bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angiographic cross-filling between inferior petrosal sinuses and alteration of adrenocorticotropic hormone sampling results for tumor localization in Cushing disease
Authors: Martini Michael L. , Ransom R. Chase , Rechberger Julian S. , O’Keeffe Derek , Young William , Atkinson John L. D. , Meyer Fredric B. , Rinaldo Lorenzo , Carlstrom Lucas , Cloft Harry J. , Van Gompel Jamie 
Published: August 2023

OBJECTIVE
Inferior petrosal sinus (IPS) sampling (IPSS) is a diagnostic procedure used to guide diagnostic localization of imaging-negative adrenocorticotropic hormone (ACTH)–secreting pituitary microadenomas. However, the efficacy of IPSS has been suboptimal at accurately lateralizing the adenoma, reducing surgical cure rates and leading to unintended pituitary dysfunction due to the added exploration. One rationale for the occasional imprecision is the existence of additional petrosal sinus collateral channels that connect the IPS bilaterally, which may lead to false localization results during sampling. The aim of this study was to explore a potential connection between normal anatomical variation in the angioarchitecture of the IPSs and the ACTH results obtained in subsequent IPSS tests.

METHODS
A retrospective review was performed on all cases between 1998 and 2013 involving patients at a single institution who underwent IPSS for radiographically equivocal pituitary microadenomas. Cases were reviewed for tumor laterality noted on either operative or pathology reports, as well as the presence of angiographic evidence of cross-filling between the sinuses. In addition, ACTH levels from the right and left IPSs were documented at baseline and at 2, 5, and 10 minutes after corticotropin-releasing hormone (CRH) administration. A ratio of the change in ACTH levels measured at the time of maximal response (10 minutes) versus the levels measured at the initial response (2 minutes) was computed for each patient and compared between patients by their angiographic cross-filling status.

RESULTS
There were 41 patients with a histopathologically confirmed right- or left-sided ACTH-secreting pituitary microadenoma who underwent preoperative IPSS. Among these patients, 28 (68%) showed angiographic evidence of cross-filling between the IPSs, and 13 showed no cross-filling. On average, ACTH levels increased by a factor of 3.91 ± 0.77 in the contralateral IPS in patients with angiographic cross-filling, compared with a factor increase of only 1.80 ± 0.27 in patients without cross-filling (p = 0.014). In comparison, ACTH levels increased by a factor of 2.01 ± 0.57 in the ipsilateral IPS in patients with cross-filling, and by 8.78 ± 7.30 in those without cross-filling (p = 0.373).

CONCLUSIONS
The presence of angiographic cross-filling, suggestive of a greater degree of vascular channel networking between the right and left IPS, is a significant factor influencing the measured rates of change of ACTH in IPSS and may impact the specificity of this test to accurately determine microadenoma laterality in the preoperative setting.
Management and outcome predictors of patients with ruptured deep-seated brain arteriovenous malformations
Authors: Sattari Shahab Aldin , Yang Wuyang , Feghali James , Hung Alice , Xu Risheng , Tamargo Rafael J. , Huang Judy 
Published: August 2023

OBJECTIVE
Decision-making for the management of ruptured deep-seated brain arteriovenous malformations (bAVMs) is controversial. This study aimed to shed light on the treatment outcomes of patients with ruptured deep-seated bAVMs.

METHODS
Data on bAVM patients were retrieved from the authors’ institutional database, spanning 1990–2021. The outcomes were annual hemorrhage risk (before and after intervention), number of follow-up hemorrhages, bAVM obliteration, poor modified Rankin Scale (mRS) score (i.e., mRS score > 2), worsened mRS score, and mortality. Multivariable Cox and logistic regression analyses were conducted to determine predictors of time-to-event and categorical outcomes, respectively.

