bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Interhemispheric Dural Inversion Technique for Indirect Parafalcine Cerebral Revascularization: Case Report
Authors: Atai Nadia A. , Nguyen Vincent N. , Kammen Alexandra , Sternbach Sarah , Rennert Robert C. , Russin Jonathan J. 
Published: November 2024

BACKGROUND AND IMPORTANCE:
Variety of revascularization strategies have been deployed to treat the deterioration of cerebral blood flow. Blood flow restoration can be achieved by direct or indirect procedures. The indirect reconstructive procedure to augment blood flow involves encephalomyosynangiosis, encephaloduroarteriosynangiosis, or encephalodurosynangiosis, and has been used effectively in ischemic Moyamoya disease. However, the preferred procedure must be evaluated on a case-by-case basis and remains controversial in other cerebral arterial diseases. Here, we report the “interhemispheric dural inversion (IDI)” as a novel technique for indirect parafalcine cortical revascularization.

CLINICAL PRESENTATION:
A 54-year-old white man with a complex history of neck radiation secondary to childhood Hodgkin's lymphoma presented with focal perfusion deficit in the right mesial occipital lobe near the primary visual cortex. A large c-shaped dural flap with a paramedian base is harvested and, after an interhemispheric dissection, placed in contact with the ischemic parafalcine cortical tissue (IDI).

CONCLUSION:
The IDI was used successfully for indirect revascularization of a focal right paramedian occipital lobe deficit in a 54-year-old man with complex cerebro-occlusive disease from childhood radiation and multiple previous bypass surgeries. The IDI is a simple approach for targeted indirect parafalcine cortical revascularization to facilitate an increased blood supply and prompt new vessels to sprout from preexisting dural arteries. It can be used as a standalone technique or combined with other revascularization strategies, as warranted.
A Hybrid Approach for the Treatment of a Pure Arterial Malformation Located at an Accessory Middle Cerebral Artery. Cerebral Revascularization Followed by Endovascular Occlusion Using nBCA: Case Report
Authors: Albiña-Palmarola Pablo , Kurucz Peter , Khanafer Ali , Hajiyev Kamran , Bäzner Hansjörg , Henkes Hans 
Published: November 2024

BACKGROUND AND IMPORTANCE:Pure arterial malformations (PAMs) are rare vascular lesions with unknown natural history. Described in 2013 and initially considered benign, recent evidence of ruptured cases and progressive angioarchitectural changes may support the need for interventional treatment for selected patients. We present the first case of an accessory middle cerebral artery PAM successfully treated using a hybrid approach, including microsurgical revascularization and endovascular occlusion using Glubran2/Lipiodol.CLINICAL PRESENTATION:A 58-year-old woman with a history of spontaneous basal ganglia hemorrhage 2 years before presented to our clinic with a dilated, multilobulated, and overlapping lesion located at a dominant left accessory middle cerebral artery, compatible with the diagnostic criteria of a PAM. The lesion was near the previous bleeding site, and since perforating and cortical vessels arose from its distal lobule, a safeguarding superficial temporal artery-MCA bypass was considered necessary before the successful endovascular embolization of the malformation using nBCA (Glubran2/Lipiodol).CONCLUSION:PAMs can be associated with intracranial bleeding; thus, active treatment is warranted for selected patients. A hybrid microsurgical-endovascular approach is feasible and can be considered the optimal treatment for specific complex anatomies.
Multimodal and Repeated Localization of Primary Hand Motor Function to the Lateral Postcentral Gyrus in a Case of Frontal Motor Area Brain Metastasis
Authors: Boerger Timothy F. , DeGroot Andrew L. , Schwartz Stephanie , Botros Nada , Schmit Brian D. , Krucoff Max O. 
Published: November 2024

BACKGROUND AND IMPORTANCE:
The human motor homunculus is a well-known topographical map of the functional-anatomical relationships of the precentral gyrus. Within this homunculus, the primary hand motor area is considered one of the least plastic functional-anatomical relationships. Only a few cases in the literature describe relocation of functional hand representation away from the classical anatomical location. These cases have been reported in the context of children, primary gliomas, or arteriovenous malformations.

