bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Transcranial Motor Evoked Potential Monitoring During Intra- and Extramedullary Spinal Cord Tumor Surgery: A Prospective Multicenter Study of the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research
Authors: Ushirozako Hiroki , Yoshida Go , Imagama Shiro , Kobayashi Kazuyoshi , Ando Kei , Ando Muneharu , Kawabata Shigenori , Yamada Kei , Kanchiku Tsukasa , Fujiwara Yasushi , Taniguchi Shinichirou , Iwasaki Hiroshi , Shigematsu Hideki , Tadokoro Nobuaki , Takahashi Masahito , Wada Kanichiro , Yamamoto Naoya , Funaba Masahiro , Yasuda Akimasa , Hashimoto Jun , Morito Shinji , Takatani Tsunenori , Tani Toshikazu , Matsuyama Yukihiro 
Published: May 2021

Study Design: Multicenter prospective study. Objectives: Although intramedullary spinal cord tumor (IMSCT) and extramedullary SCT (EMSCT) surgeries carry high risk of intraoperative motor deficits (MDs), the benefits of transcranial motor evoked potential (TcMEP) monitoring are well-accepted; however, comparisons have not yet been conducted. This study aimed to clarify the efficacy of TcMEP monitoring during IMSCT and EMSCT resection surgeries. Methods: We prospectively reviewed TcMEP monitoring data of 81 consecutive IMSCT and 347 EMSCT patients. We compared the efficacy of interventions based on TcMEP alerts in the IMSCT and EMSCT groups. We defined our alert point as a TcMEP amplitude reduction of ≥70% from baseline. Results: In the IMSCT group, TcMEP monitoring revealed 20 true-positive (25%), 8 rescue (10%; rescue rate 29%), 10 false-positive, a false-negative, and 41 true-negative patients, resulting in a sensitivity of 95% and a specificity of 80%. In the EMSCT group, TcMEP monitoring revealed 20 true-positive (6%), 24 rescue (7%; rescue rate 55%), 29 false-positive, 2 false-negative, and 263 true-negative patients, resulting in a sensitivity of 91% and specificity of 90%. The most common TcMEP alert timing was during tumor resection (96% vs. 91%), and suspension surgeries with or without intravenous steroid administration were performed as intervention techniques. Conclusions: Postoperative MD rates in IMSCT and EMSCT surgeries using TcMEP monitoring were 25% and 6%, and rescue rates were 29% and 55%. We believe that the usage of TcMEP monitoring and appropriate intervention techniques during SCT surgeries might have predicted and prevented the occurrence of intraoperative MDs.
Triggered Electromyography is a Useful Intraoperative Adjunct to Predict Postoperative Neurological Deficit Following Lumbar Pedicle Screw Instrumentation
Authors: Reddy Rajiv P. , Chang Robert , Coutinho Dominic V. , Meinert Justin W. , Anetakis Katherine M. , Crammond Donald J. , Balzer Jeffrey R. , Shaw Jeremy D. , Lee Joon Y. , Thirumala Parthasarathy D. 
Published: May 2021

Study Design: Systematic review and meta-analysis. Objectives: Malposition of pedicle screws during instrumentation in the lumbar spine is associated with complications secondary to spinal cord or nerve root injury. Intraoperative triggered electromyographic monitoring (t-EMG) may be used during instrumentation for early detection of malposition. The association between lumbar pedicle screws stimulated at low EMG thresholds and postoperative neurological deficits, however, remains unknown. The purpose of this study is to assess whether a low threshold t-EMG response to lumbar pedicle screw stimulation can serve as a predictive tool for postoperative neurological deficit. Methods: The present study is a meta-analysis of the literature from PubMed, Web of Science, and Embase identifying prospective/retrospective studies with outcomes of patients who underwent lumbar spinal fusion with t-EMG testing. Results: The total study cohort consisted of 2,236 patients and the total postoperative neurological deficit rate was 3.04%. 10.78% of the patients incurred at least 1 pedicle screw that was stimulated below the respective EMG alarm threshold intraoperatively. The incidence of postoperative neurological deficits in patients with a lumbar pedicle screw stimulated below EMG alarm threshold during placement was 13.28%, while only 1.80% in the patients without. The pooled DOR was 10.14. Sensitivity was 49% while specificity was 88%. Conclusions: Electrically activated lumbar pedicle screws resulting in low t-EMG alarm thresholds are highly specific but weakly sensitive for new postoperative neurological deficits. Patients with new postoperative neurological deficits after lumbar spine surgery were 10 times more likely to have had a lumbar pedicle screw stimulated at a low EMG threshold.
Nanoparticles: A New Approach to Upgrade Cancer Diagnosis and Treatment
Authors: Yu Zhongyang , Gao Lei , Chen Kehan , Zhang Wenqiang , Zhang Qihang , Li Quanwang , Hu Kaiwen 
Published: May 2021

