bluuebunny/crossref_metadata_2025_split huggingface dataset:
875 Comparison of Anterior Versus Posterior Approaches for Management of Cervical Trauma: A National Database Study
Authors: Sri Bhaskara Mounika Lalitha , Jiang Sam Han , Labib Bichoy , Deysher Daniel , Khilwani Harsh , Chiu Ryan Guan , Sadeh Morteza , Mehta Ankit Indravadan 
Published: March 2024

INTRODUCTION:
Cervical spine injuries are a major cause of long-term disability, accounting for almost 65% of all spinal injuries. They often result in major motor and sensory deficits and chronic pain. Prompt surgical intervention is often required to prevent further neurological deterioration and instability, yet there is no definitive evidence for the optimal operative approach.

METHODS:
The National Trauma Data Bank was queried from 2017 to 2019 for all patients with cervical trauma who underwent subsequent spinal fusion surgery with anterior or posterior approaches. Patients receiving combination management were excluded. Paired Student’s t-tests and Pearson’s Chi-squared analyses were used to compare differences in patient demographics, in-hospital complications, and lengths of stay between the two groups. Relative risks for the in-hospital complications were also calculated. Alpha was set to 0.05.

RESULTS:
A total of 10,593 patients meeting the inclusion criteria were identified, with 6,803 patients undergoing fusion with an anterior approach and 3,226 patients with a posterior approach. Patients with a posterior approach were significantly older, had a higher proportion of white and female patients, and a lower total GCS score (p < 0.05 for all). They also had higher rates of comorbidities such as hematologic disorders, COPD, CHF, Hypertension, PAD, MI, and renal disease (p < 0.05 for all). After surgery, the anterior approach group had a shorter hospital stay and a significantly lower risk of developing SSI, requiring unplanned reoperation, and experiencing MI (p < 0.05 for all).

CONCLUSIONS:
To our knowledge, this is the largest study assessing differences in in-hospital morbidities between surgical approaches for cervical trauma. Our findings suggest that the anterior approach has a lower risk of short-term complications, emphasizing its clinical advantage. Further research is needed to elucidate the long-term effects.
876 Neuron Specific Enolase and S-100 Protein in Sepsis Associated Encephalopathy (SAE)
Authors: Newsome-Cuby Takara , Talley Jan 
Published: March 2024

INTRODUCTION:
Severe sepsis and septic shock represent one of medicine's oldest and most pressing problems. Sepsis-associated encephalopathy (SAE) is associated with increased mortality and decreased quality of life. By the time a patient is septic, SAE is most often already established. Currently, no standardized laboratory markers of brain injury may aid in the diagnosis. However, S-100 protein and neuron-specific enolase (NSE) may be useful biomarkers. Neuronal injury leads to the cellular release of these biomarkers into the cerebrospinal fluid and then ultimately into the bloodstream. Rapid detection will allow for early diagnosis and intervention in the clinical setting.

METHODS:
A systematic review evaluating patients with severe sepsis and septic shock. In 170 patients, serum S-100 and NSE were measured daily for 4 consecutive days after intensive care unit admission. Admission Glasgow Coma Scale before sedation and daily Sequential Organ Failure Assessment (SOFA) scores were recorded in all patients. Each participant was continuously observed 72 hours after withdrawing sedation.

RESULTS:
S-100 was elevated in 72 patients (42%) and NSE increased in 90 patients (53%). Higher maximum SOFA scores were recorded in patients with elevated biomarkers (p = 0.001). Elevation of S-100 was associated with encephalopathy (p = 0.004).

CONCLUSIONS:
S-100 and NSE are frequently increased in patients with severe sepsis and septic shock. The higher the biomarkers, the worse the brain failure in patients. S-100 levels can be used as predictors of early ICU mortality and better reflect the development of severe encephalopathy and brain injury than NSE levels and the GCS scores.
878 Selective Brain Cooling is Possible via CSF Exchange With Double Lumen EVD- Proof of Concept in Porcine Model
Authors: Jahromi Behnam Rezai , Järveläinen Niko , Kauhanen Jaakko , Niemela Mika Risto , Ylä-Herttuala Seppo 
Published: March 2024

INTRODUCTION:
Hypothermia is seen as neuroprotective after brain insult (BI). In acute phase after BI it affects brain metabolism by decreasing oxygen and glucose consumption. Hypothermia affects apoptosis and inflammatory mediators. In the later stage of BI, enzyme activation stimulates protein and lipid breakdown, which can be slowed and decreased with hypothermia. In the latest stage of BI hypothermia has shown positive affect in angiogenesis, neurogenesis, synaptogenesis. Hypothermia also reduces vasogenic oedema and blood brain barrier dysfunction. Despite hypothermia´s neuroprotective effect randomized control trials have demonstrated its benefits only limited scenarios - mainly in global ischemia (post-cardiac infarction and ischemia of new-born). Majority of complications related to hypothermia has been due to systemic hypothermia and selective brain cooling has never been demonstrated in large mammals without changes in core temperature of subject.