CLINICAL PRESENTATION:
Here, we describe a unique case where the area of lowest hand motor stimulation threshold (ie, hand motor representation) was found in the postcentral gyrus in an older adult with a metastasis in the premotor area of the brain. This localization was based on intraoperative cortical stimulation–evoked motor potentials and confirmed with electrophysiological phase reversal and MRI-based neuronavigation. This mapping was repeated and consistent 2 months later during a reoperation for recurrence. In addition, the remapped anatomical location was found in an area that was active during finger tapping on preoperative functional MRI.

CONCLUSION:
These findings suggest that neuroplastic remapping of hand motor cortex to the postcentral gyrus can occur in brain metastases even in adults. This has implications for planning tumor resections and interventional neurorehabilitation strategies, and it suggests that the motor homunculus may have more plastic potential in adulthood than previously recognized.
Utilization of the Lateral Extracavitary Approach for the Resection of a Giant Extradural Paraspinal Schwannoma: A Case Report
Authors: Mozaffari Khashayar , Fleisher Max , Harris Peter , Rosner Michael K. 
Published: November 2024

BACKGROUND AND IMPORTANCE:
Spinal schwannomas are benign neoplasms originating from the spinal nerve sheath and account for around one-third of primary spine neoplasms. The most common treatment modality for these tumors is complete surgical resection. Compared with intradural tumors, the resection of an extradural spinal schwannoma is generally associated with a more complex approach, including longer incisions and increased lateral exposure. One useful surgical technique is the lateral extracavitary approach (LECA), which enables dorsal and ventrolateral access to the thoracolumbar spine with decreased rates of morbidity. Herein, the authors describe this approach for the resection of a giant extradural paraspinal schwannoma.

CLINICAL PRESENTATION:
A 74-year-old female patient presented with right flank pain and difficulty breathing during strenuous exercise. Imaging revealed a large 8.5 × 5.2 × 6.3 cm solid paraspinal lesion spanning from T11-L2 vertebral body levels, with mass effect on the right posterior diaphragm and lung. Before surgical resection, the lesion was confirmed to be a schwannoma by needle biopsy. A LECA approach was used, achieving gross total resection. At 1-month follow-up, the patient reported great symptomatic resolution.

CONCLUSION:
LECA proved to be an instrumental approach in a technically challenging resection of a giant extradural paraspinal schwannoma.
The Usefulness of Vascularized Flap Craniotomy for Open-Wound Depressed Skull Fractures
Authors: Nakahara Yoichiro , Kikuchi Jin , Kotaki Yoshikuni , Otsu Yusuke , Sugi Keisuke , Yoshitake Hidenobu , Negoto Tetsuya , Morioka Motohiro 
Published: November 2024

BACKGROUND AND IMPORTANCE:
Free bone flap craniotomy for open-wound depressed skull fractures poses a high risk of infection due to free bone fragments. This risk escalates in the presence of compound fractures with accompanying dural injuries. The primary objectives in managing depressed skull fractures include infection prevention and the correction of cosmetic deformities. This report describes the efficacy of vascularized flap craniotomy, which preserves blood flow to bone fragments, in reducing infection risks.

CLINICAL PRESENTATION:
In this study, we present a 54-year-old man with a head injury and a Glasgow Coma Scale score of 8. He had an open wound in the left parietal temporal area and depressed skull fractures with compound bone fragments. The patient underwent vascularized flap craniotomy, focusing on maintaining blood supply to the bone fragments, resulting in successful wound healing without acute infections.

CONCLUSION:
Vascularized flap craniotomy is an effective surgical option for treating open-wound depressed skull fractures, potentially reducing the risk of infection by maintaining blood flow to bone fragments. Further studies are required to validate its efficacy in larger patient populations.
Endovascular Embolization Through Grafts for Recurrent Giant Complex Internal Carotid Artery Aneurysms After Combined Microsurgical Low-Flow With Subsequent High-Flow Revascularization and Parent Artery Occlusion
Authors: Nurimanov Chingiz , Menlibayeva Karashash , Mammadinova Iroda , Nurakay Nurtay , Makhambetov Yerbol 
Published: November 2024

BACKGROUND AND IMPORTANCE:
The case describes the management of a giant and recurrent aneurysm in a patient. The treatment involved a combination of microsurgical protective low-flow, followed by high-flow revascularization and parent artery occlusion.

