bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is There a Difference in Hospital Stay between Patients undergoing Translabyrinthine or Retrosigmoid Surgery for Vestibular Schwannoma Stratified by Tumor Size?
Authors: Visagan Ravindran , Hall Andrew , Bradford Robert , Khalil Sherif , Saeed Shakeel Riaz 
Published: September 2018

Objective To date, no European study has compared approach-specific outcome data in vestibular schwannoma (VS) surgery stratified by tumor size. We analyzed hospital length of stay (LOS), intensive therapy/high-dependency unit (ITU/HDU) LOS, and complications in patients undergoing VS surgery via the translabyrinthine (TL) versus retrosigmoid (RS) approaches, stratifying for tumor size.
Design Prospective database undergoing retrospective review.
Setting Tertiary center.
Participants A total of 117 patients with VS undergoing TL (n = 71) or RS (n = 46) surgical resection from 2011 to 2016 were analyzed. Data including age, gender, surgical approach, tumor size, hospital, and ITU/HDU LOS and postoperative complications were evaluated.
Intervention(s) Therapeutic—VS surgery via either TL or RS approach.
Main Outcome Measure(s) LOS (hospital/intensive care unit).
Results Hospital LOS was significantly greater in patients undergoing the RS approach versus TL approach in VS between 31 and 40 mm (11 versus 7 days, p < 0.0006). The mean ITU/HDU LOS was greater in the RS group compared with the TL group (4.6 versus 1, p > 0.05). Reported complications were higher in the RS group (n = 40 versus 22). A post hoc analysis of the 31 to 40 mm group revealed no statistically significant difference in the American Society of Anesthesiologists grade or preoperative performance status.
Conclusions In our practice, in VS sized 31 to 40 mm patients stay 4 days longer post RS compared with TL surgery. This translates to £1600 extra per patient in the UK. Our data may inform decision-making during the skull base multidisciplinary team and the consent process to help decide the ideal operative approach for the patient.
Microsurgical Decompression of Trigeminal Neuralgia Caused by Simultaneous Double Arterial (SCA and AICA) and Petrosal Vein Complex Compression
Authors: Gajski Domagoj , Dennis Alicia , Arnautović Kenan 
Published: September 2018

Trigeminal neuralgia is a chronic pain disorder affecting the face. In approximately 80% of cases, it is most commonly caused, when the root entry zone (REZ) of the trigeminal nerve is compressed by the superior cerebellar artery (SCA). The etiology of the remaining 20% of cases is distributed among venous, arteriovenous malformations, posterior fossa tumors, multiple sclerosis plaque compressions, and other pathologies. Combinations of those compressive factors are very rare.1
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4 Herein, we present a video clip of microvascular decompression (MVD) in a 73-year-old female, who has failed conservative treatment with 6 medications over 10 years. She was affected by a unique triple compression of the right REZ by the SCA, anterior inferior cerebellar artery (AICA), and petrosal vein complex (Fig. 1A). Right-sided microsurgical decompression of the REZ of the trigeminal nerve through standard retrosigmoid craniotomy was performed by the senior author (K.I.A.). The SCA and AICA were separated from the nerve using Teflon pledgets. The petrosal vein complex was coagulated and divided, freeing up the right trigeminal nerve (Fig. 1B). The patient was discharged home on the third postoperative day with complete resolution of trigeminal neuralgia.The link to the Video can be found at: https://youtu.be/PYVvImGW0yE.
Microsurgical Gross Total Resection of a WHO Grade II Cerebellopontine Angle Ependymoma in an Adult
Authors: Sayyahmelli Sima , Ucer Melih , Baskaya Mustafa 
Published: September 2018