RESULTS
Of the 1066 patients in the database with brain bAVM, 177 patients harboring ruptured deep-seated bAVMs were included. The pretreatment annual hemorrhage risk was 8.24%, and the posttreatment risk was lowered to 1.65%. In multivariable Cox regression analysis, a prenidal aneurysm (HR 2.388, 95% CI 1.057–5.398; p = 0.036) was associated with a higher risk of follow-up hemorrhage, while definitive treatment (i.e., either surgery or radiosurgery vs endovascular embolization or conservative management) (HR 0.267, 95% CI 0.118–0.602; p = 0.001) was associated with a lower risk of follow-up hemorrhage. In multivariable logistic regression analysis, Spetzler-Martin grades IV and V (OR 0.404, 95% CI 0.171–0.917; p = 0.033) and brainstem arteriovenous malformation (AVM) (OR 0.325, 95% CI 0.128–0.778; p = 0.014) were associated with lower odds of obliteration, while definitive treatment (OR 8.864, 95% CI 3.604–25.399; p = 0.008) was associated with higher obliteration odds. Controlling for baseline mRS score, cerebellar AVM (OR 0.286, 95% CI 0.098–0.731; p = 0.013) and definitive treatment (OR 0.361, 95% CI 0.160–0.807; p = 0.013) were associated with lower odds of a poor mRS score, and definitive treatment (OR 0.208, 95% CI 0.076–0.553; p = 0.001) was associated with lower odds of a worsened mRS score. Furthermore, smoking (OR 6.068, 95% CI 1.531–25.581; p = 0.01) and definitive treatment (OR 0.101, 95% CI 0.024–0.361; p = 0.007) were associated with higher and lower mortality odds, respectively.

CONCLUSIONS
A definitive treatment strategy seems to be beneficial in achieving higher obliteration and lower hemorrhage rates while decreasing the odds of a poor mRS score, worsened mRS score, and mortality. In this category of patients, prenidal aneurysms warrant treatment, and smoking cessation should be encouraged.
Grade 3 meningioma survival and recurrence outcomes in an international multicenter cohort
Authors: Tosefsky Kira , Rebchuk Alexander D. , Wang Justin Z. , Ellenbogen Yosef , Drexler Richard , Ricklefs Franz L. , Sauvigny Thomas , Schüller Ulrich , Cutler Christopher B. , Lucke-Wold Brandon , Mehkri Yusuf , Lama Sanju , Sutherland Garnette R. , Karsy Michael , Hoh Brian L. , Westphal Manfred , Zadeh Gelareh , Yip Stephen , Makarenko Serge 
Published: August 2023

OBJECTIVE
Grade 3 meningioma represents a rare meningioma subtype, for which limited natural history data are available. The objective of this study was to identify demographics and pathologic characteristics, clinical and functional status outcomes, and prognostic factors in an international cohort of grade 3 meningioma patients.

METHODS
Clinical and histopathological data were collected for patients treated at 7 sites across North America and Europe between 1991 and 2022.

RESULTS
A total of 103 patients (54% female, median age 65 [IQR 52, 72] years) were included. Sixty-seven (65%) patients had de novo grade 3 lesions, whereas 29 (28%) had malignant transformations of lower-grade meningiomas. All patients underwent initial resection of their tumor. Patients were followed for a median of 46 (IQR 24, 108) months, during which time there were 65 (73%) recurrences and 50 (49%) deaths. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 66% (95% CI 56%–77%) and 37% (95% CI 28%–48%), respectively. Age ≥ 65 years and male sex were independent predictors of worse OS and PFS in multivariate regression analysis, while postoperative radiotherapy was independently associated with improved OS. Karnofsky Performance Status (KPS) remained stable relative to baseline over 5 years postdiagnosis among participants who were alive at the end of the follow-up period.

CONCLUSIONS
This large multicenter study provides insight into the longitudinal outcomes of grade 3 meningioma, with respect to recurrence, survival, and functional status. This study affirms the survival benefit conferred by radiotherapy in this population and suggests good functional status outcomes for patients surviving to 5 years postoperatively.
The impact of skull thickness on pediatric stereoencephalography electrode implantation and technical considerations
Authors: Desai Ansh , Sharma Akshay , Sundar Swetha J. , Hsieh Jason K. , Kondylis Efstathios , Patel Arpan , Bulacio Juan , Gupta Ajay , Jehi Lara , Bingaman William 
Published: August 2023

OBJECTIVE
One consideration in pediatric stereoencephalography (SEEG) is decreased skull thicknesses compared with adults, which may limit traditional bolt-based anchoring of electrodes. The authors aimed to investigate the safety profile, complication rates, and technical adaptations of placing SEEG electrodes in pediatric patients.

METHODS
The authors retrospectively reviewed all patients aged 12 years or younger at the time of SEEG implantation at their institution. Postimplantation CT scans were used to measure skull thickness at the entry point of each SEEG lead. Postimplantation lead accuracy was also assessed.