METHODS:
We inserted double lumen external ventricular drainage (EVD) into the lateral ventricle of porcine. We added spinal drainage to accelerate CSF exchange to cooled NaCl solution. Brain parenchymal temperature was measured from the contralateral brain hemisphere and the ipsilateral brain hemisphere.

RESULTS:
Contralateral brain hemisphere temperature dropped by 3.1C from baseline while core temperature changed only by 0.5C. Ipsilateral temperature cooled by 7.5C from baseline to 30.8C, while core temperature was 37.7C. Total time needed to achieve selective cooling was 1.5h. Porcine started to have arrhythmias when brain temperature approached 30.8C.

CONCLUSIONS:
We are first to describe that selective brain cooling is possible via CSF exchange with double lumen EVD to achieve significant temperature difference between body core and brain. The timing and rate of selective cooling needs to be established as cause of arrhythmias before starting human trials.
879 Comparison of Perioperative and Long-Term Outcomes Following PEEK and Autologous Cranioplasty: A Single Institution Experience
Authors: Anderson Bradley , Harris Peter Norman , Mozaffari Khashayar , Foster Chase H. , Johnson Michael , Jaco Alejandro , Rosner Michael K. 
Published: March 2024

INTRODUCTION:
Cranioplasty is a common neurosurgical procedure to correct congenital or acquired skull defects. Three-dimensionally (3D) printed polyether-ether-ketone (PEEK) implants are a relatively novel option for cranioplasty that has gained popularity in recent years. However, there is ongoing debate with respect to this material’s efficacy and safety compared to autologous bone grafts. The purpose of this study was to offer our institution’s experience and add to the growing body of literature on the topic.

METHODS:
A single-institution retrospective analysis of patients undergoing cranioplasties between 2016 and 2021 was performed. Patients were divided into PEEK and autologous cranioplasty cohorts. Parameters of interest included patient demographics as well as perioperative (<3 months postoperative) and long-term outcomes (>3 months postoperative). A p-value <0.05 was considered statistically significant.

RESULTS:
A total of 31 patients met inclusion criteria (PEEK: 15, Autologous: 16). Mean age of the entire cohort was 51.7 years (range 19-81 years). Baseline demographics using the modified frailty index (mFI) revealed greater rate of comorbidities in the autologous group (p = 0.073), which was accounted for in statistical analyses. Multiple logistic regression model revealed a significantly higher rate of surgical site infection during the immediate postoperative period in the autologous cohort (31.3% vs. 0%, p = 0.011). Otherwise, perioperative and long-term complication profiles were similar between groups. Additionally, a generalized linear model demonstrated that both cohorts had similar mean hospital length of stay (LoS) (autologous: 16.1 vs. PEEK: 10.7 days).

CONCLUSIONS:
PEEK cranioplasty implants may offer a more favorable perioperative complication profile with similar long-term complication rates and hospital LoS compared to autologous bone implants. Future studies are warranted to confirm our findings in larger series, and further examine the utility of PEEK in cranioplasty.
923 Utilization of a Gestational Age Threshold May Improve Pediatric VP Shunt Outcomes
Authors: Black Hannah , Woolard Alice , Quinsey Carolyn , Stuebe Caren , Torres Andrea , Caddell Drew 
Published: March 2024

INTRODUCTION:
The highest shunt failure rates occur in patients with hydrocephalus from intraventricular hemorrhage of prematurity (Premie-IVH). Tuli et al (1999) described a 40-week gestational age threshold that significantly differentiated shunt failure rates in a neonatal hydrocephalus population, but this threshold has not been investigated in a dedicated Premie-IVH cohort.

METHODS:
A retrospective cohort study was performed on patients treated for hydrocephalus with VP shunt implant at an academic pediatric institution from 2010-2021. Inclusion criteria were hydrocephalus from Premie-IVH, known gestational age at delivery, 1 year of follow-up, and known surgical history prior to VP shunt implant.

