bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impacting the Treatment of Highly Eloquent Supratentorial Cerebral Cavernous Malformations by Noninvasive Functional Mapping—An Observational Cohort Study
Authors: Ille Sebastian , Schroeder Axel , Hostettler Isabel C , Wostrack Maria , Meyer Bernhard , Krieg Sandro M 
Published: October 2021

Abstract

BACKGROUND
Cerebral cavernous malformations (CCM) may cause cavernoma-related epilepsy (CRE) and intracranial hemorrhage (ICH). Functional mapping has shown its usefulness during the resection of eloquent lesions including the treatment of brain arteriovenous malformations.

OBJECTIVE
To evaluate the impact of noninvasive functional mapping on decision-making and resection of eloquently located CCM.

METHODS
Of 126 patients with intracranial cavernomas, we prospectively included 40 consecutive patients (31.7%) with highly eloquent CCM between 2012 and 2020. We performed functional mapping via navigated transcranial magnetic stimulation (nTMS) motor mapping in 30 cases and nTMS language mapping in 20 cases. Twenty patients suffered from CRE. CCM caused ICH in 18 cases.

RESULTS
We used functional mapping data including function-based tractography in all cases. Indication toward (31 cases) or against (9 cases) CCM resection was influenced by noninvasive functional mapping in 36 cases (90%). We resected CCMs in 24 cases, and 7 patients refused the recommendation for surgery. In 19 and 4 cases, we used additional intraoperative neuromonitoring and awake craniotomy, respectively. Patients suffered from transient postoperative motor or language deficits in 2 and 2 cases, respectively. No patient suffered from permanent deficits. After 1 yr of follow-up, anti-epileptic drugs could be discontinued in all patients who underwent surgery but 1 patient.

CONCLUSION
Surgery-related deficit rates are low even for highly eloquent CCM and seizure outcome is excellent. The present results show that noninvasive functional mapping and function-based tractography is a useful tool for the decision-making process and during microsurgical resection of eloquently located CCM.
Versatile Use of Intraoperative Ultrasound Guidance for Brain Puncture
Authors: Unal Tugrul Cem , Gulsever Cafer Ikbal , Sahin Duran , Dagdeviren Huseyin Emre , Dolas Ilyas , Sabanci Pulat Akin , Aras Yavuz , Sencer Altay , Aydoseli Aydin 
Published: October 2021

Abstract

BACKGROUND
Intraoperative ultrasound (iUS) is an effective guidance and imaging system commonly used in neuro-oncological surgery. Despite the versatility of iUS, its utility for single burr hole puncture guidance remains fairly underappreciated.

OBJECTIVE
To highlight the simplicity, versatility, and effectiveness of iUS guidance in brain puncture by presenting the current case series and technical note collection.

METHODS
We present 4 novel uses of iUS guidance for single burr hole brain puncture: cannulation of normal-sized ventricles, endoscopic third ventriculostomy (ETV) guidance, evacuation of interhemispheric empyema, and stereotactic biopsy assistance.

RESULTS
All techniques were performed successfully in a total of 16 patients. Normal-sized ventricles were cannulated in 7 patients, among whom 5 underwent Ommaya reservoir placement and 2 underwent ventriculoperitoneal shunt placement for idiopathic intracranial hypertension. No more than 1 attempt was needed for cannulation. All ventricular tip positions were optimal as shown by postoperative imaging. iUS guidance was used in 5 ETV procedures. The working cannula was successfully introduced to the lateral ventricle, providing the optimal trajectory to the third ventricular floor in these cases. Interhemispheric subdural empyema was aspirated with iUS guidance in 1 patient. Volume reduction was clearly visible, allowing near-total evacuation of the empyema. iUS guidance was used for assistive purposes during stereotactic biopsy in 3 patients. No major perioperative complications were observed throughout this series.

