bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrolabyrinthine transsigmoid approach to complex parabrainstem tumors in the posterior fossa
Authors: Kinoshita Yusuke , Zomorodi Ali R. , Friedman Allan H. , Sato Hikari , Carter James H. , Bawornvaraporn Udom , Nakamura Hirohiko , Fukushima Takanori 
Published: October 2021

OBJECTIVE
The surgical management of large and complex tumors of the posterior fossa poses a formidable challenge in neurosurgery. The standard retrosigmoid craniotomy approach has been performed at most neurosurgical centers; however, the retrosigmoid approach may not provide enough working space without significant retraction of the cerebellum. The transsigmoid approach provides wider and shallower surgical fields; however, there have been few clinical and no cadaveric studies on its usefulness. In the present study, the authors describe the transsigmoid approach in clinical cases and cadaveric specimens.

METHODS
For the clinical study, the authors retrospectively reviewed the medical records and operative charts of patients who had been surgically treated for parabrainstem tumors using the transsigmoid approach between 1997 and 2019. They analyzed patient demographic and clinical data, as well as surgical and clinical outcomes. In the cadaveric study, they compared the surgical views obtained in different approaches (retrosigmoid, presigmoid, retrolabyrinthine, and transsigmoid) and measured the sigmoid sinus width at the level of the endolymphatic sac and the distance between the anterior edge of the sigmoid sinus and the endolymphatic sac on 35 sides in 19 cadaveric specimens.

RESULTS
A total of 21 patients (6 males and 15 females) with a mean age of 42.2 (range 15–67) years were included in the clinical study. Eleven patients had meningioma, 7 had vestibular schwannoma, 2 had hemangioblastoma, and 1 had epidermoid cyst. Gross-total, near-total, and subtotal removal were achieved in 7 (33.3%), 3 (14.3%), and 11 (52.4%) patients, respectively. In the cadaveric study, 19 cadaveric specimens were used. The sigmoid sinus was cut in the middle, and the incision was extended from the retrosigmoid to the presigmoid dura. The dura was then retracted upward and downward like opening a door. The results indicated that this technique can widen the operative field anteriorly by approximately 2 cm as compared to the retrosigmoid approach and provides a better view anterior to the brainstem.

CONCLUSIONS
The transsigmoid approach is useful for complex parabrainstem tumors in the posterior fossa because it provides a wider and shallower operative view with less retraction of the cerebellum. This enables safer tumor removal with less damage to important structures in the posterior fossa, resulting in better operative and clinical outcomes.
Quick cell-free DNA testing for the prediction of postconcussion syndrome: a single-center prospective pilot trial
Authors: Ben Zvi Ido , Harel Oren Shaia , Douvdevani Amos , Weiss Penina , Cohen Chen , Ben Ari Eynat , Gross Gal , Menndel Yehonatan , Felzensztein David , Schwartz Noa , Berkowitz Shani , Drescher Michael , Harnof Sagi 
Published: October 2021

OBJECTIVE
Mild traumatic brain injury (mTBI) is a major cause of emergency room (ER) admission. Thirty percent of mTBI patients have postconcussion syndrome (PCS), and 15% have symptoms for over a year. This population is underdiagnosed and does not receive appropriate care. The authors proposed a fast and inexpensive fluorometric measurement of circulating cell-free DNA (cfDNA) as a biomarker for PCS. cfDNA is a proven, useful marker of a variety of acute pathological conditions such as trauma and acute illness.

METHODS
Thirty mTBI patients were recruited for this prospective single-center trial. At admission, patients completed questionnaires and blood was drawn to obtain cfDNA. At 3–4 months after injury, 18 patients returned for cognitive assessments with questionnaires and the Color Trails Test (CTT). The fast SYBR Gold assay was used to measure cfDNA.

RESULTS
Seventeen men and 13 women participated in this trial. The mean ± SD age was 50.9 ± 13.9 years. Of the 18 patients who returned for cognitive assessment, one-third reported working fewer hours, 4 (22.2%) changed their driving patterns, and 5 (27.7%) reduced or stopped performing physical activity. The median cfDNA level of the mTBI group was greater than that of the matched healthy control group (730.5 vs 521.5 ng/ml, p = 0.0395). Admission cfDNA concentration was negatively correlated with performance on the CTT1 and CTT2 standardized tests (r = −0.559 and −0.599), meaning that greater cfDNA level was correlated with decreased cognitive performance status. The performance of the patients with normal cfDNA level included in the mTBI group was similar to that of the healthy participants. In contrast, the increased cfDNA group (> 800 ng/ml) had lower scores on the CTT tests than the normal cfDNA group (p < 0.001). Furthermore, patients with moderate/severe cognitive impairment according to CTT1 results had a greater median cfDNA level than the patients with scores indicating mild impairment or normal function (1186 vs 473.5 ng/ml, p = 0.0441, area under the receiver operating characteristic curve = 0.8393).

