bluuebunny/crossref_metadata_2025_split huggingface dataset:
Profil évolutif clinique des patients adultes infectés à SARS-CoV-2 et hospitalisés à partir du service des urgences de Strasbourg
Authors: Santiago T. , Oberlin M. , Contenti J. , Bilbault P. , Levraut J. 
Published: September 2021

Introduction : La prise en charge de l’épidémie de Covid-19 dans un service d’urgences (SU) requiert une évaluation de ses critères de gravité. La Covid-19 est évolutive et l’aggravation respiratoire détermine le pronostic. Notre objectif était de rechercher les facteurs prédictifs de gravité en fonction du délai d’initiation d’une oxygénothérapie dans une population française atteinte de Covid-19 au sein d’un SU.
Matériels et méthode : L’étude observationnelle rétrospective aux Hôpitaux Universitaires de Strasbourg, durant la première vague de la pandémie, incluait les patients hospitalisés depuis le SU en 2020 pour infection au SARS-CoV-2. Elle évaluait les délais entre le début des symptômes (J0) et l’initiation d’une oxygénothérapie, et entre J0 et l’apparition des complications hospitalières. L’analyse multivariée recherchait les facteurs associés à l’oxygénothérapie précoce et à la mortalité intra-hospitalière.
Résultats : 699 patients ont été inclus. L’oxygénothérapie était initiée le 7 ± 4e jour, la ventilation mécanique le 9 ± 4e jour. L’initiation précoce d’oxygénothérapie (avant le 6e jour) était significativement et indépendamment associée à l’immunosuppression, à l’âge ≥ 75 ans, à l’hypertension artérielle, et au sexe féminin. La mortalité intra-hospitalière était significativement et indépendamment associée à un âge ≥ 75 ans, une immunosuppression, une cardiopathie ischémique, et une oxygénothérapie précoce.
Conclusion : Parmi les patients hospitalisés pour la Covid-19 durant la première vague, le jour moyen d’initiation d’oxygénothérapie était le septie jour. Une oxygénothérapie précoce, un âge ≥ 75 ans, une immunosuppression et une cardiopathie ischémique étaient associés à une forme grave de la Covid-19.
Évaluation de l’épuisement professionnel chez les internes et jeunes médecins urgentistes
Authors: Gerrer P.A , Delignette M.C. , Deberdt E. , Ray P. 
Published: September 2021

Objectifs : Environnements stimulants mais stressants et exigeants, les structures d’urgences exposent les professionnels de santé à un risque accru de syndrome d’épuisement professionnel (SEP). Notre étude avait pour but d’évaluer la prévalence du SEP chez les internes et jeunes médecins urgentistes de Bourgogne-Franche-Comté.
Méthodes : Étude épidémiologique descriptive, prospective, multicentrique réalisée de juin à août 2020. Les internes de médecine d’urgence (DES MU 1, 2, 3) et médecins urgentistes (senior diplômé du DESC MU ≤ 3 ans) dépendant des universités de Besançon et de Dijon ont répondu à un questionnaire comprenant des outils d’évaluation du SEP, de l’anxiété et de la dépression.
Résultats : Le taux de réponse a été de 70 % (respectivement de 62 % pour Besançon et de 77 % pour Dijon). Quatrevingt-un praticiens (âge moyen de 29 ans) ont répondu, 41 internes de DES MU et 40 médecins urgentistes. Quarante-trois d’entre eux (53 %) présentaient des critères de SEP, 31 (38 %) des marqueurs d’anxiété et cinq des critères de dépression. On relevait un taux plus important de critères de SEP chez les jeunes seniors versus les internes (16 vs 27, p = 0,02). Il n’y avait pas de différence selon l’âge, le lieu d’exercice ou l’absence de congés récents. Il existait une faible concordance entre les marqueurs de SEP et les marqueurs d’anxiété ou de dépression.
Conclusion : La majorité des jeunes praticiens urgentistes interrogés présente des critères de SEP. Cette problématique doit être prise en compte afin d’améliorer la qualité de vie au travail.
Maturation of the anterior petrous apex: surgical relevance for performance of the middle fossa transpetrosal approach in pediatric patients
Authors: Rennert Robert C. , Brandel Michael G. , Steinberg Jeffrey A. , Gonda David D. , Friedman Rick A. , Fukushima Takanori , Day John D. , Khalessi Alexander A. , Levy Michael L. 
Published: September 2021

OBJECTIVE
The middle fossa transpetrosal approach to the petroclival and posterior cavernous sinus regions includes removal of the anterior petrous apex (APA), an area well studied in adults but not in children. To this end, the authors performed a morphometric analysis of the APA region during pediatric maturation.

