bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing language laterality: does resting-state functional MRI help?
Authors: Singh Sumit , Alhasan Mustafa S. M. , Wang Zhiyue , Clarke Rebekah , Xi Yin , Maldjian Joseph A. , Wagner Ben , Booth Timothy 
Published: March 2023

OBJECTIVE
Task-based functional MRI (tb-fMRI) is now considered the standard, noninvasive technique in establishing language laterality in children for surgical planning. The evaluation can be limited due to several factors such as age, language barriers, and developmental and cognitive delays. Resting-state functional MRI (rs-fMRI) offers a potential path to establish language dominance without active task participation. The authors sought to compare the ability of rs-fMRI for language lateralization in the pediatric population with conventional tb-fMRI used as the gold standard.

METHODS
The authors performed a retrospective evaluation of all pediatric patients at a dedicated quaternary pediatric hospital who underwent tb-fMRI and rs-fMRI from 2019 to 2021 as part of the surgical workup for patients with seizures and brain tumors. Task-based fMRI language laterality was based on a patient’s adequate performance on one or more of the following: sentence completion, verb generation, antonym generation, or passive listening tasks. Resting-state fMRI data were postprocessed using statistical parametric mapping, FMRIB Software Library, and FreeSurfer as described in the literature. The laterality index (LI) was calculated from the independent component (IC) with the highest Jaccard Index (JI) for the language mask. Additionally, the authors visually inspected the activation maps for two ICs with the highest JIs. The rs-fMRI LI of IC1 and the authors’ image-based subjective interpretation of language lateralization were compared with tb-fMRI, which was considered the gold standard for this study.

RESULTS
A retrospective search yielded 33 patients with language fMRI data. Eight patients were excluded (5 with suboptimal tb-fMRI and 3 with suboptimal rs-fMRI data). Twenty-five patients (age range 7–19 years, male/female ratio 15:10) were included in the study. The language laterality concordance between tb-fMRI and rs-fMRI ranged from 68% to 80% for assessment based on LI of independent component analysis with highest JI and for subjective evaluation by visual inspection of activation maps, respectively.

CONCLUSIONS
The concordance rates between tb-fMRI and rs-fMRI of 68% to 80% show the limitation of rs-fMRI in determining language dominance. Resting-state fMRI should not be used as the sole method for language lateralization in clinical practice.
Crossing the cervicothoracic junction: an evaluation of radiographic alignment, functional outcomes, and patient-reported outcomes
Authors: Aflatooni Justin , Mohanty Sarthak , Angelov Ivan , Hirase Takashi , Bondar Kevin , Kakareka Michael , Saucedo Jose , Casper David , Saifi Comron 
Published: March 2023

OBJECTIVE
There is currently no consensus regarding the appropriate lower instrumented vertebra (LIV) for multilevel posterior cervical fusion (PCF) constructs between C7 and crossing the cervicothoracic junction (CTJ). The goal of the present study was to compare postoperative sagittal alignment and functional outcomes among adult patients presenting with cervical myelopathy undergoing multilevel PCF terminating at C7 versus spanning the CTJ.

METHODS
A single-institution retrospective analysis (January 2017–December 2018) was performed of patients undergoing multilevel PCF for cervical myelopathy that involved the C6–7 vertebrae. Pre- and postoperative cervical spine radiographs were analyzed for cervical lordosis, cervical sagittal vertical axis (cSVA), and first thoracic (T1) vertebral slope (T1S) in two randomized independent trials. Modified Japanese Orthopaedic Association (mJOA) and Patient-Reported Outcomes Measurement Information System (PROMIS) scores were used to compare functional and patient-reported outcomes at the 12-month postoperative follow-up.

RESULTS
Sixty-six consecutive patients undergoing PCF and 53 age-matched controls were included in the study. There were 36 patients in the C7 LIV cohort and 30 patients in the LIV spanning the CTJ cohort. Despite significant correction, patients undergoing fusion remained less lordotic than asymptomatic controls, with a C2–7 Cobb angle of 17.7° versus 25.5° (p < 0.001) and a T1S of 25.6° versus 36.3° (p < 0.001). The CTJ cohort had superior alignment corrections in all radiographic parameters at the 12-month postoperative follow-up compared with the C7 cohort: increase in T1S (ΔT1S 14.1° vs 2.0°, p < 0.001), increase in C2–7 lordosis (ΔC2–7 lordosis 11.7° vs 1.5°, p < 0.001), and decrease in cSVA (ΔcSVA 8.9 vs 5.0 mm, p < 0.001). There were no differences in the mJOA motor and sensory scores between cohorts pre- and postoperatively. The C7 cohort reported significantly better PROMIS scores at 6 months (22.0 ± 3.2 vs 11.5 ± 0.5, p = 0.04) and 12 months (27.0 ± 5.2 vs 13.5 ± 0.9, p = 0.01) postoperatively.