CONCLUSION
iUS is an effective and versatile guidance system that allows for real-time imaging and can be easily and safely employed for various brain puncture procedures.
Forbidden Fruits: The Political Economy of Science, Religion, and Growth
Authors: Bénabou Roland , Ticchi Davide , Vindigni Andrea 
Published: October 2021

AbstractWe study the co-evolution of religion, science, and politics. We first uncover, in international and U.S. data, a robust negative relationship between religiosity and patents per capita. The model then combines: (1) scientific discoveries that raise productivity but sometimes erode religious beliefs; (2) a government that allows innovations to diffuse, or blocks them; (3) religious institutions that can invest in doctrinal reform. Three long-term outcomes emerge. The “Western-European Secularization” regime has declining religiosity, unimpeded science, and high taxes and transfers. The “Theocratic” regime involves knowledge stagnation, unquestioned dogma, and high religious-public-goods spending. The “American” regime combines scientific progress and stable religiosity through doctrinal adaptations, with low taxes and some fiscal-legal advantages for religious activities. Rising income inequality can, however, empower a Religious-Right alliance that starts blocking belief-eroding ideas.
Transforming an Orthopaedic Unit Into an “Age-Friendly” Unit Through Implementation of the American Geriatrics Society's CoCare: Ortho Program
Authors: Shen Jenny Y. , Mendelson Daniel Ari , Lang Valerie J. 
Published: October 2021

Objective:
To transform an inpatient orthopaedic unit into an age-friendly unit for geriatric fracture center (GFC) patients.

Design:
Pragmatic dissemination study of a continuous quality improvement intervention with episodic data review.

Setting:
Large quaternary care university hospital with no on-site geriatrics program and no dedicated geriatric inpatient unit.

Participants:
Individuals 60 years of age and older with fragility fracture of the native proximal femur hospitalized from July 2017 to June 2020.

Intervention:
A hospital medicine-orthopaedics comanagement model for a GFC was developed using processes, tools, and education provided by the American Geriatrics Society's AGS CoCare: Ortho program to support the age-friendly 4Ms principles: mentation, mobility, medications, and what matters. Delirium reduction strategies included minimizing sleep interruption through changes in blood draw times, order sets for pain management, and nursing education. Mobility specialists were incorporated to improve early mobilization on the orthopaedic unit.

Main Outcome Measurements:
Frequency of weight-bearing on postoperative day 1 and frequency of delirium among GFC patients on the orthopaedic unit were compared with those among concurrent GFC patients on other units.

Results:
Frequency of delirium was 26% among patients on the orthopaedic unit versus 35% among those on other units (P = 0.055). Frequency of weight-bearing on post-operative day 1 was 84% among patients on the orthopaedic unit versus 72% among those on other units (P = 0.003).

Conclusions:
AGS CoCare: Ortho is an effective dissemination program for establishing a hospital medicine-orthopaedics comanagement program and making an orthopaedic unit age-friendly in a hospital without onsite geriatricians or a dedicated geriatrics unit.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Validation and Clinical Application of a Liquid Chromatography–Ultraviolet Detection Method to Quantify Dolutegravir in Dried Blood Spots
Authors: Akinloye Abdulafeez , Eniayewu Oluwasegun , Adeagbo Babatunde , Bolaji Oluseye , Olagunju Adeniyi 
Published: October 2021

Background:
Dolutegravir is currently the preferred component of first-line antiretroviral therapy. To facilitate clinical pharmacology studies in key populations, quantitative analytical methods compatible with microsampling and adaptable to resource-limited settings are desirable. The authors developed and validated a liquid chromatography–ultraviolet detection method to quantify dolutegravir in dried blood spots (DBS).

Methods:
Calibration standards and quality control samples were prepared by spotting 50 μL of dolutegravir-spiked whole blood on each circle of DBS cards. Three spots (two 6-mm punches/spot) were extracted with methanol. Chromatographic separation was achieved with gradient elution of acetonitrile/potassium phosphate monobasic buffer (pH 5) on a reverse-phase C18 column (flow rate, 1 mL/min) using pioglitazone as the internal standard. UV detection was performed at 260 nm. In the clinical pharmacokinetic study, DBS from finger prick was collected from participants (n = 10) at 8 time points over 12 hours postdosing, with paired plasma at 1 and 12 hours. The method was used to quantify dolutegravir, estimating pharmacokinetic parameters. Agreement between DBS and plasma concentrations was evaluated using linearity and Bland–Altman plots.