METHODS
Measurements of the distance from the clivus to the internal auditory canal (IAC; C-IAC), the distance of the petrous segment of the internal carotid artery (petrous carotid; PC) to the mesial petrous bone (MPB; PC-MPB), the distance of the PC to the mesial petrous apex (MPA; PC-MPA), and the IAC depth from the middle fossa floor (IAC-D) were made on thin-cut CT scans from 60 patients (distributed across ages 0–3, 4–7, 8–11, 12–15, 16–18, and > 18 years). The APA volume was calculated as a cylinder using C-IAC (length) and PC-MPB (diameter). APA pneumatization was noted. Data were analyzed by laterality, sex, and age.

RESULTS
APA parameters did not differ by laterality or sex. APA pneumatization was seen on 20 of 60 scans (33.3%) in patients ≥ 4 years. The majority of the APA region growth occurred by ages 8–11 years, with PC-MPA and PC-MPB increasing 15.9% (from 9.4 to 10.9 mm, p = 0.08) and 23.5% (from 8.9 to 11.0 mm, p < 0.01) between ages 0–3 and 8–11 years, and C-IAC increasing 20.7% (from 13.0 to 15.7 mm, p < 0.01) between ages 0–3 and 4–7 years. APA volume increased 79.6% from ages 0–3 to 8–11 years (from 834.3 to 1499.2 mm3, p < 0.01). None of these parameters displayed further significant growth. Finally, IAC-D increased 51.1% (from 4.3 to 6.5 mm, p < 0.01) between ages 0–3 and adult, without significant differences between successive age groups.

CONCLUSIONS
APA development is largely complete by the ages of 8–11 years. Knowledge of APA growth patterns may aid approach selection and APA removal in pediatric patients.
Peaks in the beta band of the human subthalamic nucleus: a case for low beta and high beta activity
Authors: Plate Annika , Hell Franz , Mehrkens Jan H. , Koeglsperger Thomas , Bovet Ayse , Stanslaski Scott , Bötzel Kai 
Published: September 2021

OBJECTIVE
Peaks in the beta band of local field potentials (LFPs) may serve as a biological feedback signal for closed-loop deep brain stimulation (DBS) in Parkinson’s disease (PD). However, the specific frequency of such peaks and their response to DBS and to different types of movement remains uncertain. In the present study, the authors examined the abundance of discernible peaks in the beta band and the effect of different types of movement and DBS on these peaks.

METHODS
Subthalamic nucleus LFPs were analyzed from 38 patients with PD in a frequency range between 10 and 35 Hz, as well as the impact of movement (gait, hand movements) and electrical stimulation on these peaks. The position of the electrode segments from which LFPs were recorded was computed.

RESULTS
The authors found a bimodal distribution of peaks in the beta band with discernible high- (27 Hz) and low-frequency (15 Hz) peaks. Movement of either hand had no significant effect on these peaks, whereas walking significantly reduced high-frequency beta peaks but not the peaks in the low beta band. Stimulation caused an amplitude-dependent suppression of both peaks.

CONCLUSIONS
DBS suppresses LFP beta peaks of different frequencies, whereas beta suppression caused by movement is dependent on the type of movement and frequency of the peak. These results will support the investigation of distinct LFP spectra for the application of closed-loop DBS.
Aerosolization risk during endoscopic transnasal surgery: a prospective qualitative and quantitative microscopic analysis of particles spreading in the operating room
Authors: Russo Federico , Valentini Marco , Sabatino Daniele , Cerati Michele , Facco Carla , Battaglia Paolo , Turri-Zanoni Mario , Castelnuovo Paolo , Karligkiotis Apostolos 
Published: September 2021

OBJECTIVE
The coronavirus disease 2019 (COVID-19) pandemic represents the greatest public health emergency of this century. The primary mode of viral transmission is droplet transmission through direct contact with large droplets generated during breathing, talking, coughing, and sneezing. However, the virus can also demonstrate airborne transmission through smaller droplets (< 5 μm in diameter) generated during various medical procedures, collectively termed aerosol-generating procedures. The aim of this study was to analyze droplet contamination of healthcare workers and splatter patterns in the operating theater that resulted from endoscopic transnasal procedures in noninfected patients.

METHODS
A prospective nonrandomized microscopic evaluation of contaminants generated during 10 endoscopic transnasal procedures performed from May 14 to June 11, 2020, in the same operating theater was carried out. A dilution of monosodium fluorescein, repeatedly instilled through nasal irrigation, was used as a marker of contaminants generated during surgical procedures. Contaminants were collected on detectors worn by healthcare workers and placed in standard points in the operating theater. Analysis of number, dimensions, and characteristics of contaminants was carried out with fluorescence microscopy.

