bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overlapping single-level lumbar fusion and adverse short-term outcomes
Authors: Farooqi Ali S. , Detchou Donald K. E. , Glauser Gregory , Strouz Krista , McClintock Scott D. , Malhotra Neil R. 
Published: August 2021

OBJECTIVE
There is a paucity of research on the safety of overlapping surgery. The purpose of this study was to evaluate the impact of overlapping surgery on a homogenous population of exactly matched patients undergoing single-level, posterior-only lumbar fusion.

METHODS
The authors retrospectively analyzed case data of 3799 consecutive adult patients who underwent single-level, posterior-only lumbar fusion during a 6-year period (June 7, 2013, to April 29, 2019) at a multihospital university health system. Outcomes included 30-day emergency department (ED) visit, readmission, reoperation, and morbidity and mortality following surgery. Thereafter, coarsened exact matching was used to match patients with and without overlap on key demographic factors, including American Society of Anesthesiologists (ASA) class, Charlson Comorbidity Index (CCI) score, sex, and body mass index (BMI), among others. Patients were subsequently matched by both demographic data and by the specific surgeon performing the operation. Univariate analysis was carried out on the whole population, the demographically matched cohort, and the surgeon-matched cohort, with significance set at a p value < 0.05.

RESULTS
There was no significant difference in morbidity or any short-term outcome, including readmission, reoperation, ED evaluation, and mortality. Among the demographically matched cohort and surgeon-matched cohort, there was no significant difference in age, sex, history of prior surgery, ASA class, or CCI score. Overlapping surgery patients in both the demographically matched cohort and the matched cohort limited by surgeon had longer durations of surgery (p < 0.01), but no increased morbidity or mortality was noted. Patients selected for overlap had fewer prior surgeries and lower ASA class and CCI score (p < 0.01). Patients with overlap also had a longer duration of surgery (p < 0.01) but not duration of closure.

CONCLUSIONS
Exactly matched patients undergoing overlapping single-level lumbar fusion procedures had no increased short-term morbidity or mortality; however, duration of surgery was 20 minutes longer on average for overlapping operations. Further studies should assess long-term patient outcomes and the impact of overlap in this and other surgical procedures.
The effectiveness of systemic therapies after surgery for metastatic renal cell carcinoma to the spine: a propensity analysis controlling for sarcopenia, frailty, and nutrition
Authors: Massaad Elie , Saylor Philip J. , Hadzipasic Muhamed , Kiapour Ali , Oh Kevin , Schwab Joseph H. , Schoenfeld Andrew J. , Shankar Ganesh M. , Shin John H. 
Published: August 2021

OBJECTIVE
The effectiveness of starting systemic therapies after surgery for spinal metastases from renal cell carcinoma (RCC) has not been evaluated in randomized controlled trials. Agents that target tyrosine kinases, mammalian target of rapamycin signaling, and immune checkpoints are now commonly used. Variables like sarcopenia, nutritional status, and frailty may impact recovery from spine surgery and are considered when evaluating a patient’s candidacy for such treatments. A better understanding of the significance of these variables may help improve patient selection for available treatment options after surgery. The authors used comparative effectiveness methods to study the treatment effect of postoperative systemic therapies (PSTs) on survival.

METHODS
Univariable and multivariable Cox regression analyses were performed to determine factors associated with overall survival (OS) in a retrospective cohort of adult patients who underwent spine surgery for metastatic RCC between 2010 and 2019. Propensity score–matched (PSM) analysis and inverse probability weighting (IPW) were performed to determine the treatment effect of PST on OS. To address confounding and minimize bias in estimations, PSM and IPW were adjusted for covariates, including age, sex, frailty, sarcopenia, nutrition, visceral metastases, International Metastatic RCC Database Consortium (IMDC) risk score, and performance status.

