bluuebunny/crossref_metadata_2025_split huggingface dataset:
SISTEMAS SILVIPASTORIS: UMA ABORDAGEM ENTRE A INTERAÇÃO DOS COMPONETES BIÓTIPOS E ABIÓTIPOS
Authors: De Almeida Emizael Menezes , De Almeida Roberto Giolo , Miyagi Eliane Sayuri , De Freitas Paulo Vitor Divino Xavier , Ribeiro Fagner Machado , Fernandes Patrick Bezerra , Garcia Emilia Da Costa 
Published: August 2019

Os sistemas silvipastoris é uma modalidade dos sistemas agroflorestais, onde a produção animal, forrageira e árborea encontra-se em consórcio na mesma área, no mesmo tempo. A maior parte da produção da pecuária bovina no Brasil baseia-se na utilização de pastagens. No Brasil, há mais de 100 milhões de hectares com pastagens cultivadas, cerca de 80% dessas pastagens encontram-se em algum grau de degradação. Uma alternativa para a recuperação dessas pastagens de forma sustentável e o uso de sistemas silvipastoris. Entretanto os sistemas sombreados são muito dinâmicos e podem modificar a estrutura do pasto de forma significativa quanto a quantidade e a qualidade da forrageira produzida com reflexos na produção animal, principalmente em razão da competição por luz, água e nutrientes.
Axial crushing behavior of circular aluminum tubes
Authors: Yalçın Muhammet M. , Mete Osman H. , Genel Kenan 
Published: August 2019

Abstract
The axial crushing behavior and energy absorption ability of metallic tubes are areas in which a large number of academic studies have been undertaken. In this study, the basic steps in the progressive folding behavior of circular-sectioned aluminum tubes under axial loading, changes in tube geometry after deformation and the ability to absorb energy were investigated both experimentally and by the finite element method. The deformation behavior of an aluminum tube wall, derived from finite element analysis was validated by experimental results with a degree of accuracy reaching 99 %. In addition, absorbed energy values approached the experimental results by approximately 93 %. As a result, the folding behavior of aluminum tubes under axial loading was successfully investigated using the finite element method. Thus, some difficulties and costs in experimental studies could be overcome.
Intracranial infections: lessons learned from 52 surgically treated cases
Authors: Kural Cahit , Kırmızıgoz Sahin , Ezgu Mehmet Can , Bedir Orhan , Kutlay Murat , Izci Yusuf 
Published: August 2019

OBJECTIVEIntracranial infections are serious and life-threatening health problems. They may present as subdural empyemas or intracerebral abscesses. Surgical drainage and subsequent antibiotic treatment is the main technique for a satisfactory clinical outcome. The aims of this study were to present a 10-year intracranial infection series and discuss the surgical characteristics in the light of literature.METHODSFifty-two patients with intracranial infection underwent surgical treatment between 2008 and 2018. Eleven patients were female and 41 patients were male. The mean age was 40.46 years (range 10–75 years). Eighteen patients had intracerebral abscesses, and 34 had subdural empyemas. All patients underwent surgical treatment as well as an antibiotic regimen.RESULTSNo etiological agent was isolated in 29 (56%) cases. Bacterial agents were detected in 20 cases, while fungi were observed in 3 cases. Staphylococci species were the most common agents and were isolated in 8 (15%) cases. Endoscopic aspiration was performed in 3 cases, while surgical drainage and capsule resection via craniotomy was performed in 49 cases. An associated intracranial tumor was diagnosed in 2 patients with brain abscesses. Four (8%) patients died despite surgical and medical treatments.CONCLUSIONSSurgical treatment via craniotomy is an older method, but it is still the best to treat the intracranial infections not only for decompression of the brain but also to attain an accurate diagnosis. The abscess wall should always be histologically examined after surgery to rule out any intracranial tumor.
Intracranial fungal granuloma: a single-institute study of 90 cases over 18 years
Authors: Mishra Ajit , Prabhuraj Andiperumal Raj , Shukla Dhaval P. , Nandeesh Bevinahalli N. , Chandrashekar Nagarathna , Ramalingaiah Arvinda , Arivazhagan Arimappamagan , Bhat Dhananjaya Ishwar , Somanna Sampath , Devi Bhagavatula Indira 
Published: August 2019