RESULTS
A total of 70 samples collected from 10 surgical procedures were analyzed. Liquid droplets and solid-tissue fragments were identified as contaminants on all detectors analyzed. All healthcare workers appeared to have been exposed to a significant number of contaminants. A significant degree of contamination was observed in every site of the operating room. The mean (range) diameter of liquid droplets was 4.1 (1.0–26.6) μm and that of solid fragments was 23.6 (3.5–263.3) μm.

CONCLUSIONS
Endoscopic endonasal surgery is associated with the generation of large amounts of contaminants, some of which measure less than 5 μm. All healthcare workers in the surgical room are exposed to a significant and similar risk of contamination; therefore, adequate personal protective equipment should be employed when performing endoscopic endonasal surgical procedures.
Awake craniotomy with transcortical motor evoked potential monitoring for resection of gliomas within or close to motor-related areas: validation of utility for predicting motor function
Authors: Saito Taiichi , Muragaki Yoshihiro , Tamura Manabu , Maruyama Takashi , Nitta Masayuki , Tsuzuki Shunsuke , Ohashi Mana , Fukui Atsushi , Kawamata Takakazu 
Published: September 2021

OBJECTIVE
The authors previously showed that combined evaluation of changes in intraoperative voluntary movement (IVM) during awake craniotomy and transcortical motor evoked potentials (MEPs) was useful for predicting postoperative motor function in 30 patients with precentral gyrus glioma. However, the validity of the previous report is limited to precentral gyrus gliomas. Therefore, the current study aimed to validate whether the combined findings of IVM during awake craniotomy and transcortical MEPs were useful for predicting postoperative motor function of patients with a glioma within or close to motor-related areas and not limited to the precentral gyrus.

METHODS
The authors included 95 patients with gliomas within or close to motor-related areas who were treated between April 2000 and May 2020. All tumors were resected with IVM monitoring during awake craniotomy and transcortical MEP monitoring. Postoperative motor function was classified into four categories: “no change” or “declined,” the latter of which was further categorization as “mild,” “moderate,” or “severe.” The authors defined moderate and severe deficits as those that impact daily life.

RESULTS
Motor function 6 months after surgery was classified as no change in 71 patients, mild in 18, moderate in 5, and severe in 1. Motor function at 6 months after surgery significantly correlated with IVM (p < 0.0001), transcortical MEPs (decline ≤ or > 50%) (p < 0.0001), age, preoperative motor dysfunction, extent of resection, and ischemic change on postoperative MRI. Thirty-two patients with no change in IVM showed no change in motor function at 6 months after surgery. Five of 34 patients (15%) with a decline in IVM and a decline in MEPs ≤ 50% had motor dysfunction with mild deficits 6 months after surgery. Furthermore, 19 of 23 patients (83%) with a decline in IVM and decline in MEPs > 50% had a decline in motor function, including 13 patients with mild, 5 with moderate, and 1 with severe deficits. Six patients with moderate or severe deficits had the lowest MEP values, at < 100 µV.

CONCLUSIONS
This study validated the utility of combined application of IVM during awake craniotomy and transcortical MEP monitoring to predict motor function at 6 months after surgery in patients with a glioma within or close to motor-related areas, not limited to the precentral gyrus. The authors also validated the usefulness of the cutoff value, 100 µV, in MEP monitoring.
The safety and efficacy of dexamethasone in the perioperative management of glioma patients
Authors: Medikonda Ravi , Patel Kisha , Jackson Christina , Saleh Laura , Srivastava Siddhartha , Feghali James , Mohan Aditya , Pant Ayush , Jackson Christopher M. , Weingart Jon , Mukherjee Debraj , Bettegowda Chetan , Gallia Gary L. , Brem Henry , Lim Michael 
Published: September 2021

OBJECTIVE
In this single-institution retrospective cohort study, the authors evaluated the effect of dexamethasone on postoperative complications and overall survival in patients with glioma undergoing resection.

METHODS
A total of 435 patients who underwent resection of a primary glioma were included in this retrospective cohort study. The inclusion criterion was all patients who underwent resection of a primary glioma at a tertiary medical center between 2014 and 2019.