RESULTS:
Among 32 Premie-IVH patients, 50% experienced shunt failure within 1 year after VP shunt implant. Average gestational age (GA) at delivery was 27.5 weeks and average GA at surgery was 45.2 weeks. In total, 44% of patients received a VP shunt before 40 weeks of gestational age. In this population, 64% experienced VP shunt failure within one year and had an average of 0.79 temporizing surgeries prior to VP shunt implant. In the 56% of patients who received VP shunt surgery after 40 weeks of GA, 39% experienced VP shunt failure within one year and had an average of 1.3 temporizing surgeries prior to VP shunt surgery.

CONCLUSIONS:
In patients with hydrocephalus from Premie-IVH, those who had VP shunt surgery after 40 weeks gestational age received a greater number of temporizing measures while experiencing a 49% lower VP shunt failure rate. Temporizing measures may be used to improve VP shunt outcomes by delaying VP shunt surgery until after 40 weeks gestational age.
Prognostic Evaluation of Surgical Re-Resection for Recurrent Glioblastoma Using the Novel RANO Classification for Extent of Resection by The RANO Resect Group
Authors: Karschnia Philipp , Dono Ostorga Antonio Gabriel , Young Jacob , Jünger Stephanie T. , Teske Nico , Häni Levin , Sciortino Tommaso , Mau Christine Y. , Bruno Francesco , Nunez Luis C. , Weller Michael , van den Bent Martin , Beck Juergen , Hervey-Jumper Shawn L. , Molinaro Annette , Tandon Nitin , Rudà Roberta , Vogelbaum Michael A. , Bello Lorenzo , Schnell Oliver , Grau Stefan J. , Chang Susan M. , Berger Mitchel S. , Esquenazi Yoshua , Tonn Joerg-Christian 
Published: March 2024

INTRODUCTION:
The value of re-resection in recurrent glioblastoma remains unclear since leaving certain tumor deliberately behind appears ethically not justified.

METHODS:
The international RANO resect group retrospectively compiled an eight-center cohort of patients with first recurrence from a previously resected glioblastoma. The associations of re-resection and clinical factors with outcome were analyzed. Propensity score-matched analyses were constructed to minimize potential confounders when comparing the different RANO classes.

RESULTS:
We identified 681 patients with first recurrence of IDH-wildtype glioblastomas, including 310 patients who underwent re-resection. The use of re-resection was associated with prolonged survival also when stratifying for molecular and clinical confounders on multivariate analysis; and ≤ 1 cm3 residual CE tumor translated into improved survival compared to non-surgical management. Accordingly, ‘maximal resection’ (class 2) had superior survival compared to ‘submaximal resection’ (class 3). Adjuvant (radio-)chemotherapy further augmented the beneficial effects of lower residual CE tumor. Conversely, ‘supramaximal resection’ of non-CE tumor (class 1) was not associated with prolonged survival but frequently accompanied by post-operative deficits, hampering further treatment. The prognostic role of residual CE tumor was confirmed in propensity score analyses.

CONCLUSIONS:
Maximal extent of re-resection measured as residual CE tumor is highly prognostic in recurrent glioblastoma. The RANO classification serves to stratify patients accordingly. While the optimal adjuvant therapy awaits evaluation, our study supports that (radio-)chemotherapy consolidates the effects of re-resection.
Targeted DNA Sequencing Reveals Molecular Factors Associated with Clinical Outcomes in Recurrent Glioblastoma
Authors: Al-Adli Nadeem , Chen William , Young Jacob , Mirchia Kanish , Peeran Zain , Braunstein Steve , Perry Arie , de Groot John , Raleigh David R. , Costello Joseph , Berger Mitchel , Vasudevan Harish 
Published: March 2024

INTRODUCTION:
The prognostic significance of molecular alterations in recurrent glioblastoma (rGBM) remains unclear.

METHODS:
121 consecutive glioblastoma (GBM) patients who underwent re-resection at a single institution from 2016-2021 were retrospectively reviewed. All patients underwent maximal safe resection followed by radiotherapy with concurrent and adjuvant temozolomide (TMZ) at time of initial diagnosis. DNA mutations from re-resection samples were assessed with a CLIA certified next-generation targeted DNA sequencing assay. Overall (OS) and progression-free survival (PFS) from re-resection were analyzed with the Kaplan-Meier method and Cox regression analyses.