CONCLUSIONS
Crossing the CTJ may provide a greater cervical sagittal alignment correction in multilevel PCF surgeries. However, the improved alignment may not be associated with improved functional outcomes as measured by the mJOA scale. A new finding is that crossing the CTJ may be associated with worse patient-reported outcomes at 6 and 12 months of postoperative follow-up as measured by the PROMIS, which should be considered in surgical decision-making. Future prospective studies evaluating long-term radiographic, patient-reported, and functional outcomes are warranted.
Can semirigid fixation of the rostral instrumented segments prevent proximal junctional kyphosis in the case of long thoracolumbar fusions? A finite element study
Authors: Turbucz Mate , Fayad Jennifer , Pokorni Agoston J. , Varga Peter P. , Eltes Peter E. , Lazary Aron 
Published: March 2023

OBJECTIVE
Proximal junctional kyphosis (PJK) is a relatively common complication following long instrumented posterior spinal fusion. Although several risk factors have been identified in the literature, previous biomechanical studies suggest that one of the leading causes is the sudden change in mobility between the instrumented and noninstrumented segments. The current study aims to assess the biomechanical effect of 1 rigid and 2 semirigid fixation techniques (SFTs) on developing PJK.

METHODS
Four T7–L5 finite element (FE) models were developed: 1) intact spine; 2) 5.5-mm titanium rod from T8 to L5 (titanium rod fixation [TRF]); 3) multiple rods from T8 to T9 connected with titanium rod from T9 to L5 (multiple-rod fixation [MRF]); and 4) polyetheretherketone rod from T8 to T9 connected with titanium rod from T9 to L5 (PEEK rod fixation [PRF]). A modified multidirectional hybrid test protocol was used. First, a pure bending moment of 5 Nm was applied to measure the intervertebral rotation angles. Second, the TRF technique’s displacement from the first loading step was applied to the instrumented FE models to compare the pedicle screw stress values in the upper instrumented vertebra (UIV).

RESULTS
In the load-controlled step, at the upper instrumented segment, the intervertebral rotation values relative to TRF increased by 46.8% and 99.2% for flexion, by 43.2% and 87.7% for extension, by 90.1% and 137% for lateral bending, and by 407.1% and 585.2% for axial rotation, in the case of MRF and PRF, respectively. In the displacement-controlled step, maximum pedicle screw stress values at the UIV level were highest in the case of TRF (37.26 MPa, 42.13 MPa, 44.4 MPa, and 44.59 MPa for flexion, extension, lateral bending, and axial rotation, respectively). Compared to TRF, in the case of MRF and PRF, the screw stress values were reduced by 17.3% and 27.7% for flexion, by 26.6% and 36.7% for extension, by 6.8% and 34.3% for lateral bending, and by 49.1% and 59.8% for axial rotation, respectively.

CONCLUSIONS
FE analysis has shown that the SFTs increase the mobility at the upper instrumented segment and therefore provide a more gradual transition in motion between the instrumented and rostral noninstrumented segments of the spine. In addition, SFTs decrease the screw loads at the UIV level and hence could help reduce the risk for PJK. However, further investigations are recommended to evaluate the long-term clinical usefulness of these techniques.
CHANGES IN THE USE OF MEDICAL IMAGING MODALITIES IN THE EMERGENCY DEPARTMENTS FROM 2016 TO 2022
Authors: BEŞTEMİR Attila , BOZDERELİ BERİKOL Göksu 
Published: March 2023