RESULTS
In total, 88 patients (73.9% male; median age 62 years, range 29–84 years) were identified; 49 patients (55.7%) had an intermediate IMDC risk, and 29 (33.0%) had a poor IMDC risk. The median follow-up was 17 months (range 1–104 months) during which 57 patients (64.7%) died. Poor IMDC risk (HR 3.2 [95% CI 1.08–9.3]), baseline performance status (Eastern Cooperative Oncology Group score 3 or 4; HR 2.7 [95% CI 1.5–4.7]), and nutrition (prognostic nutritional index [PNI] first tertile, PNI < 40.74; HR 2.69 [95% CI 1.42–5.1]) were associated with worse OS. Sarcopenia and frailty were not significantly associated with poor survival. PST was associated with prolonged OS, demonstrated by similar effects from multivariable Cox analysis (HR 0.55 [95% CI 0.30–1.00]), PSM (HR 0.53 [95% CI 0.29–0.93]), IPW (HR 0.47 [95% CI 0.24–0.94]), and comparable confidence intervals. The median survival for those receiving PST was 28 (95% CI 19–43) months versus 12 (95% CI 4–37) months for those who only had surgery (log-rank p = 0.027).

CONCLUSIONS
This comparative analysis demonstrated that PST is associated with improved survival in specific cohorts with metastatic spinal RCC after adjusting for frailty, sarcopenia, and malnutrition. The marked differences in survival should be taken into consideration when planning for surgery.
Sex-based differences in outcomes for adult patients presenting to the emergency department with a concussion
Authors: Rowe Brian H. , Yang Esther H. , Gaudet Lindsay A. , Eliyahu Leeor , Junqueira Daniela R. , Beach Jeremy , Mrazik Martin , Cummings Garnet , Voaklander Donald 
Published: August 2021

OBJECTIVE
Patients with concussion frequently present to the emergency department (ED). Studies of athletes and children indicate that concussion symptoms are often more severe and prolonged in females compared with males. Given infrequent study of concussion symptoms in the general adult population, the authors conducted a sex-based comparison of patients with concussion.

METHODS
Adults (≥ 17 years of age) presenting with concussion to one of three urban Canadian EDs were recruited. Discharged patients were contacted by telephone 30 and 90 days later to capture the extent of persistent postconcussion symptoms using the Rivermead Post Concussion Symptoms Questionnaire (RPQ). A multivariate logistic regression model for persistent symptoms that included biological sex was developed.

RESULTS
Overall, 250 patients were included; 131 (52%) were women, and the median age of women was significantly higher than that of men (40 vs 32 years). Women had higher RPQ scores at baseline (p < 0.001) and the 30-day follow-up (p = 0.001); this difference resolved by 90 days. The multivariate logistic regression identified that women, patients having a history of sleep disorder, and those presenting to the ED with concussions after a motor vehicle collision were more likely to experience persistent symptoms.

CONCLUSIONS
In a community concussion sample, inconsequential demographic differences existed between adult women and men on ED presentation. Based on self-reported and objective outcomes, work and daily activities may be more affected by concussion and persistent postconcussion symptoms for women than men. Further analysis of these differences is required to identify different treatment options and ensure adequate care and management of injury.
Comparison of 1.0 g/kg of 20% mannitol initiated at different time points and effects on brain relaxation in patients with midline shift undergoing supratentorial tumor resection: a randomized controlled trial
Authors: Zhang Jun-Jie , Liu Yi-Heng , Tu Meng-Yun , Wei Kai , Wang Ying-Wei , Deng Meng 
Published: August 2021

OBJECTIVE
Previous studies have suggested the use of 1.0 g/kg of 20% mannitol at the time of skin incision during neurosurgery in order to improve brain relaxation. However, the incidence of brain swelling upon dural opening is still high with this dose. In the present study, the authors sought to determine a better timing for mannitol infusion.