CONCLUSIONS
The data from this pilot study show the potential to use cfDNA, as measured with a fast test, as a biomarker to screen for PCS in the ER. A large-scale study is required to establish the value of cfDNA as an early predictor of PCS.
Neoadjuvant teriparatide therapy targeting the osteoporotic spine: influence of administration period from the perspective of bone histomorphometry
Authors: Sawakami Kimihiko , Watanabe Kei , Hasegawa Kazuhiro , Yamamoto Noriaki , Shimakura Taketoshi , Ohashi Masayuki , Shoji Hirokazu , Mizouchi Tatsuki , Tanaka Yuki , Segawa Hiroyuki , Ishikawa Seiichi , Hirano Toru , Kawashima Hiroyuki , Endo Naoto , Takahashi Hideaki E. 
Published: October 2021

OBJECTIVE
Teriparatide (TPTD) is a potent promoter of early-stage osteogenesis and may be a useful adjuvant therapy to reduce complications related to bone fragility in spinal surgery patients with osteoporosis. However, effective neoadjuvant TPTD therapy regimens remain poorly understood. This study aimed to examine the effect of preoperative TPTD administration on cancellous bone with bone histomorphometry and to clarify the timing of preoperative TPTD administration for patients with spinal fusion and osteoporosis.

METHODS
In this longitudinal multicenter study, 57 patients with spinal fusion and osteoporosis, who consented to undergo iliac biopsy, were allocated to the following treatment groups: neoadjuvant TPTD therapy group (n = 42) and no neoadjuvant therapy (NTC) group (n = 15). Patients in the TPTD group were categorized into subgroups on the basis of duration of preoperative TPTD administration, as follows: 1 month (n = 9), 2 months (n = 8), 3 months (n = 9), 4 months (n = 7), and 6 months (n = 9). All patient samples were preoperatively double labeled with tetracycline, and iliac biopsies were performed during spinal fusion surgery. Histomorphometric analyses were performed on nondecalcified, thin-sliced specimens. Specimens were classified on the basis of TPTD administration duration and subsequently compared with those of the NTC group. Postoperative complications and Oswestry Disability Index scores were evaluated at 1 and 2 years after surgery.

RESULTS
There were no demographic differences between groups. Mineralizing surface/bone surface, a key parameter of dynamic bone formation, started to increase after 1 month of TPTD administration; this increase became significant after 3 months of administration and peaked at 4 months, with a 6-fold increase relative to that of the NTC group. The patients who received preoperative TPTD for 3 months or more had superior clinical results in terms of the osteoporotic complication rate and Oswestry Disability Index scores, except for bisphosphonate-pretreated patients.

CONCLUSIONS
When considering neoadjuvant TPTD therapy, the authors recommend at least 3 months of preoperative administration to provide a more substantial anabolic effect from the early postoperative stage.
Cauda equina ependymomas: surgical treatment and long-term outcomes in a series of 125 patients
Authors: Marchesini Nicolò , Tommasi Nicola , Faccioli Franco , Pinna Giampietro , Sala Francesco 
Published: October 2021

OBJECTIVE
Cauda equina ependymoma (CEE) is a rare tumor for which little information is available on the oncological and clinical outcomes of patients. In this study the authors aimed to address functional, oncological, and quality-of-life (QOL) outcomes in a large series of consecutive patients operated on at their institution during the past 20 years.

METHODS
The records of 125 patients who underwent surgery between January 1998 and September 2018 were reviewed. Analyzed variables included demographic, clinical, radiological, surgical, and histopathological features. Neurological outcomes were graded according to the McCormick and Kesselring scales. The QOL at follow-up was evaluated by administering the EQ-5DL questionnaire.