RESULTS
Fifty-three patients were reviewed. The median skull thickness was 4.1 (interquartile range [IQR] 3.15–5.2) mm. There were 5 total complications: 1 retained bolt fragment, 3 asymptomatic subdural hematomas, and 1 asymptomatic intracranial hemorrhage. Median radial error from the lead target was 3.5 (IQR 2.24–5.25) mm. Linear regression analysis revealed that increasing skull thickness decreased the deviation from the intended target, implying an improved accuracy to target at thicker skull entry points; this trended towards improved accuracy, but did not achieve statistical significance (p = 0.54).

CONCLUSIONS
This study found a 1.9% hardware complication rate and a 9.4% asymptomatic hemorrhage rate. Suturing electrodes to the scalp may represent a reasonable option if there are concerns of young age or a thin skull. These data indicate that invasive SEEG evaluation is safe among patients 12 years old or younger.
Impact of preoperative spinal injections within 30 days of lumbar decompression on surgical outcomes: a matched institutional study
Authors: Flanigan Patrick , Nathani Karim R. , Martini Michael , Michalopoulos Giorgos D. , Chen Selby , Kalani Maziyar , Bydon Mohamad 
Published: August 2023

OBJECTIVE
The authors sought to determine how the temporal proximity of lumbar epidural spinal injection prior to surgery impacts clinical outcomes (e.g., 30-day readmission, postoperative complications, CSF leak) in patients undergoing lumbar decompression without fusion.

METHODS
The authors queried their institutional registry to identify patients who underwent elective lumbar decompression for spondylotic pathology between January 2019 and March 2022 at multiple centers within the same hospital network. Patients were divided into groups based on the time between their surgical date and the most recent preoperative spinal injection: group 1, patients with duration < 1 month; group 2, 1–3 months; and group 3, no spinal injection within 3 months. Primary outcomes of interest were the length of hospital stay, postoperative complications, rate of intraoperative CSF leak, and rates of reoperation and hospital readmission. For patients in groups 1 and 2, the authors also recorded the number of injections within 12 months prior to surgery to better understand the effect of multiple recent injections. The independent Student t-test and Pearson’s chi-square test were mainly performed for univariate analyses of the continuous and categorical variables, respectively.

RESULTS
A total of 121 and 283 patients received a spinal injection at < 1 month and 1–3 months prior to surgery, respectively, and were separately matched in a 3:1 ratio with 2562 patients with no history of preoperative spinal injection within 3 months before surgery. Among the matched cohorts, patients who received spinal injections < 1 month before lumbar decompression had significantly higher risks of 30-day complication (7.4% vs 0.8%, OR 9.6, p < 0.001), 30-day readmission (5.8% vs 2.2%, OR 3.5, p = 0.049), and 90-day readmission (9.1% vs 2.8%, OR 3.5, p = 0.003) than patients with no history of spinal injection. However, compared with patients with no history of spinal injection, the patients who received spinal injections 1–3 months before surgery were not at higher risk for postoperative complications or readmission. The CSF leak rates were significantly different between the three patient cohorts (10.7% vs 6.7% vs 4.9% for the < 1 month, 1–3 months, and no injection cohorts, respectively; p = 0.02).

CONCLUSIONS
Lumbar decompression within 1 month of preoperative spinal injection was associated with higher risks of readmission and postoperative complications, including CSF leak. However, with the exception of CSF leak, these risks were no longer observed when spinal injection occurred 1–3 months prior to lumbar decompression.
Selective thoracolumbar fusion in adult spinal deformity double curves with circumferential minimally invasive surgery: 2-year minimum follow-up
Authors: Anand Neel , Robinson Jerry , Chung Andrew , Gendelberg David , Jiménez-Almonte José H. , Kahwaty Sheila , Khandehroo Babak , Walker Corey 
Published: August 2023

OBJECTIVE
Selection of the upper instrumented vertebra (UIV) level for adult spinal deformity (ASD) remains controversial. Although selective fusion attempts have been described for fractional curves or adolescent curves, no authors have described selective thoracolumbar fusion performance for ASD with double curves. This study evaluated the clinical impact of selective fusion constructs within the lower thoracic and/or lumbar spine on ASD with double curves.

