bluuebunny/crossref_metadata_2025_split huggingface dataset:
When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve
Authors: Guedes Fernando , Henriques Vinícius M. , Torrão Francisco L. , Haikal Neder P. , Sanches Gabriel E. , Barbosa Daniel A. N. , Marsicano Felipe G. , Rosa Livia A. N. , Siquara Ana C. , Malessy Martijn J. A. 
Published: August 2023

OBJECTIVE
Biopsies of peripheral nerve tumors (PNTs) are often used to plan an efficient treatment strategy. However, performing a biopsy is controversial when the mass is likely to be a benign PNT (BPNT). The aim of this study was to evaluate the side effects of biopsies in patients with potential PNTs.

METHODS
A retrospective and cross-sectional study was conducted on 24 patients who underwent biopsy of a mass of unknown origin potentially originating from a peripheral nerve (MUOPON), performed in nonspecialty services, and who were later referred to the authors’ service for resection of their lesion between January 2005 and December 2022. The patients were evaluated for pain score, presence of a motor or sensory deficit, biopsy diagnosis, and definitive histopathological postsurgical diagnosis.

RESULTS
The location of the tumor was supraclavicular in 7 (29.2%) patients, in the axillary region in 3 (12.5%), in the upper limb in 7 (29.2%), and in the lower limb in 7 (29.2%). Twenty-one (87.5%) patients were evaluated by MRI before biopsy, and 3 (12.5%) underwent ultrasound. One patient did not have an examination before the procedure. Based on the biopsy findings, 12 (50%) analyses had an inconclusive histopathological result. The preexisting pain worsened, as measured 1 week after biopsy, in all patients and had remained unchanged at the first evaluation by the authors (median 3 months, range 2–4 months). In 1 case, the open biopsy had to be interrupted because the patient experienced excruciating pain. Four (16.7%) patients developed motor deficits. Subsequent surgery was hampered by scar formation and intratumoral hemorrhage in 5 (20.8%) patients. The initial diagnosis obtained by biopsy differed from the final histopathological diagnosis in all patients, of whom 21 (87.5%) had BPNTs, 2 (8.3%) malignant peripheral nerve sheath tumors, and 1 (4.2%) an ancient schwannoma.

CONCLUSIONS
Biopsies of PNTs are controversial and may result in misdiagnosis, neuropathic pain, or neurological deficit due to axonal damage, and they may also hinder microsurgical resection when if performed when not indicated. Indications for biopsy of an MUOPON must be carefully considered, especially if BPNT is a possible diagnosis.
The influence of facility type on intracranial meningioma treatment and outcomes: predicting overall survival using the National Cancer Database
Authors: Brown Nolan J. , Gendreau Julian , Chakravarti Sachiv , Abraham Benjamin M. , Mehkri Yusuf , Kuo Cathleen C. , Chowdhury Naib , Cohen-Gadol Aaron 
Published: August 2023

OBJECTIVE
There is a growing body of evidence demonstrating improved outcomes for patients with CNS neoplasms treated at academic centers (ACs) versus nonacademic centers (non-ACs), which represents a potential healthcare disparity within neurosurgery. In this paper, the authors sought to investigate the relationship between facility type and surgical outcomes in meningioma patients.

METHODS
The National Cancer Database was queried for adult patients diagnosed with intracranial meningioma between 2004 and 2019. Patients were stratified by facility type, and the Mann-Whitney U-test and Fisher exact test were used for bivariate comparisons of continuous and categorical variables, respectively. Multivariate logistic regression was used to assess whether demographic variables were associated with treatment at ACs. Furthermore, multivariate Cox proportional hazards models were used to determine whether facility type was associated with overall survival (OS) outcomes.