RESULTS
The use of both pre- and postoperative dexamethasone demonstrated a trend toward the development of postoperative wound infections (3% vs 0% in single use or no use, p = 0.082). No association was detected between dexamethasone use and the development of new-onset hyperglycemia (p = 0.149). On multivariable Cox proportional hazards analysis, dexamethasone use was associated with a greater hazard of death (overall p = 0.017); this effect was most pronounced for preoperative (only) dexamethasone use (hazard ratio 3.0, p = 0.062).

CONCLUSIONS
Combined pre- and postoperative dexamethasone use may increase the risk of postoperative wound infection, and dexamethasone use, specifically preoperative use, may negatively impact survival. These findings highlight the potential for serious negative consequences with dexamethasone use.
First documented clinical account of brachial plexus palsy from the 12th century
Authors: Basma Jaafar , Gienapp Andrew J. , Arnautovic Kenan I. , Konofaos Petros 
Published: September 2021

OBJECTIVE
Although literary depiction of brachial plexus injury can be traced to Homer’s Iliad, there is a scientific consensus that the first clinical description of brachial plexus palsy was not documented until the British physician Smellie reported it in the 18th century. However, the authors’ recent review of the Syriac Book of Medicines (12th century) has uncovered a much earlier clinical documentation.

METHODS
For this historical vignette, the authors reviewed the historical and anatomical literature regarding earlier descriptions of brachial plexus anatomy and pathology, including a thorough analysis of the Syriac Book of Medicines (attributed to an unknown Syriac physician in the Middle Ages) and Galen’s On Anatomical Procedures and On the Usefulness of the Parts of the Body.

RESULTS
Building on the galenic tradition with reference to independent dissections, the Syriac physician discussed nervous system anatomy and the clinical localization of neurological injuries. He described a patient who, after initial pulmonary symptoms, developed upper-extremity weakness more pronounced in the proximal muscles. His anatomical correlation placed the injury “where the nerves issue from the first and second muscles between the ribs” (scalene muscles), are “mixed,” and “spread through many parts.” The patient’s presentation and recovery raise the possibility of Parsonage-Turner syndrome. The anatomical description of the brachial plexus is in line with Galen’s earlier account and step-by-step surgical exposure, which the authors reviewed. They also examined Ibn Ilyas’ drawing of the brachial plexus, which is believed to be a copy of the earliest artistic representation of the plexus.

CONCLUSIONS
Whereas the Middle Ages were seen as a period of scientific stagnation from a Western perspective, Galen’s teachings continued to thrive and develop in the East. Syriac physicians were professional translators, clinicians, and anatomists. There is evidence that brachial plexus palsy was documented in the Syriac Book of Medicines 6 centuries before Smellie.
Perioperative team communication through a mobile app for improving coordination and education in neurosurgery cases
Authors: Ber Roee , London Dennis , Senan Samya , Youssefi Yasmin , Harter David H. , Golfinos John G. , Pacione Donato 
Published: September 2021

OBJECTIVE
Miscommunication and poor coordination among surgical teams are known causes of preventable medical harms and operating room inefficiencies and inhibit surgical training. Technology may help overcome these challenges. This study used the personal experience of one of the authors as a former Air Force F-15 pilot to design a combat aviation pre- and postoperative communication workflow in the neurosurgery department and tested its effect on safety, efficiency, and education. The authors hypothesized that the adoption of this workflow through a tailored technological platform will increase compliance and improve the chances of sustainability.

METHODS
Data were prospectively collected from neurosurgery cases before (January–May 2020) and after (June–October 2020) implementation of this workflow. Briefing and debriefing were executed using a custom mobile platform and were defined as nonmandatory for all participants. All faculty and residents who operated at NYU Langone Medical Center (Tisch campus) during the intervention period were enrolled on the platform. Primary outcomes were morbidity and mortality per the department’s criteria, and intraoperative last-minute requests as reported by operating room staff in a double-blinded fashion. Secondary outcomes were user responses on the subjective questionnaires.

RESULTS
Data were collected from 637 and 893 cases during the preintervention and intervention periods, respectively. The average briefing rates for residents and surgeons were 71% and 81%, respectively, and the average debriefing rates for residents and surgeons were 67% and 88%. There was no significant difference in preoperative risk score between the preintervention and intervention patient populations (p = 0.24). The rate of intraoperative last-minute requests significantly decreased from 16.6% (35/211) to 10.5% (35/334, p = 0.048). There was no significant change in morbidity and mortality between the preintervention and intervention periods. On subjective questionnaires there was a statistically significant improvement in safety, efficiency, and educational aspects of the cases during the intervention period.