Infratentorial ependymomas that arise in the fourth ventricle and extend into the cerebellopontine angle (CPA) through the foramina of Luschka are well described. However, a primary CPA location of an ependymoma is distinctly uncommon. In this video, we present a 46-year-old man with episodes of dizziness, left-sided tinnitus, imbalance, double vision, and nausea. An magnetic resonance imaging (MRI) scan of the head showed a large mass lesion centered in the CPA with heterogenous enhancement. Differential diagnosis included ependymoma, meningioma, schwannoma of the vestibular nerve, or lower cranial nerves, and choroid plexus papilloma. He underwent microsurgical gross total resection of the tumor via a retrosigmoid approach. Direct stimulation of the cranial nerves was performed throughout the case and there was no attachment of the tumor to any cranial nerve to suggest that this might be a schwannoma. The tumor encased important vasculature, including the posterior-inferior cerebellar artery. The histopathology was a grade II ependymoma. The patient tolerated the surgery well and his postoperative course was uneventful. He remained neurologically intact. He received radiation therapy and there was no recurrent or residual disease on follow-up studies. This video demonstrates important steps of the surgical approach and microsurgical resection techniques for this type of challenging tumor.The link to the video can be found at: https://youtu.be/KK-y6EYh888.
A Rare Complication of Endovascular Embolization: Extruded Onyx on Trigeminal Nerve
Authors: Eser Ocak Pinar , Başkaya Mustafa 
Published: September 2018

Objectives To demonstrate a rare complication of endovascular tumor embolization with onyx.
Design Operative video.
Setting Department of neurological surgery in a university hospital.
Participants A 39-year-old male who was diagnosed with a right sided hemangioblastoma.
Main Outcome Measures Surgical resection of the tumor, preservation of the cranial nerves and extruded embolization material on trigeminal nerve.
Results The tumor was embolized with onyx the day before surgery. Patient woke up with no sensation in the right side of his face. Diffusion magnetic resonance imaging (MRI) showed a small restricted diffusion area within the right superior cerebellar vermis. Microsurgical resection of the tumor was uneventful and complete resection was achieved (Fig. 1). After the resection was completed, the trigeminal nerve was identified. Some of the capillaries overlying the nerve as well as the cerebellum and brain stem had extruded onyx-embolic material (Fig. 2). Some of the onyx over the cerebellum was removed; however, the ones on the trigeminal nerve and brain stem were not removed due to the risk of injury to the nerve. Postoperative MRI confirmed total resection. Patient made excellent recovery except he continued to have no sensation in the right side of his face.
Conclusion Preoperative embolization is an important adjunct to resection of large hemangioblastomas in selected cases because it may facilitate circumferential dissection and debulking of the tumor. Although extrusion of the embolization material is relatively common, immediate extrusion of onyx and its transfixion on a cranial nerve has not been reported before. Judicial selection of preoperative embolization is required in hemangioblastomas.The link to the Video can be found at: https://youtu.be/s0DjD26Xkas.
Retrosigmoid Approach for Resection of Cerebellopontine Angle Meningioma
Authors: Abou-Al-Shaar Hussam , Gozal Yair , Alzhrani Gmaan , Couldwell William 
Published: September 2018

This video depicts the case of an 81-year-old man who presented with a 3-month history of left-sided facial numbness and gait imbalance. On examination, he had gait ataxia and decreased left facial sensation in the V2 and V3 distribution. Magnetic resonance imaging (MRI) revealed a large homogenously enhancing lesion arising from the inferior surface of the tentorium toward the left cerebellopontine angle causing significant brainstem compression (Fig. 1A and 1B). The differential diagnoses for this lesion included meningioma and trigeminal nerve schwannoma. Given the patient's symptoms, the size of the lesion, and the severity of brainstem compression, surgical resection was recommended. The patient underwent a left retrosigmoid craniotomy for resection of the mass (Fig. 2). The patient tolerated the procedure well with no new postoperative neurological deficit. Histopathological examination of the lesion revealed a World Health Organization (WHO) grade I meningioma. Postoperative MRI was consistent with gross total resection of the tumor (Fig. 1C and 1D). The patient was discharged home on postoperative day 4. At his last follow-up appointment, 1 month after surgery, the patient reported complete resolution of his imbalance and left-sided facial numbness. The patient gave consent for publication.The link to the video can be found at: https://youtu.be/xoHmhv7bme4.
Retrosigmoid Approach to the Posterior Fossa Trigeminal Schwannoma
Authors: Yang Alexander , Kunigelis Katherine , Youssef A. 
Published: September 2018

