bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser interstitial thermal therapy for cavernous malformations: a meta-analysis of individual patient-level data
Authors: Jimenez Adrian E. , Geist Elias G. , Connolly E. Sander , McKhann Guy M. , Youngerman Brett E. 
Published: November 2024

OBJECTIVE
Several case series have investigated the use of laser interstitial thermal therapy (LITT) to treat cavernous malformations (CMs), for either seizure control or reduction of neurological symptoms and future hemorrhage risk. However, pooled outcomes are largely unknown. The authors aimed to quantify posttreatment seizure freedom, symptomatic progression or hemorrhage, perioperative complications, and imaging outcomes from the available literature.

METHODS
This study was a PRISMA-compliant systematic review and individual patient-level data meta-analysis of studies reporting LITT ablation of CMs. For patients with epilepsy, the pooled Engel seizure freedom rate was calculated. The rate of symptomatic progression or hemorrhage was calculated for all patients. Fixed-effects logistic regression models were used to test for predictors of seizure freedom and postoperative complications. Linear regression models were used to obtain pooled estimates of the percent CM volume ablated.

RESULTS
A total of 39 patients (28 with epilepsy) underwent LITT for the treatment of 45 CMs (37 cortical, 8 subcortical) at six centers. Among patients with epilepsy, 88.0% (95% CI 68.7%–96.1%) were seizure free at the last follow-up (median 30.0 months, range 12.0–49.0 months). Six patients (15.4%) experienced immediate postoperative neurological deficits. No perioperative hemorrhage was reported, and no patients experienced subsequent hemorrhage or symptomatic progression during follow-up (median 26.0 months, range 2.0–53.0 months). There was no difference in the odds of seizure freedom or adverse events based on preoperative characteristics. Nonepileptogenic CMs (mean volume 2.5 cm3) were significantly larger than epileptogenic CMs (mean volume 0.8 cm3; p = 0.002). LITT was associated with a mean CM volume reduction of 73.7% (95% CI 64.1%–83.2%, p < 0.0001) for epileptogenic CMs and 53.8% (95% CI 14.2%–93.3%, p < 0.023) for nonepileptogenic CMs (p = 0.14).

CONCLUSIONS
LITT is a promising therapy for CMs with the goal of seizure control or prevention of symptomatic progression or hemorrhage. While there is a notable risk of immediate postablation neurological deficit, most were transient and nondisabling, and this risk must be weighed against that of continued observation or open resection. Considering the limited number of studies, small number of patients, and limited follow-up time available, additional experience and research with larger patient cohorts and longer-term follow-up will be necessary to validate these findings.
The value of a neurosurgeon: is neurosurgical compensation proportional to value added? A systematic review of the literature and an update on a changing healthcare economy
Authors: Hopkins Benjamin S. , Dallas Jonathan , Guerra Gage , Hofmann Hayden L. , Ordon Matthew , Nguyen Vincent N. , Caravan Bassir , Liu John , Zada Gabriel , Mack William J. 
Published: November 2024

OBJECTIVE
Determining the value of a neurosurgeon is complex. Services provided by neurosurgeons have a range of interested parties—from a patient’s singular health interest to a community catchment area rendering on-call emergency services. Such complexity makes it difficult to determine and define value. As healthcare reimbursement changes continue to transition further toward value-based/bundled payments, such determinations remain difficult and confusing. Given these factors, now more than ever before, neurosurgeons need to be active participants in the evolving discussions surrounding healthcare advocacy, value, and compensation in an ever-evolving and convoluted system. The objective of this study was to review and present current trends within the evolving landscape of healthcare economics and their impacts on the perceived value of neurosurgical services.

METHODS
A systematic review regarding payments and compensation within neurosurgery was performed using a key term search. Additionally, a neurosurgical value model for hospitals was created using Medicare reimbursement methods to attempt to determine the financial contribution of a single neurosurgeon to a hospital system. Furthermore, Internal Revenue Service (IRS) form 990 tax filings from 5380 organizations were examined for comparative trends in profits and revenue on a hospital-wide basis.