AbstractTraditional cancer therapeutics have been criticized due to various adverse effects and insufficient damage to targeted tumors. The breakthrough of nanoparticles provides a novel approach for upgrading traditional treatments and diagnosis. Actually, nanoparticles can not only solve the shortcomings of traditional cancer diagnosis and treatment, but also create brand-new perspectives and cutting-edge devices for tumor diagnosis and treatment. However, most of the research about nanoparticles stays in vivo and in vitro stage, and only few clinical researches about nanoparticles have been reported. In this review, we first summarize the current applications of nanoparticles in cancer diagnosis and treatment. After that, we propose the challenges that hinder the clinical applications of NPs and provide feasible solutions in combination with the updated literature in the last two years. At the end, we will provide our opinions on the future developments of NPs in tumor diagnosis and treatment.
Accel-Align: a fast sequence mapper and aligner based on the seed–embed–extend method
Authors: Yan Yiqing , Chaturvedi Nimisha , Appuswamy Raja 
Published: May 2021

Abstract
Background
Improvements in sequencing technology continue to drive sequencing cost towards $100 per genome. However, mapping sequenced data to a reference genome remains a computationally-intensive task due to the dependence on edit distance for dealing with INDELs and mismatches introduced by sequencing. All modern aligners use seed–filter–extend methodology and rely on filtration heuristics to reduce the overhead of edit distance computation. However, filtering has inherent performance–accuracy trade-offs that limits its effectiveness.

Results
Motivated by algorithmic advances in randomized low-distortion embedding, we introduce SEE, a new methodology for developing sequence mappers and aligners. While SFE focuses on eliminating sub-optimal candidates, SEE focuses instead on identifying optimal candidates. To do so, SEE transforms the read and reference strings from edit distance regime to the Hamming regime by embedding them using a randomized algorithm, and uses Hamming distance over the embedded set to identify optimal candidates. To show that SEE performs well in practice, we present Accel-Align an SEE-based short-read sequence mapper and aligner that is 3–12$$\times$$
×
faster than state-of-the-art aligners on commodity CPUs, without any special-purpose hardware, while providing comparable accuracy.

Conclusions
As sequencing technologies continue to increase read length while improving throughput and accuracy, we believe that randomized embeddings open up new avenues for optimization that cannot be achieved by using edit distance. Thus, the techniques presented in this paper have a much broader scope as they can be used for other applications like graph alignment, multiple sequence alignment, and sequence assembly.
Dynamic transcriptome and histomorphology analysis of developmental traits of hindlimb thigh muscle from Odorrana tormota and its adaptability to different life history stages
Authors: Shu Yilin , He Jun , Zhang Huijuan , Liu Guangxuan , Li Shikun , Deng Shuaitao , Wu Hailong 
Published: May 2021

AbstractBackgroundSystematic studies on the development and adaptation of hindlimb muscles in anura amphibians are rare. Here, we integrated analysis of transcriptome and histomorphological data for the hindlimb thigh muscle ofOdorrana tormota(concave-eared torrent frog) at different developmental stages, to uncover the developmental traits of hindlimb thigh muscle fromO. tormotaand its adaptability to different life history stages.ResultsThe development of hindlimb thigh muscle fromO. tormotahas the following characteristics. Before metamorphosis, myogenous cells proliferate and differentiate into myotubes, and form 11 muscle groups at G41; Primary myofibers and secondary myofibers appeared during metamorphosis; 11 muscle groups differentiated continuously to form myofibers, accompanied by myofibers hypertrophy after metamorphosis; During the growth process ofO. tormotafrom G42 to G46, there were differences between the sexes in the muscle groups that differentiate into muscle fibers, indicating that there was sexual dimorphism in the hindlimb thigh muscles ofO. tormotaat the metamorphosis stages. Some genes and pathways related to growth, development, and movement ability ofO. tormotaat different developmental stages were obtained. In addition, some pathways associated with adaptation to metamorphosis and hibernation also were enriched. Furthermore, integrated analysis of the number of myofibers and transcriptome data suggested that myofibers of specific muscle groups in the hindlimbs may be degraded through lysosome and ubiquitin pathways to transform into energy metabolism and other energy-related substances to meet the physiological needs of hibernation.ConclusionsThese results provide further understanding the hindlimb thigh muscle development pattern of frogs and their adaption to life history stages.
Residual paralysis caused by 50 mg rocuronium after reversal with 4 mg/kg sugammadex: a case report
Authors: Uzawa Kohji , Seki Hiroyuki , Yorozu Tomoko 
Published: May 2021