RESULTS
On admission, 84% of patients had a McCormick grade of I and 76.8% had a Kesselring score of 0. At follow-up (clinical 8.13 years; radiological 5.87 years) most scores were unchanged. Sacral level involvement (p = 0.029) and tumor size (p = 0.002) were predictors of poor functional outcome at discharge. Tumor size (p = 0.019) and repeated surgery (p < 0.001) were predictors of poor outcome. A preoperative McCormick grade ≥ III and Kesselring grade ≥ 2 were associated with worse outcomes (p = 0.035 and p = 0.002, respectively). Myxopapillary ependymoma (MPE) was more frequent than grade II ependymoma (EII). The overall rate of gross-total resection (GTR) was 91.2% and rates were significantly higher for patients with EII (98%) than for those with MPE (84%) (p = 0.0074). On multivariate analysis, the only factor associated with GTR was the presence of a capsule (p = 0.011). Seventeen patients (13.7%) had recurrences (13 MPE, 4 EII; 76.4% vs 23.6%; p = 0.032). The extent of resection was the only factor associated with recurrence (p = 0.0023) and number of surgeries (p = 0.006). Differences in progression-free survival (PFS) were seen depending on the extent of resection at first operation (p < 0.001), subarachnoid seeding (p = 0.041), piecemeal resection (p = 0.004), and number of spine levels involved (3 [p = 0.016], 4 [p = 0.011], or ≥ 5 [p = 0.013]). At follow-up a higher proportion of EII than MPE patients were disease free (94.7% vs 77.7%; p = 0.007). The QOL results were inferior in almost all areas compared to a control group of subjects from the Italian general population. A McCormick grade ≥ 3 and repeated surgeries were associated with a worse QOL (p = 0.006 and p = 0.017).

CONCLUSIONS
An early diagnosis of CEE is important because larger tumors are associated with recurrences and worse functional neurological outcomes. Surgery should be performed with the aim of achieving an en bloc GTR. The histological subtype was not directly associated with recurrences, but some of the features more commonly encountered in MPEs were. The outcomes are in most cases favorable, but the mean QOL perception is inferior to that of the general population.
Simple parameters of synthetic MRI for assessment of bone density in patients with spinal degenerative disease
Authors: Chang Hsuan-Kan , Hsu Tun-Wei , Ku Johnson , Ku Jason , Wu Jau-Ching , Lirng Jiing-Feng , Hsu Shih-Ming 
Published: October 2021

OBJECTIVE
Good bone quality is the key to avoiding osteoporotic fragility fractures and poor outcomes after lumbar instrumentation and fusion surgery. Although dual-energy x-ray absorptiometry (DEXA) screening is the current standard for evaluating osteoporosis, many patients lack DEXA measurements before undergoing lumbar spine surgery. The present study aimed to investigate the utility of using simple quantitative parameters generated with novel synthetic MRI to evaluate bone quality, as well as the correlations of these parameters with DEXA measurements.

METHODS
This prospective study enrolled patients with symptomatic lumbar degenerative disease who underwent DEXA and conventional and synthetic MRI. The quantitative parameters generated with synthetic MRI were T1 map, T2 map, T1 intensity, proton density (PD), and vertebral bone quality (VBQ) score, and these parameters were correlated with T-score of the lumbar spine.

RESULTS
There were 62 patients and 238 lumbar segments eligible for analysis. PD and VBQ score moderately correlated with T-score of the lumbar spine (r = −0.565 and −0.651, respectively; both p < 0.001). T1 intensity correlated fairly well with T-score (r = −0.411, p < 0.001). T1 and T2 correlated poorly with T-score. Receiver operating characteristic curve analysis demonstrated area under the curve values of 0.808 and 0.794 for detecting osteopenia/osteoporosis (T-score ≤ −1.0) and osteoporosis (T-score ≤ −2.5) with PD (both p < 0.001).

CONCLUSIONS
PD and T1 intensity values generated with synthetic MRI demonstrated significant correlation with T-score. PD has excellent ability for predicting osteoporosis and osteopenia.
ПАРАДИГМА ФОРМУВАННЯ МЕХАНІЗМУ ЗМІЦНЕННЯ ЕКОНОМІЧНОЇ БЕЗПЕКИ ПІДПРИЄМНИЦЬКОЇ ДІЯЛЬНОСТІ
Authors: Калінеску Тетяна Василівна , Ревенко Даніїл Сергійович , Підмогильний Сергій Сергійович 
Published: October 2021

