bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flow Diversion as Destination Treatment of Intracranial Mycotic Aneurysms: A Retrospective Case Series
Authors: Kashkoush Ahmed , El-Abtah Mohamed E. , Achey Rebecca , Hussain Muhammad Shazam , Toth Gabor , Moore Nina Z. , Bain Mark 
Published: January 2023

BACKGROUND:
Mycotic aneurysms represent a rare type of intracranial aneurysm. Treatment options usually consist of coiling, clipping, or liquid embolization. Data regarding outcomes after flow diversion of mycotic aneurysms are sparse.

OBJECTIVE:
To present a single-center case series regarding our experience with FD as definitive treatment for ruptured mycotic aneurysms initially treated with coil embolization.

METHODS:
We retrospectively reviewed a prospectively maintained database of all cerebrovascular procedures performed at a single institution between 2017 and 2021 for cases that used FD for the management of intracranial mycotic aneurysms. Prospectively collected data included patient demographics, medical history, rupture status, aneurysm morphology, aneurysm location, and periprocedural complications. The main outcomes included neurological examination and radiographic occlusion rate on cerebral digital subtraction angiography.

RESULTS:
Three patients with 4 ruptured mycotic aneurysms that were initially treated with coil embolization were identified that required retreatment. The aneurysms were located along the middle cerebral artery bifurcation (n = 2), posterior cerebral artery P1/2 junction (n = 1), and basilar artery apex (n = 1), which all demonstrated recurrence after initial coil embolization. Successful retreatment using flow diverting stents was performed in all 3 patients. At the last angiographic follow-up, all aneurysms demonstrated complete occlusion. No patients suffered new periprocedural complications or neurological deficits after FD.

CONCLUSION:
Flow-diverting stents may be an effective treatment option for intracranial mycotic aneurysms that are refractory to previous endovascular coiling. Future studies are warranted to establish the associated long-term safety and clinical efficacy.
Surgical Resection of Deep-Seated Arteriovenous Malformations Through Stereotactically Guided Tubular Retractor Systems: A Case Series
Authors: Achey Rebecca , Kashkoush Ahmed , Potter Tamia , Davison Mark , Moore Nina Z. , Kshettry Varun R. , Bain Mark 
Published: January 2023

BACKGROUND:
Arteriovenous malformations (AVMs) in the subcortical and/or periventricular regions can cause significant intraventricular and intracranial hemorrhage. These AVMs can pose a unique surgical challenge because traditional, open approaches to the periventricular region require significant cortical/white matter retraction to establish sufficient operative corridors, which may result in risk of neurological injury. Minimally invasive tubular retractor systems represent a novel, feasible surgical option for treating deep-seated AVMs.

OBJECTIVE:
To explore 5 cases of NICO BrainPath-assisted resection of subcortical/periventricular AVMs.

METHODS:
Five patients from a single institution were operated on for deep-seated AVMs using tubular retractor systems. Collected data included demographics, AVM specifications, preoperative neurological status, postoperative neurological status, and postoperative/intraoperative angiogram results.

RESULTS:
Five patients, ranging from age 10 to 45 years, underwent mini-craniotomy for stereotactically guided tubular retractor-assisted AVM resection using neuronavigation for selecting a safe operative corridor. No preoperative embolization was necessary. Mean maximum AVM nidal diameter was 8.2 mm. All deep-seated AVMs were completely resected without complications. All AVMs demonstrated complete obliteration on intraoperative angiogram and on 6-month follow-up angiogram.

CONCLUSION:
Minimally invasive tubular retractors are safe and present a promising surgical option for well-selected deep-seated AVMs. Furthermore, study may elucidate whether tubular retractors improve outcomes after microsurgical AVM resection secondary to mitigation of iatrogenic retraction injury risk.
Above-The-Hairline Suboccipital Transverse Approach for the Treatment of Chiari I Malformation
Authors: Naylor Ryan M. , Rotter Juliana , Proctor Mark R. , Bite Uldis , Ahn Edward S. 
Published: January 2023

BACKGROUND:
Chiari I malformation is a common pediatric neurosurgical disorder with an established treatment paradigm. Posterior fossa decompression and duraplasty (PFDD) is associated with symptom improvement but it carries postoperative risk, particularly cerebrospinal fluid (CSF) leak and wound complications. In addition, the cosmetic outcomes of PFDD have been overlooked in the literature.