OBJECTIVEIntracranial fungal granuloma (IFG) remains an uncommon entity. The authors report a single-institute study of 90 cases of IFG, which is the largest study until now.METHODSIn this retrospective study, all cases of IFG surgically treated in the years 2001–2018 were included. Data were obtained from the medical records and the pathology, microbiology, and radiology departments. All relevant clinical data, imaging characteristics, surgical procedure performed, perioperative findings, and follow-up data were recorded from the case files. Telephonic follow-up was also performed for a few patients to find out their current status.RESULTSA total of 90 cases consisting of 64 males (71.1%) and 26 (28.9%) females were evaluated. The mean patient age was 40.2 years (range 1–79 years). Headache (54 patients) was the most common presenting complaint, followed by visual symptoms (35 patients), fever (21 patients), and others such as limb weakness (13 patients) or seizure (9 patients). Cranial nerve involvement was the most common sign (47 patients), followed by motor deficit (22 patients) and papilledema (7 patients). The mean duration of symptoms before presentation was 6.4 months (range 0.06–48 months). Thirty patients (33.3%) had predisposing factors like diabetes mellitus, tuberculosis, or other immunocompromised status. A pure intracranial location of the IFG was seen in 49 cases (54.4%), whereas rhinocerebral or paranasal sinus involvement was seen in 41 cases (45.6%). Open surgery, that is, craniotomy and decompression, was performed in 55 cases, endoscopic biopsy was done in 30 cases, and stereotactic biopsy was performed in 5 cases. Aspergilloma (43 patients) was the most common fungal mass, followed by zygomycosis (13 patients), chromomycosis (9 patients), cryptococcoma (7 patients), mucormycosis (5 patients), and candida infection (1 patient). In 12 cases, the exact fungal phenotype could not be identified. Follow-up was available for 69/90 patients (76.7%). The mean duration of the follow-up was 37.97 months (range 3–144 months). The mortality rate was 52.2% (36/69 patients) among the patients with available follow-up.CONCLUSIONSA high index of suspicion for IFG should exist for patients with an immunocompromised status and diabetic patients with rhinocerebral mass lesions. Early diagnosis, aggressive surgical decompression, and a course of promptly initiated antifungal therapy are associated with a better prognosis.
Implementation of an infection prevention bundle is associated with reduced surgical site infections in cranial neurosurgery
Authors: Rubeli Samuel L. , D’Alonzo Donato , Mueller Beate , Bartlomé Nicole , Fankhauser Hans , Bucheli Evelin , Conen Anna , Fandino Javier , Fux Christoph A. 
Published: August 2019