METHODS
One hundred patients with midline shift who were undergoing elective supratentorial tumor resection were randomly assigned to receive early (immediately after anesthesia induction) or routine (at the time of skin incision) administration of 1.0 g/kg body weight of 20% mannitol. The primary outcome was the 4-point brain relaxation score (BRS) immediately after dural opening (1, perfectly relaxed; 2, satisfactorily relaxed; 3, firm brain; and 4, bulging brain). The secondary outcomes included subdural intracranial pressure (ICP) measured immediately before dural opening; serum osmolality and osmole gap (OG) measured immediately before mannitol infusion (T0) and at the time of dural opening (TD); changes in serum electrolytes, lactate, and hemodynamic parameters at T0 and 30, 60, 90, and 120 minutes thereafter; and fluid balance at TD.

RESULTS
The time from the start of mannitol administration to dural opening was significantly longer in the early administration group than in the routine administration group (median 66 [IQR 55–75] vs 40 [IQR 38–45] minutes, p < 0.001). The BRS (score 1/2/3/4, n = 14/26/9/1 vs 3/25/18/4, p = 0.001) was better and the subdural ICP (median 5 [IQR 3–6] vs 7 [IQR 5–10] mm Hg, p < 0.001) was significantly lower in the early administration group than in the routine administration group. Serum osmolality and OG increased significantly at TD compared to levels at T0 in both groups (all p < 0.001). Intergroup comparison showed that serum osmolality and OG at TD were significantly higher in the routine administration group (p < 0.001 and = 0.002, respectively). Patients who had received early administration of mannitol had more urine output (p = 0.001) and less positive fluid balance (p < 0.001) at TD. Hemodynamic parameters, serum lactate concentrations, and incidences of electrolyte disturbances were comparable between the two groups.

CONCLUSIONS
Prolonging the time interval between the start of mannitol infusion and dural incision from approximately 40 to 66 minutes can improve brain relaxation and decrease subdural ICP in elective supratentorial tumor resection.
Neuroanatomical considerations for optimizing thalamic deep brain stimulation in Tourette syndrome
Authors: Morishita Takashi , Sakai Yuki , Iida Hitoshi , Yoshimura Saki , Ishii Atsushi , Fujioka Shinsuke , Tanaka Saori C. , Inoue Tooru 
Published: August 2021

OBJECTIVE
Deep brain stimulation (DBS) of the centromedian thalamic nucleus has been reportedly used to treat severe Tourette syndrome, yielding promising outcomes. However, it remains unclear how DBS electrode position and stimulation parameters modulate the specific area and related networks. The authors aimed to evaluate the relationships between the anatomical location of stimulation fields and clinical responses, including therapeutic and side effects.

METHODS
The authors collected data from 8 patients with Tourette syndrome who were treated with DBS. The authors selected the active contact following threshold tests of acute side effects and gradually increased the stimulation intensity within the therapeutic window such that acute and chronic side effects could be avoided at each programming session. The patients were carefully interviewed, and stimulation-induced side effects were recorded. Clinical outcomes were evaluated using the Yale Global Tic Severity Scale, the Yale-Brown Obsessive-Compulsive Scale, and the Hamilton Depression Rating Scale. The DBS lead location was evaluated in the normalized brain space by using a 3D atlas. The volume of tissue activated was determined, and the associated normative connective analyses were performed to link the stimulation field with the therapeutic and side effects.

RESULTS
The mean follow-up period was 10.9 ± 3.9 months. All clinical scales showed significant improvement. Whereas the volume of tissue activated associated with therapeutic effects covers the centromedian and ventrolateral nuclei and showed an association with motor networks, those associated with paresthesia and dizziness were associated with stimulation of the ventralis caudalis and red nucleus, respectively. Depressed mood was associated with the spread of stimulation current to the mediodorsal nucleus and showed an association with limbic networks.