Results:
The method was validated over the concentration range of 0.4–10 mcg/mL, accuracy was 102.4%–114.8%, and precision was 3.4%–14.7%. The mean recovery was 42.3% (%CV: 8.3). The mean (±SD) dolutegravir concentration in DBS was 37.5% (±3.8%) lower than that in the plasma. DBS-derived and measured plasma concentrations showed strong correlation with linearity (R2 = 0.9804) and Bland–Altman plots. Means (%CV) of area under curve, Cmax, and C24 from the DBS-derived plasma concentration were 37.8 (23.2) mcg·h/mL, 2.7 (24.7) mcg/mL, and 1.34 (31.6) mcg/mL, respectively.

Conclusions:
The application of this simple, accurate, and precise method will expand opportunities for clinical assessment of dolutegravir in resource-limited settings.
Immunization-Associated Corneal Transplantation Rejection: A Review
Authors: Lee Edward H. , Li Jennifer Y. 
Published: October 2021

Purpose:
The purpose of this review was to examine and characterize the available literature regarding immunization-associated corneal graft rejection.

Methods:
A Literature search was conducted using PubMed keywords relevant to corneal transplantation, graft rejection, and immunization to find relevant publications through July 2021. Nine studies were included in this review. Data including patient demographics, type of transplant, chronology of disease, type of immunization, treatment, and outcomes were evaluated.

Results:
Twenty-three cases of corneal graft rejection associated temporally with immunizations have been described in the literature. Most of these patients were female, and most commonly had received the influenza vaccine before the rejection episode. Most episodes resulted in graft preservation with intensive corticosteroid therapy.

Conclusions:
Immunization-associated corneal graft rejection is a rare but likely underreported phenomenon. Patients and surgeons should be aware of this possible risk, although the evidence is inconclusive. Conclusions are limited because of the small sample size and the retrospective nature of all existing literature on this subject. Surgeons should be encouraged to document and report these episodes.
IgA nephropathy in IgG kappa multiple myeloma
Authors: Couto Maria Eduarda , Sousa Domingos , Ferreira Hugo , Tavares Alda , Oliveira Isabel , Domingues Nelson , Paiva Ana , Chuva Teresa , Maximino José , Henrique Rui Manuel Ferreira , Mariz José Mário 
Published: October 2021

Abstract
Multiple myeloma (MM) frequently affects kidney function through multiple mechanisms. Nonetheless, some patients develop kidney injury due to other causes. A 54-year-old woman was diagnosed with IgG kappa MM developed IgA nephropathy without cast nephropathy. Further studies did not show criteria for MM progression or other causes. This case highlights the need for further investigation of kidney injury in MM patients (such as toxicity of previous drugs, infectious events, or immune-mediated disorders).
Severe ocular involvement in hereditary gelsolin amyloidosis
Authors: da Silva Nisa Filipa Pinho , Beirão João Nuno Melo 
Published: October 2021

Abstract
Hereditary gelsolin amyloidosis is a rare subtype of hereditary systemic amyloidosis. An old male presented with the characteristic triad of symptoms, including bilateral facial palsy, cutis laxa, and corneal lattice amyloidosis. The diagnosis was confirmed by the detection of the mutation in gelsolin gene located on chromosome 9. Although the presenting symptoms were highly suggestive of the disease, reports of severe ocular involvement are scarce in the literature.
Estimation of Utility Values for Computing Quality-adjusted Life Years Associated With Homelessness
Authors: Rajan Suja S. , Tsai Jack 
Published: October 2021

Background:
There is a lack of data-driven evidence about the burden of homelessness, and lack of a holistic measure of effectiveness for evaluating interventions targeting homelessness. Quality-adjusted life years (QALYs) can help holistically capture the burden of homelessness, and facilitate the valuation and comparison of interventions designed to address homelessness.

Objective:
This study estimated utility values required to compute the QALYs associated with homelessness, and also examined individual-level characteristics that affect these values.

Research Design:
The study is cross-sectional and derived from a large national survey conducted during the coronavirus disease 2019 pandemic.

Subjects:
A sample of 6607 middle- and low-income adults in the United States.

Measures:
A self-completion standard gamble survey was used to estimate utility values associated with homelessness. Linear regression was used to analyze the association between individual-level characteristics and these utility values.

