bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incisional CSF leakage after intradural cranial surgery in children: incidence, risk factors, and complications
Authors: Slot Emma M. H. , van Doormaal Tristan P. C. , van Baarsen Kirsten M. , Krayenbühl Niklaus , Regli Luca , Germans Menno R. , Hoving Eelco W. 
Published: February 2023

OBJECTIVE
The risk of cerebrospinal fluid (CSF) leakage after cranial surgery and its associated complications in children are unclear because of variable definitions and the lack of multicenter studies. In this study, the authors aimed to establish the incidence of CSF leakage after intradural cranial surgery in the pediatric population. In addition, they evaluated potential risk factors and complications related to CSF leakage in the pediatric population.

METHODS
The authors performed an international multicenter retrospective cohort study in three tertiary neurosurgical referral centers. Included were all patients aged 18 years or younger who had undergone cranial surgery to reach the subdural space during the period between 2015 and 2021. Patients who died or were lost to follow-up within 6 weeks after surgery were excluded. The primary outcome measure was the incidence of CSF leakage, defined as leakage through the skin, within 6 weeks after surgery. Univariable and multivariable logistic regression analyses were performed to identify risk factors for and complications related to CSF leakage.

RESULTS
In total, 759 procedures were identified, performed in 687 individual patients. The incidence of CSF leakage was 7.5% (95% CI 5.7%–9.6%). In the multivariate model, independent risk factors for CSF leakage were hydrocephalus (OR 4.5, 95% CI 2.2–8.9) and craniectomy (OR 7.6, 95% CI 3.0–19.5). Patients with CSF leakage had higher odds of pseudomeningocele (5.7, 95% CI 3.0–10.8), meningitis (21.1, 95% CI 9.5–46.8), and surgical site infection (7.4, 95% CI 2.6–20.8) than patients without leakage.

CONCLUSIONS
CSF leakage risk in children after cranial surgery, which is comparable to the risk reported in adults, is an event of major concern and has a serious clinical impact.
Epidemiology and practice variations of shunt surgery for hydrocephalus: a nationwide registry–based study
Authors: Mansoor Nadia , Gulati Sasha , Fredriksli Oddrun A. , Salvesen Øyvind , Solheim Ole 
Published: February 2023

OBJECTIVE
Indications for surgical treatment of hydrocephalus (HC) can vary across centers. The authors sought to investigate the frequencies of surgically treated HC disorders and to study variations in the practice of shunt surgery in Norway, a country with universal and free healthcare.

METHODS
This is a nationwide registry–based study using data from the Norwegian Patient Registry. Four neurosurgical centers serve exclusively in 4 defined geographic regions. All patients who underwent shunt surgery in Norway between January 1, 2008, and December 31, 2021, were included and regional differences and time trends were explored.

RESULTS
The national annual rate of shunt surgery in the study period was 6.0 per 100,000. A total of 4139 individuals (49.5% male) underwent primary shunt surgeries, and a total of 9262 operations including revision surgeries were performed. There were statistically significant regional differences between the 4 treating centers in Norway in terms of patients’ age (median 61 years, range 53–65 years); mean annual rate of primary shunt surgery (5.1–7.6 per 100,000); annual rate of primary shunt surgery in patients of different age groups (0.9–1.2 in 0–17 years, 1.8–2.7 in 18–64 years, and 1.6–3.9 in ≥ 65 years); annual rate of revision surgeries (2.4–5.7 per 100,000); annual rate of primary surgery for communicating HC (0.7–2.0 per 100,000); annual rate of primary surgery for normal pressure HC (0.5–1.8 per 100,000); and annual rate of primary surgery for HC associated with cerebrovascular disease (0.5–2.0 per 100,000). There was significant variation in overall shunt surgeries during the study period (p = 0.026), and there was an overall decrease in revision surgeries over time (p < 0.001). There appears to be a homogenization of revision surgeries over time.