OBJECTIVEThe objective of this study was to quantify surgical site infection (SSI) rates after cranial neurosurgery in a tertiary care hospital, identify risk factors for SSI, and evaluate the impact of standardized surveillance and an infection prevention bundle (IPB).METHODSThe authors compared SSI rates during 7 months before and after the intervention. The IPB included standardized patient preparation, perioperative antibiotic/antiseptic use, barrier precautions, coaching of surgeons, and the implementation of a specialized technical operation assistant team.RESULTSThree hundred twenty-two unselected consecutive patients were evaluated before the IPB, and 296 were evaluated after implementation. Infection rates after 1 year decreased from 7.8% (25/322) to 3.7% (11/296, p = 0.03) with similar mortality rates (14.7% vs 13.8%, p = 0.8). The isolated bacteria included Staphylococcus aureus (42%), Cutibacterium acnes (22%), and coagulase-negative staphylococci (14%). Organ/space infections dominated with 67%, and mostly consisted of subdural empyema and meningitis/ventriculitis. Among the 36 SSIs, 13 (36%) occurred during hospitalization, and 29 (81%) within the first 3 months of follow-up. In multivariable analysis including established risk factors described in the literature, non-CNS neoplasia (odds ratio [OR] 3.82, 95% confidence interval [CI] 1.39–10.53), postoperative bleeding (OR 4.09, 1.44–11.62), operations performed by or under supervision of a senior faculty surgeon (OR 0.38, 0.17–0.84), and operations performed after the implementation of standardized surveillance and an IPB (OR 0.38, 0.17–0.85) significantly influenced the infection rate.CONCLUSIONSThe introduction of an IPB combined with routine surveillance and personal feedback was associated with a 53% reduced infection rate. The lower infection rates of senior faculty and the strong association between postoperative bleeding and infection underline the importance of both surgical experience as well as thorough supervision and coaching of younger surgeons.
Outcome following postneurosurgical Acinetobacter meningitis: an institutional experience of 72 cases
Authors: Sharma Ravi , Goda Revanth , Borkar Sachin Anil , Katiyar Varidh , Agarwal Samagra , Kumar Amandeep , Mohapatra Sarita , Kapil Arti , Suri Ashish , Kale Shashank S. 
Published: August 2019

OBJECTIVEThe authors aimed to evaluate the antimicrobial susceptibility pattern of Acinetobacter isolates responsible for nosocomial meningitis/ventriculitis in the neurosurgical ICU. The authors also sought to identify the risk factors for mortality following Acinetobacter meningitis/ventriculitis.METHODSThis was a retrospective study of 72 patients admitted to the neurosurgical ICU between January 2014 and December 2018 with clinical and microbiological diagnosis of nosocomial postneurosurgical Acinetobacter baumanii meningitis/ventriculitis. Electronic medical data on clinical characteristics, underlying pathology, CSF cytology, antibiotic susceptibilities, and mortality were recorded. To evaluate the outcome following nosocomial postneurosurgical Acinetobacter meningitis/ventriculitis, patients were followed up until discharge or death in the hospital. Kaplan-Meier survival analysis and multivariable Cox proportional hazards models were used to compute factors affecting survival.RESULTSThe study population was divided into two groups depending on the final outcome of whether the patient died or survived. Forty-three patients (59.7%) were included in the survivor group and 29 patients (40.3%) were included in the nonsurvivor group. Total in-hospital mortality due to Acinetobacter meningitis/ventriculitis was 40.3% (29 cases), with a 14-day mortality of 15.3% and a 30-day mortality of 25%. The 43 (59.7%) patients who survived had a mean length of hospital stay of 44 ± 4 days with a median Glasgow Outcome Scale–Extended score at discharge of 6. On univariate analysis, age > 40 years (p = 0.078), admission Glasgow Coma Scale (GCS) score ≤ 8 (p = 0.003), presence of septic shock (p = 0.011), presence of external ventricular drain (EVD) (p = 0.03), CSF white blood cell (WBC) count > 200 cells/mm3 (p = 0.084), and comorbidities (diabetes, p = 0.036; hypertension, p = 0.01) were associated with poor outcome. Carbapenem resistance was not a risk factor for mortality. According to a multivariable Cox proportional hazards model, age cutoff of 40 years (p = 0.016, HR 3.21), GCS score cutoff of 8 (p = 0.006, HR 0.29), CSF WBC count > 200 cells/mm3 (p = 0.01, HR 2.76), presence of EVD (p = 0.001, HR 5.42), and comorbidities (p = 0.017, HR 2.8) were found to be significant risk factors for mortality.CONCLUSIONSThis study is the largest case series reported to date of postneurosurgical Acinetobacter meningitis/ventriculitis. In-hospital mortality due to Acinetobacter meningitis/ventriculitis was high. Age older than 40 years, GCS score less than 8, presence of EVD, raised CSF WBC count, and presence of comorbidities were risk factors for mortality.
Nocardia amikacinitolerans and cytomegalovirus: distinctive clinical and radiological characterization of the rare etiologies of brain abscesses: report of 2 cases
Authors: Quinoa Travis , Jumah Fareed , Narayan Vinayak , Xiong Zhenggang , Nanda Anil , Hanft Simon 
Published: August 2019