RESULTS
Mean and median annualized excess hospitalization revenue from a neurosurgeon over the same number of equal medical admissions was $5,120,533 and $5,141,160, respectively. For private practice groups, the annualized mean and median yearly hospital revenue over a comparable medical admission was calculated to be $1,539,704 and $1,902,555, respectively. For hospital-employed neurosurgeons, the respective addition of Medicare part B payments increased the mean and median values to $2,249,552 and $2,612,403, respectively. Analysis of nonprofit hospital IRS form 990 filings revealed a substantial increase in executive compensation and hospital revenue since 2011. Neurosurgeon median earnings over a similar period, reported through surveys, exhibited varied increases, but significant reporting variation exists.

CONCLUSIONS
Medical compensation continues to evolve toward more value-driven methods. Value created as a neurosurgeon is complex, but it should not be underestimated as a key driver of hospital revenue, with up to $2.6 million created annually from neurosurgical hospital admissions. Further discussion is needed to elucidate alternative innovative payment strategies to ensure physicians remain active in the evolving structure of our healthcare system.
Distinct brain network structure of mesial temporal lobe epilepsy compared to that of neocortical epilepsy: functional MRI study with surgically treated patients
Authors: Nishibayashi Hiroki , Nakai Yasuo , Donishi Tomohiro , Nakao Naoyuki , Kaneoke Yoshiki 
Published: November 2024

OBJECTIVE
Mesial temporal lobe epilepsy (mTLE) and neocortical epilepsy (NE) have different anatomo-clinical characteristics. The authors hypothesized that this may be reflected in the different functional connectivity of the epileptogenic zone between mTLE and NE. The authors, therefore, examined preoperative resting-state functional connectivity MRI with regional global connectivity (rGC) analysis for surgically treated patients. The goal of this study was to detect the different functional networks associated with the epileptogenic zone between mTLE and NE.

METHODS
Twenty-four patients (12 with mTLE and 12 with NE) who underwent surgery were included in the study. All patients received resting-state functional MRI preoperatively. The mean rGC and number of high-rGC or low-rGC voxels were calculated using preoperative MRI in various regions of interest including the resected area.

RESULTS
The ratio of mean rGC in the resected area to that of the whole brain was significantly lower in mTLE patients than in NE patients. Mean rGC was significantly lower than that of the contralateral counterpart of the resected area in mTLE patients, although it was not significantly different in NE patients. Low rGC was more frequently observed in the resected area in mTLE patients than NE patients, and high rGC more frequently observed in NE than mTLE. Multivariate analysis showed that the etiology of hippocampal sclerosis, the ratio of mean rGC in the resected area to that in the whole brain, and the ratio of the number of low- and high-rGC voxels relative to the whole brain were significant factors to distinguish mTLE from NE.

CONCLUSIONS
The authors revealed a distinct brain network structure between mTLE and NE based on rGC analysis with resting-state functional MRI. The authors’ unique functional connectivity analysis may be helpful for providing landmarks for lateralization or epileptogenic zones in mTLE and NE.
Implementation of high-definition fiber tractography for preoperative evaluation and surgical planning of brainstem cavernous malformation: long-term outcomes
Authors: Fernandes Cabral David T. , Zenonos Georgios A. , Barrios-Martinez Jessica , Bonhomme Gabrielle R. , Yeh Fang-Cheng , Fernandez-Miranda Juan C. , Friedlander Robert M. 
Published: November 2024

OBJECTIVE
The aim of this study was to describe the role and long-term outcomes of high-definition fiber tractography (HDFT) in the surgical management of brainstem cavernomas.

METHODS
The authors performed a retrospective evaluation of their database at the HDFT laboratory in a single academic institution.

RESULTS
The authors identified 11 patients with brainstem cavernomas who had HDFT for preoperative workup and underwent microsurgical resection. The mean patient age was 39 years (range 20–76 years), and the mean follow-up was 75.2 months (range 37–149 months). Four cavernomas were located anterolaterally in the pons (2 right and 2 left), 2 were left pontomesencephalic, 1 was thalamomesencephalic, 1 was in the posterior midbrain (right superior colliculus), and 3 were in the posterior pontine/floor of the fourth ventricle. Gross-total resection was achieved in 8 patients (72.7%) and subtotal resection in 3 patients (27.3%). Although 5 patients (45.5%) experienced transient worsening of preoperative symptoms or new deficits, all fully improved within 3 months. None of the patients developed new permanent neurological deficit. Preoperative symptoms improved partially in 8 patients (72.7%) and completely in 3 patients (27.3%). There was one asymptomatic new hemorrhage, and another patient had a symptomatic hemorrhage with a recurrence of his presenting symptoms 15 months after his initial surgery. This patient underwent a re-resection of his residual cavernoma, with no improvement in his preoperative symptoms.