CONCLUSIONS
There are significant and large practice variations in the surgical management of HC in Norway. There are significant differences between regions, particularly in terms of rates of shunt surgery for some diagnoses (communicating HC, normal pressure HC, and HC associated with cerebrovascular disease) as well as revision rates.
Neurosurgical management of proton beam therapy–induced moyamoya syndrome
Authors: Zhang Catherine H. , Muirhead William , Silva Adikarige H. D. , Toolis Claire , Robertson Fergus , Rennie Adam , Bhate Sanjay , Thompson Dominic N. P. , Ganesan Vijeya , James Greg 
Published: February 2023

OBJECTIVE
Proton beam therapy (PBT) is an increasingly used treatment modality for pediatric patients with brain tumors. Moyamoya syndrome (MMS) is well recognized as a complication of traditional photon radiotherapy, however its association with PBT is less well described. The authors discuss their initial experience with the neurosurgical management of MMS secondary to PBT in a large-volume pediatric neurovascular service.

METHODS
The authors performed a retrospective case review of consecutive children referred for neurosurgical management of MMS after PBT between 2009 and 2022. Patient demographic characteristics, oncological history and treatment, interval between PBT and MMS diagnosis, and MMS management were recorded. Clinical outcome at last review was classified as good if the modified Rankin Scale (mRS) score was ≤ 2 and/or the patient attended mainstream education without additional assistance. Poor outcome was defined as mRS score ≥ 3 and/or the patient received additional educational support. The recorded radiological outcomes included angiographic analysis of stenosis, evidence of brain ischemia/infarction on MRI, and postsurgical angiographic revascularization.

RESULTS
Ten patients were identified. Oncological diagnosis included craniopharyngioma (n = 6), optic pathway glioma (1), ependymoma (1), Ewing sarcoma (1), and rhabdosarcoma (1). The median (interquartile range [IQR]) age at PBT was 5.1 (2.7–7.9) years. The median (IQR) age at MMS diagnosis was 7.8 (5.7–9.3) years. The median time between PBT and diagnosis of MMS was 20 (15–41) months. Six patients had poor functional status after initial oncological treatment and prior to diagnosis of MMS. All 10 patients had endocrine dysfunction, 8 had visual impairment, and 4 had behavioral issues prior to MMS diagnosis. Four patients had a perioperative ischemic event: 2 after tumor surgery, 1 after MMS surgical revascularization, and 1 after receiving a general anesthetic for an MRI scan during oncological surveillance. Seven children were treated with surgical revascularization, whereas 3 were managed medically. The incidence of ischemic events per cerebral hemisphere was reduced after surgical revascularization: only 1 patient of 7 had an ischemic event during the follow-up period after surgery. No children moved from good to poor functional status after MMS diagnosis.

CONCLUSIONS
MMS can occur after PBT. Magnetic resonance angiography sequences should be included in surveillance MRI scans to screen for MMS, and families should be counseled about this complication. Management at a high-volume pediatric neurovascular center, including selective use of revascularization surgery, appears to maintain functional status in these children.
The Effects of SARS-CoV-2 Infection on the Cognitive Functioning of Patients with Pre-Existing Dementia
Authors: Dubey Souvik , Das Shambaditya , Ghosh Ritwik , Dubey Mahua Jana , Chakraborty Arka Prava , Roy Dipayan , Das Gautam , Dutta Ajitava , Santra Arindam , Sengupta Samya , Benito-León Juliàn 
Published: February 2023

Background: Cognitive postscripts of COVID-19, codenamed as ‘cognitive COVID’ or ‘brain fog,’ characterized by multidomain cognitive impairments, are now being reckoned as the most devastating sequelae of COVID-19. However, the impact on the already demented brain has not been studied. Objective: We aimed to assess the cognitive functioning and neuroimaging following SARS-CoV-2 infection in patients with pre-existing dementia. Methods: Fourteen COVID-19 survivors with pre-existing dementia (four with Alzheimer’s disease, five with vascular dementia, three with Parkinson’s disease dementia, and two with the behavioral variant of frontotemporal dementia) were recruited. All these patients had detailed cognitive and neuroimaging evaluations within three months before suffering from COVID-19 and one year later. Results: Of the 14 patients, ten required hospitalization. All developed or increased white matter hyperintensities that mimicked multiple sclerosis and small vessel disease. There was a significant increase in fatigue ( p = 0.001) and depression ( p = 0.016) scores following COVID-19. The mean Frontal Assessment Battery (p < 0.001) and Addenbrooke’s Cognitive Examination ( p = 0.001) scores also significantly worsened. Conclusion: The rapid progression of dementia, the addition of further impairments/deterioration of cognitive abilities, and the increase or new appearance of white matter lesion burden suggest that previously compromised brains have little defense to withstand a new insult (i.e., ‘second hit’ like infection/dysregulated immune response, and inflammation). ‘Brain fog’ is an ambiguous terminology without specific attribution to the spectrum of post-COVID-19 cognitive sequelae. We propose a new codename, i.e. ‘FADE-IN MEMORY’ (i.e., Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment).
miR-101a-3p Impairs Synaptic Plasticity and Contributes to Synucleinopathy
Authors: Xylaki Mary , Paiva Isabel , Al-Azzani Mohammed , Gerhardt Ellen , Jain Gaurav , Islam Md Rezaul , Vasili Eftychia , Wassouf Zinah , Schulze-Hentrich Julia M. , Fischer André , Outeiro Tiago Fleming 
Published: February 2023

