bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep Brain Stimulation for Treatment of Refractory Epilepsy
Authors: de Oliveira Tatiana V , Cukiert Arthur 
Published: April 2021

Background and Introduction:
Deep brain stimulation (DBS) has been increasingly used in the treatment of refractory epilepsy with remarkable safety. Experimental data demonstrated that electric current could modulate distinct brain circuits and decrease neuronal hypersynchronization seen in epileptic activity. The ability to carefully choose the most suitable anatomical target and precisely implant the lead is of extreme importance for satisfactory outcomes.

Objective:
This video aimed to explore the targeting of the three most relevant nuclei in the treatment of refractory epilepsy.

Technique:
Through a step-by-step approach, this video describes the surgical planning for DBS implantation in the anterior nucleus of the thalamus (ANT), the centromedian nucleus of the thalamus (CM), and the hippocampus (HIP).

Conclusion:
Each of the discussed targets has its own pearls and pitfalls that should be considered for an adequate lead placement. Accurate planning of the surgical procedure is essential for achieving optimal results.
Simple Indigenous Two-Point Discrimination Testing Device
Authors: Agarwal Pawan , Mukati Prachir , Kukrele Rajeev , Sharma Dhananjaya 
Published: April 2021

Background:
Measurement of two-point discrimination (2-PD) is used in clinical practice to evaluate the severity of nerve injuries, neuropathy, and recovery of patients following nerve repair. Commercially available 2-PD testing devices are costly and therefore not available everywhere.

Methods and Material:
We made an economical indigenous 2-PD testing device from off-the-shelf components and tested its efficacy in volunteers.

Statistical Analysis:
The data were analyzed using Minitab Statistical Software Version 17.0 and Kappa statistics were used in the assessment of agreement between two devices.

Results:
A total of 30 (23 men, 7 women) subjects were included in the study. There was good agreement between the measurements of static 2-PD with the two different test devices: from fair (Kappa = 0.408, P = 0.018) to strong (Kappa = 0.618–0.795, P = 0.000).

Conclusions:
This device is simple to make, very economical, and obtains accurate 2-PD measurements.
Ischemia Modified Albumin and miR-126 Play Important Role in Diagnosis of Posterior Circulation Transient Ischemic Attack and Prediction of Secondary Cerebral Infarction
Authors: Lidong Ding , Zhanghong Xiao , Huawu Mao , Xiaofang Hang , Junhua Guo , Kaifu Ke , Jue Chen 
Published: April 2021

Background:
Transient ischemic attack (TIA) is a super warning for cerebral infarction stroke, thus probe of sensitive biomarker for TIA diagnosis and prognosis can contribute to make an optimal intervention plan.

Objective:
This study was conducted to explore the value of ischemic modified albumin (IMA) and microRNA-12miR-126 on the diagnosis of posterior circulation TIA and the prediction of secondary cerebral infarction.

Study Design:
This study was conducted as a longitudinal prospective research.

Methods:
The levels of serum IMA and miR-126 at 3h, 6h and 12h after TIA onset were analyzed in 106 patients, then the predictive value of IMA and miR-126 for secondary cerebral infarction were tested.

Results:
A significant increase of serum IMA and a decrease of miR-126 were observed after TIA onset (P = 0.000),simultaneously a significant negative correlation was found between serum IMA for 3 h and miR-126 for 12 hr=-0.401, P = 0.000. Both IMA and miR-126 were significant associated with the secondary cerebral infarction.

Conclusion:
Early detection of IMA and miR-126 is of great value in diagnosing posterior circulation TIA and predicting the secondary cerebral infarction.
Differential Characteristics of Ischemic and Hemorrhagic Stroke in Patients with Cerebral Small Vessel Disease
Authors: Bernal Mireia , Escarcena Paula , Arboix Adrià , García-Eroles Lluis , Vergés Enric , Díez Laura , Massons Joan 
Published: April 2021

Background:
Small vessel disease (SVD) is the underlying anatomical substrate for both lacunar infarction and subcortical hemorrhage.

Aim:
To assess predictive factors of ischemic or hemorrhagic stroke in patients with cerebral SVD.

Materials and Methods:
Prospective hospital-based stroke registry (“The Sagrat Cor Hospital of Barcelona Stroke Registry”) in an acute-care teaching hospital in Barcelona, Spain. From 4597 acute stroke patients included in the stroke registry over a 24-year period, 440 cases of lacunar stroke and 210 of subcortical intracerebral hemorrhage were selected. Demographics, clinical characteristics, risk factors, and early outcome were compared. Predictors of lacuna versus subcortical hemorrhage were assessed by multivariate analyses.