CONCLUSIONS
HDFT provides critical anatomical information guiding an optimal surgical corridor and more importantly defining eloquent perilesional boundaries. In this preliminary experience, preoperative planning with HDFT appeared to decrease morbidity in patients who underwent microsurgical resection of their brainstem cavernoma.
Characterizing pediatric cervical fusion in the modern era: indications, complications, and fusion rates
Authors: Tang Alan R. , Zeoli Tyler , Bishay Anthony E. , Rogers James L. , Sellyn Georgina E. , Liles Campbell , Bonfield Christopher M. 
Published: November 2024

OBJECTIVE
Cervical fusion within the pediatric population presents unique challenges, because pediatric cervical fixation demands careful consideration of anatomical size, physiological differences, and significant prospective growth potential for young patients. In the present systematic review, the authors outline the indications for cervical fusion, summarize patient outcomes in the pediatric population, and characterize the various cervical fixation surgical techniques.

METHODS
A retrospective literature review of pediatric cervical fusion was conducted in June 2024 via PubMed, in accordance with PRISMA guidelines and using appropriate search syntax and evidence schemes. The initial literature search yielded 1107 articles, with 259 articles undergoing a full-text review. Inclusion criteria included studies examining pediatric populations (age ≤ 18 years) requiring cervical spine surgical fixation between 2000 and 2024. Studies in which patients with cervical pathology were not surgically treated, those examining primarily adult populations > 18 years old (n = 504), case reports (n = 150), and non-English studies (n = 96) were excluded. Outcomes consisted of demographic variables, fusion rates, bone morphogenetic protein (BMP)/graft material used, and complications.

RESULTS
In total, 106 studies between 2000 and 2024 examining 2086 patients were included in the review. The most common surgical indications across all studies included atlantoaxial instability (n = 49, 48.5%). Most studies reported cases involving occipitocervical (OC) junction pathology (n = 74, 69.8%) and using iliac crest autograft (n = 53, 50.0%) and rib autograft (n = 28, 26.4%). Allografting was used in 25 studies (23.9%) and BMP was used in 26 studies (24.5%). Overall, the fusion rate for pediatric patients undergoing cervical fusion was 95.8%, with OC fusion having comparable fusion rates (0.95 ± 0.02) to those without OC junction involvement (0.96 ± 0.01, p = 0.703). The overall complication rate was 14.9%. There were similar rates of complications compared to studies with and without OC fusion (OC: 0.15 ± 0.18, non-OC: 0.13 ± 0.17; p = 0.075).

CONCLUSIONS
Despite efforts to characterize the comparative advantages of different immobilization techniques, such as screw constructs versus wiring, and the use of bone graft materials including BMP, a comprehensive understanding of outcomes remains elusive. The overall fusion rate observed in the analyzed cohort aligns with prior research, yet complications persist, with a notable proportion necessitating reoperation or revision in those with OC pathology. Although the incorporation of BMP alongside autograft and allograft materials remains relatively uncommon, the potential benefits warrant further research, with longitudinal follow-up of fusion rates.
Myelomeningocele repair in Latin America: a systematic review
Authors: Vazquez Sima , Lu Victor M. , Brun Jorge , Muller José M. , Niazi Toba N. 
Published: November 2024

OBJECTIVE
Myelomeningocele (MMC) carries high morbidity and mortality. The Management of Myelomeningocele Study (MOMS) showed improved outcomes after prenatal compared to postnatal repair. However, it is unclear how the MOMS trial affected practice and outcomes in the Latin American region. The objective of this study was to review the literature published by or including patients from the Latin American region and the reported management patterns of MMC.

METHODS
A systematic review of MMC repair was performed. Articles were included if the senior author or patient population was from a Latin American country or territory. Article characteristics such as senior author, title, year of publication, senior author department, and outcomes studied were extracted. Management of MMC repair was the primary outcome explored.