Background: Synucleinopathies are disorders characterized by the abnormal accumulation of α-synuclein (aSyn). Synaptic compromise is observed in synucleinopathies parallel to aSyn aggregation and is accompanied by transcript deregulation. Objective: We sought to identify microRNAs associated with synaptic processes that may contribute to synaptic dysfunction and degeneration in synucleinopathies. Methods: We performed small RNA-sequencing of midbrain from 6-month-old transgenic mice expressing A30P mutant aSyn, followed by comparative expression analysis. We then used real-time quantitative polymerase chain reaction (qPCR) for validation. Functional analysis was performed in primary neurons by biochemical assays and imaging. Results: We found several deregulated biological processes linked to the synapse. miR-101a-3p was validated as a synaptic miRNA upregulated in aSyn Tg mice and in the cortex of dementia with Lewy bodies patients. Mice and primary cultured neurons overexpressing miR-101a-3p showed downregulation of postsynaptic proteins GABA Ab2 and SAPAP3 and altered dendritic morphology resembling synaptic plasticity impairments and/or synaptic damage. Interestingly, primary cultured neuron exposure to recombinant wild-type aSyn species efficiently increased miR-101a-3p levels. Finally, a dynamic role of miR-101a-3p in synapse plasticity was shown by identifying downregulation of miR-101a-3p in a condition of enhanced synaptic plasticity modelled in Wt animals housed in enriched environment. Conclusion: To conclude, we correlated pathologic aSyn with high levels of miR-101a-3p and a novel dynamic role of the miRNA in synaptic plasticity.
Occupational exposure of vehicular emissions and cardiorespiratory risk among urban metropolitan bus drivers: A cross-sectional comparative study
Authors: Pagdhune Avinash , Kashyap Rekha , SivaPerumal P. , Balachandar Rakesh , Viramgami Ankit , Sarkar Kamalesh 
Published: February 2023

BACKGROUND: Vehicular emissions on long-term exposure predispose metropolitan bus drivers to cardiorespiratory ailments. OBJECTIVE: To evaluate the cardiorespiratory risk of urban metropolitan bus drivers related to vehicular emission exposure. METHODS: Bus drivers (with service >5 years, n = 254) and their administrative controls (primarily engaged in indoor white collared jobs, n = 73) were recruited. Demographic, occupational and clinical details were collected through pre-validated standardized format. Pulmonary Function Test (PFT) and lipid profile were carried out with standard protocol. Risk for cardiovascular events for preceding 10-years was estimated with WHO/ISH risk prediction chart and QRISK3 score. Exposure assessments for particulate matter (PM) were performed for both groups while duty hours. RESULTS: Exposure of drivers to PM2.5 six times and PM10 five times higher in comparison to administration staff (PM2.5- 970.9 v/s 145.0μg/m3 TWA and PM10- 1111.7 v/s 233.8μg/m3 TWA). Bus drivers exhibited significantly higher prevalence of respiratory symptoms (dyspnea-25% v/s 6.8% and cough-20.1% v/s 9.8%) and compromised PFT (obstructive–21% v/s 5.7% and restrictive–4.2% v/s 2.9%) in comparison to controls. Multivariate regression statistics reveal a significant decline for FEV1/FVC and FEV25–75 % among bus drivers compared to controls, controlling the influence of physiological and environmental factors. The difference between predicted cardiac age and their respective chronological age was twice higher (8.3 v/s 4.3 years) among drivers compared to their administration staff. CONCLUSION: Bus drivers were exposed to high levels of outdoor air pollutants. Further, the drivers exhibited higher risk for ischemic attack and obstructive airway diseases as compared to administration staff.
UNIVERSITY STUDENTS’ PERCEPTIONS AND USE OF CAMPUS GREEN SPACES AT GOMBE STATE UNIVERSITY, GOMBE STATE, NIGERIA
Authors: Wunubo Bala , Adamu Jafun , Audu Mohammed Usman , Idah Yina Paul 
Published: February 2023