CLINICAL PRESENTATION:
The patient presented with severe headaches and progressive visual impairment. Brain magnetic resonance imaging revealed a giant saccular intracranial aneurysm in the left internal carotid artery. The examination also revealed hypoplasia of the right anterior cerebral artery and a fetal-type left posterior cerebral artery originating from the neck of the aneurysm. Considering the location and size of the aneurysm, a combination of endovascular and microsurgical approaches was applied. A protective low-flow procedure was followed by high-flow revascularization and occlusion of the parent artery. After 12 months, the aneurysm recanalized through the graft. To address the recurrence of giant complex aneurysms, endovascular embolization was performed through the radial artery grafts. These interventions showed positive midterm outcomes for the patient's giant aneurysm.

CONCLUSION:
In the treatment of complex giant aneurysms, it is important to consider both endovascular and microsurgical approaches as complementary, rather than mutually exclusive. Endovascular embolization using radial artery grafts may be used when dealing with retrograde recanalization and the challenges associated with accessing the aneurysm.
‘Iterative Bleaching Extends Multiplexity’ facilitates simultaneous identification of all major retinal cell types
Authors: Kothurkar Aanandita A. , Patient Gregory S. , Noel Nicole C. L. , Krzywańska Aleksandra M. , Carr Brittany J. , Chu Colin J. , MacDonald Ryan B. 
Published: November 2024

ABSTRACT
To understand the multicellular composition of tissues, and how it is altered during development, ageing and/or disease, we must visualise the complete cellular landscape. Currently, this is hindered by our limited ability to combine multiple cellular markers. To overcome this, we adapted a highly multiplexed immunofluorescence (IF) technique called ‘Iterative Bleaching Extends Multiplexity’ (IBEX) to the zebrafish retina. We optimised fluorescent antibody micro-conjugation to perform sequential rounds of labelling on a single tissue to simultaneously visualise all major retinal cell types with 11 cell-specific antibodies. We further adapted IBEX to be compatible with fluorescent transgenic reporter lines, in situ hybridisation chain reaction (HCR), and whole-mount immunofluorescence (WMIF). We applied IBEX at multiple stages to study the spatial and temporal relationships between glia and neurons during retinal development. Finally, we demonstrate the utility of IBEX across species by testing it on the turquoise killifish (Nothobranchius furzeri) and African clawed frog (Xenopus laevis) to glean large amounts of information from precious tissues. These techniques will revolutionise our ability to visualise multiple cell types in any organism where antibodies are readily available.
Technologie sztucznej inteligencji w praktyce klinicysty i naukowca w fizjoterapii i rehabilitacji
Authors: Mikołajewska Emilia 
Published: November 2024

Technologie inteligencji obliczeniowej prowadzą do przełomu w sposobie oferowania oddziaływań terapeutycznych w rehabilitacji i fizjoterapii, w tym w ramach personalizowanej medycyny prewencyjnej ludzi zdrowych. Pandemia pokazała, że nowoczesna diagnostyka, leczenie, rehabilitacja i opieka nie są w pełni możliwe bez wsparcia nowoczesnych technologii, a w szczególności sztucznej inteligencji (ang. Artificial Intelligence – AI). Obszarami oddziaływania technologii AI w rehabilitacji i fizjoterapii są: - diagnostyka (sztucznointeligentna analiza chodu, ruchu kończyn górnych, jakości życia), - nowatorskie systemy motywowania pacjenta do ćwiczeń, w tym poprzez wykorzystanie rzeczywistości wirtualnej (VR) i rzeczywistości rozszerzonej (AR), - kreatywne łączenie oddziaływań terapeutycznych, optymalizacja oddziaływań, - monitorowanie realizacji ćwiczeń, - personalizowana ocena efektywności procesu terapeutycznego, - wykorzystanie egzoszkieletów i robotów rehabilitacyjnych, - boty jako narzędzia diagnostyczne i wspomagające terapię, - telerehabilitacja i rehabilitacja hybrydowa, - inteligentne środowiska terapeutyczne, - pomiar wpływu terapii na czynności codziennego życia i jakość życia, - modele obliczeniowe procesów terapeutycznych, - ocena klinicznej przydatności rozwiązań AI, - oprogramowanie medyczne wykorzystujące AI jako wyrób medyczny zgodnie z dyrektywą MDR oraz ISO 13485, - etyka sztucznej inteligencji z punku widzenia klinicysty. Monografia prezentuje zagadnienia o wysokim poziomie naukowym i istotnym znaczeniu kliniczny, a przez to ważne dla rozwoju nauki i wzrostu polskiej gospodarki poprzez poprawę zdrowia społeczeństwa, w tym: - poprawę profilaktyki u osób zdrowych w ramach medycyny prewencyjnej, - poprawę wczesnej diagnostyki zmian patologicznych, - zwiększenie skuteczności rehabilitacji, - zmniejszenie liczby osób czasowo lub trwale niepełnosprawnych, - dłuższe utrzymanie sprawności osób w podeszłym wieku.
The Blockchain Newsvendor: Value of Freshness Transparency and Smart Contracts
Authors: Keskin N. Bora , Li Chenghuai , Song Jing-Sheng 
Published: November 2024