Results:
The study estimated the average utility value associated with homelessness as 43.4% among the study participants. This implies that 1 year of life as a homeless individual is perceived to be equivalent to less than half a year of life as a stably housed individual in good health. The study also found that individuals who have experienced homelessness and financial distress value life as a homeless person considerably less than those who have not had these experiences.

Conclusions:
The method developed in this study can be used to estimate QALYs in studies evaluating homelessness interventions, thereby establishing the societal value of these interventions and informing policy and budgetary decision-making. Future studies estimating the utility values associated with homelessness in the general population, as well as specific homeless groups, are required to provide more generalizable evidence.
A Risk Prediction Model for Long-term Prescription Opioid Use
Authors: Tseregounis Iraklis E. , Tancredi Daniel J. , Stewart Susan L. , Shev Aaron B. , Crawford Andrew , Gasper James J. , Wintemute Garen , Marshall Brandon D.L. , Cerdá Magdalena , Henry Stephen G. 
Published: October 2021

Background:
Tools are needed to aid clinicians in estimating their patients’ risk of transitioning to long-term opioid use and to inform prescribing decisions.

Objective:
The objective of this study was to develop and validate a model that predicts previously opioid-naive patients’ risk of transitioning to long-term use.

Research Design:
This was a statewide population-based prognostic study.

Subjects:
Opioid-naive (no prescriptions in previous 2 y) patients aged 12 years old and above who received a pill-form opioid analgesic in 2016–2018 and whose prescriptions were registered in the California Prescription Drug Monitoring Program (PDMP).

Measures:
A multiple logistic regression approach was used to construct a prediction model with long-term (ie, >90 d) opioid use as the outcome. Models were developed using 2016–2017 data and validated using 2018 data. Discrimination (c-statistic), calibration (calibration slope, intercept, and visual inspection of calibration plots), and clinical utility (decision curve analysis) were evaluated to assess performance.

Results:
Development and validation cohorts included 7,175,885 and 2,788,837 opioid-naive patients with outcome rates of 5.0% and 4.7%, respectively. The model showed high discrimination (c-statistic: 0.904 for development, 0.913 for validation), was well-calibrated after intercept adjustment (intercept, −0.006; 95% confidence interval, −0.016 to 0.004; slope, 1.049; 95% confidence interval, 1.045–1.053), and had a net benefit over a wide range of probability thresholds.

Conclusions:
A model for the transition from opioid-naive status to long-term use had high discrimination and was well-calibrated. Given its high predictive performance, this model shows promise for future integration into PDMPs to aid clinicians in formulating opioid prescribing decisions at the point of care.
Optic Disc Edema in Syphilis
Authors: Kabanovski Anna , Donaldson Laura , Jeeva-Patel Trishal , Margolin Edward A. 
Published: October 2021

Background:
Syphilis is an uncommon cause of optic nerve head edema; however, differentiating syphilis from other etiologies of optic nerve head swelling may be challenging. We describe 4 cases of ocular syphilis presenting with swollen optic nerve head(s) without overt signs of intraocular inflammation to better define the phenotypic presentation of this condition to allow its early recognition and treatment and discuss potential pathophysiological mechanisms of syphilitic optic neuropathy.

Methods:
Retrospective case series of patients presenting to a tertiary neuro-ophthalmology practice with a swollen optic nerve head(s) but no overt signs of intraocular inflammation, which was eventually determined to be secondary to syphilis.

Results:
Four patients were included in the study. The mean age was 43 years, 2 were women and 2 had bilateral involvement. Two patients had a recent history of skin rash, and one patient was investigated for abdominal pain and elevated liver enzymes. Two patients presented with photopsias and preserved visual function, whereas 2 presented with vision loss. Although chorioretinitis was present in all cases, it was very subtle in all and was only appreciated on fundus autofluorescence (FA) in 3 of 4 cases. Three patients demonstrated evidence of optic perineuritis on neuro-imaging. All patients were treated with a course of intravenous penicillin with a variable degree of visual recovery.

