bluuebunny/crossref_metadata_2025_split huggingface dataset:
Center of rotation analysis for thoracic and lumbar 3-column osteotomies in patients with sagittal plane spinal deformity: insights in geometrical changes can improve understanding of correction mechanics
Authors: Koller Heiko , Ansorge Alexandre , Hostettler Isabel C. , Koller Juliane , Hitzl Wolfgang , Hempfing Axel , Jeszenszky Dezsoe 
Published: October 2021

OBJECTIVE
Three-column osteotomy (3CO) is used for severe spinal deformities. Associated complications include sagittal translation (ST), which can lead to neurological symptoms. Mismatch between the surgical center of rotation (COR) and the concept of the ideal COR is a potential cause of ST. Matching surgical with conceptual COR is difficult with pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR). This mismatch influences correction geometry, which can prevent maximum possible correction. The authors’ objective was to examine the sagittal correction geometry and surgical COR of thoracic and lumbar 3CO.

METHODS
In a retrospective study of patients with PSO or VCR for severe sagittal plane deformity, analysis of surgical COR was performed using pre- and postoperative CT scans in the PSO group and digital radiographs in the VCR group. Radiographic analysis included standard deformity measurements and regional kyphosis angle (RKA). All patients had 2-year follow-up, including neurological outcome. Preoperative CT scans were studied for rigid osteotomy sites versus mobile osteotomy sites. Additional radiographic analysis of surgical COR was based on established techniques superimposing pre- and postoperative images. Position of the COR was defined in a rectangular net layered onto the osteotomy vertebrae (OVs).

RESULTS
The study included 34 patients undergoing PSO and 35 undergoing VCR, with mean ages of 57 and 29 years and mean RKA corrections of 31° and 49°, respectively. In the PSO group, COR was mainly in the anterior column, and surgical and conceptual COR matched in 22 patients (65%). Smaller RKA correction (27° vs 32°, p = 0.09) was seen in patients with anterior eccentric COR. Patients with rigid osteotomy sites were more likely to have an anterior eccentric COR (41% vs 11%, p = 0.05). In the VCR group, 20 patients (57%) had single-level VCR and 15 (43%) had multilevel VCR. COR was mainly located in the anterior or middle column. Mismatch between surgical and conceptual COR occurred in 24 (69%) patients. Larger RKA correction (63° vs 45°, p = 0.03) was seen in patients with anterior column COR. Patients with any posterior COR had a smaller RKA correction compared to the rest of the patients (42° vs 61°, p = 0.007).

CONCLUSIONS
Matching the surgical with the conceptual COR is difficult and in this study failed in one- to two-thirds of all patients. In order to avoid ST during correction of severe deformities, temporary rods, tracking rods, or special instruments should be used for correction maneuvers.
The meningioma surface factor: a novel approach to quantify shape irregularity on preoperative imaging and its correlation with WHO grade
Authors: Popadic Branko , Scheichel Florian , Pinggera Daniel , Weber Michael , Ungersboeck Karl , Kitzwoegerer Melitta , Roetzer Thomas , Oberndorfer Stefan , Sherif Camillo , Freyschlag Christian F. , Marhold Franz 
Published: October 2021

OBJECTIVE
Atypical and anaplastic meningiomas account for 20% of all meningiomas. An irregular tumor shape on preoperative MRI has been associated with WHO grade II–III histology. However, this subjective allocation does not allow quantification or comparison. An objective parameter of irregularity could substantially influence resection strategy toward a more aggressive approach. Therefore, the aim of this study was to objectively quantify the level of irregularity on preoperative MRI and predict histology based on WHO grade using this novel approach.

METHODS
A retrospective study on meningiomas resected between January 2010 and December 2018 was conducted at two neurosurgical centers. This novel approach relies on the theory that a regularly shaped tumor has a smaller surface area than an irregularly shaped tumor with the same volume. A factor was generated using the surface area of a corresponding sphere as a reference, because for a given volume a sphere represents the shape with the smallest surface area possible. Consequently, the surface factor (SF) was calculated by dividing the surface area of a sphere with the same volume as the tumor with the surface area of the tumor. The resulting value of the SF ranges from > 0 to 1. Finally, the SF of each meningioma was then correlated with the corresponding histopathological grading.

RESULTS
A total of 126 patients were included in this study; 60.3% had a WHO grade I, 34.9% a WHO grade II, and 4.8% a WHO grade III meningioma. Calculation of the SF demonstrated a significant difference in SFs between WHO grade I (SF 0.851) and WHO grade II–III meningiomas (SF 0.788) (p < 0.001). Multivariate analysis identified SF as an independent prognostic factor for WHO grade (OR 0.000009, 95% CI 0.000–0.159; p = 0.020).