Results:
In a logistic regression model based on demographics, risk factors, clinical features and outcome, dyslipidemia (odds ratio [OR] 2.06 (95% confidence interval (CI) 1.17-3.62) and diabetes (OR 1.97, 95% CI 1.19–3.26) were independent risk factors for lacunar infarction. Anticoagulation therapy (OR 0.05, 95% CI 0.01–0.28), sudden onset (OR 0.51, 95% CI 0.33–0.78), motor symptoms (OR 0.44, 95% CI 0.26–0.76), headache (OR 0.23, 95% CI 0.12–0.41), altered consciousness (OR 0.10, 95% CI 0.05–0.21), respiratory complications (OR 0.19, 95% CI 0.08–0.46), and in-hospital death (OR 0.08, 95% CI 0.02–0.36) were predictors of subcortical hemorrhage.

Conclusion:
Identification of differential clinical and prognostic profile between ischemic and hemorrhagic consequences of underlying cerebral SVD is useful for risk stratification in the current process pursuing precision medicine.
Isolated Cervical Pain Revealing a Common Carotid Artery Dissection in a Child Following a Minor Trauma
Authors: Messelmani Mariem , Akkari Manel , Souissi Wala , Mrissa Ridha 
Published: April 2021

Background:
Cervical artery dissections are not exceptional in the pediatric population. Typically, it affects the internal carotid artery or the vertebral artery. To our knowledge, this is the first case of common carotid artery (CCA) dissection in a child.

Case:
We present a case of a 7-year-old-boy admitted to our neurology department complaining of cervical pain after a minor neck trauma. The neurological examination was normal. The ultrasound showed a mural hematoma with an intimal flap. The magnetic resonance angiography revealed an irregular segment of the left CCA just before its bifurcation. The diagnosis of an acute dissection on the left CCA was confirmed and antiplatelet therapy was started.

Conclusion:
The diagnosis of cervical artery dissections remains a challenge because of its variable clinical presentation. It should be suspected in the context of neck trauma and treatment should be initiated rapidly to reduce the risk of ischemic stroke.
Basal Cisternostomy - A Microsurgical Cerebro Spinal Fluid Let Out Procedure and Treatment Option in the Management of Traumatic Brain Injury. Analysis of 40 Consecutive Head Injury Patients Operated with and without Bone Flap Replacement Following Cisternostomy in a Tertiary Care Centre in India
Authors: Parthiban Jutty K B C , Sundaramahalingam Shanthanam , Rao J Balaparameswara , Nannaware Vaishali Pralhad , Rathwa Vishnu Najarubhai , Nasre Vaibhav Yogesh , Prahlad Shantigrama Thirumalachar 
Published: April 2021

Background:
Decompressive craniectomy (DC) is considered the gold standard blanket surgical procedure for all medically intractable cerebral oedema in Traumatic Brain Injury (TBI). It's only proven fact is that it reduces Intra Cerebral Pressure (ICP) by providing space for the oedematous brain. Attempts are being made to find additional or alternative procedures to improve outcomes in TBI. Basal Cisternostomy is one such technique proposed to bring such a change in world literature.

Aim:
To analyse the validity of Basal Cisternostomy in TBI patients

Materials and Methods:
A total of 40 patients who underwent Basal Cisternostomy (BC) in TBI admitted in the senior author's unit between January 2016 and April 2019 were analysed retrospectively. All surgeries were performed by single surgeon with microsurgical expertise. Outcome was assessed according to Glasgow outcome scale (GOS). Results were analysed using SPSS software.

Results:
In severe TBI, Basal Cisternostomy group showed 77.8% favourable outcome while Decompressive Craniectomy in addition to Basal Cisternostomy group showed 72.7% only. While favourable GOS was seen in 82% (33/40), the unfavourable outcome was noticed in 12.5% (5/40) and death in 5% (2/40) in this series. Hydrocephalus was seen in 12.5% (5/40). Patients operated earlier from the time of injury showed better results than those who got operated later irrespective of severity of neurological status. ICU stay and hospital stay duration and its validity could not be assessed.