Green spaces are essential areas in the university campuses. Attractive green space areas are considered as features which contribute positively not only to the student experience but the image of the university. The study generated data from undergraduate students at Gombe State University, it reveals understandings about students’ perceptions and use of campus green spaces (CGS). The quantitative data collected via the questionnaires were digitalized and analyzed using MS Excel statistic package. Descriptive statistics, including measures of percentage and frequency to analyze the associations between perceptions and use of CGS and students’ well-being on campus. Content analysis was used to analyze qualitative data generated. The study results indicate that majority of respondents (94%) both use and aware of campus green spaces, and CGS are important for the image of the university and also an integral component of the campus environment. The campus aesthetic quality and its design and management style have impact on the perception and use of its green spaces. The students (73%) preferred areas with manicured gardens, seats, and lawns over those areas without these facilities. The study recommends that a university campus needs manifold forms of green spaces to satisfy the needs of increasing number of student users
NUMERICAL SOLUTIONS OF COVID-19 SIRD MODEL IN NIGERIA
Authors: Akogwu Blessing O. , Fatoba J. O. 
Published: February 2023

A mathematical model of the Susceptible, Infectious, Recovery and Death (SIRD) for the spread of the COVID-19 disease in Nigeria was considered in this paper. The model values and parameters were obtained from Nigeria Centre for Disease Control Coronavirus COVID-19. The model was solved using Heun's method and Runge-Kutta's method of orders four and five to obtain an approximated solution for the model with the help of the Matlab Program. The result obtained was illustrated in plots to show the progression of the disease in the various classes. The comparisons of the three numerical methods used correspond well with each other by showing the same behavior pattern
DETERMINATION OF GREYWATER REUSE POTENTIAL IN DAMATURU YOBE STATE, NIGERIA
Authors: Shettima Lawan Muhammad , Bukar Mohammed , Gide Suleiman 
Published: February 2023

Greywater reuse is an untapped available water resource for many rural areas in developing countries. Meanwhile, it is one of the alternative ways to overcome water scarcity in many parts of the world. This study was carried out to investigate the potential of Greywater reuse as a means to overcome the problem of water scarcity and environmental pollution among restaurants and hotel owners within Damaturu metropolis in Yobe State of Nigeria. A field survey was conducted from 25 restaurants/hotels operating within Damaturu and Greywater samples were collected for reclamation using rice husk as a filter. The results of the survey indicated that the majority of the respondents expressed the problem of water scarcity and about 99% mentioned that they rely on buying multiple water trucks for their daily needs. The survey further revealed that 76% of the respondents fully agreed with greywater reuse, while 12% disagreed, and the rest of the respondents (10%) remain undecided. Physical parameters including; Total Dissolved Solids (TDS), Total Suspended Solids (TSS), pH, and Turbidity as well as general coliforms were determined before and after treatment with normal and chemically modified rice husk. However, an insignificant treatment efficiency was observed in the laboratory scale experiment with the normal rice husk which indicates the requirement for further modification. However, modification of the rice husk filter with an acidic reagent was confirmed to increase pH and electrical conductivity of the filter media, and determination of the retention time is always important in developing a greywater system
TIME-TO-OPTIMAL CONTROL OF HYPERTENSION USING KAPLAN-MEIER ESTIMATOR, COX PROPORTIONAL HAZARD AND WEIBULL MODEL
Authors: Usman Umar , Arkilla Bello Magaji , Ismail Abduljalil Alfa , Dauda Usman 
Published: February 2023