RESULTS:
Median age at first recurrence was 57 years (range, 27-78), and median follow up from re-resection was 11 months. Salvage therapy comprised re-irradiation (n = 52, 43%), temozolomide (TMZ) (n = 39, 32%), lomustine (n = 47, 39%), and/or bevacizumab (n = 22, 18%). Median OS and PFS times were 12.1 and 4.4 months, respectively. Median tumor mutation burden (TMB) was 4 mut/Mb (range, 1-650), microsatellite instability (MSI) was 1.16% (range, 0-20), and MGMT methylation was present in 71 (59%) patients. Longer OS was found after postoperative TMZ (19.1 vs. 9.1), KPS >70 (13.6 vs. 11.1), and/or re-irradiation (12.6 vs. 8.4) (p < .05 for each). On multivariate analysis, TMZ (HR 0.2, 0.079-0.48), re-irradiation (HR 0.27, 0.12-0.58), and mutations in the PDGFRA (HR 0.24, 0.067-0.83) or PTEN (HR 2.3, 1.1-4.8) genes on targeted sequencing were associated with longer OS after re-resection (p < .05). Multivariate predictors of re-irradiation response included MSI > 1.16 (HR 0.25, 0.084-0.75), and mutations in PDGFRA (HR 0.04, 0.005-0.33), TERT (HR 0.16, 0.033-0.78), or PIK3R1 (HR 0.18, 0.041-0.8) genes. In the 46 matched primary/recurrent tumors, 40 (46%) had a longitudinal change in a mutation and 9 (24%) demonstrated hypermutation, of which 4 (57%) had simultaneous mismatch repair deficiencies.

CONCLUSIONS:
Our study identifies molecular factors associated with survival and response to re-irradiation in rGBM.
Tumor Treating Fields for Treatment of Spinal Metastasis
Authors: Tatsui Claudio Esteves , Ledbetter Daniel , North Robert Y. , Alvarez-Breckenridge Christopher , Andrade de Almeida Romulo 
Published: March 2024

INTRODUCTION:
Tumor treating fields(TTF) has never been described for treatment of spinal metastasis. We investigate the anti-mitotic effect of TTF to inhibit the growth of human cancer using cells in vitro and in vivo models of spinal metastasis.

METHODS:
In-vitro: human derived osteosarcoma (Krib-Luc-1) and lund adenocarcinoma (A549-Luc) cells were seeded in 5x5mm human demineralized bone grafts kept in culture while treated with 0 KHz (control) or 150 KHz of TTF for 14 days. Bioluminescence images (BLI) were obtained at baseline and 14 days. In-vivo: Krib-Luc-1 cells were surgically implanted via trasperitoneal approach to the L3 vertebra in nude mice. Animals were treated with 0 KHz or 150 KHz of TTF for 30 days or until paralysis. BLI were obtained at day 0 and every 7 days. MRI was obtained at day 22. Histological analysis was performed at the end of the experiment. Control and TTF treated groups were compared with two-tailed t-tests.

RESULTS:
In vitro: BLI of the control grafts demonstrated a median value of 1×10^10 photons/sec at 14 days, significantly higher than 1×10^8 photons/sec observed in the 150 KHz group (p < 0.0001). In Vivo: median time to paralysis in control animals was 25 days, all animals treated with TTF at 150 KHz reached the 30 day mark without deficits. BLI of the control group was 3.5×10^9 photons/sec significantly higher than 1×10^9 photons/sec in the 150 KHz TTF group (p = 0.0212). MRI and histological analysis confirmed significant smaller tumors in the treated group when compared to controls.

CONCLUSIONS:
Application of TTF 150 KHz reduced cellular proliferation in both in vitro and in vivo models of spinal metastasis. We believe TTF could become a groundbreaking treatment for spinal metastasis.
Demographic Variations and Time to Initiation of Adjunct Treatment following Surgical Resection of Anaplastic Astrocytoma in the United States—A National Cancer Database Analysis
Authors: Sharma Mayur , Mckenzie Grant , Gaskins Jeremy , Yusuf Mehran , Woo Shiao Y. , Mistry Akshitkumar , Williams Brian Jeremy 
Published: March 2024

INTRODUCTION:
Anaplastic Astrocytoma (AA) is a rare primary brain tumor with a significant variation in the type and timing of adjunct treatment (AT) following the surgical resection.