Conclusion:
Basal Cisternostomy is an effective procedure in Traumatic Brain Injury patients that not only improves outcome but also reduces the need for Decompressive Craniectomy as a blanket procedure and thus avoiding its associated complications.
Bone Wax as an Intra-Cavitary Fiducial for Intra-Operative Magnetic Resonance Imaging Guided Resections of Eloquent Cortex Glioma
Authors: Arumalla Kirit , Deora Harsh 
Published: April 2021

Background:
The extent of resection of eloquent cortex low-grade glioma is improved by intraoperative magnetic resonance imaging (IOMRI) which is faced with challenges such as difficulty in automated registration after the MRI and prolongation of operative time.

Objective:
We describe an easier and foolproof method of resection using bone wax as fiducial.

Surgical Procedure:
A young male with right-frontal low-grade glioma anterior and superficial to the motor fibers was operated using IOMRI and awake craniotomy under neuromonitoring. Motor cortex mapping using phase reversal and continuous motor evoked potential (MEP) monitoring was used initially followed by continuous sub-cortical suction stimulation for deeper decompression until stimulation was seen. Bone wax in a triangular shape was placed at the suspicious margin and IOMRI was done.

Results:
The tumor residue was seen anterior and deeper to the bone wax and removed subsequently.

Conclusion:
The use of bone wax as a fiducial can aid in IOMRI-guided resection of eloquent cortex glioma in awake patients.
Anomalous Vertebral Artery During Cranio Vertebral Junction Surgery Using DCER (Distraction, Compression, Extension, and Reduction)
Authors: Chandra P S , Ghonia Raj , Singh Simranjeet , Garg Kanwaljeet 
Published: April 2021

Introduction:
Vertebral artery (VA) may run an anomalous course in congenital craniovertebral junction anomalies. Anomalous VA, though rare, is challenging to handle. An anomalous VA can get injured during exposure of craniovertebral junction, even in the experienced hands.

Objective:
The objective of this article was to describe the technique of repairing the VA in case of its damage during exposure in the craniovertebral junction (atlantoaxial dislocation [AAD] with basilar invagination [BI]).

Procedure:
The authors describe a case of VA artery injury in a case of severe BI & AAD, which was anomalous and coursing over the joints. Following the repair of injured VA, we proceeded with the surgery (distraction, compression, extension, and reduction [DCER]).

Conclusion:
To avoid injury, it is important to always perform a CT 3-D angiogram, perform meticulous dissection under the microscope while exposing the joints, use variable impedance bipolar to control venous bleeding and always expose the side with non-dominant VA first.
Interleaved Stimulation for Freezing of Gait in Advanced Parkinson's Disease
Authors: Zafar Syed M , Rajan Roopa , Krishnan Syam , Kesavapisharady Krishnakumar , Kishore Asha 
Published: April 2021

Background:
Freezing of gait (FOG) is a disabling and refractory symptom of advanced Parkinson's disease (PD). Interleaved stimulation (ILS) is a novel paradigm which may benefit axial symptoms of PD.

Objectives:
To assess the effect of ILS on FOG in patients unresponsive to conventional subthalamic nucleus (STN) stimulation.

Methods:
19 PD patients receiving subthalamic stimulation and experiencing FOG at both conventional (130–150Hz) and low frequency (60Hz) stimulation were given ILS. The primary outcome measure was the UPDRS part III gait score (item 29) at 3 months after ILS. A subset of patients was tested with the stand–walk–sit (SWS) test, 30 min after ILS.

Results:
The mean UPDRS part III gait score (baseline: 1.8 ± 0.6) improved at 30 min (1.1 ± 0.8, P = 0.017) and remained improved at 3 months (1.2 ± 0.8, P = 0.048). FOG episodes reduced during SWS test (P = 0.041).

Conclusions:
ILS of STN through two adjacent contacts provided significant short-term beneficial effects on FOG.
Efficacy of Antibacterial Sealant to Prevent Microlekage at the Implant Superstructure Interface – An In vivo Study
Authors: Nayak Aishwarya , Nadiger Ramesh , Bhat Kishore , Ingalgi Preeti , Kulkarni Raghvendra 
Published: April 2021

Objective:
The aim of this study is to evaluate the efficacy of antibacterial sealants to prevent microleakage at the implant superstructure interface.