Hypertension is a worldwide public health challenge. The study investigated the time it takes to attain an optimal control of hypertension and the major factors that influence the control in Specialist Hospital, Sokoto.
A retrospective cohort study was conducted involving 300 patient records. The population consisted all hypertensive patients on follow-ups at Specialist Hospital Sokoto from1st February, 2015 to 1st February, 2021.Statistical Package for the Social Sciences version 20 and R software were used for descriptive, Kaplan-Meier estimator, Cox Proportional Regression (CPH) Model and Weibull Regression Model analyses.
Hypertensive patients attain an optimal control after a median survival time of 40.43 (at 95% CI: 33.67- 47.19) months (3.37 years) and mean survival time of 44.18 (CI: 37.24-51.12) months (3.68 years). The CPH analysis revealed that the factors that influenced an optimal control of hypertension were body mass index (BMI) (P <0.001), number of anti-hypertensive drugs (P <0.001), place of residence (P = 0.030). similarly, the Weibull model revealed that the factors that affected an optimal control of hypertension were BMI (P <0.01), number of anti-hypertensive drugs (P <0.001), place of residence (P = 0.042) and educational status (P = 0.036).
In conclusion, BMI, number of anti-hypertensive drugs, Place of residence, Educational status. should be watched out during management of hypertensive patients. This also call for an extension of this study through a prospective design to be able to measure the effect of other factors in the achievement of optimal control of hypertension
Eldecalcitol effectively prevents alveolar bone loss by partially improving Th17/Treg cell balance in diabetes-associated periodontitis
Authors: Gao Ruihan , Zhang Weidong , Jiang Yujun , Zhai Junzhe , Yu Jian , Liu Hongrui , Li Minqi 
Published: February 2023

Background: Diabetes-associated periodontitis (DPD) is an inflammatory and destructive disease of periodontal tissues in the diabetic population. The disease is manifested as more severe periodontal destruction and is more difficult to treat when compared with periodontitis (PD). Eldecalcitol (ELD) is a novel active vitamin D3 analog; however, little clinical evidence is available on its role on improving PD and DPD, and its specific mechanisms remain unclear. In this study, we evaluated the preventative effects of ELD toward PD and DPD and explored its underlying molecular mechanisms.Methods: Experimental PD and DPD mouse models were established by ligation combined with lipopolysaccharide (LPS) from Porphyromonas gingivalis injection in C57BL/6J and C57BLKS/J Iar- + Leprdb/+Leprdb (db/db) mice, respectively. Simultaneously, ELD (0.25 μg/kg) was orally administered to mice via an intragastric method. Micro-computed tomography (CT), hematoxylin-eosin (HE) staining, immunohistochemistry (IHC), and tartrate-resistant acid phosphatase (TRAP) staining were used to evaluate alveolar bone alterations in vivo. Flow cytometry, immunofluorescence, and real-time polymerase chain reaction (qRT-PCR) were also used to examine gene expression and probe systemic and local changes in Treg and Th17 cell numbers. Additionally, western blotting and immunofluorescence staining were used to examine changes in STAT3/STAT5 signaling.Results: Micro-CT and HE staining showed that the DPD group had higher alveolar bone loss when compared with the PD group. After applying ELD, alveolar bone loss decreased significantly in both PD and DPD groups, and particularly evident in the DPD group. IHC and TRAP staining also showed that ELD promoted osteoblast activity while inhibiting the number of osteoclasts, and after ELD treatment, the receptor activator of nuclear factor-κB ligand (RANKL) to osteoprotegerin (OPG) ratio decreased. More importantly, this decreasing trend was more obvious in the DPD group. Flow cytometry and qRT-PCR also showed that the systemic Th17/Treg imbalance in PD and DPD groups was partially resolved when animals were supplemented with ELD, while immunofluorescence staining and qRT-PCR data showed the Th17/Treg imbalance was partially resolved in the alveolar bone of both ELD supplemented groups. Western blotting and immunofluorescence staining showed increased p-STAT5 and decreased p-STAT3 levels after ELD application.Conclusion: ELD exerted preventative effects toward PD and DPD by partially rectifying Th17/Treg cell imbalance via STAT3/STAT5 signaling. More importantly, given the severity of DPD, we found ELD was more advantageous in preventing DPD.