METHODS
A retrospective review was performed on an ASD (Cobb angle > 20°, sagittal vertical axis [SVA] > 50 mm, and pelvic incidence minus lumbar lordosis mismatch [PI-LL] > 10°) database consisting of 438 patients who underwent correction with circumferential minimally invasive surgery (CMIS) between 2007 and 2020. The inclusion criteria were ASD double curves (lumbar Cobb angle > 35° and thoracic Cobb angle > 30°), 4 or more levels fused, and minimum 2-year follow-up. Analyses were performed on spinopelvic data and clinical outcome scores. Complications were recorded, specifically the need for revision surgery and hardware-related complications.

RESULTS
Twenty-one ASD double curve patients underwent selective correction with a mean ± SD (range) follow-up of 91 ± 43 (24–174) months. A total of 141 levels were fused with a mean of 6.7 ± 1.3 (4–8) levels. T10 was the most proximal and most common UIV (10/21 [48%]). Pelvic fixation was performed in 12 patients (57%). Significant improvements in lumbar Cobb angle, thoracic Cobb angle, coronal balance, lumbar lordosis, thoracic kyphosis, SVA, and PI-LL were achieved. The uninstrumented thoracic spine demonstrated 14.5° of mean coronal correction and a mean increase of 9.4° in kyphosis. Significant improvements in visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were observed. Four patients required revision for the following reasons: 1) superficial wound infection requiring irrigation and debridement; 2) bilateral L5 pars fractures requiring L5–S1 anterior lumbar interbody fusion and pelvic fixation; 3) adjacent-segment degeneration at L5–S1 requiring anterior lumbar interbody fusion and pelvic fixation; and 4) proximal junctional kyphosis requiring revision fusion to include the entire thoracic curve. There were no instances of hardware failure such as rod breakage or screw loosening.

CONCLUSIONS
Selective thoracolumbar fusion with CMIS for ASD double curves can provide significant clinical improvements. Despite limiting fusion constructs to within the lower thoracic and/or lumbar spine, significant correction can be observed in the uninstrumented thoracic curve. The rate of mechanical complications was low, and the 2-year follow-up results suggested that limited fusion constructs are viable options for ASD double curve patients.
Characterization of the influence of spinopelvic parameters on thoracolumbar trauma
Authors: Withrow Joseph S. , Monterey Michael D. , Narro Analisa , Haley Lauren , Martinez Cruz Marco , Budde Bradley , Trimble Duncan , Sheinberg Dallas , Zaragoza Jennifer , Li Wen , Li Zhouxuan , Caridi John , Quinn John C. 
Published: August 2023

OBJECTIVE
The current Roussouly classification identifies four groups of “normal” sagittal spine morphology, which has greatly expanded the understanding of normal heterogeneity of the spine. While there has been extensive characterization of the influence of spinopelvic parameters on outcomes after degenerative spine surgery, the influence of spinopelvic parameters on thoracolumbar trauma has yet to be described. The goal of this study was to determine if spinopelvic parameters and global spine morphology influence fracture location, fracture morphology, and rate of neurological deficit in the setting of thoracolumbar trauma.

METHODS
Of 2896 patients reviewed in the authors’ institutional spine database between January 2014 and April 2020 with an ICD-9/10 diagnosis of thoracolumbar trauma, 514 met the inclusion criteria of acute thoracolumbar fracture on CT and visible femoral heads on sagittal CT. Pelvic incidence (PI) was calculated on sagittal CT. Demographic and clinical data including age, sex, BMI, smoking status, concomitant cervical fracture, mechanism of injury, major fracture location, neurological deficit, AO Spine thoracolumbar injury classification, and management type (operative vs nonoperative) were collected. Patients were stratified into high-PI (≥ 50°) and low-PI (< 50°) groups.

RESULTS
Patients with high PI had a lower incidence of fractures in the lower lumbar spine (below L2) compared with patients with low PI (16% vs 8%, p < 0.01). The last lordotic vertebrae were observed between T10 and L4, and of fractures that occurred at these levels, 75% were at the last lordotic vertebrae. Fall from height was the most common cause of neurological deficit, accounting for 47%. Of the patients presenting with a fall from height, AO Spine type B distraction injuries were more common in the high-PI group (41% vs 18%, p = 0.01). Similarly, within the same subgroup, AO Spine type A compression injuries were more common in the low-PI group (73% vs 53%, p = 0.01).