Motivated by blockchain applications in the fresh produce industry, we consider a newsvendor problem in which a retailer faces stochastic and freshness-dependent consumer demand. The retailer can adopt blockchain technology to have more transparent information on the freshness of supply. We quantify the value of blockchain-enabled freshness transparency by deriving closed-form expressions for the retailer’s expected profit growth and food waste reduction brought by blockchain adoption. Using publicly available data, we provide a numerical example illustrating that for Walmart’s strawberry business in the United States (which is about only 4% of Walmart’s fresh produce sales), blockchain can increase annual profit by [Formula: see text] million while eliminating 23 million pounds of food waste annually through operational improvements. Despite this substantial value for the retailer, blockchain adoption can decrease the expected profit of the retailer’s supplier. We design a family of threshold-type smart contracts contingent on a blockchain-based freshness consensus and examine when such contracts offer a win-win proposition to the retailer and the supplier. Moreover, when the retailer offers freshness-based price discounts, we find that less fresh supply leads to less food waste. In contrast, when the supplier adjusts the wholesale price based on freshness, less fresh supply causes more food waste. We also generalize our findings to the cases of (i) dual sourcing, (ii) noisy measurements in the Internet of Things sensors feeding data into blockchain, and (iii) the retailer’s culling processes. This paper was accepted by David Simchi-Levi, operations management. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.02949 .
ARCTIC ENVIRONMENT IN DEFIANCE TO FAST-TRACK OPERATIONS ON HIP FRACTURES: A CHALLENGE ENLIGHTED
Authors: Hansen E. C. , Christensen S. , Simony A. , Damborg F. , Andersen S. 
Published: November 2024

IntroductionMost western countries have implemented fast-track hip fracture aiming at surgery within 24 hours, since the mortality rate hereafter rises markedly.In Greenland, it is not achievable to operate within 24 hours. Arctic people live in sparsely populated areas and Greenland's population is scattered along the vast coastline. All patients must be chartered to Nuuk by airplane which can take up till several days to weeks, due to logistics and the Arctic weather. This presents a challenge regarding adhering to western guidelines. The operative delay may be acceptable though, as it is the impression that the Greenlandic population survives and endures better than patients of western populations.However, as data are lacking, we aimed to describe mortality among hip fracture patients in Greenland taking frailty and comorbidities into account.MethodAll patients with ICD-10 codes DS720, DS721 and DS722 from 2018-2022 were identified as 261 patients diagnosed with hip fractures. Variables including time of diagnosis, time to operation, reasons for delay, ASA-score, Charlson Comorbidity index, time of death, and other possible confounding variables were analyzed. Primary outcome was mortality rates at 30-day post-OP and 1-year post-OP.ResultsThe average time from fracture to operation was 91.4 hours. In the Danish Cohort (DC) 70,6 % of patient were operated within 24 hours. Overall, 30-day mortality was 9,9 %, and 1-year mortality was 29,4 %, compared to the DC with 10,8 % 30-day mortality and 28,3 % 1-year mortality.Multivariate regression was conducted, showing no statiscal significant increase in mortality, despite extended delay.ConclusionWith no increase in death, the authors find it justifiable that patients in Greenland endure longer delays than the western population. The influence on further adverse effects needs to be investigated as well as causes of survival, but perhaps the Arctic people unveil mechanisms for raised survival among other populations.
BONE PEG-IN-BONE TECHNIQUE FOR LONG BONE NONUNIONS: A RETROSPECTIVE REVIEW
Authors: Chalak A. , Singh S. , Kale S. 
Published: November 2024