Central nervous system infections in immunosuppressed patients are rare but potentially lethal complications that require swift diagnoses and intervention. While the differential diagnosis for new lesions on neuroradiological imaging of immunosuppressed patients typically includes infections and neoplasms, image-based heuristics to differentiate the two has been shown to have variable reliability.The authors describe 2 rare CNS infections in immunocompromised patients with atypical physical and radiological presentations. In the first case, a 59-year-old man, who had recently undergone a renal transplantation, was found to have multifocal Nocardia amikacinitolerans abscesses masquerading as neoplasms on diffusion-weighted imaging (DWI); in the second case, a 33-year-old man with suspected recurrent Hodgkin’s lymphoma was found to have a nonpyogenic abscess with cytomegalovirus (CMV) encephalitis.As per review of the literature, this appears to be the first case of brain abscess caused by N. amikacinitolerans, a recently isolated superbug. Despite confirmation through brain biopsy later on in case 1, the initial radiological appearance was atypical, showing subtle diffusion restriction on DWI. Similarly, the authors present a case of CMV encephalitis that presented as a ring-enhancing lesion, which is extremely rare. Both cases draw attention to the reliability of neuroimaging in differentiating an abscess from a neoplasm.
Diagnosis, treatment, and survival in spinal dissemination of primary intracranial glioblastoma: systematic literature review
Authors: Wright Christina Huang , Wright James , Onyewadume Louisa , Raghavan Alankrita , Lapite Isaac , Casco-Zuleta Antonio , Lagman Carlito , Sajatovic Martha , Hodges Tiffany R. 
Published: August 2019

OBJECTIVESpinal metastases from primary intracranial glioblastoma (GBM) are infrequently reported, and the disease has yet to be well characterized. A more accurate description of its clinical presentation and patient survival may improve understanding of this pathology, guide patient care, and advocate for increased inclusion in GBM research. The authors sought to describe the clinical presentation, treatment patterns, and survival in patients with drop metastases secondary to primary intracranial GBM.METHODSA systematic review was performed using the PRISMA guidelines. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane databases were queried for abstracts that included patients with primary intracranial GBM and metastases to the spinal axis. Descriptive statistics were used to evaluate characteristics of the primary brain lesion, timing of spinal metastases, clinical symptoms, anatomical location of the metastases, and survival and treatment parameters. Kaplan-Meier analysis and log-rank analysis of the survival curves were performed for selected subgroups.RESULTSOf 1225 abstracts that resulted from the search, 51 articles were selected, yielding 86 subjects. The patients’ mean age was 46.78 years and 59.74% were male. The most common symptom was lumbago or cervicalgia (90.24%), and this was followed by paraparesis (86.00%). The actuarial median survival after the detection of spinal metastases was 2.8 months and the mean survival was 2.72 months (95% CI 2.59–4.85), with a 1-year cumulative survival probability of 2.7% (95% CI 0.51%–8.33%). A diagnosis of leptomeningeal disease, present in 53.54% of the patients, was correlated, and significantly worse survival was on log-rank analysis in patients with leptomeningeal disease (p = 0.0046; median survival 2.5 months [95% CI 2–3] vs 4.0 months [95% CI 2–6]).CONCLUSIONSThis study established baseline characteristics of GBMs metastatic to the spinal axis. The prognosis is poor, though these results will provide patients and clinicians with more accurate survival estimates. The quality of studies reporting on this disease pathology is still limited. There is significant need for improved reporting methods for spinal metastases, either through enrollment of these patients in clinical trials or through increased granularity of coding for metastatic central nervous system diseases in cancer databases.
Heterotopic ossification and radiographic adjacent-segment disease after cervical disc arthroplasty
Authors: Yang Michael M. H. , Ryu Won Hyung A. , Casha Steven , DuPlessis Stephan , Jacobs W. Bradley , Hurlbert R. John 
Published: August 2019