Abstract
Background
Rocuronium-induced neuromuscular blockade can be quickly and completely reversed by administration of an optimal dose of sugammadex. Sugammadex antagonizes rocuronium-induced neuromuscular blockade by encapsulating rocuronium. Herein, we report a case of residual neuromuscular paralysis in which the recommended dose of sugammadex (4 mg·kg− 1) failed to antagonize a rocuronium-induced blockade.

Case presentation
A 71-year-old man (body mass index: 26.7 kg·m− 2) underwent endoscopic submucosal dissection of early-stage gastric cancer. He had no known factors that may have affected the effects of rocuronium and sugammadex. He received rocuronium (50 mg; 0.7 mg·kg− 1) for anesthesia induction. No additional rocuronium was administered during the 71-min procedure. Ninety-four minutes after rocuronium administration, neuromuscular monitoring showed 20 twitches in response to post-tetanic count stimulation. The train-of-four (TOF) ratio was not measurable despite sugammadex (280 mg; 4 mg/kg) administration, although four weak twitches in response to TOF stimulation appeared in 3 min. The TOF ratio became detectable following administration of an additional dose of sugammadex (120 mg; 1.7 mg·kg− 1), and it recovered to 107% 8 min after the second dose. The patient opened his eyes; moved his neck, arms, and limbs; and regained consciousness. The trachea was extubated and the patient was transferred to the ward.

Conclusions
Neuromuscular monitoring should be used if a neuromuscular blockage agent is administered, even if the recommended dose of sugammadex is administered.
Socio-economic inequality in the prevalence of violence against older adults – findings from India
Authors: Sinha Debashree , Mishra Prem Shankar , Srivastava Shobhit , Kumar Pradeep 
Published: May 2021

Abstract
Background
Violence against older adults is a well-recognised socio-psychological and public health problem. It is uncared-for, undiagnosed, and an untreated problem that is widespread across both developed and developing countries. The present paper aims to understand the extent of the socio-economic status related inequality in violence against older adults in India.

Methods
The study uses data from Building a Knowledge Base on Population Aging in India (BKPAI). Violence against older adults is the outcome variable for the study and is defined as older adults who faced any abuse or violence or neglect or disrespect by any person. Bivariate analysis and regression-based decomposition technique is used to understand the relative contribution of various socio-economic factors to violence against older adults (N = 9541).

Results
The prevalence of violence faced by older adults was 11.2%. Older adults aged 80+ years [OR: 1.49; CI: 1.14–1.93] and working [OR: 1.26; CI: 1.02–1.56] had higher likelihood to face violence than their counterparts. On the other hand, older adults who were currently in union [OR: 0.79; CI: 0.65–0.95], lived with children [OR: 0.53; CI: 0.40–0.72] and who belonged to richer wealth quintile [OR: 0.35; CI:0.24–0.51] had lower likelihood to suffer from violence than their counterparts. The decomposition results revealed that poor older adults were more prone to violence (Concentration index: − 0.20). Household’s wealth status was responsible for explaining 93.7% of the socio-economic status related inequality whereas living arrangement of older adults explained 13.7% of the socio-economic related inequality. Education and working status of older adults made a substantial contribution to the inequalities in reported violence, explaining 3.7% and 3.3% of the total inequality, respectively.