IntroductionThe non-union of long bones poses a substantial challenge to clinicians and patients alike. The Ilizarov fixation system and Limb Reconstruction System (LRS), renowned for their versatility in managing complex non-unions. The purpose of this retrospective study was to assess the outcomes of acute docking with the bone peg-in-bone technique for the management of non-unions of long bones. The study seeks to evaluate its effectiveness in achieving complete bony union, preserving limb length and alignment, correcting existing deformities, and preventing the onset of new ones.MethodA retrospective analysis of 42 patients was done with infected and non-infected non-unions of long bones who received treatment at a tertiary care hospital between April 2016 to April 2022. We utilized the Association for the Study and Application of Methods of the Ilizarov (ASAMI) scoring system to assess both bone and functional outcomes and measured mechanical lateral distal femoral angle (mLDFA) for the femur and the medial proximal tibial angle (MPTA) for the tibia.ResultIn our retrospective study involving 42 patients, a total of 30 patients had post debridement gap of >2 cm and average gap of 4.54 cm (range 1 – 13 cm) and therefore underwent corticotomy and lengthening. The average external fixation time was 6.52 (range 4 – 11 months) and average external fixation index of 2.08 (range 0.4 – 4.5 months/cm). The ASAMI scoring system showed bone result of 38 excellent, 3 good and 1 fair. Functional result of 40 excellent and 2 good outcomes. The post op mLDFA and MPTA were in normal range except in 3 patients which not statistically significant.ConclusionIn conclusion, the use of acute docking provides several advantages such as promoting early fracture healing, increasing stability, shortening treatment time, reducing the number of surgical procedures and reduced number of complications.
BIENNIAL EXPERIENCE OF ROBOTIC TECHNOLOGIES, ARTIFICIAL INTELLIGENCE, AND TELEREHABILITATION IN KNEE PROSTHETICS: ANALYSIS, CORRELATIONS, AND FUTURE PROSPECTS
Authors: Panzera R. M. 
Published: November 2024

IntroductionOrthopedics is experiencing a significant transformation with the introduction of technologies such as robotics and apps. These, integrated into the post-operative rehabilitation process, promise to improve clinical outcomes, patient satisfaction, and the overall efficiency of the healthcare system. This study examines the impact of an app called Mymobility and intra-operative data collected via the ROSA® robotic system on the functional recovery of patients undergoing robot-assisted knee arthroplasty.MethodThe study was conducted at a single center from 2020 to 2023. Data from 436 patients were included, divided into “active” patients (active users of Mymobility) and “non-active” patients. Clinical analyses and satisfaction surveys were carried out on active patients. The intra-operative parameters recorded by ROSA® were correlated with the Patient-Reported Outcome Measures (PROMs) collected via MymobilityResultIntra-operative data showed significant correlations with PROMs for the 48 active patients, highlighting the importance of parameters such as medial joint space and ligament laxity. No significant differences were observed between the sexes, but a positive correlation was detected between age and PROMs. The data analysis indicated that an increased medial joint space and reduced ligament laxity are associated with better PROMs. The adoption of Mymobility remained limited, with only 10% of patients fully utilizing the app. Critical factors have been identified to improve recruitment, engagement, and overall experience with the platform.ConclusionThe integration of technologies such as Mymobility and ROSA® in post-operative rehabilitation offers numerous advantages, including the objectification of data, active patient involvement, and personalized care. Challenges remain related to costs, patient compliance, and demographic limitations. Nevertheless, these technologies represent a milestone in modern peri-operative management, being able to improve clinical outcomes and the quality of care.