Introduction: Due to the presence or proximity of medical imaging modalities in emergency departments, their use is becoming widespread in pediatric and adult emergency departments. Especially with the COVID-19 pandemic, the use of computed tomography as a rapid and sensitive method for the diagnosis of pneumonia has also increased. This study aimed to analyse the change in the trends of imaging modalities in emergency departments over the last 6 years in our country.
Material and Methods: A retrospective descriptive study was conducted in the emergency departments of public and university hospitals in Turkey between January 1, 2016, and December 31, 2021. The numbers and percents of imaging requests (CT,MRI,radiographs,USG) were analyzed.
Results: Regarding imaging per admission were considered, Plain radiograph constituted the most requested examinations compared to all applications (31%-36%). Then, the rates were followed by CT (10.84%-23.40%), and the highest CT requests were found in 2020(n=17.192.695). Overall, there was a statistically significant difference between years in terms of imaging types (X2 65.05, p
A BCI framework for smart home automation using EEG signal
Authors: Borah Bidyut Bikash , Hazarika Uddipan , Baruah Satyabrat Malla Bujar , Roy Soumik , Jamir Ayangla 
Published: March 2023

Since the first recording in 1924, modern developments in technology have enabled human electroencephalogram (EEG) acquisition as a non-invasive process, enabling a multitude of opportunities to learn about human brain dynamics. With the capability to tap into localized brain dynamics, it is possible to correlate event-related potentials such as meditation, concentration, and motor control with localized brain activities, opening up a broad spectrum for exploration and implementation in prosthetic, control, and brain computer interfaces. In this work, an attempt has been made to explore human emotions and other intelligent states that can be interpreted to automate and control electrical appliances for differently abled people. A smart home automation model has been designed and implemented using a Think Gear Application-specific integrated circuit (ASIC) Module (TGAM) EEG sensor module integrated with a Bluetooth module, which serves as the core for control applications. A combination of external triggers and brain states are interpreted and forwarded to gain control of the connected appliances via a local server over the internet. Equipped with internet connectivity and Internet of Things (IoT), the system also facilitates long-distance communication and control, which can be easily translated to industrial control and automation applications. Based on a single-channel analog EEG signal acquisition module, this study details the development of a Brain Computer Interface (BCI) control and monitoring system for smart home automation with blink and attention features. The designed BCI system has a large bandwidth of 400 Hz, an easy setup, Morphological Component Analysis (MCA) based blink detection, monitoring, control of devices, and high accuracy at a low cost. Each subject completed three trials separated by one minute. The smart devices underwent testing in two states, namely on and off. The response time and accuracy of the system were recorded for each trial. The average system response time for the devices was determined to be 17.13 sec for switching ON and 20.66 sec for switching OFF, with an accuracy of 98.73% and 95.75% for ON and OFF states respectively.
Policy Analysis on Tax Amnesty, Tax Compliance, and Tax Audit on Tax Revenue: Bibliometric Analysis
Authors: Salma Aulia Mutiara , Larasati Ayuning , Melgasari Diny , Suryanto Tulus 
Published: March 2023

Tax is one of the state revenues used to finance the State Expenditure Budget (APBN). This study aims to provide empirical evidence of the effect of implementing tax amnesty, tax compliance, and tax audit policies on tax revenues. The method used in this research is descriptive quantitative method. Data collection uses the help of the Harzing's Publish or Perish program with the keywords used Tax amnesty, Tax Compliance, Tax audit. From the results of the research carried out, then mapping the findings using the VOSviewers application to be taken as a bibliometric analysis tool to visualize the network of authors and keywords. The results of the study show that tax amnesty, tax compliance, and tax audits have an effect on tax revenues. The tax amnesty policy is more effective in increasing tax revenue compared to tax compliance and tax audits. Keywords: Tax Amnesty, Tax Compliance, Tax Audit, and Tax Revenue
Protection of trademark property rights in pharmaceuticals. Analysis of judicial practice
Authors: Minchenko Nataliia 
Published: March 2023