OBJECTIVE:
To describe a novel approach for PFDD in which the transverse surgical incision is completely hidden above the hairline and to report early outcomes in a prospective patient cohort.

METHODS:
Clinical and cosmetic outcomes were recorded for 15 consecutive pediatric patients who underwent PFDD for Chiari I malformation via the above-the-hairline transverse suboccipital approach.

RESULTS:
The median clinical follow-up time was 6 months (range 1-12 months), and the majority of patients experienced significant improvement of their preoperative symptoms. Three patients (20%) experienced complications associated with surgery, which included injury to the greater occipital nerve, CSF hypotension and subfascial pseudomeningocele, and superficial wound dehiscence that resolved spontaneously with oral antibiotics. Zero patients (0%) returned to the operating room for persistent CSF leak, deep wound infection, or revision decompression. An excellent cosmetic outcome was achieved in 12 patients (80%). No patient had a poor cosmetic outcome.

CONCLUSION:
The above-the-hairline transverse suboccipital approach for PFDD in patients with Chiari I malformation offers favorable cosmetic outcomes and fascial closure while permitting adequate decompression.
Defining Occult High-Risk Cysts of the Pineal Region: A Case Series
Authors: Guadix Sergio W. , Marianayagam Neelan J. , Weidman Elizabeth K. , Yuan Melissa , Liechty Benjamin , Greenfield Jeffrey P. , Souweidane Mark M. 
Published: January 2023

BACKGROUND:
Absence of hydrocephalus on neuroimaging may impart a false sense of security for patients with pineal cysts. In this case series, we characterize a subset of patients with pineal cysts having an occult presentation. Unifying features of worsening paroxysmal headaches suggesting intermittent obstructive hydrocephalus and radiographic evidence of third ventricular invagination characterize these patients as high risk.

OBJECTIVE:
To define features of occult, high-risk pineal cysts and outcomes of endoscopic cyst fenestration.

METHODS:
Charts were retrospectively reviewed for patients with pineal cysts evaluated at our institution between 2018 and 2021 who underwent endoscopic cyst fenestration. To capture cysts presenting as occult, patients were excluded if hydrocephalus was noted at presentation. Relevant clinical history, imaging, operative data, and clinical outcomes were reviewed.

RESULTS:
Of 50 pineal cyst patients, 4 satisfied inclusion criteria. All patients presented with worsening paroxysmal headaches. In addition, 75% (3/4) also experienced intermittent syncope. Patients exhibited no hydrocephalus (n = 3) or fluctuating ventricular size on longitudinal imaging (n = 1). In all cases, high-resolution sagittal 3-dimensional T2 magnetic resonance imaging demonstrated invagination of the cyst anteriorly into the posterior third ventricle. All patients underwent endoscopic cyst fenestration with complete symptom resolution (mean follow-up of 20.6 months; range 3.5-37.4 months).

CONCLUSION:
The clinical history for occult, high-risk pineal cysts is notable for worsening paroxysmal headaches and episodic alterations of consciousness suggesting intermittent obstructive hydrocephalus. Because ventricular size can appear normal on standard imaging protocols, clinical suspicion should trigger workup with high-resolution magnetic resonance imaging designed to detect these cysts. Endoscopic cyst fenestration is a safe and efficacious management strategy.
Optic cup morphogenesis across species and related inborn human eye defects
Authors: Cardozo Marcos J. , Sánchez-Bustamante Elena , Bovolenta Paola 
Published: January 2023

ABSTRACT
The vertebrate eye is shaped as a cup, a conformation that optimizes vision and is acquired early in development through a process known as optic cup morphogenesis. Imaging living, transparent teleost embryos and mammalian stem cell-derived organoids has provided insights into the rearrangements that eye progenitors undergo to adopt such a shape. Molecular and pharmacological interference with these rearrangements has further identified the underlying molecular machineries and the physical forces involved in this morphogenetic process. In this Review, we summarize the resulting scenarios and proposed models that include common and species-specific events. We further discuss how these studies and those in environmentally adapted blind species may shed light on human inborn eye malformations that result from failures in optic cup morphogenesis, including microphthalmia, anophthalmia and coloboma.
Dynamic Information Design under Constrained Communication Rules
Authors: Lorecchio Caio , Monte Daniel 
Published: January 2023