OBJECTIVECervical disc arthroplasty (CDA) is an accepted motion-sparing technique associated with favorable patient outcomes. However, heterotopic ossification (HO) and adjacent-segment degeneration are poorly understood adverse events that can be observed after CDA. The purpose of this study was to retrospectively examine 1) the effect of the residual exposed endplate (REE) on HO, and 2) identify risk factors predicting radiographic adjacent-segment disease (rASD) in a consecutive cohort of CDA patients.METHODSA retrospective cohort study was performed on consecutive adult patients (≥ 18 years) who underwent 1- or 2-level CDA at the University of Calgary between 2002 and 2015 with > 1-year follow-up. REE was calculated by subtracting the anteroposterior (AP) diameter of the arthroplasty device from the native AP endplate diameter measured on lateral radiographs. HO was graded using the McAfee classification (low grade, 0–2; high grade, 3 and 4). Change in AP endplate diameter over time was measured at the index and adjacent levels to indicate progressive rASD.RESULTSForty-five patients (58 levels) underwent CDA during the study period. The mean age was 46 years (SD 10 years). Twenty-six patients (58%) were male. The median follow-up was 29 months (IQR 42 months). Thirty-three patients (73%) underwent 1-level CDA. High-grade HO developed at 19 levels (33%). The mean REE was 2.4 mm in the high-grade HO group and 1.6 mm in the low-grade HO group (p = 0.02). On multivariable analysis, patients with REE > 2 mm had a 4.5-times-higher odds of developing high-grade HO (p = 0.02) than patients with REE ≤ 2 mm. No significant relationship was observed between the type of artificial disc and the development of high-grade HO (p = 0.1). RASD was more likely to develop in the lower cervical spine (p = 0.001) and increased with time (p < 0.001). The presence of an artificial disc was highly protective against degenerative changes at the index level of operation (p < 0.001) but did not influence degeneration in the adjacent segments.CONCLUSIONSIn patients undergoing CDA, high-grade HO was predicted by REE. Therefore, maximizing the implant-endplate interface may help to reduce high-grade HO and preserve motion. RASD increases in an obligatory manner following CDA and is highly linked to specific levels (e.g., C6–7) rather than the presence or absence of an adjacent arthroplasty device. The presence of an artificial disc is, however, protective against further degenerative change at the index level of operation.
The Role of Universities in Curbing Interregional Educational Migration
Authors: Zakharova I. V. 
Published: August 2019

The article addresses the problem of outflow of youth from the region in connection with higher education. The aim is to determine the possibility of influencing the flows of interregional educational migration. The role of universities in curbing educational migration from the region and in attracting migration flows of young people is substantiated. The author presents a review of studies on educational migration and indicates the factors behind applicants’ choice of study location. The article dwells on the trends of interregional educational migration in the Volga Federal district, analyzes migration plans of high school seniors in Ulyanovsk region. The research bases on the methods of interdisciplinary literature analysis, sociological survey, method of expert assessments, and analysis of statistical data. The empirical base of the study became the results of a survey of 1010 high school seniors, 91 parents and 27 heads of educational institutions conducted in September-November 2018 in Ulyanovsk region. The proposed classification of the reasons for educational migration from the region and the reasons for staying in the region has a theoretical relevance. Based on the empirical data obtained, the ways of preventing educational migration from the region are suggested. In particular, it is revealed that the quality of education in regional universities is not a factor that significantly affects the choice of study location. To the greatest extent, the plans of school leavers are determined by the subjective perception of the socio-economic conditions of the region in which they would like to receive education. Since educational migration has objective and subjective reasons, the solution of this problem requires a set of economic, legal, advocacy tools. The article argues that there are two main forces in the region that can influence educational migration – these are the authorities and the territorial education system itself, the main structural elements of which are universities. In addition to the effective educational and scientific activities, universities need to conduct the targeted marketing policy, as well as to make efforts to promote their image and the image of the entire territorial education system.