Keywords: trademarks in the pharmaceutical industry, trademarks ownershipviolations, trademarks protection, case law, trademarks protection cases, invalidationof the trade mark certificate, early termination of the certificate
The relevance of this article is that the largest number of legal disputes in the sphere of intellectual property are disputes concerning violation of property rights for trademarks. At the same time, in economicproceedings, part of the court cases on the protection of trademark rights in the pharmaceutical industry represents about 40% of the total number of court cases on the protection of rights to trademarks. The article studies theoretical provisions of protection of trademark rights in the field of pharmaceuticals, as well as practical issues of violations of these rights. Special attention is paid to the analysis of court practice of protection of trademark rights in the field of pharmaceuticals. It has been found that the overwhelming number of cases investigated concerns recognition of the Ukrainian trademark certificateas invalid. The analysis of judicial practice made it possible to establish the following statistical data in economic proceedings: cases of invalidation of a trademark certificate are 70%; cases on termination of infringement of rights to the trademark are 12%; cases on early termination of the trademark certificate are 15%; other cases on protection of rights to trademarks make 5%. The article details the legal requirements for each category of court cases. What additional claims are submitted for each category of court cases.
The case law analysis revealed that courts for the protection of trademark rights in the pharmaceutical industry are most often sued for declaring the Ukraine trademark invalid in whole or in part and for an obligation to act. In addition, it was found that 70 percent of trademark cases in the pharmaceutical industry resulted in a full or partial award. In civil proceedings it is almost 90 percent. Thus, litigation is a very effective way of protecting trademark rights in the pharmaceutical industry.
Biomechanical comparison of intramedullary nail and plate osteosynthesis for extra-articular proximal tibial fractures with segmental bone defect
Authors: Gao Weihang , Zhao Ke , Guo Yuanyuan , Xie Mao , Feng Xiaobo , Liu Ping , Xie Xin , Fu Dehao 
Published: March 2023

Purpose: Proximal tibial fractures are common, but the current available internal fixation strategies remain debatable, especially for comminuted fractures. This study aimed to compare the biomechanical stability of three internal fixation strategies for extra-articular comminuted proximal tibial fractures.Methods: A total of 90 synthetic tibiae models of simulated proximal tibial fractures with segmental bone defects were randomly divided into three groups: Single lateral plating (LP), double plating (DP) and intramedullary nailing (IN). Based on the different number of fixed screws, the above three groups were further divided into nine subgroups and subjected to axial compression, cyclic loading and static torsional testing.Results: The subgroup of intramedullary nailing with five proximal interlocking screws showed the highest axial stiffness of 384.36 ± 35.00 N/mm. The LP group obtained the lowest axial stiffness performance with a value of 96.59 ± 16.14 N/mm. As expected, the DP group offered significantly greater biomechanical stability than the LP group, with mean static axial stiffness and mean torque increasing by approximately 200% and 50%, respectively. According to static torsional experiments, the maximum torque of the DP subgroup was 3,308.32 ± 286.21 N mm, which outperformed all other groups in terms of torsional characteristics.Conclusion: Utilizing more than four distal screws did not provide improved biomechanical stability in the LP or DP groups, while a substantial increase in the biomechanical stability of DP was obtained when an additional medial plate was used. For the intramedullary nailing group, increasing the number of proximal interlocking screws could significantly improve biomechanical stability, and the intramedullary nailing with three proximal interlocking screws had similar static and cyclic stiffness as the DP group. The intramedullary nailing with five proximal screws had better axial stability, whereas DP had better torsional stability.
Infective endocarditis with anomalous origin of coronary arteries and an abnormal aortic root bulge: A case report
Authors: Yang Guoliang , Lai Xiaoyue , Liang Chunshui , Fan Weijie , Fu Wanlei , Liu Zheng , Xia Hongmei 
Published: March 2023

BackgroundThe aortic bulge sign possibly indicates an arterial aneurysm, pseudoaneurysm, aortic dissection, or aortic diverticulum. The aortic diverticulum is a congenital abnormality of the aorta, mainly known as an aneurysmal remnant of the dorsal fourth aortic arch or ductus arteriosus. However, the diverticulum of another part of the aorta has rarely been reported.Case summaryWe report a case of a 24-year-old male with a history of oral ulcer presented with recurrent hyperpyrexia and chest pain. Echocardiography and computed tomography showed the anomalous origin of the coronary arteries, aortic valve vegetations, and a bulge at the aortic root. The patient then received a Bentall procedure. The aorta and aortic valves were replaced by a valved conduit. The bulge with a normal arterial wall at the aortic root was considered to be a diverticulum. The infective endocarditis was verified as a secondary oral-derived streptococcal infection. The patient was discharged 15 days after surgery. Post-operative echocardiography had no positive findings.ConclusionOur case report highlights the role of multimodal cardiovascular imaging for the diagnostic workup of rare disorders, such as the presence of a diverticulum in the aortic root in a patient with endocarditis and anomalous origin of the right coronary artery.
Quantitative flow ratio-guided versus angiography-guided operation for valve disease accompanying coronary heart disease
Authors: Yan Wenlong , Wang Yangyang , Zheng Xin , Guo Pengfei , Yang Sumin 
Published: March 2023