RESULTS
A total of 71 studies satisfied all criteria for selection. Brazil (75%), Mexico (11%), Argentina (8%), Chile (7%), Costa Rica (1%), and Puerto Rico (1%) were represented countries or territories (some studies included patients from multiple countries). Neurosurgery (n = 23) was the most represented senior author department, followed by fetal medicine or fetal surgery (n = 15) and obstetrics (n = 14). Puerto Rico and Costa Rica described postnatal repair, while studies from Brazil, Chile, Argentina, and Mexico described prenatal repair. Brazil was the only country to prospectively study urological outcomes, reporting little to no improvement in urological outcomes with pre- versus postnatal repair. Prospective studies showed the safety and efficacy of endoscopic, microhysterotomy, and microneurosurgical approaches to in utero surgery.

CONCLUSIONS
Six countries or territories in the Latin American region have published articles on MMC repair. All recent papers describe a prenatal approach. Prospective studies show a trend toward open fetal microhysterotomy and microneurosurgery in the region and a need for more research on long-term urological outcomes following in utero repair.
The importance of timing: evaluating the optimal age for surgical intervention in asymptomatic dermal sinus tracts
Authors: Chesney Kelsi M. , Keating Gregory F. , Patel Nirali , Aguilera Carlos , Myseros John S. , Oluigbo Chima , Syed Hasan R. , Keating Robert F. 
Published: November 2024

OBJECTIVE
Dermal sinus tracts (DSTs) are rare congenital lesions resulting from errors of spinal cord disjunction, leading to a persistent connection between the cutaneous ectoderm and underlying neural elements. As patients are at increased risk of infection and irreversible neurological compromise due to tethering, resection and detethering are recommended as a prophylactic measure. The ideal timing of surgical intervention in an asymptomatic cohort, however, remains unclear.

METHODS
A retrospective chart review was performed at a single institution from 1998 to 2022 of all patients surgically treated for lumbar DST by 10 different surgeons. Demographic, presentation, operative, and postoperative details were obtained. Five patients who presented with infectious or neurological symptoms were excluded from primary analysis. The age at the time of surgery was then analyzed as a continuous variable against the operative details and postoperative outcomes utilizing Spearman’s correlation coefficient and the Mann-Whitney U-test.

RESULTS
Fifty-two patients underwent prophylactic surgical excision of their DST as well as detethering. Overall, 65% of patients were female and the median age at diagnosis was 3 months, while the median age at the time of surgery was 7 months. An additional cutaneous finding was identified in 71% of patients, with hemangioma being most frequent (40%). Additional spinal lesions were radiographically identified in 29% of patients, including lipoma (19%), dermoid and epidermoid inclusion cysts (8%), and an arachnoid cyst (2%). Postoperative complications occurred in 8% (n = 4) of patients, primarily related to wound healing (3/4), with significant risk attributed to younger age at time of surgery (mean 3 months, range 1–5 months) (p = 0.01). During 56 months of follow-up, long-term rates of retethering (6%, p = 0.02) and abnormal neurological examinations (8%, p = 0.001) were associated with concurrent lipomas, but not with age at operation.

CONCLUSIONS
In a series of 52 pediatric patients undergoing prophylactic resection of a DST with detethering, the complication rate was 8% and was significantly associated with age < 6 months at the time of operation. Associated spinal lipomas significantly influenced long-term outcomes. When evaluating asymptomatic infants with DST, patient age is a significant factor in assessing the risks and benefits of surgical timing.
Pelatihan Pengolahan Sampah Organik Sebagai Pupuk Kompos Yang Ramah Lingkungan dan Ekonomis di Desa Weranggere Kecamatan Witihama Kabupaten Flores Timur
Authors: Pele Kornelis Andito , Ola Urbanus , Niron Eusabius Separera 
Published: November 2024