CONCLUSIONS
This study addresses the importance of accurate implantation of DBS electrodes for obtaining standardized clinical outcomes and suggests that meticulous programming with careful monitoring of clinical symptoms may improve outcomes.
Development and persistence of patient-reported visual problems associated with serotonin reuptake inhibiting antidepressants
Authors: Healy David , Mangin Dee , Lochhead Jonathan 
Published: August 2021

BACKGROUND: The majority of antidepressants inhibit serotonin reuptake and include the selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and the serotonin reuptake inhibiting tricyclic antidepressants. OBJECTIVE: The objective of this study was to investigate and describe the range and impact of reported adverse visual effects linked to serotonin reuptake inhibiting antidepressants. METHODS: Using data from a global database of patient spontaneous reports of drug adverse events, we systematically identified eligible reports of visual problems linked to the use of serotonin reuptake inhibiting antidepressants. We analyzed these data using simple descriptive statistics to present the range and impact. RESULTS: We identified 124 reports of visual problems. Reports originate from 18 countries and involve 11 different drugs. The most commonly reported symptoms were vision blurred/visual acuity reduced (n = 79, 63.7%), night blindness (n = 22, 17.7%), vitreous floaters (n = 21, 16.9%), photophobia (n = 19, 15.3%), diplopia (n = 15, 12.1%), palinopsia (n = 13, 10.5%), visual field defect (n = 12, 9.7%), photopsia (n = 11, 8.9%) and visual snow syndrome (n = 11, 8.9%). 74 patients indicated that the side effect was bad enough to affect everyday activities, 62 had sought health care, and 50 indicated that their work had been affected. 49 patients reported an enduring vision problem after discontinuation of treatment. CONCLUSIONS: The data suggest that serotonin reuptake inhibiting antidepressants can produce a range of adverse effects on vision that in some cases can be long-lasting after discontinuation of the drug. Further efforts are needed to understand the mechanisms involved, the incidence among those prescribed these medications, and identify any risk or mitigation factors.
FORENSIC INNOVATION: CONCEPTS, FUNCTIONS, TASKS AND RESEARCH PROSPECTS
Authors: Shevchuk V. 
Published: August 2021

The article is devoted to topical problems of formation of forensic innovation as a new scientific direction in criminalistics. Theoretical and methodological bases for development and formation of forensic innovation, its functions, tasks and prospects of introduction of its provisions in law enforcement practice are investigated, perspective directions for research of the considered scientific concept are outlined.
It’s substantiated that in present-day realities attention should be drawn to research on forensic innovation on the basis of general theoretical approaches which ensure explanation and substantiation of such fundamental principles of any separate scientific theory as its genesis, essence, fact, hypothesis and theoretical construction. It’s noted that the level of formation and validity of any scientific theory, including forensic innovation, is determined by the degree and level of development of its theoretical and methodological foundations. I
t’s stressed that the process of constructing forensic innovation as a weighty forensic theory cannot yet be completed due to the large number of uncoordinated, undeveloped and debatable issues. Therefore, today the concept of forensic innovation has not yet reached the level of a separate forensic theory and is still in the process of forming. Accordingly, it is important to study and reveal patterns of functioning at the theoretical level, all stages of the life cycle of innovations in criminalistics, starting with creation, proposal, implementation, and ending with their application in practice. It’s noted that issues of determining the place of this theory in criminalistics taxonomy, its structure and functions are significant. It’s argued that currently scientific preconditions for the development and formation of forensic innovation are created and such research in modern conditions is a promising innovative direction in the development of criminalistics, which requires further research.
The methodological basis for the development and implementation of forensic innovations in law enforcement are activity, system-structural and technological approaches, the use of which is promising for the formation of a separate forensic theory: forensic innovation. An integrated approach to the development and formation of forensic innovation is the methodological foundation for further research on this issue. New scientific approaches to the solution of researched debatable questions are substantiated and promising directions for research on the specified problems are defined.
PSYCHOLOGICAL ASPECTS OF CRIMES PRE-TRIAL INVESTIGATION
Authors: Synchuk O. 
Published: August 2021