We present a case of a posterior fossa trigeminal schwannoma in a 31-year-old gentleman. Preoperative symptomatology included headaches and dizziness of 6 months in duration. Trigeminal schwannomas isolated to the posterior fossa, not extending into Meckel's Cave, may be adequately resected via a retrosigmoid approach. Thus, a tailored retrosigmoid approach was planned with navigation assistance. A key point to highlight is the difficult identification and preservation of trigeminal nerve fascicles within the tumor mass. In this operative video we show a nerve preservation technique. By identifying the nerve at the anticipated anatomical location and utilizing sharp dissection, we create a dissection plane from the nerve fascicles. The surgical strategy of near total resection and leaving minimal tumor tissue on the nerve should be pursued in return for anatomical preservation of the nerve. Postoperative course was significant for facial hypoesthesia, abducens partial palsy, and gradual improvement of headaches.The link to the video can be found at: https://youtu.be/JsE1-Eonr0k.
Presigmoid Approach to Dumbbell Trigeminal Schwannoma
Authors: Kunigelis Katherine , Craig Daniel , Yang Alexander , Gubbels Samuel , Youssef A. 
Published: September 2018

This case is a 15-year-old male, presenting with headaches, right face, and arm numbness, and ataxia. MRI (magnetic resonance imaging) revealed a large right sided dumbbell shaped lesion, extending into the middle and posterior fossa with compression of the brainstem consistent with a trigeminal schwannoma. Treatment options here would be a retrosigmoid suprameatal approach or a lateral presigmoid approach. Given the tumor extension into multiple compartments, a presigmoid craniotomy, combining a middle fossa approach with anterior petrosectomy, and retrolabyrinthine approach with posterior petrosectomy were used to maximize the direct access corridor for resection. The petrous apex was already expanded and remodeled by the tumor. Nerve fascicles preservation technique is paramount to the functional preservation of the trigeminal nerve. The extent of resection should be weighed against the anatomical functional integrity of the nerve. Near total resection is considered if that means more nerve preservation. Postoperatively, the patient had a slight (House–Brackman grade II) facial droop, which resolved over days and developed right trigeminal hypesthesia at several weeks. This case is presented to demonstrate a combined petrosectomy technique for resection of lesions extending into both the middle and posterior cranial fossa with near total resection and trigeminal nerve preservation.The link to the video can be found at: https://youtu.be/kA9GyFhL1dg.
Single-molecule optical absorption imaging by nanomechanical photothermal sensing
Authors: Chien Miao-Hsuan , Brameshuber Mario , Rossboth Benedikt K. , Schütz Gerhard J. , Schmid Silvan 
Published: September 2018

Significance
Absorption microscopy is a promising technique that can detect single nonfluorescent molecules. However, fundamental limitations of existing optical absorption methods result in noisy detection signals for single molecules, which has hindered many anticipated applications. A promising method is to optically measure the photothermal heating of single molecules. In this paper, we present a photothermal microscopy technique where we detect the photothermal heating of single molecules mechanically with a temperature-sensitive nanomechanical drum. With our method, we achieve an unprecedented optical absorption sensitivity, enabling the detection of single molecules with large signal-to-noise ratios. This enables interesting applications such as the accurate localization of naturally occurring marker molecules or the identification of single molecules by measuring their absorption spectrum.
Symmetric coalescence of two hydraulic fractures
Authors: O’Keeffe Niall J. , Zheng Zhong , Huppert Herbert E. , Linden P. F. 
Published: September 2018

Significance
We present an experimental investigation on the coalescence of hydraulic fractures in a brittle solid. Using a dual-fracturing setup, we obtain high-resolution experimental measurements on the time evolution of the fracture profiles and internal velocity field before, during, and after fracture coalescence. These measurements show an intermediate time self-similar coalescence during the dynamic interaction of two fractures. The work probes the dynamic formation of a fracture network, which is crucial to the industrial practice of energy resource recovery, compensation grouting, and the reservoir integrity of many confined systems involving fluid injection.
Strategies for robustness:Five perspectives on how policy design is done
Authors: Van der Steen Martijn , van Twist Mark 
Published: September 2018