Materials and Methods:
Around twenty patients were selected after a thorough investigation with lower missing teeth (1st and 2nd premolars 1st and 2nd molars) by inclusion criteria. The patients were divided into two groups Group A (10 patients)– Control group and Group B (10 patients)-test group. The implants were placed with proper surgical protocol in all the patients except that in the test group antibacterial sealant was used before putting the coverscrew. The implants were allowed to osseointegrate for 3 months after which swabs were collected from the interior of the implant once the cover screw was removed. The swabs collected from all the patients were immediately transported to the microbiology laboratory by placing in 1 ml of phosphate buffered saline. The swabs were inoculated on brain heart infusion and McKonkeys medium and processed for routine culture and sensitivity. The identification of the isolates was done by standard microbiological methods. The data thus obtained were subjected to statistical analysis using t-tests for equality.

Results:
Microbial growth was found in both the groups, but lesser variation in colony-forming units was observed in the test group where antibacterial sealant was used.

Conclusions:
It was concluded that in spite of using antibacterial sealants; some amount of microleakage was still observed.
Scoping Review on the Concept of Patient Motivation and Practical Tools to Assess it
Authors: Hosseini Fatemeh , Alavi Negin Masoud , Mohammadi Eesa , Sadat Zohreh 
Published: April 2021

Background:
In this scoping review, the concept of patients' motivation and the tools that have been designed to measure this concept in clinical settings are presented.

Materials and Methods:
Arksey and O'Malley's framework was used in conducting the current scoping review. Google Scholar, PubMed, Scopus, and Web of Science databases were searched for relevant English articles published between January 1995 and January 2020 using the keywords motivation and tool, and their synonyms. Out of 2820 articles, 34 articles were chosen and were entered into the final analysis. Definitions of patients' motivation were determined using Kyngäs et al., content analysis method.

Results:
The findings showed that new tools had been developed in 38% of the studies and other studies had revised or translated existing questionnaires. Moreover, 62% of the tools were used to measure patient motivation in mental disorders. Most of the studies did not clearly define the concept of patient motivation in the clinical environment. The findings of content analysis outlined the 3 categories of motivation determinant factors, decisions, and behaviors that determine overall levels of motivations and its consequences.

Conclusions:
Motivation is a dynamic concept and is a result of internal and external motives that lead to decisions and behaviors. There are limited tools for measuring motivation in clinical settings. This addresses the need to design specific tools in various diseases, especially chronic diseases. By the concept defined in this study, it is possible to design a short tool with general application that can be used in all diseases.
Comparing the Effectiveness of Sexual Counseling Based on PLISSITand BETTER Models on Sexual Selfdisclosure in Women with Sexual Problems after Childbirth
Authors: Karimi Farzane , Babazadeh Raheleh , Roudsari Robab Latifnejad , Asgharipour Negar , Esmaily Habibollah 
Published: April 2021

Background:
Sexual self-disclosure is one of the factors that affect sexual satisfaction. The aim of this study was to assess the efficacy of individual therapy using the Bring up, Explain, Tell, Timing, Educate, and Record (BETTER model) in comparison to individual therapy using the Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT model) in terms of increasing sexual self-disclosure in women with sexual problems after childbirth.

Materials and Methods:
This randomized trial was conducted in 2017 in Mashhad, Iran. 80 women with sexual problems within 4 weeks to 6 months after childbirth were randomized into two equal groups and received the interventions in 2 sessions of 60–90 minutes. The research instruments included a demographic questionnaire, the Female Sexual Function Index (FSFI) and Hulbert sexual self-disclosure index. Changes in mean (SD) scores of sexual self-disclosures between groups were assessed before and 4 weeks after the intervention and the results (mean changes) were compared between groups. The data analysis was conducted using independent t-test, paired t-test, Chi-square, analysis of covariance (ANOVA), and Mann-Whitney U test in SPSS (p < 0.05).

Results:
In the PLISSIT group, the mean (SD) sexual self-disclosure score at baseline was 43.80 (9.50) and after 4 weeks was 51.60 (8.30). In the BETTER group, at baseline and after 4 weeks the mean (SD) sexual self-disclosure score was, respectively, 44.10 (10.30) and 55.60 (8.20) (Z = -2.5, p = 0.013).

Conclusions:
The findings confirm the effectiveness of the BETTER counseling model in increasing sexual self-disclosure after childbirth.
Experiences of Family Caregivers of Patients with Borderline Personality Disorder of Social Stigma
Authors: Meshkinyazd Ali , Bordbar Mohammadreza Fayyazi , Heydari Abbas 
Published: April 2021

Background:
Social stigma is the most common and challenging burden of care on the family of people with Borderline Personality Disorder (BPD) In Iran, despite the cultural and social influences, this issue has been less studied. Therefore, present study was conducted to determine the lived experiences of caregivers of patients with BPD of social stigma.