Conclusion
Though interpretation of the results requires a cautious understanding of the data used, the present study highlights some of the relevant issues faced by the country’s older adults. With no or meagre income of their own, older adults belonging to the poorest wealth quintile have little or no bargaining power to secure a violent free environment for themselves. Therefore, special attention in terms of social and economic support should be given to the economically vulnerable older population.
A case report of endocarditis and spondylitis caused by Brucella melitensis biovar 3
Authors: Zhang Huan , Xie Songsong , Wang Yueli , Zhao Xiaoli , Yi Jihai , Wang Zhen , Liu Qi , Deng Xiaoyu , Li Bingjie , Cui Buyun , Wang Yuanzhi , Chen Chuangfu 
Published: May 2021

Abstract
Background
This case report describes the clinical process of a shepherd who suffered brucellosis-related endocarditis (BE) and spondylitis (BS) and was infected with Brucella melitensis biovar 3 (B. melitensis biovar 3).

Case presentation
A 55-year-old male patient was admitted to The First Affiliated Hospital of Shihezi University on October 11, 2018, due to over 3 months of intermittent fever, back pain, and heart trouble. The Rose Bengal Plate test was positive, the standard agglutination test titer for brucellosis was 1/800, and the blood culture was positive for B. melitensis biovar 3. Three instances of transthoracic echocardiography examination at days 1, 25, and 376 after admission to the hospital and magnetic resonance imaging (MRI) and computed tomography (CT) checks at days 5 and 38 revealed that the size of the vegetation on the posterior leaflet of the mitral valve increased from 0.7 × 1.4 cm to 1.2 × 1.5 cm and that the left atrium and ventricle were enlarged. The MRI and CT results showed hyperplasia of the second and third vertebra, a cold abscess formed on both sides of the psoas major muscles, and the vertebra hyperplasia became aggravated at a later time point. The patient’s situation deteriorated, and heart failure was discovered on October 22, 2019. At the moment of submission of this manuscript, the patient remains in bed at home because of severe debility caused by brucellosis.

Conclusions
This is the first reported case of endocarditis combined with spondylitis caused by B. melitensis biovar 3 in a shepherd. Brucellosis infection can cause work-power losses because of misdiagnosis or a lack of proper treatment. Early diagnosis and treatment are essential for a successful outcome.
Crossed brainstem syndrome revealing bleeding brainstem cavernous malformation: an illustrative case
Authors: Beucler Nathan , Boissonneau Sébastien , Ruf Aurélia , Fuentes Stéphane , Carron Romain , Dufour Henry 
Published: May 2021

Abstract
Background
Since the nineteenth century, a great variety of crossed brainstem syndromes (CBS) have been described in the medical literature. A CBS typically combines ipsilateral cranial nerves deficits to contralateral long tracts involvement such as hemiparesis or hemianesthesia. Classical CBS seem in fact not to be so clear-cut entities with up to 20% of patients showing different or unnamed combinations of crossed symptoms. In terms of etiologies, acute brainstem infarction predominates but CBS secondary to hemorrhage, neoplasm, abscess, and demyelination have been described. The aim of this study was to assess the proportion of CBS caused by a bleeding episode arising from a brainstem cavernous malformation (BCM) reported in the literature.

Case presentation
We present the case of a typical Foville syndrome in a 65-year-old man that was caused by a pontine BCM with extralesional bleeding. Following the first bleeding episode, a conservative management was decided but the patient had eventually to be operated on soon after the second bleeding event.

Discussion
A literature review was conducted focusing on the five most common CBS (Benedikt, Weber, Foville, Millard-Gubler, Wallenberg) on Medline database from inception to 2020. According to the literature, hemorrhagic BCM account for approximately 7 % of CBS. Microsurgical excision may be indicated after the second bleeding episode but needs to be carefully weighted up against the risks of the surgical procedure and openly discussed with the patient.

Conclusions
In the setting of a CBS, neuroimaging work-up may not infrequently reveal a BCM requiring complex multidisciplinary team management including neurosurgical advice.
In utero fetal left ventricular rupture and pseudoaneurysm formation: a case report
Authors: Heland Sarah , Hope Sarah , Edwards Andrew , Chalmers Rebecca , Stewart Alice , Kroushev Annie , Sheridan Bennett , Hooper Stuart , Palmer Kirsten R. 
Published: May 2021

Abstract
Background
Cardiac ventricular aneurysms affect 1 in 200,000 live births. To the best of our knowledge, no reported cases of a left ventricular pseudoaneurym and in utero rupture exist to guide optimal management.