The article is devoted to the problem of a psychological component of crimes pre-trial investigation. The factors of negative impact of circumstances and consequences of illegal actions on the psyche of participants of criminal
proceedings are considered. The need to use knowledge of psychological phenomena and processes in the course of crime investigation by investigators is substantiated.
The activities of investigator are characterized by significant emotional intensity. Taking into account full complexity of investigative activities encompassing a variety of interpersonal interactions, special attention is paid to the issue of psychological training of law enforcement agencies. Long-term perception of antisocial phenomena and communication with representatives of different social classes under conditions of time pressure and strict procedural regulation by investigator can result in increased mental stress in investigator and, as a result, in professional deformation. The investigator, being under the influence of negative emotions, must be able to maintain emotional stability. In this regard, the intellectual, volitional and communicative personal qualities of an investigator are particularly important. Keeping in touch with other participants of criminal proceedings, an investigator must maintain rationalism and composure, avoid formalism and bias. The purpose of such communication is to obtain information contributing to the establishment of truth on a specific criminal proceeding. The main task of an investigator in this process is to establish psychological contact with the use of psychological influence methods.
COMPLEX ISSUES ARISING WHILE CONDUCTING RESEARCH ON WHEELCHAIR RAMPS FOR ACCESS TO BUILDINGS BY PERSONS WITH REDUCED MOBILITY AND DETERMINATION OF WHEELCHAIR RAMPS’ COMPLIANCE WITH BUILDING STANDARDS AND REGULATIONS
Authors: Petryshyna Yu. , Radchenko S. , Syla N. 
Published: August 2021

The article outlines issues which arise when conducting research on wheelchair (reconstructed) ramps of existing buildings, technical re-equipment of building porches and buildings or their construction projects for compliance with building standards and regulations. As a method of research we have chosen visual inspection of construction and planning solutions, namely measuring of geometric parameters of over 30 ramps in different districts in the city of Kharkiv has been conducted.
Requirements of current building regulations are analyzed, their applicability to public and residential buildings for access by persons with reduced mobility is established. Main types of violations of building standards and regulations while construction of ramps, which create significant obstacles for people with limited mobility to access residential and public buildings, have been identified and systematized. Recommendations are provided regarding the possibility of making necessary changes in the design of ramps and adapted porches of residential and public buildings in order to prevent injury to persons with reduced mobility.
PROBLEMATIC ISSUES AND WAYS FOR THEIR RESOLUTION WHILE RESEARCH ON TAX CREDIT OF VALUE-ADDED TAX (Review Article)
Authors: Fesenko O. 
Published: August 2021

The article deals with problematic issues faced by a forensic economist in practice when conducting a forensic economic examination in relation to confirmation of violations established by tax audit reports of the State tax service of Ukraine, particularly tax credit overstatement, which in their essence are legal in nature and require not only knowledge in the field of economics, accounting, tax accounting and reporting, but also legal knowledge.
The Article purpose is to highlight a number of challenging issues that arise during forensic economic examination; ways to resolve them are suggested, at the same time examples from forensic practice are offered.
The analysis of judicial practice and the role of availability of a court judgment concluded between enterprises on invalidation of documents, of the results of handwriting analysis for investigative bodies while appointment of forensic economic examination is substantiated.
According to the results of the carried out research, it was concluded that, in order to verify tax audit reports on violations of tax legislation, in terms of tax credit overstatement which in its essence are of a legal nature, a forensic expert should be provided not only with properly executed primary documents, but also judgment concluded between enterprises on recognition of invalid documents, court verdict on fictitious nature of the entity of economic activity, which became legally binding. Prior to appointment of forensic economic examination, it is expedient to conduct handwriting analysis (in case of signing of tax and expenditure invoices by a non-authorized person).
In questions addressed to a forensic expert-economist, it is useful to take into consideration court judgment and handwriting analysis forensic report. All the above will increase the number of disclosure of economic crimes and provide money to the budget of a country.