RESULTS
Data on 139,304 patients (74% male, 84% White) were retrieved. Patients were stratified by facility type, with 50,349 patients (36%) treated at ACs and 88,955 patients (64%) treated at non-ACs. Patients treated at ACs were more likely to have private insurance (41% vs 34%, p < 0.001) and less likely to have Medicare (46% vs 57%, p < 0.001). Patients treated at ACs were more likely to have larger tumors (36.91 mm vs 33.57 mm, p < 0.001) and more likely to undergo surgery (47% vs 34%, p < 0.001). Interestingly, patients treated at ACs had decreased comorbidities (Charlson Comorbidity Index rating 0: 74% vs 69%) and similar income levels (income ≥ $46,000: 44% vs 43%). With respect to survival outcomes, patients treated at ACs demonstrated a higher median OS at 10 years than patients treated at non-ACs (65.2% vs 54.1%). The association of improved OS in patients treated at ACs continued to be true when adjusting for all other clinical and demographic variables (HR 0.900, 95% CI 0.882–0.918; p < 0.001).

CONCLUSIONS
The results of this study indicate that facility type is associated with disparate survival outcomes in the treatment of intracranial meningiomas. Namely, patients treated at non-ACs appear to have a survival disadvantage even when controlling for additional comorbidities.
Neurosurgery resident education in Ethiopia: a cross-sectional study, history, and future educational opportunities
Authors: Asfaw Zerubabbel K. , Laeke Tsegazeab , Aklilu Abenezer T. , Sahlu Abat , Yibeltal Mestet , Awano Mekdes Musie , Barthélemy Ernest J. , Germano Isabelle M. 
Published: August 2023

OBJECTIVE
An adequate healthcare workforce characterizes high-quality health systems. Sustainable domestic neurosurgery training is critical to developing a local neurosurgical workforce in low- and middle-income countries (LMICs). This study evaluated how neurosurgical training is delivered in Ethiopia, provides a historical narrative of neurosurgery training in the nation, and proposes future educational opportunities.

METHODS
A mixed-methods design consisting of a semi-structured interview and a comprehensive survey was used to acquire data. The interview participants included neurosurgery program directors and faculty involved in resident education. The survey was sent to all current neurosurgery residents in Ethiopia.

RESULTS
Ethiopian neurosurgical service began in 1970, and neurosurgical education started in 2006 with the establishment of the Addis Ababa University (AAU) residency program. The survey response rate was 86%, with 69 of 80 eligible neurosurgery residents responding. Most respondents were male (93%), aged 20–25 years (62%), and enrolled in the AAU program (61%). The oldest medical schools affiliated with tertiary hospitals were the top feeder institutions for neurosurgery training. Seventy-one percent of respondents worked for more than 60 hours/week, and 52% logged at least 100 cases annually. Survey responses demonstrated a critical need to establish subspecialty training and harmonize the national training curriculum.

CONCLUSIONS
The history of Ethiopian neurosurgery training exemplifies how global neurosurgery efforts focused on capacity building can rapidly expand the local neurosurgical workforces of LMICs. Opportunities for neurosurgical education require initiatives promoting a subspecialized, diverse workforce that attains both the clinical and academic proficiency necessary for advancing neurosurgical care locally and globally.
Effectiveness of indirect revascularization for adult hemorrhagic moyamoya disease: a 10-year follow-up study
Authors: Zhang Qihang , Yin Zihan , Zhu Chenyu , Li Wenjie , Zhu Huan , Wang Peijiong , Zhang Dong , Zhao Jizong , Zhang Yan , Liu Xingju 
Published: August 2023

OBJECTIVE
The optimal surgical approach for hemorrhagic moyamoya disease (hMMD) continues to be a topic of debate. The authors’ prior research demonstrated that both combined and indirect revascularization were efficacious. However, questions remain regarding the long-term prognosis consistency between these two treatments. Therefore, the objective of this study was to evaluate and compare the enduring effects of these surgical modalities on adult hMMD, extending the findings of the authors’ previous studies.

METHODS
The authors recruited patients diagnosed with hMMD between 2010 and 2015. The patients were categorized into two groups: those who underwent combined revascularization (superficial temporal artery–middle cerebral artery bypass alongside dural reverse application) and those who underwent indirect revascularization (encephaloduroarteriosynangiosis [EDAS]). The primary and secondary endpoints of this study were instances of rebleeding, confirmed with CT scan, and death resulting from rebleeding, respectively. The authors estimated rebleeding-free and death-free survival rates by utilizing the Kaplan-Meier survival method. They used Cox regression to adjust for confounders and to evaluate the effects of the varying surgical modalities on the endpoints.