An information designer wishes to persuade agents to invest in a project of unknown quality. To do so, she must induce investment and collect feedback from these investments. Motivated by data regulations and simplicity concerns, our designer faces communication constraints. These constraints hinder her without benefiting the agents: they impose an upper bound on the induced belief spread, limiting persuasion. Nevertheless, two-rating systems (direct recommendations) are the optimal design when experimentation is needed to generate information and approximate the designer’s first-best payoff for specific feedback structures. When the designer has altruistic motives, constrained rules significantly decrease welfare. (JEL D64, D82, D83)
Clinical value of combined preoperative–postoperative neutrophil-to-lymphocyte ratio in predicting hepatocellular carcinoma prognosis after radiofrequency ablation
Authors: Ni ZiHao , Wu BoLin , Liu Zhao , Wang QiuCheng , Han Xue , Cheng Wen , Guo CunLi 
Published: January 2023

Objective:
Previous studies focused on the prognostic significance of the pre- or post-operative neutrophil–lymphocyte ratio (NLR); the significance of combined pre- and post-operative NLR (PP-NLR) remains unknown. Therefore, we investigated the value of PP-NLR for predicting prognosis after radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC) to improve treatment and prolong survival.

Methods:
We investigated pre- and post-operative NLR and PP-NLR in predicting prognosis after RFA in patients with HCC. Optimal thresholds for leukocytes, lymphocytes, neutrophils, and NLR before and after RFA were retrospectively assessed in patients with HCC who had undergone RFA between January 2018 and June 2019 in Harbin Medical University Cancer Hospital. Risk factors for early HCC recurrence and those affecting recurrence-free survival (RFS) were analyzed.

Results:
The respective pre- and post-operative optimal thresholds were as follows: neutrophils, 3.431 and 4.975; leukocytes, 5.575 and 6.61; lymphocytes, 1.455 and 1.025; and NLR, 1.53 and 4.36. Univariate analysis revealed tumor number; alpha-fetoprotein level; post-operative leukocytes, lymphocytes, NLR, and neutrophils; pre-operative neutrophils and NLR; and PP-NLR as factors influencing early recurrence and RFS. Multivariate analysis indicated PP-NLR as an independent risk factor for poor RFS and early recurrence.

Conclusion:
PP-NLR was more effective for predicting prognosis than pre- or post-operative NLR alone for patients with HCC.

Advances in knowledge:
The novelty of this study lies in the combination of pre- and post-operative NLR, namely PP-NLR, to study its prognostic value for HCC patients after RFA, which has not been found in previous studies. The contribution of our study is that PP-NLR can provide clinicians with a new reference index to judge the prognosis of patients and make timely treatment to help patients improve their prognosis.
Evaluation of the difficult intravenous access (DIVA) scoring in hospitalized pediatric patients
Authors: Kanaley Rebecca L , Gillette Cheryl , Schriefer Jan , Gottfried Julie Albright , Bramley John 
Published: January 2023