Economic security embraces all spheres of activity, and brings neglect over by it’s to the negative (catastrophic) consequences, decline of different aspects of development the industries of economy, separate types of enterprise. Therefore there is a requirement in forming a paradigm of mechanism the strengthening economic security of entrepreneurial activity in obedience to the doctrines of economy development of Ukraine. A research aim is directed on forming of effective mechanism of strengthening economic security according to terms of business development, dynamics of moving the national economy, level of innovative diffusions and existent internal and external calls. Methodological basis of research became modern normative, legal, legislative aspects of strengthening economic security and eliminated of existent threats in the process of business developments. In the researches was using methods of dialectics, principles of scientific cognition, instruments of economic analysis for the sake of forming the effective mechanism of strengthening economic security of enterprise. The basic hypothesis of research became supposition about possibility of creation of universal mechanism of strengthening economic security that can provide stable development of entrepreneurial activity in the different spheres of national economy. Exposition of basic material. in the article are investigated the threats that influence on economic security of enterprise. Underline, that each of threats can have the mechanisms strengthening of economic security, that consist with facilities, instruments, methods and forms composition, that it can be enough unique, depending on the type of enterprise. Originality and practical meaningfulness of research are confirmed by the offered composition of facilities, methods, forms and instruments of mechanism the strengthening of economic security that it is universal from one hand, and from other is allowing to tune the specific of activity the separate type of enterprise. Conclusions and prospects of further researches. It is well-proven that the mechanism of strengthening the economic security of enterprise must provide possibilities of the effective functioning of business and be the element of mechanism the economic security of the system of higher level. For every businessman there are the absolutely individual approaches to forming of mechanism the strengthening of economic security that depends from material and technical and financial resources, quality and structure of management entrepreneurial activity; state and regional support, legislative and legal base of functioning. Further researches will be directed on adaptation of the offered mechanism of strengthening the economic security, its monitoring and correcting, going out the requirements of internal and external environment of business and dynamics of global economic changes
Fertilización in vitro (FIV) de ovocitos obtenidos en ovejas mediante la técnica de recolección laparoscópica de óvulos
Authors: Ugalde Julio Ramón , Cervera Paúl Deneb , Domínguez Rebolledo Álvaro , Baeza-Rodríguez Juan , Pinzón-López Luis , Zamora-Bustillos Roberto 
Published: October 2021

Con el objetivo de poner a punto la técnica de recolección laparoscópica de óvulos (LOPU) y desarrollar un protocolo de fertilización in vitro (FIV) dos grupos de ovejas; el primero, G1, con 3 prepúberes y G2, con 3 adultas, fueron sincronizadas (esponjas vaginales 14 días) y superovuladas (FSHp), iniciando 60 h antes de cada LOPU (tres sesiones). La aspiración folicular laparoscópica se realizó a las 12 h de la última dosis de FSHp. La tasa de recuperación global de los ovocitos en tres sesiones de LOPU en el G2 y G1, fue de 41.0 ± 2.5 y 24.0 ± 2.4% EEM, respectivamente, presentando diferencias (P < 0.05) a favor del G2. El cultivo in vitro de los ovocitos a las 48 h presenta una diferencia (P < 0.05) a favor del G1 (9.7%) respecto aG2 (0.0).
Inflammation-Based Scores as a Common Tool for Prognostic Assessment in Heart Failure or Cancer
Authors: Arfsten Henrike , Cho Anna , Prausmüller Suriya , Spinka Georg , Novak Johannes , Goliasch Georg , Bartko Philipp E. , Raderer Markus , Gisslinger Heinz , Kornek Gabriela , Köstler Wolfgang , Strunk Guido , Preusser Matthias , Hengstenberg Christian , Hülsmann Martin , Pavo Noemi 
Published: October 2021