RESULTS
After an average follow-up period of 114 months, 35 patients (28.6%) experienced 40 rebleeding events, yielding an average annual incidence of 3.5%. Of the 79 patients who received combined revascularization, 17 (21.5%) experienced rebleeding events. Similarly, of 43 patients who underwent EDAS, 18 (41.9%) experienced rebleeding events (p = 0.018). Most rebleeding instances occurred 61–120 months after surgery (21 patients [60%]), followed by 12–60 months (11 patients [31.4%]). Multivariate survival analysis highlighted significant differences in surgical outcomes (HR 0.33, 95% CI 0.15–0.74, p = 0.007). The authors observed that 8 patients (10.1%) died of rebleeding events in the combined group, as well as 10 patients (23.3%) in the EDAS group. Despite the lack of a statistically significant difference in mortality (p = 0.051), multivariable survival analysis found a significant difference (HR 0.31, 95% CI 0.10–0.97, p = 0.044).

CONCLUSIONS
High rebleeding rates persist in adult hMMD patients, even after revascularization. Combined revascularization proved superior to EDAS in preventing long-term rebleeding. In contrast, EDAS alone did not display a clear effect on reducing long-term rebleeding rates.
Differences in microorganisms causing infection after cranial and spinal surgeries
Authors: Pralea Alexander , Walek Konrad W. , Auld Dianne , Mermel Leonard A. 
Published: August 2023

OBJECTIVE
The primary aim of this retrospective study was to assess differences in the pathogens causing surgical site infections (SSIs) following craniectomies/craniotomies and open spinal surgery. The secondary aim was to assess differences in rates of SSI among these operative procedures.

METHODS
ANOVA tests with Bonferroni correction and incidence risk ratios (RRs) were used to identify differences in pathogens by surgical site and procedure using retrospective, de-identified records of 19,993 postneurosurgical patients treated between 2007 and 2020.

RESULTS
The overall infection rates for craniotomy/craniectomy, laminectomy, and fusion were 2.1%, 1.1%, and 1.5%, respectively, and overall infection rates for cervical, thoracic, and lumbar spine surgery were 0.3%, 1.6%, and 1.9%, respectively. Craniotomy/craniectomy was more likely to result in an SSI than spine surgery (RR 1.8, 95% CI 1.4–2.2, p < 0.0001). Cutibacterium acnes (RR 24.2, 95% CI 7.3–80.0, p < 0.0001); coagulase-negative staphylococci (CoNS) (methicillin-susceptible CoNS: RR 2.9, 95% CI 1.6–5.4, p = 0.0006; methicillin-resistant CoNS: RR 5.6, 95% CI 1.4–22.3, p = 0.02); Klebsiella aerogenes (RR 6.5, 95% CI 1.7–25.1, p = 0.0003); Serratia marcescens (RR 2.4, 95% CI 1.1–7.1, p = 0.01); Enterobacter cloacae (RR 3.1, 95% CI 1.2–8.1, p = 0.02); and Candida albicans (RR 3.9, 95% CI 1.2–12.3, p = 0.02) were more commonly associated with craniotomy/craniectomy cases than fusion or laminectomy SSIs. Pseudomonas aeruginosa was more commonly associated with fusion SSIs than craniotomy SSIs (RR 4.4, 95% CI 1.3–14.8, p = 0.02), whereas Escherichia coli was nonsignificantly associated with fusion SSIs compared to craniotomy SSIs (RR 4.1, 95% CI 0.9–18.1, p = 0.06). Infections with E. coli and P. aeruginosa occurred primarily in the lumbar spine (p = 0.0003 and p = 0.0001, respectively).