ABSTRACTRobust policy design is an activity that is ‘done’ by policymakers; in this paper we look further into how exactly robust policy design is done. We use the literature on strategizing to distinguish various theoretical perspectives on how policy design is done in practice. Moreover, we conducted a survey-feedback study with a group of senior level policymakers to see what they do when ‘doing’ robust policy design, how they think it should be done, and what they think are challenges for doing robust policy design in the context of a public organization. The study shows that although the language of strategy and policy design is rooted in the rational-analytical ‘planning’ approach, other perspectives are in fact more suitable for designing robust policies for deeply uncertain and volatile conditions. Moreover, our study shows that practitioners are well-aware of this bias; they have developed practical ways to combine the rational-analytical approach to design that is expected from them with other approaches for doing design.
Selective Osteotomies to Correct Deviated Bony Vaults of Asian Noses
Authors: Nam Yong Seok , Baek Jong Tae , Kang Jae-Goo 
Published: September 2018

Abstract

Background
Standard osteotomies for the correction of deviated noses are bilateral and comprise a combination of medial and lateral osteotomy procedures. However, their uniform application to the small/delicate Asian bony vault is inappropriate and often results in suboptimal outcomes.

Objectives
This study describes how asymmetric bony pyramids were defined through 3-component analysis, which was then used to inform selective/individualized osteotomies.

Methods
Bony vault deviations were categorized after 3-component analysis in 117 patients seeking correction of a deviated nose. Selective osteotomies were applied accordingly. Pre- and postoperative photographs were compared and rated by 2 independent evaluators. Patients’ subjective evaluations were also included.

Results
Selective osteotomies were possible in 79 (68%) out of 117 patients. Among the 79 study subjects, outcome ratings were excellent in 37 (47%), acceptable in 25 (32%), unsatisfactory in 8 (10%), and unspecified in 9 (11%). Unspecified cases aside, satisfactory correction was achieved in 88% (62/70 patients). Of the 54 patients who responded to telephone interviews, patient satisfaction was excellent in 43 (80%), improved in 10 (18.2%), and unchanged in 1 (1.8%). Follow-up of the 88% of patients with satisfactory correction showed a stable long-term outcome.

Conclusions
Each bony vault in deviated noses is different, and thus, its correction must be individualized for each patient and for each side. The protocol described herein achieves a controlled correction of deviated bony vault. Restoration of bony pyramid symmetry via current techniques is best suited to short Asian bony vaults, where additional structural needs from routine nasal augmentation/lengthening are required.

Level of Evidence: 4
Author Disclosures in Plastic Surgery Journals Compared With Information Reported in the Open Payments Database: How Open Are We?
Authors: Boyll Piper , Neville Matthew , Bernard Robert , Mahabir Raman C 
Published: September 2018

Abstract

Background
Relationships between companies in the biomedical industry and authors submitting scientific articles for publication has been an issue of some concern for many years. It has been frequently demonstrated that these financial relationships can influence the manner in which research findings are presented. The National Physician Payment Transparency Program, also known as the Open Payment Program or the Sunshine Act, was legislated to expose potential conflicts of interest (COIs). Likewise, most peer-reviewed journals require disclosure of any potential COIs.

Objectives
The purpose of this paper was to compare the information published in the Open Payment Database to authors’ self-disclosed COIs in their published articles.

Methods
An analysis was performed by one of the authors (P.S.B.) of all articles published in Aesthetic Surgery Journal (ASJ) and Plastic and Reconstructive Surgery (PRS) from August 2013 through December 2016. Financial disclosures reported in these articles were compared with the physician payment information provided by the biomedical industry and published in the Open Payments Database in 2013 and 2018.