CONCLUSIONS
Spinopelvic parameters and sagittal balance influence the location and morphology of thoracolumbar fractures. Fractures of the thoracolumbar junction are strongly associated with the inflection point, which is defined by sagittal alignment. While the importance of considering sagittal balance is known for decision-making in degenerative spinal pathology, further studies are required to determine if spinopelvic parameters and sagittal balance should play a role in the decision-making for management of thoracolumbar fractures.
Potensi Perluasan Kemitraan Internasional Universitas Hasanuddin dengan Universitas dalam Lingkungan ASEAN
Authors: Perosyah Nasly 
Published: August 2023

This study aims to determine the form and effect of partnerships conducted by Hasanuddin University with universities in Southeast Asia. The research method used is a qualitative method where data collection is carried out by conducting in-depth interviews.
The results of this study indicate that the partnership between Hasanuddin University and the University of Malaysia and the University of Thailand includes student and staff exchanges; Symposium; exchange of scientific works; research funding; cooperation in the honey bee industry to cooperation in the fields of marine and fisheries and biotechnology. So far, this collaboration has shown a significant positive impact. What needs to be improved is that in this partnership it is related to the development of human resources both at Hasanuddin University and partner universities in Southeast Asia.

Penelitian ini bertujuan untuk mengetahui bentuk dan pengaruh kerjasama kemitraan yang dilakukan oleh Universitas Hasanuddin dengan universitas dalam lingkup Asia Tenggara. Metode penelitian yang digunakan adalah metode kulitatif dimana pengumpulan data dilakukan dengan melakukan wawancara mendalam.
Hasil penelitian ini menujukkan bahwa kerjasama kemitraan antara Universitas Hasanuddin dengan Universitas Malaysia dan Universitas Thailand mencakup pertukaran pelajar dan staf; Symposia; pertukaran karya ilmiah; pendanaan penelitian; kerjasama industri lebah madu hingga pada kerjasama dalam bidang kelautan dan perikanan serta bioteknologi. Sejauh ini kerjasama tersebut menunjukkan dampak positif yang signifikan. Adapun yang perlu ditingkatkan adalah dalam kemitraan ini adalah terkait dengan pengembangan sumber daya manusia baik di Universitas Hasanuddin maupun universitas mitra di lingkup Asia Tenggara
Pengaruh Sanksi Uni Eropa Terhadap Rusia Atas Krisis Ukraina
Authors: Massaguni Mahfud , Badu Muhammad Nasir , Sallatu Muhammad Ashry 
Published: August 2023

The crisis of Ukraine is one of the hot topics in the international world talks. The cancellation of the signing of the Association Agreement, which is a stage of integration of Ukraine into the EU, resulted in a wave of massive protests from citizens of Ukraine. Representatives of the EU mediating between the Ukrainian government and the protesting parties ultimately resulted in an agreement to oust President Viktor Yanukovych. The deposition of President Viktor Yanukovych, called pro-Russian, resulted in anger on the part of Russia, on the grounds that the elected president of Viktor Yanukovych's successor was a pro-European party. After the election, unarmed armed forces took over the Crimea territory and held a referendum for the territory to join Russia. Russian involvement in this conflict led to the EU sanctioning Russia. This prolonged sanction not only affects Russia, but also against Europe, because basically each side is one of the largest trading partners.

Krisis Ukraina merupakan salah satu topik hangat dalam perbincangan dunia internasional. Pembatalan penandatanganan Association Agreement, yaitu sebuah tahapan integrasi Ukraina kedalam Uni Eropa, mengakibatkan gelombang protes besar-besaran dari warga Ukraina. Perwakilan Uni Eropa yang menjadi penengah antara pemerintah Ukraina dan para pihak yang melakukan protes, akhirnya menghasilkan kesepakatan untuk melengserkan presiden Viktor Yanukovych. Dilengserkannya Presiden Viktor Yanukovych yang disebut sebagai pro-Rusia, mengakibatkan kemarahan dari pihak Rusia, dengan alasan presiden terpilih pengganti Viktor Yanukovych merupakan pihak yang pro-Eropa. Setelah pemilihan, pasukan bersenjata tanpa identitas mengambil alih wilayah Krimea dan mengadakan referendum agar wilayah tersebut bergabung dengan Rusia. Keterlibatan Rusia dalam konflik ini menyebabkan Uni Eropa memberi sanksi terhadap Rusia. Sanksi berkepanjangan ini tidak hanya berdampak pada Rusia, namun juga terhadap Eropa, karena pada dasarnya masing-masing pihak merupakan salah satu mitra dagang paling besar.