CONCLUSIONS
SSIs due to typical gastrointestinal or genitourinary gram-negative bacteria occur most commonly following lumbar surgery, particularly fusion, and are likely to be due to contamination of the surgical bed with microbial flora in the perianal area and genitourinary tract. Cutibacterium acnes in the skin flora of the head and neck increases risk of infection due to this microbe following surgical interventions in these body sites. The types of gram-negative bacteria associated with craniotomy/craniectomy SSIs suggest potential environmental sources of these pathogens. Based on the authors’ findings, neurosurgeons should consider using a two-step skin preparation with benzoyl peroxide, in addition to a standard antiseptic such as alcoholic chlorhexidine for cranial, cervical, and upper thoracic surgeries. Additionally, broader gram-negative bacterial coverage, such as use of a third-generation cephalosporin, should be considered for lumbar/lumbosacral fusion surgical antibiotic prophylaxis.
Comparison of PED/PED Flex and PED Shield in the treatment of unruptured intracerebral aneurysms
Authors: El Naamani Kareem , Mastorakos Panagiotis , Yudkoff Clifford J. , Abbas Rawad , Tjoumakaris Stavropoula I. , Gooch M. Reid , Herial Nabeel A. , Rosenwasser Robert H. , Zarzour Hekmat , Schmidt Richard F. , Jabbour Pascal M. 
Published: August 2023

OBJECTIVE
The object of this study was to compare the efficacy and safety profile of the Pipeline embolization device (PED)/Pipeline Flex embolization device (PED Flex) with that of the Pipeline Flex embolization device with Shield Technology (PED Shield). After introducing the first-generation PED and the second-generation PED Flex with its updated delivery system, the PED Shield was launched with a synthetic layer of phosphorylcholine surface modification to reduce thrombogenicity.

METHODS
This is a retrospective review of unruptured aneurysms treated with PED/PED Flex versus PED Shield between 2017 and 2022 at the authors’ institution. Patients with ruptured aneurysms, adjunctive treatment, failed flow diverter deployment, and prior treatment of the target aneurysm were excluded. Baseline characteristics were collected for all patients, including age, sex, past medical history (hypertension, hyperlipidemia, diabetes mellitus), smoking status, aneurysm location, and aneurysm dimensions (neck, width, height) and morphology (saccular, nonsaccular). The primary outcome was procedural and periprocedural complication rates.

RESULTS
The study cohort comprised 200 patients with 200 aneurysms, including 150 aneurysms treated with the PED/PED Flex and 50 treated with the PED Shield. With respect to intraprocedural and periprocedural complications, length of stay, length of follow-up, and functional outcome at discharge, there was no significant difference between the two cohorts. At the midterm follow-up, the rate of in-stent stenosis (PED/PED Flex: 14.2% vs PED Shield: 14.6%, p = 0.927), aneurysm occlusion (complete occlusion: 79.5% vs 80.5%, respectively; neck remnant: 4.7% vs 12.2%; dome remnant: 15.7% vs 7.3%; p = 0.119), and the need for retreatment (5.3% vs 0%, p = 0.097) were comparable between the two cohorts.

CONCLUSIONS
This study suggests that, as compared to first- and second-generation PED and PED Flex, the third-generation PED Shield offers similar rates of complications, aneurysm occlusion, and in-stent stenosis at the midterm follow-up.
Church Tin Utensils of the XVII–XVIII Centuries in the Collections of the Museum of the Moscow Theological Academy and the Museum named after Andrey Rublev
Authors: Герасимова Наталья Викторовна 
Published: August 2023

Статья посвящена исследованию и атрибуции не известных ранее памятников русского церковного оловянного литья конца XVII–XVIII вв. Качественные оловянные сплавы и готовые изделия из европейского олова появились на Руси с конца XVI в. Оловянные предметы широко использовались не только в быту как питьевая посуда, но и при богослужении в храмах. Благодаря практическим и эстетическим качествам, и относительной дешевизне по сравнению с драгоценными металлами, оловянные изделия нашли свое применение в многочисленных храмах и монастырях. На настоящий момент из всего многообразия церковной утвари из олова в научный оборот введены лишь отдельные предметы из коллекций крупнейших музеев России. Автором статьи проведено комплексное исследование и атрибуция ранее не изученных 14 предметов из собраний Музея Московской духовной академии (ЦАК МДА) и Музея имени Андрея Рублева (ЦМИАР). Это потиры, дискосы, кресты, дароносицы и дарохранительницы.
The article is devoted to the study and attribution of previously unknown monuments of Russian church tin casting of the late XVII–XVIII centuries. High- quality pewter alloys and finished products made of European tin appeared in Moscow state since the end of the XVI century. Tin objects were widely used not only in everyday life as drinking utensils, but also during worship in temples. Due to its practical and aesthetic qualities, and relative cheapness compared to precious metals, tin products have found their application in numerous temples and monasteries. At the moment, out of the whole variety of church utensils made of pewter, only individual items from the collections of the largest museums in Russia have been put into scientific circulation. The author of the article conducted a comprehensive study and attribution of previously unexplored 14 items from the collections of the Museum of the Moscow Theological Academy and Museum named after Andrey Rublev. These are chalices, patens, crosses and tabernacles.
The “Materials of the Church-archaeological Cabinet” as a Source on the History of the Church-Archaeological Cabinet
Authors: Григорьева Наталья Ивановна 
Published: August 2023