METHODS:
The National Cancer Database (NCDB) was queried for patients diagnosed with AA from 2004 to 2016. Cox proportional hazards and modeling was used to determine factors influencing survival, including the impact of time to initiation (TTI) of adjuvant therapy.

RESULTS:
Overall, 5890 patients were identified from the database. The use of combined RT+CT temporally increased from 66.3% (2004-2007) to 79% (2014-2016), p < 0001. Patients more likely to receive no treatment following surgical resection included elderly (>60 years old), hispanic patients, those with either no or government insurance, those living >20 miles from the cancer facility, those treated at low volume centers (<2 cases/year). AT was received following surgical resection within 0-4 weeks, 4.1-8 weeks, and >8 weeks in 41%, 48%, and 3%, respectively. Compared to patients who received RT + CT, patients were likely to receive RT only as AT either at 4-8 weeks or >8 weeks after the surgical procedure. Patients who received AT within 0-4 weeks had the 3-year OS of 46% compared to 56.7% for patients who received treatment at 4.1-8 weeks.

CONCLUSIONS:
Across the cohort, nearly 15% of patients received no AT following surgery, with the proportion of patients receiving no AT generally decreasing over time. This decrease corresponds to increased utilization of combined modality AT during the same time span. The highest utilization of combined AT within this cohort was between 4.1-8 weeks following the surgery.
A thermal performance curve perspective explains decades of disagreements over how air temperature affects the flight metabolism of honey bees
Authors: Glass Jordan R. , Harrison Jon F. 
Published: March 2024

ABSTRACT
While multiple studies have shown that honey bees and some other flying insects lower their flight metabolic rates when flying at high air temperatures, critics have suggested such patterns result from poor experimental methods as, theoretically, air temperature should not appreciably affect aerodynamic force requirements. Here, we show that apparently contradictory studies can be reconciled by considering the thermal performance curve of flight muscle. We show that prior studies that found no effects of air temperature on flight metabolism of honey bees achieved flight muscle temperatures that were near or on equal, opposite sides of the thermal performance curve. Honey bees vary their wing kinematics and metabolic heat production to thermoregulate, and how air temperature affects the flight metabolic rate of honey bees is predictable using a non-linear thermal performance perspective of honey bee flight muscle.
Building a Sphere from Imaginary Points
Authors: Girsh A. 
Published: March 2024

Euclidean spaces of various dimensions do not contain imaginary images and objects by definition, but are inextricably linked with them through special cases, and this leads to the need to expand the field in geometry into the region of imaginary values [1, 19, 26]. Such an extension, i.e. adding to the field of real coordinates spaces of different dimensions, the field of imaginary coordinates leads to different variants of spaces of different dimensions, depending on the chosen axiomatics. Earlier in a number of articles, examples of solving some actual problems of geometry using imaginary geometric images and objects were shown [4, 5, 6, 13, 21, 22, 29].
The article provides constructions for constructing a sphere from four predetermined points, of which one pair or both pairs of points can be imaginary complex conjugate. The construction is carried out on combined diagrams by the methods of descriptive geometry by analogy with the well-known problem of constructing a sphere from four real points. The construction of a sphere is based on seven auxiliary constructions for constructing a circle from points that can be imaginary conjugates. Both 3D problems of constructing spheres for given points and methods of 2D construction problems for determining the required imaginary points are considered. A method for calculating the parameters of the obtained sphere is described. The application of the method to other problems of descriptive geometry, for example, to the problems of finding geometric places of points, is considered. equidistant from two given surfaces. Recently, this issue has been intensively studied, for example, in the works [5, 6].
Inflation, Monetary Policy, and Portfolio Decisions of U.S. Households
Authors: Bonaparte Yosef , Korniotis George M. , Kumar Alok , Vosse Melina 
Published: March 2024

We study the impact of monetary policy changes on portfolio decisions of U.S. households. Contrary to the predictions of canonical portfolio choice models, interest rate increases are related to increased equity ownership and larger wealth allocations to risky assets. Inflation hedging is a likely explanation for these findings. Interest rates have a stronger impact on the equity exposure of households that experience higher inflation, especially those with greater inflation awareness and potentially stronger hedging motives. Using household portfolios at a large discount brokerage house, we provide direct evidence that investors with greater inflation sensitivity overweight stocks with high hedging potential. This paper was accepted by Camelia Kuhnen, finance. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2023.02197 .