CONCLUSIONS
The SF is a proposed mathematical model for a quantitative and objective measurement of meningioma shape, instead of the present subjective assessment. This study revealed significant differences between the SFs of WHO grade I and WHO grade II–III meningiomas and demonstrated that SF is an independent prognostic factor for WHO grade.
Middle meningeal artery embolization for chronic subdural hematoma in cancer patients with refractory thrombocytopenia
Authors: Lee Sungho , Srivatsan Aditya , Srinivasan Visish M. , Chen Stephen R. , Burkhardt Jan-Karl , Johnson Jeremiah N. , Raper Daniel M. S. , Weinberg Jeffrey S. , Kan Peter 
Published: October 2021

OBJECTIVE
Surgical evacuation of chronic subdural hematoma (SDH) in cancer patients is often contraindicated owing to refractory thrombocytopenia. Middle meningeal artery embolization (MMAE) recently emerged as a potential alternative to surgical evacuation for patients with chronic SDH. The goal of this study was to evaluate the safety and efficacy of MMAE for chronic SDH in cancer patients with refractory thrombocytopenia.

METHODS
A multiinstitutional registry was reviewed for clinical and radiographic outcomes of cancer patients with transfusion-refractory thrombocytopenia and baseline platelet count < 75 K/µl, who underwent MMAE for chronic SDH.

RESULTS
MMAE was performed on a total of 31 SDHs in 22 patients, with a mean ± SD (range) platelet count of 42.1 ± 18.3 (9–74) K/µl. At the longest follow-up, 24 SDHs (77%) had reduced in size, with 15 (48%) showing > 50% reduction. Two patients required surgical evacuation after MMAE. There was only 1 procedural complication; however, 16 patients (73%) ultimately died of cancer-related complications. Median survival was significantly longer in the 16 patients with improved SDH than the 6 patients with worsened SDH after MMAE (185 vs 24 days, p = 0.029). Length of procedure, technical success rate, SDH size reduction, and complication rate were not significantly differ between patients who underwent transfemoral and transradial approaches.

CONCLUSIONS
Transfemoral or transradial MMAE is a potential therapeutic option for thrombocytopenic cancer patients with SDH. However, treatment benefit may be marginal for patients with high disease burden and limited life expectancy. A prospective trial is warranted to address these questions.
The Epidemiological Boehringer Ingelheim Employee Study (Part 3): Association of Elevated Fasting Insulin Levels but Not HOMA-IR With Increased Intima Media Thickness and Arteriosclerosis in Middle-Aged Persons
Authors: Röhling Martin , Kempf Kerstin , Kolb Hubert , Martin Tobias , Schneider Michael , Martin Stephan 
Published: October 2021

Background:Recently published genetic studies have indicated a causal link between elevated insulin levels and cardiovascular disease (CVD) risk. We, therefore, hypothesized that increased fasting insulin levels are also associated with precursors of CVD such as endothelial lesions.Methods:Middle-aged (≥40 years,n= 1,639) employees were followed up for the occurrence of increased intima media thickness (IMT ≥ 1 mm) or plaques in abdominal or cervical arteries (arteriosclerosis). Multivariable logistic regression analyses determined the incidence of increased IMT or arteriosclerosis. Adjusted relative risk (ARR) for increased IMT and arteriosclerosis was calculated by using Mantel-Haenszel analysis.Results:Increased IMT was diagnosed in 238 participants (15 %) and 328 (20 %) developed arteriosclerosis after 5 years of follow-up. Logistic regression analysis identified fasting insulin, BMI and smoking as risk factors for both cardiovascular endpoints (allp&lt; 0.05), whereas age and diastolic blood pressure were risk factors for increased IMT only, and male sex was associated with incident arteriosclerosis only (allp&lt; 0.01). Additional adjustment for BMI change during follow-up did not modify these associations (including fasting insulin), but adjustment for fasting insulin change during follow-up removed BMI as risk factor for both cardiovascular endpoints. Fasting insulin change during follow-up but not BMI change associated with increased IMT and arteriosclerosis (bothp&lt; 0.001). ARR analysis indicated that high fasting insulin and BMI added to age and sex as risk factors. Homeostatic model assessment of insulin resistance (HOMA-IR) did not associate with either cardiovascular endpoint in any model and smoking did not increase the risk conferred by high fasting insulin levels.Conclusions:Higher fasting insulin levels and increases in fasting insulin over time are associated with atherogenic progression and supersede BMI as well as HOMA-IR as risk factors.
A Charge Balanced Neural Stimulator Silicon Chip for Human-Machine Interface
Authors: Liu Xu , Li Juzhe , Mao Wei , Chen Zhuangguang , Chen Zhijie , Wan Peiyuan , Yu Hao 
Published: October 2021