Materials and Methods:
This qualitative study was performed at Ibn Sina hospital in Mashhad, Iran from 2017 to 2019. Participants were selected by purposive and snowball sampling method. Data were collected through semi-structured interviews. Data saturation was achieved after 16 interviews. Finally, the data were analyzed by the method proposed by Diekelmann (1989).

Results:
In data analysis, one main theme and two sub-themes emerged. The main themes include Black shadow. Two sub-themes consisted of society dagger and secrecy. The sub-theme of society dagger included the two common meanings (inner turmoil in response to the stigma of others and weakening of family status among relatives and acquaintances). The sub-theme of secrecy comprised of the three common meanings (concealment of disease, hide hospitalization, and seclusion).

Conclusions:
An understanding of the experience of family stigma can lead to the development of supportive strategies to manage this problem among caregivers of patients with BPD. Nurses can support caregivers by offering them opportunities to discuss how stigma is disrupting their caregiving roles. They can also support the caregivers in negotiating the experienced social and emotional distress and when necessary, refer them to the other members of healthcare teams.
The Effect of Exposure to Rubber Production Emissions and Physical Activity on Pulmonary Function Indices among Tyre Manufacturing Employees in Iran
Authors: Rafeemanesh Ehsan , Esmaily Habibollah , Ahmadi Fatemeh , Sardar Mohammadali , Ghooshchi Golnoosh 
Published: April 2021

Background:
Exposure to rubber production emissions can cause respiratory problems. There is some evidence that physical activity might have protective effects against respiratory obstruction.

Aims:
This study, was investigated the effect of physical activity on potential respiratory damages induced by the exposure to rubber production chemicals.

Methods:
This cross-sectional study was carried out during 2019 on the staff of a rubber manufacturing company in Khorasan, Iran. Employees of a rubber manufacturing company were recruited in this cross-sectional study (n = 385), and were classified into exposed (n = 266) and unexposed (n = 119) groups. Baecke Physical Activity Questionnaire (BPAQ) was used to assess the level of physical activity. Logistic regression was used to evaluate the effects of exposure, physical activity and confounding variables on pulmonary function test (PFT) results.

Results:
Work, leisure time and total physical activity scores were significantly higher in exposure group compared with control group subjects. Although no significant differences were observed between the exposure and control groups in most spirometric parameters, FEF25-75 was significantly lower in the exposure group (P = 0.035). Abnormal PFT was observed in 93 participants (24.2%) and in the multivariate model was significantly associated with exposure (OR = 1.80, CI95: 1.01-3.22) and age (OR = 1.08, CI95: 1.02-1.14) but not physical activity score.

Conclusion:
Exposure to rubber manufacturing chemicals nearly doubles the odds of abnormal PFT, and the self-reported level of physical activity had no protective effect against these occupational hazards.
Magnetic Resonance Imaging Scan of the Dimensions of Normal Lumbar Intervertebral Foramina - An Observational Study
Authors: Mallick Santanu P. 
Published: April 2021

Background:
Intervertebral foramen (IVF) is an oval, round, or inverted teardrop shaped bilateral fibro osseous window throughout the entire vertebral column through which neurovascular structures pass. The lumber canal stenosis due to variations of narrowing of intervertebral foramina causes compression of exiting spinal nerve or other foraminal components, for which normal IVF dimensions must be known and understood thoroughly.

Aims and Objectives:
Although computed tomography scan remains very effective in the evaluation of osseous tissues, but being a fibro osseous canal, intervertebral foramina can be better evaluated by magnetic resonance imaging (MRI) scan for superior resolution.

Materials and Methods:
Normal morphometric database of right and left lumber IVF of 195 normal adult males (96) and females (99) from different age groups (20–69 years) has been taken to draw conclusions from the data relevant to clinical practice and future research. MRI scan in the sagittal plane gives a complete view of the fibro osseous canal, whereas horizontal imaging (axial view) does not demonstrate the entire IVF on a single image. That's why all the measurements were taken from the sagittal plane.

Results:
All the values are evaluated with the subjects' age, sex, weight, height, and also with the left versus right sides. The development of this normal database should further allow for more meaningful evaluation of the dimensions of the IVFs in pathologic states. Although diagnosis can be suspected from the history and physical findings, knowledge of the specific anatomy of this clinically significant area with radiological support is very important in the differential diagnosis which helps in proper management.

Conclusion:
Therefore, it is really convincing that, with regard to morphometry of the spine by means of MRI, the future is very promising.