Case presentation
We present a case of fetal left ventricular rupture with a large pericardial effusion, cardiac tamponade and subsequent pseudoaneurysm formation with concerns for a poor prognosis. Interventional drainage of the pericardial effusion led to resolution of tamponade and significant improvement in fetal condition. A multidisciplinary team was utilised to plan birth to minimise risk of pseudoaneurysmal rupture and a catastrophic bleed at birth.

Conclusion
For similar cases we recommend consideration of birth by caesarean section, delayed cord clamping and a prostaglandin E1 infusion, to reduce the systemic pressures on the left ventricle during transition from fetal to neonatal circulations, until definitive surgical repair. In this case, this resulted in a successful outcome.
Can an amino acid mixture alleviate gastrointestinal symptoms in neuroendocrine tumor patients?
Authors: Chauhan Aman , Das Satya , Miller Rachel , Luque Laura , Cheuvront Samuel N. , Cloud James , Tarter Zach , Siddiqui Fariha , Ramirez Robert A. , Anthony Lowell 
Published: May 2021

AbstractBackgroundNeuroendocrine tumors, although relatively rare in incidence, are now the second most prevalent gastrointestinal neoplasm owing to indolent disease biology. A small but significant sub-group of neuroendocrine tumor patients suffer from diarrhea. This is usually secondary to carcinoid syndrome but can also be a result of short gut syndrome, bile acid excess or iatrogenic etiologies. Recently, an amino acid based oral rehydration solution (enterade® Advanced Oncology Formula) was found to have anti-diarrheal properties in preclinical models.MethodsA retrospective chart review of all NET patients treated with enterade® AO was performed after IRB approval.ResultsNinety-eight NET patients who had received enterade® AO at our clinic from May 2017 through June 2019 were included. Patients (N = 49 of 98) with follow up data on bowel movements (BMs) were included for final analysis. Eighty-four percent of patients (41/49) had fewer BMs after taking enterade® AO and 66% (27/41) reported more than 50% reduction in BM frequency. The mean number of daily BMs was 6.6 (range, 3–20) at baseline before initiation of therapy, while the mean number of BMs at 1 week time point post enterade® AO was 2.9 (range, 0–11).ConclusionsOur retrospective observations are encouraging and support prospective validation with appropriate controls in NET patients. This is first published report of the potential anti-diarrheal activity of enterade® AO in NET patients.
Refractive errors and visual impairment among children and adolescents in southernmost China
Authors: Peng Li , Gao Ling , Zheng Yunyan , Dai Yanan , Xie Qing 
Published: May 2021

Abstract
Background
Refractive errors and visual impairment in southernmost China have not been reported previously. We aim to investigate and determine the age-specific prevalence of myopia, hyperopia, astigmatism, and visual impairment based on a large population cross-sectional study in Hainan area of southernmost tropical province in China.

Methods
A population-based sample of 31,524 children aged 6–15 years from Hainan was assessed. Non-cycloplegic autorefraction and visual acuity (VA) analyses were performed on all participants and a subgroup of participants undergoing cycloplegia.

Results
Of all participants, 23.0% presented uncorrected VA (UCVA) was worse than 20/40 in worse eye, 6.0% presented mild presenting visual acuity impairment (PVAI), 7.0% presented moderate PVAI, 0.2% presented severe PVAI in the better eye, and 46.9% presented abnormal UCVA [worse than 20/25 (≥ 6, < 8 years old) and worse than 20/20 (≥ 8 years and older)] at least in one eye. The overall prevalence of myopia [spherical equivalent (SE) ≤  − 0.50 D] and high myopia (SE ≤  − 6.00 D) were 46.0%, 1.0% respectively. Hyperopia [SE ≥  + 1.00 D (≥ 7 years old) and SE ≥  + 2.00 D (≥ 6, < 7 years old)] and significant hyperopia (SE ≥  + 3.00 D) were 4.2 and 0.6%, respectively. Astigmatism [cylinder ≥ 1.00 D (≥ 7 years old) and ≥ 1.75 D (≥ 6, < 7 years old)] was found in 31.9%.

Conclusions
Myopia was the most common refractive error in southernmost province in China (Hainan). Its prevalence increased with age, while hyperopia prevalence showed a decreasing trend. However, myopia, especially high myopia prevalence was much lower than in other urban regions across China.