BackgroundValve replacement combined with coronary artery bypass graft (CABG) operation (VR + CABG) is usually associated with higher mortality and complication rates. Currently, angiography remains the most commonly used approach to guide CABG. The aim of this study is to investigate whether a quantitative flow ratio (QFR)-guided strategy can improve the clinical outcomes of VR + CABG.MethodsPatients (n = 536) treated by VR + CABG between January 2018 and December 2021 were retrospectively assessed. In 116 patients, all lesions were revascularized entirely based on QFR (the QFR-guided group), whereas in 420 patients, all lesions were revascularized entirely based on angiography (the angiography-guided group). To minimize selection bias between the 2 groups, propensity score matching was performed at a ratio of 1:2. The primary endpoint of the study was the rate of major adverse cardiac and cerebrovascular events (MACCE) at 1-year, which was defined as a composite of cardiac mortality, myocardial infarction (MI), any repeat revascularization, and stroke.ResultsNo statistically significant differences were observed in the baseline clinical characteristics between the QFR-guided and angiography-guided groups after propensity score matching. The mean age of all patients was 66.2 years [standard deviation (SD) = 8.3], 370 (69%) were men, the mean body-mass index of the population was 24.8 kg/m2 (SD = 4.5), 129 (24%) had diabetes, and 229 (43%) had angina symptoms. When compared with the angiography-guided group, the QFR-guided group had a significantly shorter operative time (323 ± 60 min vs. 343 ± 71 min, P = 0.010), extra corporal circulation time (137 ± 38 min vs. 155 ± 62 min, P = 0.004), clamp time (73 ± 19 min vs. 81 ± 18 min, P &lt; 0.001), and less intraoperative bleeding volume (640 ± 148 ml vs. 682 ± 166 ml, P = 0.022). Compared with the angiography-guided group, the 1-year MACCE was significantly lower in the QFR-guided group (6.9% vs. 14.7%, P = 0.036, hazard ratio = 0.455, 95% confidence interval: 0.211–0.982).ConclusionOur results raise the hypothesis that among patients who undergo VR + CABG, QFR-guided strategy is associated with optimized surgical procedure and a superior clinical outcome, as evidenced by a lower rate of MACCE at 1-year compared with conventional angiography-guided strategy.
New perspectives in patient education for cardiac surgery using 3D-printing and virtual reality
Authors: Grab Maximilian , Hundertmark Fabian , Thierfelder Nikolaus , Fairchild Matthew , Mela Petra , Hagl Christian , Grefen Linda 
Published: March 2023

BackgroundPreoperative anxiety in cardiac surgery can lead to prolonged hospital stays and negative postoperative outcomes. An improved patient education using 3D models may reduce preoperative anxiety and risks associated with it.MethodsPatient education was performed with standardized paper-based methods (n = 34), 3D-printed models (n = 34) or virtual reality models (n = 31). Anxiety and procedural understanding were evaluated using questionnaires prior to and after the patient education. Additionally, time spent for the education and overall quality were evaluated among further basic characteristics (age, gender, medical expertise, previous non-cardiac surgery and previously informed patients). Included surgeries were coronary artery bypass graft, surgical aortic valve replacement and thoracic aortic aneurysm surgery.ResultsA significant reduction in anxiety measured by Visual Analog Scale was achieved after patient education with virtual reality models (5.00 to 4.32, Δ-0.68, p &lt; 0.001). Procedural knowledge significantly increased for every group after the patient education while the visualization and satisfaction were best rated for patient education with virtual reality. Patients rated the quality of the patient education using both visualization methods individually [3D and virtual reality (VR) models] higher compared to the control group of conventional paper-sheets (control paper-sheets: 86.32 ± 11.89%, 3D: 94.12 ± 9.25%, p &lt; 0.0095, VR: 92.90 ± 11.01%, p &lt; 0.0412).ConclusionRoutine patient education with additional 3D models can significantly improve the patients' satisfaction and reduce subjective preoperative anxiety effectively.