Background: Inflammation-based scores are widely tested in cancer and have been evaluated in cardiovascular diseases including heart failure.Objectives: We investigated the impact of established inflammation-based scores on disease severity and survival in patients with stable heart failure with reduced ejection fraction (HFrEF) paralleling results to an intra-institutional cohort of treatment naïve cancer patients.Methods: HFrEF and cancer patients were prospectively enrolled. The neutrophil-to-lymphocyte-ratio (NLR), the monocyte-to-lymphocyte-ratio (MLR), the platelet-to-lymphocyte-ratio (PLR), and the prognostic nutritional index (PNI) at index day were calculated. Association of scores with disease severity and impact on overall survival was determined. Interaction analysis was performed for the different populations.Results: Between 2011 and 2017, a total of 818 patients (443 HFrEF and 375 cancer patients) were enrolled. In HFrEF, there was a strong association between all scores and disease severity reflected by NT-proBNP and NYHA class (p ≤ 0.001 for all). In oncologic patients, association with tumor stage was significant for the PNI only (p = 0.035). In both disease entities, all scores were associated with all-cause mortality (p ≤ 0.014 for all scores). Kaplan–Meier analysis confirmed the discriminatory power of all scores in the HFrEF and the oncologic study population, respectively (log-rank p ≤ 0.026 for all scores). A significant interaction with disease (HFrEF vs. cancer) was observed for PNI (pinteraction = 0.013) or PLR (pinteraction = 0.005), respectively, with higher increase in risk per inflammatory score increment for HFrEF.Conclusion: In crude models, the inflammatory scores NLR, MLR, PLR, and PNI are associated with severity of disease in HFrEF and with survival in HFrEF similarly to cancer patients. For PNI and PLR, the association with increase in risk per increment was even stronger in HFrEF than in malignant disease.
Investigation of Specific Proteins Related to Different Types of Coronary Atherosclerosis
Authors: Meng Heyu , Ruan Jianjun , Chen Yanqiu , Yan Zhaohan , Shi Kaiyao , Li Xiangdong , Yang Ping , Meng Fanbo 
Published: October 2021

Objective: Coronary heart disease (CHD) is a complex disease caused by multifaceted interaction between genetic and environmental factors, which makes identification of the most likely disease candidate proteins and their associated risk markers a big challenge. Atherosclerosis is presented by a broad spectrum of heart diseases, including stable coronary artery disease (SCAD) and acute myocardial infarction (AMI), which is the progressive stage of SCAD. As such, the correct and prompt diagnosis of atherosclerosis turns into imperative for precise and prompt disease diagnosis, treatment and prognosis.Methods: The current work aims to look for specific protein markers for differential diagnosis of coronary atherosclerosis. Thirty male patients between 45 and 55 years diagnosed with atherosclerosis were analyzed by tandem mass tag (TMT) mass spectrometry. The study excluded those who were additionally diagnosed with hypertension and type 1 and 2 diabetes. The Mufuzz analysis was applied to select target proteins for precise and prompt diagnosis of atherosclerosis, most of which were most related to high lipid metabolism. The parallel reaction monitoring (PRM) was used to verify the selected target proteins. Finally, The receiver operating characteristic curve (ROC) was calculated by a random forest experiment.Results: One thousand one hundred and forty seven proteins were identified in the TMT mass spectrometry, 907 of which were quantifiable. In the PRM study, six proteins related to lipid metabolism pathway were selected for verification and they were ALB, SHBG, APOC2, APOC3, APOC4, SAA4.Conclusion: Through the detected specific changes in these six proteins, our results provide accuracy in atherosclerosis patients' diagnosis, especially in cases with varying types of the disease.
Characteristics of Shale Pores and Surfaces and Their Potential Effects on the Fluid Flow From Shale Formation to Fractures
Authors: Li Xu , Cai Jingong , Gao Bo , Long Shengxiang , Feng Dongjun , Peng Zeyang , Guo Benqiang 
Published: October 2021

Fluid flow is critical for the efficient exploitation of shale resources and can be split into two stages: the flow in the artificial fractures and, more importantly, the flow from shale formations to the artificial fractures. In this study, X-ray diffraction, N2 adsorption, mercury intrusion, and ethylene glycol monoethyl ether adsorption were conducted on the shales collected from Es3middle, Es3lower, and Es4upper sub-members in the Dongying Sag to reveal the potential effects of the characteristics and properties of pores and surfaces on the fluid flow in shale formations. The results are indicated as follows: 1) The shales from Es3middle and Es3lower contain more I/S and detrital minerals but less illite and carbonate minerals than those of Es4upper. 2) The shales from Es3middle and Es3lower are mainly composed of smaller pores present in larger surface areas and lead to the steeper slope between the BrunauerEmmettTeller specific surface area (BET-SSA) and pore volumes. 3) Clay minerals mainly contribute to pore development, and carbonate minerals inhibit pore development. All kinds of surface areas (especially the inner surface area) are sourced by clay minerals, while I/S and illite present opposite effects. 4) Pore size and surface properties affect significantly the fluid flow in shale formations. The shales from Es4upper are the favorable interval for shale oil accumulation and flow, especially for the shales with depth ranges of 3360∼3410 m, which possess high carbonates, illite and total organic carbon content, low clay mineral content, large pore volume, high large pore content, and small surface areas. Additionally, fluid composition needs to be paid more concern in the future.