This paper proposes a neural stimulator silicon chip design with an improved charge balancing technology. The proposed neural stimulation integrated circuit (IC) uses two charge balancing modules including synchronous charge detection module and short-time pulse insertion module. The synchronous charge detection module is designed based on a current splitter with ultra-small output current and an integrator circuit for neural stimulation pulse width control, which greatly reduces the residual charge remained on the electrode-tissue interface. The short-time pulse insertion module is designed based on the electrode voltage detection and compensation current control, which further reduces the accumulated residual charge and keeps the electrode voltage within a safety range of ±25 mV during multiple stimulation cycles. Finally, this neural stimulator is implemented in TSMC 0.18-μm CMOS process technology, and the chip function is tested and verified in both experiments with the electrode-tissue RC model and the PBS saline solution environment. The measurement result shows the neural stimulator chip achieves improved charge balancing with the residual charge smaller than 0.95 nC, which is the lowest compared to the traditional neural stimulator chips.
Computationally Accelerated Discovery and Experimental Demonstration of Gd0.5La0.5Co0.5Fe0.5O3 for Solar Thermochemical Hydrogen Production
Authors: Park James Eujin , Bare Zachary J. L. , Morelock Ryan J. , Rodriguez Mark A. , Ambrosini Andrea , Musgrave Charles B. , McDaniel Anthony H. , Coker Eric N. 
Published: October 2021

Solar thermochemical hydrogen (STCH) production is a promising method to generate carbon neutral fuels by splitting water utilizing metal oxide materials and concentrated solar energy. The discovery of materials with enhanced water-splitting performance is critical for STCH to play a major role in the emerging renewable energy portfolio. While perovskite materials have been the focus of many recent efforts, materials screening can be time consuming due to the myriad chemical compositions possible. This can be greatly accelerated through computationally screening materials parameters including oxygen vacancy formation energy, phase stability, and electron effective mass. In this work, the perovskite Gd0.5La0.5Co0.5Fe0.5O3 (GLCF), was computationally determined to be a potential water splitter, and its activity was experimentally demonstrated. During water splitting tests with a thermal reduction temperature of 1,350°C, hydrogen yields of 101 μmol/g and 141 μmol/g were obtained at re-oxidation temperatures of 850 and 1,000°C, respectively, with increasing production observed during subsequent cycles. This is a significant improvement from similar compounds studied before (La0.6Sr0.4Co0.2Fe0.8O3 and LaFe0.75Co0.25O3) that suffer from performance degradation with subsequent cycles. Confirmed with high temperature x-ray diffraction (HT-XRD) patterns under inert and oxidizing atmosphere, the GLCF mainly maintained its phase while some decomposition to Gd2-xLaxO3 was observed.
Association Between Infections and Risk of Ankylosing Spondylitis: A Systematic Review and Meta-Analysis
Authors: Zhang Xiao , Sun Zhe , Zhou Aihong , Tao Lei , Chen Yingxin , Shi Xinyu , Yin Jia , Sun Zheng , Ding Guoyong 
Published: October 2021

BackgroundPrevious literature on the association between infections and the risk of developing ankylosing spondylitis (AS) presented controversial results. This meta-analysis aimed to quantitatively investigate the effect of infections on the risk of AS.MethodsWe searched the PubMed, Embase, and Web of Science databases until March 26, 2021 for analytical epidemiological studies on the association between infections and the risk of AS. Fixed or random effect models were used to calculate total risk estimates based on study heterogeneity. Subgroup analysis, and sensitivity analysis were also performed. Publication bias was estimated using funnel plots and Begg’s test.ResultsSix case-control articles (n=1,296,239) and seven cohort articles (n=7,618,524) were incorporated into our meta-analysis. The pooled odds ratio (OR) from these case-control studies showed that infections were associated with an increased risk of AS (OR=1.46, 95% confidence interval [CI], 1.23–1.73), and the pooled relative risk (RR) from the cohort studies showed the same findings (RR=1.35, 95% CI, 1.12–1.63). Subgroup analysis showed that infections in participants with unadjusted comorbidities (OR=1.66, 95% CI, 1.35–2.03), other types of infection (OR=1.40, 95% CI, 1.15–1.70), and infection of the immune system (OR=1.46, 95% CI, 1.42–1.49) were associated with the risk of AS in case-control studies. In cohort studies, infections with adjusted comorbidities (RR=1.39, 95% CI, 1.15–1.68), viral infection (RR=1.43, 95% CI, 1.22–1.66), other types of infection (RR=1.44, 95% CI, 1.12–1.86), and other sites of infection (RR=1.36, 95% CI, 1.11–1.67) were associated with an increased risk of AS.ConclusionsThe findings of this meta-analysis confirm that infections significantly increase the risks of AS. This is helpful in providing an essential basis for the prevention of ASviathe avoidance of infections.
Ordinal Prediction Model of 90-Day Modified Rankin Scale in Ischemic Stroke
Authors: Zhang Michelle Y. , Mlynash Michael , Sainani Kristin L. , Albers Gregory W. , Lansberg Maarten G. 
Published: October 2021