Pupuk menjadi solusi bagi masyarakat dalam memberikan nutrisi pada tanaman yang membantu para petani dalam menigkatkan kualitas tanah dan kesuburan pada tanaman. Namun kesulitan pupuk memaksa petani mengeluarkan sejumlah dana untuk membeli pupuk kimia dari luar pada hal tersedia bahan baku pembuat pupuk yang ramah lingkungan. Pupuk yang dibeli umumnya adalah pupuk kimia mengandung pestisida. Jika digunakan secara overdosis maka akan merusak unsur hara pada tanah dan merusak tanaman. Oleh karena itu, dalam kegiatan PKM di Desa Weranggere ini dilaksanakan kegiatan sosialisasi dan pelatihan pengolahan sampah organik sebagai pupuk kompos organik yang ramah lingkungan dan ekonomis. Metode yang digunakan adalah sosialisasi dan pelatihan. Kegiatan ini dilaksanakan mengingat ada potensi di desa yang belum dimanfaatkan masyarakat, yakni limbah pertanian di ladang dan sampah rumah tangga yang menjadi bahan dasar pembuatan pupuk kompos yang ramah lingkungan. Proses pembuatan pupuk kompos sangatlah mudah sehingga masyarakat di desa Weranggere dapat mempraktekannya didukung oleh bahan-bahan yang mudah didapat.dibutuhkan sangatlah mudah didapatkan dan tidak menguras banyak tenaga dalam pembuatannya. Melalui kegiatan ini masyarakat Desa Weranggera memahami kerugian dan keuntungan menggunakan pupuk kompos organik dan pupuk kimiah. Masyarakat desa Weranggera dapat membuat pupuk kompos denganmemanfaatkan limbah pertanian dan sampah rumah tangga sehingga mampu memenuhi kebutuhan pupuk secara mandiri, menghemat pengeluaran rumah tangga membeli pupuk kimia serta secara cerdas menanggulangi limbah pertanian dan sampah rumah tangga.
ЗАБЕЗПЕЧЕННЯ ЕКОНОМІЧНОЇ БЕЗПЕКИ ДЕРЖАВИ В УМОВАХ НАДСКЛАДНИХ ВИКЛИКІВ СЬОГОДЕННЯ
Authors: КРИМЧАК Людмила , СЛОБОДЯНЮК Іванна , КРИМЧАК Олександр 
Published: November 2024

Стаття присвячена дослідженню питання економічної безпеки держави та висвітленню його актуальної проблематики в сучасних умовах воєнного стану. На основі проведеного дослідження розкрито зміст та складові економічної безпеки, основні фактори, що впливають на її формування в умовах війни в Україні, визначено основні ризики та загрози, які постали перед вітчизняними підприємствами та державою, розглянуто основні напрями міжнародної підтримки для стабілізації економічної безпеки України.
Комплексне оцінювання віддаленого прогнозу пацієнтів після перенесеного інфаркту міокарда з елевацією сегмента ST
Authors: Besh D. I. , Gutor T. G. 
Published: November 2024

The aim – to develop a validated scale for predicting long-term prognosis after ST-elevation myocardial infarction (STEMI), taking into account both clinical, laboratory, and instrumental parameters and the morphological features of intracoronary thrombi. Materials and methods. The study included 100 patients with STEMI aged 57.81 ± 10.26 years. They underwent primary percutaneous coronary intervention within 12 (7.00 [4.75; 10.00]) hours of the onset of the disease, which also included manual thrombus aspiration. Not only clinical, laboratory, or instrumental parameters were determined in patients, but also the morphological structure of intracoronary thrombi. The prognosis was assessed by the occurrence of one of the three events studied: death, myocardial infarction, and coronary revascularization. The duration of observation was two years.Results. The analysis included 24 clinical, anamnestic, laboratory, or instrumental parameters, as well as 5 morphologic signs of intracoronary thrombi. From the set of factors that were studied in the course of the work, three factors have been identified by the method of logistic regression, which, when combined, have an impact on the risk of developing the events. One factor has a preventive effect (layered thrombus structure), and two factors have a provocative effect (arterial hypertension, chronic kidney disease). The formula for calculating Z to determine the probability of the influence of the selected factors on the occurrence of the studied events is as follows: Z = - 3.35 - 1.08 . X1 + 2.58 . X2 + 1.37 . X3, where X1 is a layer structure (possible options are 1 or 0), X2 is arterial hypertension, and X3 is chronic kidney disease. The sensitivity of the model is 75.00 % and the specificity is 75.68 %. The total ratio of correctly predicted (positive and negative) cases is 75.56 %.Conclusions. A comprehensive determination of the prognosis of STEMI using a scale that includes clinical, anamnestic, laboratory, instrumental and morphological examinations may provide an additional means of risk stratification in such patients.