Conclusions:
Systemic symptoms are common in patients with syphilic optic neuropathy. Optic disc edema as a manifestation of syphilis is usually accompanied by subtle chorioretinitis, which is best appreciated on FA. Optic perineuritis is common in patients with syphilitic optic neuropathy, with its pathophysiology likely similar to meningitis seen in neurosyphilis.
Decreased hospital visits and increased mortality rate in the emergency department during the COVID-19 pandemic: Evidence from Albania
Authors: Bucaj Jorgjia , Mechili Enkeleint A. , Galanis Petros , Mersini Bruna , Nika Sonila , Hoxhaj Inis , Likaj Stefano , Patelarou Athina E. , Patelarou Evridiki 
Published: October 2021

AbstractObjectiveTo investigate the hospital visits and mortality rate during the COVID-19 in emergency department of Vlora regional hospital in Albania and to compare with the three previous years (2017-2019).Data sourcesSecondary data of patients that visited emergency department of Vlora Regional hospital Albania (largest hospital in the south of the country), since January 1, 2017 till December 31, 2020.Study DesignThis is a retrospective study. We used the hard copy of the patients’ health register records.Extraction methodsThe data extraction was conducted during March 2021 till June 2021. Eligible were all patients admitted and recorded in the registry of the Emergency department. The causes of admission were categorized in 14 different disease categories. All registered patient admitted to the Vlora regional hospital were included in the study. Patients that all data were not recorded and patients that data were not possible to be read were excluded.Principal FindingsStudy population included 44.917 patients during 2017-2020. Mean age of patients was 51.5 years, while 53.6% were females. The highest number of patients was in 2017 (n=12.407) and the lowest in 2020 (n=9.266). Increase of patients presented with cardiovascular, psychiatric and renal/urinary tract were observed in 2020 in comparison to 2019. Patients decreased over time with an average annual percent decrease of −7% (p-value=0.22). Joinpoint analysis revealed that mortality rate increased over time with an average annual percent increase of 34.3% (95% confidence interval= −42.7% to 214.8%, p-value=0.27).ConclusionsDuring the study years the number of patients visiting emergency department decreased while mortality rate increased. Educating and raising awareness of patient to seek medical assistance should be a key objective of health policy makers and health personnel. A specific focus should be put on the more vulnerable (elderly and unemployed) as their health status is in higher risk.
Individual Symptom Severity in Adult Autism Spectrum Disorder Predicts Reduction in Right Dorsal Stream Neural Activity During Live Eye-to-Eye Contact
Authors: Hirsch Joy , Zhang Xian , Noah J. Adam , Naples Adam , Wolf Julie M. , McPartland James C. 
Published: October 2021

AbstractBackgroundSocial symptomatology quantified by clinical interview (Autism Diagnostic Observation Schedule, ADOS) and self-report (Social Responsiveness Scale, SRS) indicate symptom severity in autism spectrum disorder (ASD). Reluctance to engage in interpersonal eye contact is a frequently observed behavioral hallmark, though neural bases for these difficulties and relation to symptomatology are not understood. We test the hypothesis that eye contact in ASD activates atypical neural mechanisms that are related to individual differences in symptomatology.MethodsNeural activity represented by hemodynamic signals was acquired by functional near-infrared spectroscopy (fNIRS) during real person-to-person eye contact (confirmed by eye-tracking) for 17 adult ASD (3 female, 14 male) and 19 typically-developed (TD) participants (8 female, 11 male). Assessment of social function was based on ADOS scores for ASD participants and SRS scores for the combined group of ASD and TD participants.ResultsIndividual ADOS scores were negatively correlated (r = -0.69) with individual fNIRS beta-values (representing strength of hemodynamic signals) within clusters in the right dorsal stream regions: somatosensory cortices, angular gyrus, and supramarginal gyrus. Hemodynamic responses in the right dorsolateral prefrontal cortex (DLPFC) were also negatively correlated (r = -0.77) with ADOS scores. Similarly, SRS scores for the combined ASD and TD groups were also negatively correlated (r = -0.58) with somatosensory cortices and the supramarginal gyrus.ConclusionsThese findings are consistent with the hypothesis that neural mechanisms in the dorsal stream and DLPFC are related to social symptomatology and implicate high-level interactive face and eye-processing systems as potential neurobiological markers of ASD.