Care Centers (PHCs) in AL-Resafa Sector /Baghdad/2018
Authors: Hassan Rana A. , Hasan Lamyaa Ali 
Published: October 2020

Background
The proportion of older population throughout the world is continuously increasing, and becomes a challenge worldwide, since it may lead to an increasing number of disabled populations, and to a rise of the national health burden, and so there is greater need to look into their physical disability aspects, which is otherwise neglected.
Objectives
To estimate the prevalence of Activity of Daily Living dependency(ADL) in primary health care centers(PHCs) in AL Resafa health sector in Baghdad, and to find association between dependency and some sociodemographic factors.
Method
A Descriptive cross- sectional study was carried out in all PHCs in AL Resafa health sector in Baghdad and 250 elderly were interviewed using pretested questionnaire which covered some Sociodemographic factors and Barthal index scale( a 10 item instrument measuring functional independence in personal Activities of Daily Living).
Results
250 participants all of them are aged 60 year and older, those aged 60 to 69 years were 47.6%, minority aged 80 years and older , elderly female were slightly more than male (51.6%,48.4% ), Most of participants 97.6% were living in company with their families, 82.0% were not currently employed, 48% overweight , According to Barthal index scale score: 78.0% were independent while ADL with assistance observed in 15.2% and those of ADL with severity 6.8%. There was a significant association between increase in age, Female gender, low education and obesity with decrease in ADL.
Conclusion
Preserving functional capacity of elderly is a great challenge to public health, subjects categorization on the basis of Barthel index to correlates functional disability will be of value for a better quality of life.
Epidemiology of the domestic and repatriation (Covid-19) Infection in Al Najaf province , Iraq
Authors: Al-Shaibani Ahmed H. Al- Shareef 
Published: October 2020

ABSTRACT
Background: Al-Najaf province , Iraq , has experienced an outbreak of coronavirus disease 2019 (Covid-19). Epidemiological and clinical characteristics of (Covid-19) infection have been reported but a detailed clinical course and risk factors for mortality including medical comorbidities and severity of illness at time of presentation , have not been well described.
Methods: From February 24 to April 7, 2020, a case series study done on 123 PCR-confirmed cases of (Covid-19) admitted to Al-Hakeem Hospital And Quarantine Center (AHQC), in Al-Najaf Province, Iraq. Demographics, clinical and laboratory data gathered from a local database at (AHQC). SPSS(statistical package for social sciences) used for statistical analysis. Frequency, percentage, mean and standard deviation used as descriptive statistics. Chi square or Yates corrected chi square used as needed.(P value≤0.05) regarded significant.
Results: In total of 123 Patients, most infections occur inside Iraq 96(78%) .The cohort included 67 (54.5%) females and 56 (45.5%) males, mean age was 32.58±18.56 years. most infections were mild or asymptomatic (72.3%). The most common symptoms was fever (74.8% ) , followed by cough (66.7%), headache (59.3%), and dyspnoea (28.5%). Most patients 108(87.8%) recovered and four patients (3.3%) died. There is a significant association between medical comorbidities , severity of illness and patients outcome (P value <0.001).
Conclusions: The potential risk factors of medical comorbidities and severity of illness could help clinicians to identify patients with poor prognosis at an early stage and provides the rationale for a treatment strategy of infected patients and optimal antiviral interventions in the future.
The Migration Pattern of Florida Seasonal Farmworkers
Authors: Guan Zhengfei , Qushim Berdikul , Wu Feng , Whidden Alicia J. 
Published: October 2020

This article investigates the migration pattern of seasonal farmworkers in the Florida strawberry industry based on a worker survey conducted in 2016. In the survey, we asked workers where they were working and what crops they were working on before this job. We also asked where they would migrate and what crops they would be working on after this job. We found most workers were from Florida, Michigan, North Carolina, California in that order, and similar percentages of workers would migrate to these states after the job. Blueberries, tomatoes, and apples were the top three crops they were working on before and after the job.
Recreational Harvest of the Florida Bay Scallop: Wakulla County
Authors: Barry Savanna 
Published: October 2020

This handy brochure includes a full-color map identifying access routes to the boat ramps and marinas in Wakulla County, plus the latest information on scallops and scalloping, the recommended equipment you will want to bring, and a few tasty recipes for preparing Florida’s best summertime catch. Written by Savanna Barry and published by the UF/IFAS Extension Florida Sea Grant College Program. https://edis.ifas.ufl.edu/sg149
Revised May 2019.