CONCLUSIONS
Implementation of aviation-like structured team communication practices in the neurosurgery department through a technological platform improved education and communication between surgical teams and led to a reduction in last-minute surgical requests that could impact costs.
Intraplaque high-intensity signal on time-of-flight magnetic resonance angiography and restenosis after carotid artery stenting
Authors: Tokunaga Keisuke , Tokunaga So , Hara Kenta , Yasaka Masahiro , Okada Yasushi , Kitazono Takanari , Tsumoto Tomoyuki 
Published: September 2021

OBJECTIVE
To test the hypothesis that intraplaque hemorrhage is a predictor of restenosis after carotid artery stenting (CAS), the association between intraplaque high-intensity signal (HIS) on time-of-flight MR angiography (TOF-MRA), as a marker of intraplaque hemorrhage, and restenosis after CAS was assessed in the present observational study.

METHODS
Consecutive patients who underwent initial CAS for atherosclerotic stenosis in the cervical internal carotid artery in the authors’ department were enrolled. Of these, patients without preprocedural cervical TOF-MRA were excluded. Outcome measures were ≥ 50% restenosis, defined as a peak systolic velocity of > 1.3 m/sec; or occlusion and ≥ 70% restenosis, defined as a peak systolic velocity of > 2.1 m/sec; or occlusion on carotid duplex ultrasound.

RESULTS
Of 230 consecutive patients who underwent initial CAS, 22 without preprocedural cervical TOF-MRA were excluded. Of the remaining 208 patients (mean age 73 years; 33 women), 46 had intraplaque HIS. Ultrasound follow-up was not performed in 4 patients. The median follow-up duration was 3.2 years (interquartile range 1.7–5.1 years). During the follow-up period, 102 patients had ≥ 50% restenosis and 36 had ≥ 70% restenosis. Intraplaque HIS was significantly associated with increased risk of ≥ 50% restenosis (adjusted hazard ratio 2.18; 95% CI 1.28–3.68) and ≥ 70% restenosis (adjusted hazard ratio 3.12; 95% CI 1.32–7.52).

CONCLUSIONS
Intraplaque HIS on TOF-MRA was associated with increased risk of restenosis after CAS. The present results indicate that intraplaque hemorrhage is a predictor of restenosis after CAS.
Strategi Memasyarakatkan Olahraga Sebagai Support System UMKM Ditengah Pandemi Covid-19
Authors: Abdullah Syahriar , Wijiastuti Sri , Widodo Zandra Dwanita , Fatoni Muhad , Widodo Rissa Marina 
Published: September 2021

Pandemi Covid-19 memberikan kesan yang begitu mendalam bagi seluruh manusia dibumi. Perkembangan Covid-19 belum memperlihatkan penurunan yang berarti, masyarakat dihimbau untuk selalu waspada dalam berkaktifitas baik di dalam rumah maupun diliuar rumah. Berbagai program dan kebijakan pemerintah diupayakan dalam penanggulangan serta penanganan Covid-19 ini. Pandemi Covid-19 menuntut para akademisi dan seluruh lapisan masyarakat untuk berkontribusi aktif melalui upaya semangat berkegiatan positif dalam rangka menumbuhkan harapan bangkit dan berdikari untuk bertahan hidup dengan aktifitas new normal ditengah pandemi. Hampir seluruh masyarakat di wilayah Jaten Karanganyar khususnya para UMKM menjaga kebiasaan baik dengan hidup bersih dan sehat untuk mengoptimalkan kesehatan. Pada kelompok UMKM Karangtaruna RW-19 Desa Jaten Kecamatan Jaten Kabupaten Karanganyar Provinsi Jawa Tengah, kegiatan pengabdian masyarakat ini dilaksanakan. Kegiatan ini sebagai upaya perhatian, kepedulian, serta dukungan kesehatan untuk berkontribusi menggerakan perekonomian masyarakat. Kegiatan yang dilakukan adalah memasyarakatkan olahraga sebagai support system masyarakat pada khususnya pelaku UMKM ditengah pandemi Covid-19. Hakikat dari usaha memasyarakatkan kembali olahraga ditengah pandemi adalah menciptakan perubahan sosial masyarakat untuk beraktifitas fisik dilingkungan masyarakat di era new normal. Melalui sosialisasi dan edukasi memasyarakatkan, dan memberikan dukungan perbaikan fasilitas, membuat warga lebih memahami terkait dari pemahaman konsep memasyarakatkan olahraga sebagai support system penunjang kesehatan pelaku UMKM di wilayah jaten karanganyar ditengah pandemi ini dalam berwirausaha dengan harapan dapat membantu memulihkan roda perputaran ekonomi di Indonesia.