HIGHLIGHTSThe DIVA scoring tool has previously been validated in the pediatric ED setting. Our project applied DIVA to an inpatient pediatric sample. DIVA may not predict likelihood of PIV success in the inpatient setting.Background: First-attempt success rate for placing pediatric peripheral intravenous (PIV) catheters ranges from to 24% to 52%. Multiple attempts can increase risk of deleterious outcomes. It is essential to screen pediatric patients appropriately to identify those who will require additional resources for successful PIV placement. Methods: A convenience sample of hospitalized pediatric patients 0 to 18 years of age on a general care unit was used in this performance improvement project. Prior to attempting PIV access, nurses completed a data collection tool that included elements of established difficult intravenous access (DIVA) tools as well as first attempt successful PIV placement. The primary outcome measure was to determine if each DIVA scoring tool is accurate in predicting the need for additional resources to achieve successful first-attempt PIV placement. The secondary outcome measure was to compare the predictive value of each DIVA scoring tool among an inpatient pediatric population. Following data exploration and cleaning, a correlation analysis was performed with logistic regression to assess DIVA score effectiveness in predicting success of PIV insertion on the first attempt. Results: Out of 133 children, 167 PIV attempts were analyzed with 150 PIV attempts included in the final data analysis. Of the 150 PIV attempts analyzed, 60% (n=90) were successful on the first attempt. Performance of prediction for first-time insertion success was comparable among all 4 DIVA scoring tools. Conclusions: None of the 4 DIVA scoring tools were superior in predicting first-time PIV placement among hospitalized children. Vein palpability was more predictive, although not statistically significant.
The Role of Information and Knowledge in COVID-19 Vaccination Among People With Intellectual and Developmental Disabilities and Their Families
Authors: Lineberry Sarah , Bogenschutz Matthew , Dinora Parthenia , Ayers Kara 
Published: January 2023

Abstract
People with intellectual and developmental disabilities (IDD) may be at an increased risk of severe illness and death from COVID-19. This article examines the role of information and knowledge in COVID-19 vaccine uptake for people with IDD and their families. We developed a survey about COVID-19 vaccine uptake, confidence, and knowledge for people with IDD and their families. COVID-19 vaccine uptake was associated with higher self-reported knowledge about the vaccine, learning about the vaccine from one's doctor, and social media use. Qualitative results reflected the importance of trusted relationships with medical providers in vaccination.
Optical limiting in multilayer graphene films on a cobalt buffer-layer produced by the sputtering technique
Authors: Barreto Luiz M. M. , da Silva Davinson M. , Santos Antonio D. , Araki Koiti , de Araújo Cid B. , Kassab Luciana R. P. 
Published: January 2023

Multilayer graphene (MLG) thin films were produced by a sputtering technique on a cobalt buffer-layer prepared at 500°C and thermal annealed after the deposition. The transformation of amorphous carbon (C) to graphene occurs by diffusion of C atoms through the catalyst metal; then the C atoms dissolved in the metal are nucleated as graphene. The thicknesses of cobalt and MLG thin films were 55 and 54 nm, respectively, obtained by atomic force microscopy (AFM). Raman spectroscopy showed that the ratio between the Raman bands 2D and G (I2D/IG) was 0.4 for the graphene thin film that was annealed at 750°C for 25 min, indicating that the films obtained are MLG. The Raman results were corroborated by transmission electron microscopy analysis. AFM was used to determine the Co and C film thickness and roughness. Transmittance measurements at 980 nm as a function of input power from a continuous-wave diode laser showed that the obtained MLG films present large nonlinear absorption and can be used as optical limiters.
Information theoretic evidence for layer- and frequency-specific changes in cortical information processing under anesthesia
Authors: Pinzuti Edoardo , Wollstadt Patricia , Tüscher Oliver , Wibral Michael 
Published: January 2023

Nature relies on highly distributed computation for the processing of information in nervous systems across the entire animal kingdom. Such distributed computation can be more easily understood if decomposed into the three elementary components of information processing, i.e. storage, transfer and modification, and rigorous information theoretic measures for these components exist. However, the distributed computation is often also linked to neural dynamics exhibiting distinct rhythms. Thus, it would be beneficial to associate the above components of information processing with distinct rhythmic processes where possible. Here we focus on the storage of information in neural dynamics and introduce a novel spectrally-resolved measure of active information storage (AIS). Drawing on intracortical recordings of neural activity in ferrets under anesthesia before and after loss of consciousness (LOC) we show that anesthesia- related modulation of AIS is highly specific to different frequency bands and that these frequency-specific effects differ across cortical layers and brain regions.
We found that in the high/low gamma band the effects of anesthesia result in AIS modulation only in the supergranular layers, while in the alpha/beta band the strongest decrease in AIS can be seen at infragranular layers. Finally, we show that the increase of spectral power at multiple frequencies, in particular at alpha and delta bands in frontal areas, that is often observed during LOC (’anteriorization’) also impacts local information processing—but in a frequency specific way: Increases in isoflurane concentration induced a decrease in AIS in the alpha frequencies, while they increased AIS in the delta frequency range < 2Hz. Thus, the analysis of spectrally-resolved AIS provides valuable additional insights into changes in cortical information processing under anaesthesia.
Risk of fracture in adults with type 2 diabetes in Sweden: A national cohort study
Authors: Axelsson Kristian F. , Litsne Henrik , Kousoula Konstantina , Franzén Stefan , Eliasson Björn , Lorentzon Mattias 
Published: January 2023