Background and Purpose: Prediction models for functional outcomes after ischemic stroke are useful for statistical analyses in clinical trials and guiding patient expectations. While there are models predicting dichotomous functional outcomes after ischemic stroke, there are no models that predict ordinal mRS outcomes. We aimed to create a model that predicts, at the time of hospital discharge, a patient's modified Rankin Scale (mRS) score on day 90 after ischemic stroke.Methods: We used data from three multi-center prospective studies: CRISP, DEFUSE 2, and DEFUSE 3 to derive and validate an ordinal logistic regression model that predicts the 90-day mRS score based on variables available during the stroke hospitalization. Forward selection was used to retain independent significant variables in the multivariable model.Results: The prediction model was derived using data on 297 stroke patients from the CRISP and DEFUSE 2 studies. National Institutes of Health Stroke Scale (NIHSS) at discharge and age were retained as significant (p &lt; 0.001) independent predictors of the 90-day mRS score. When applied to the external validation set (DEFUSE 3, n = 160), the model accurately predicted the 90-day mRS score within one point for 78% of the patients in the validation cohort.Conclusions: A simple model using age and NIHSS score at time of discharge can predict 90-day mRS scores in patients with ischemic stroke. This model can be useful for prognostication in routine clinical care and to impute missing data in clinical trials.
Neurodegeneration Over 3 Years Following Ischaemic Stroke: Findings From the Cognition and Neocortical Volume After Stroke Study
Authors: Brodtmann Amy , Werden Emilio , Khlif Mohamed Salah , Bird Laura J. , Egorova Natalia , Veldsman Michele , Pardoe Heath , Jackson Graeme , Bradshaw Jennifer , Darby David , Cumming Toby , Churilov Leonid , Donnan Geoffrey 
Published: October 2021

Background: Stroke survivors are at high risk of dementia, associated with increasing age and vascular burden and with pre-existing cognitive impairment, older age. Brain atrophy patterns are recognised as signatures of neurodegenerative conditions, but the natural history of brain atrophy after stroke remains poorly described. We sought to determine whether stroke survivors who were cognitively normal at time of stroke had greater total brain (TBV) and hippocampal volume (HV) loss over 3 years than controls. We examined whether stroke survivors who were cognitively impaired (CI) at 3 months following their stroke had greater brain volume loss than cognitively normal (CN) stroke participants over the next 3 years.Methods: Cognition And Neocortical Volume After Stroke (CANVAS) study is a multi-centre cohort study of first-ever or recurrent adult ischaemic stroke participants compared to age- and sex-matched community controls. Participants were followed with MRI and cognitive assessments over 3 years and were free of a history of cognitive impairment or decline at inclusion. Our primary outcome measure was TBV change between 3 months and 3 years; secondary outcomes were TBV and HV change comparing CI and CN participants. We investigated associations between group status and brain volume change using a baseline-volume adjusted linear regression model with robust standard error.Results: Ninety-three stroke (26 women, 66.7 ± 12 years) and 39 control participants (15 women, 68.7 ± 7 years) were available at 3 years. TBV loss in stroke patients was greater than controls: stroke mean (M) = 20.3 cm3 ± SD 14.8 cm3; controls M = 14.2 cm3 ± SD 13.2 cm3; [adjusted mean difference 7.88 95%CI (2.84, 12.91) p-value = 0.002]. TBV decline was greater in those stroke participants who were cognitively impaired (M = 30.7 cm3; SD = 14.2 cm3) at 3 months (M = 19.6 cm3; SD = 13.8 cm3); [adjusted mean difference 10.42; 95%CI (3.04, 17.80), p-value = 0.006]. No statistically significant differences in HV change were observed.Conclusions: Ischaemic stroke survivors exhibit greater neurodegeneration compared to stroke-free controls. Brain atrophy is greater in stroke participants who were cognitively impaired early after their stroke. Early cognitive impairment was associated greater subsequent atrophy, reflecting the combined impacts of stroke and vascular brain burden. Atrophy rates could serve as a useful biomarker for trials testing interventions to reduce post-stroke secondary neurodegeneration.Clinical Trail Registration:http://www.clinicaltrials.gov, identifier: NCT02205424.
Altered Cortical-Striatal Network in Patients With Hemifacial Spasm
Authors: Gao Wenwen , Yang Dong , Zhang Zhe , Du Lei , Liu Bing , Liu Jian , Chen Yue , Wang Yige , Liu Xiuxiu , Yang Aocai , Lv Kuan , Xue Jiajia , Ma Guolin 
Published: October 2021