Results
A total of 1346 articles were included in the study, from which 320 authors and 899 total authorships were eligible for analysis. Out of 782 authorships with noted discrepancies, 96% were related to potential COIs found in the Open Payments database but not disclosed in the journal publication.

Conclusions
Our data suggest major discordance between authors’ self-reported COIs in the plastic surgery literature and industry payments published in the Open Payments database.
Glucomannan Hydrolysate Promotes Gut Proliferative Homeostasis and Extends Life Span in Drosophila melanogaster
Authors: Si Yuan , Liu Xi , Ye Kaixiong , Bonfini Alessandro , Hu Xun Yang , Buchon Nicolas , Gu Zhenglong 
Published: September 2018

Abstract
Dietary supplementation of glucomannan has been shown to have multiple health benefits, but its effect on life span has not been investigated. Here, we show that glucomannan hydrolysate (GMH) treatment extends mean life span of the model organism Drosophila melanogaster. To unravel the underlying mechanisms, we first examined the effect of GMH on the gut microbiota. We found that GMH treatment is associated with an elevated bacterial load in aged flies but overall has limited effects on the relative microbiota composition. We also demonstrated that GMH inhibits age-associated hyperproliferation of intestinal stem cells and thus delays the deterioration of gut integrity. Further analysis of the midgut transcriptome revealed that both EGFR/MAPK and JAK/STAT signaling pathways are suppressed in GMH groups. Multiple key regulators or effectors of EGFR/MAPK pathway, Ets21c, Mkp3, and Rho, are downregulated by GMH treatment. In the JAK/STAT pathway, major ligands (eg, Upd2 and Upd3) and negative feedback inhibitors (eg, Socs36e) are all significantly downregulated. Additionally, the expression of genes encoding antimicrobial peptides is elevated by GMH treatment. Taken together, our study shows that dietary supplementation of GMH can prolong life span, possibly through regulating gut proliferative homeostasis.
The Impact of Reactogenicity After the First Dose of Recombinant Zoster Vaccine on the Physical Functioning and Quality of Life of Older Adults: An Open-Label, Phase III Trial
Authors: Schmader Kenneth E , Levin Myron J , Grupping Katrijn , Matthews Sean , Butuk David , Chen Michael , Idrissi Mohamed El , Fissette Laurence A , Fogarty Charles , Hartley Paul , Klein Nicola P , Nevarez Max , Uusinarkaus Kari , Oostvogels Lidia , Curran Desmond 
Published: September 2018

Abstract

Background
Herpes zoster and its related complications are associated with significant medical burden, which negatively affects quality of life and daily functioning of the patients. The recently licensed recombinant zoster vaccine (RZV) offers high efficacy but is associated with local and systemic reactions. This study assessed the impact of RZV on the quality of life and daily functioning of participants and implications for caregivers.

Methods
Four hundred and one adults aged 50 years or older received single RZV doses at 0 and 2 months in this open-label, single-arm, multicenter study (NCT02979639). Change in mean SF-36 Physical Functioning score following first-dose administration, quality of life, reactogenicity, safety, productivity loss, and health care resource utilization was assessed. The current analysis was performed post-vaccine dose-1; safety follow-up will continue until 1 year post-dose-2.

Results
The most common solicited local symptoms were injection-site pain (77.5%), redness (23.0%), and swelling (13.3%); the most frequent solicited systemic reactions were fatigue (33.5%), headache (28.3%), and myalgia (26.8%). Grade 3 reactogenicity occurred in 9.5% of participants and was associated with a transient clinically important decrease in SF-36 Physical Functioning score (affecting activities such as walking, carrying groceries, climbing stairs) on Days 1 and 2 post-first vaccination. No clinically meaningful reductions in mean SF-36 Physical Functioning scale scores from pre- to post-RZV dose-1 were observed (mean +1.9 points, primary end point), and no overall quality-adjusted-life-year loss was recorded post-dose-1. Five participants reported lost workdays; caregiver workload was not increased.

Conclusions
Overall, the physical functioning and quality of life of older adults were not affected by a first RZV dose. The observed reactogenicity was consistent with previous studies.