Background
Type 2 diabetes mellitus (T2DM) is considered a risk factor for fracture but the evidence regarding the impact of T2DM on fracture risk is conflicting. The objective of the study was to determine if patients with T2DM have increased fracture risk and if T2DM-related risk factors could be identified.

Methods and findings
In this national cohort study in Sweden, we investigated the risk of fracture in 580,127 T2DM patients, identified through the national diabetes register including from both primary care and hospitals, and an equal number of population-based controls without diabetes matched for age, sex, and county from 2007 to 2017. The mean age at entry was 66.7 years and 43.6% were women. During a median follow-up time of 6.6 (interquartile range (IQR) 3.1 to 9.8) years, patients with T2DM had a marginally but significantly increased risk of major osteoporotic fracture (MOF) (hazard ratio (HR) 1.01 (95% confidence interval [CI] 1.00 to 1.03)) and hip fracture (HR 1.06 (95% CI 1.04 to 1.08)) compared to controls, associations that were only minimally affected (HR 1.05 (95% CI 1.03 to 1.06) and HR 1.11 (95% CI 1.09 to 1.14), respectively) by multivariable adjustment (age, sex, marital status, and an additional 20 variables related to general morbidity, cardiovascular status, risk of falls, and fracture). In a multivariable-adjusted Cox model, the proportion of the risk for all fracture outcomes (Heller’s R2) explained by T2DM was below 0.1%. Among the T2DM patients, important risk factors for fracture were a low BMI (<25 kg/m2), long diabetes duration (≥15 years), insulin treatment, and low physical activity. In total, 55% of the T2DM patients had none of these risk factors and a significantly lower fracture risk than their respective controls. The relatively short mean duration of T2DM and lack of bone density data, constitute limitations of the analysis.

Conclusion
In this study, we observed only a marginally increased fracture risk in T2DM, a condition that explained less than 0.1% of the fracture risk. Consideration of the herein identified T2DM-related risk factors could be used to stratify T2DM patients according to fracture risk.
Evaluation of machine learning algorithms for the prognosis of breast cancer from the Surveillance, Epidemiology, and End Results database
Authors: Wu Ruiyang , Luo Jing , Wan Hangyu , Zhang Haiyan , Yuan Yewei , Hu Huihua , Feng Jinyan , Wen Jing , Wang Yan , Li Junyan , Liang Qi , Gan Fengjiao , Zhang Gang 
Published: January 2023

IntroductionMany researchers used machine learning (ML) to predict the prognosis of breast cancer (BC) patients and noticed that the ML model had good individualized prediction performance.ObjectiveThe cohort study was intended to establish a reliable data analysis model by comparing the performance of 10 common ML algorithms and the the traditional American Joint Committee on Cancer (AJCC) stage, and used this model in Web application development to provide a good individualized prediction for others.MethodsThis study included 63145 BC patients from the Surveillance, Epidemiology, and End Results database.ResultsThrough the performance of the 10 ML algorithms and 7th AJCC stage in the optimal test set, we found that in terms of 5-year overall survival, multivariate adaptive regression splines (MARS) had the highest area under the curve (AUC) value (0.831) and F1-score (0.608), and both sensitivity (0.737) and specificity (0.772) were relatively high. Besides, MARS showed a highest AUC value (0.831, 95%confidence interval: 0.820–0.842) in comparison to the other ML algorithms and 7th AJCC stage (all P < 0.05). MARS, the best performing model, was selected for web application development (https://w12251393.shinyapps.io/app2/).ConclusionsThe comparative study of multiple forecasting models utilizing a large data noted that MARS based model achieved a much better performance compared to other ML algorithms and 7th AJCC stage in individualized estimation of survival of BC patients, which was very likely to be the next step towards precision medicine.