Objective: Hemifacial spasm (HFS) is a kind of motor disorder, and the striatum plays a significant role in motor function. The purpose of this study was to explore the alterations of the cortical-striatal network in HFS using resting-state functional magnetic resonance imaging (fMRI).Methods: The fMRI data of 30 adult patients with primary unilateral HFS (15 left-side and 15 right-side) and 30 healthy controls were collected. Six subregions of the striatum in each hemisphere were selected for functional connectivity (FC) analysis. One-sample t-test was used to analyze the intragroup FC of the HFS group and the control group. Two-sample t-test was used to compare the difference of FC between the two groups. The correlation between the abnormal FC and severity of HFS was evaluated by using the Spearman correlation analysis.Results: Compared with the controls, the striatal subregions had altered FC with motor and orbitofrontal cortex in patients with HFS. The altered FC between striatal subregions and motor cortex was correlated with the spasm severity in patients with HFS.Conclusion: The FC of the cortical-striatal network was altered in primary HFS, and these alterations were correlated with the severity of HFS. This study indicated that the cortical-striatal network may play different roles in the underlying pathological mechanism of HFS.
Influence of Vitamin D3 Supplementation on Infliximab Effectiveness in Chinese Patients With Crohn's Disease: A Retrospective Cohort Study
Authors: Xia Sheng-long , Min Quan-jia , Shao Xiao-xiao , Lin Dao-po , Ma Guo-long , Wu Hao , Cao Shu-guang , Jiang Yi 
Published: October 2021

Background: It remains uncertain whether vitamin D3 (vitD3) supplementation is beneficial for remission of Crohn's disease (CD). The influence of vitD3 supplementation on Infliximab (IFX) effectiveness was analyzed in Chinese CD patients.Methods: In this retrospective cohort study, moderate-to-severe CD patients, who were bio-naïve and prescribed with IFX treatment for at least 54 weeks, were recorded from January 2014 to December 2019. VitD3 supplementation was defined as patients additionally took oral vitD3 (125 IU/d) within 3 days after the first infusion and persisted in the whole follow-up period. Disease activity was assessed using Harvey-Bradshaw Index (HBI). Serum cytokine profiles (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were quantitatively analyzed in a subset of all patients at baseline and 54-week after intervention.Results: Among 73 enrolled patients, 37 took vitD3 regularly (D3-patients), the others (non-D3-patients) did not. At 54-week, the mean 25-hydroxyvitaminD level increased in D3-patients (20.33 vs. 15.07 ng/mL, P &lt; 0.001). The clinical remission rate was higher in D3-patients compared to non-D3-patients (83.8 vs. 61.6%, P = 0.030). The decrease of HBI from baseline to 54-week was more in D3-patients than non-D3-patients (7.41 ± 3.0 vs. 6.28 ± 2.75, P = 0.023). Furthermore, vitD3 supplementation was independently related to the increase of remission rate at 54-week in D3-patients (β = −1.667, P = 0.015). The benefit of vitD3 supplementation was significant only in patients with deficient vitD3 (all P &lt; 0.05), but not in non-deficient vitD3. A total of nine patients (four non-D3-patients and five D3-patients) were selected to determine serum cytokine profiles after 54-week IFX treatment. In non-D3-patients, the decreases of TNF-α and IL-6 at 54-week were more obvious than at baseline (P = 0.032, 0.022, respectively). In D3-patients, however, only IL-10 increased at 54-week compared with its baseline value (P = 0.037).Conclusions: VitD3 supplementation could improve IFX effectiveness in CD patients, especially for patients with vitD3 deficiency. This beneficial effect of vitD3 supplementation probably arose from the up-regulation of IL-10.Trial Registration: NCT04606017.