Статья посвящена важному историческому источнику по истории Церковно-археологического кабинета Московской духовной академии — машинописным сборникам «Материалы церковно-археологического кабинета», которые на сегодняшний день являются малоизученными. Инициатором их появления стал доцент Московской духовной академии Алексий Данилович Остапов, впоследствии протоиерей, профессор, заведующий Церковно-археологическим кабинетом с 1955 по 1975 гг. Сборники отражают внутреннюю жизнь музея Академии: этапы формирования его фондов, экспозиций, коллектива, научную деятельность сотрудников. Выпуск сборников продолжился после смерти протоиерея Алексия, но периодичность выпуска очередных сборников была не столь регулярной. Всего, на сегодняшний день, в распоряжении исследователей имеются 16 сборников, последний из которых вышел в 2005 г. В настоящей статье представлен анализ материалов сборников, вышедших в период с 1955 по 1975 гг., а также дана история их появления и краткая историческая справка по всему периоду, который нашел отражение в имеющихся шестнадцати выпусках. При исследовании были использованы как материалы самих сборников, так и литература, источники, отражающие историю их появления: журналы Совета академии, воспоминания, дневники.
The article is dedicated to an important historical source on the history of the Moscow Theological Academy Museum «Church-archaeological Cabinet», which is a mainly unknown typewritten collection of “Materials of the Church-archaeological Cabinet”. Alexy Danilovich Ostapov, Professor of the Moscow Theological Academy, later archpriest and Head of the Church-Archaeological Cabinet in 1955–1975, was the first one who started keeping record of a museum collection. The Materials reflect a life of the academic museum such as setting up its funds and an exhibition as well as its scientific activity. The work carried on even after Archpriest Alexy’s repose; however, it was less regular. Overall, there are 16 issues and the last one was published in 2005. The article analyses the materials published in 1955–1975, their history and a brief overview of the entire period. The research used both the materials themselves and extra sources like journals of the Academy Council, memoirs, diaries.
Neo-Patristic Synthesis: Possibilities in Natural Science
Authors: Рупова Розалия Моисеевна 
Published: August 2023

В работе дано обоснование возможности расширения сферы охвата такого значительного направления современного богословия, как неопатристический синтез. Исторически это направление формировалось в среде русской послереволюционной эмиграции ХХ в. и включало гуманитарное знание. Разделы богословия, история, философия, науки об обществе были платформами жарких дискуссий и составляли исследовательское поле как для самого прот. Георгия Флоровского, основателя этого направления, так и для его последователей. Развитие концепции на рубеже тысячелетий и в XXI в. пошло по пути антропологизации. Опираясь на позицию прот. Георгия, который позиционировал богословие как универсальный, без изъятия, способ рассмотрения всех аспектов культуры, автор предлагает включить в поле неопатристики естественнонаучное знание. Это откроет перспективу построения системного богословия культуры.
The paper provides a rationale for the possibility of expanding the scope of such a significant area of modern theology as Neo-Patristic synthesis. Historically, this trend was formed in the midst of the Russian post-revolutionary emigration of the 20th century and included humanitarian knowledge. Sections of theology, history, philosophy, social sciences were platforms for heated discussions and constituted a research field for Archpriest Georges Florovsky, the founder of this trend, and for his followers. The development of the concept at the turn of the millennium and in the 21st century followed the path of anthropologization. Based on the position of Fr. Georges, who positioned theology as a universal, without exception, way of considering all aspects of culture, the author proposes to include natural science in the field of Neo-Patristics. This will open up the prospect of building a systemic theology of culture.
Archpriest Georges Florovsky’s Concept of Catholic Personalism
Authors: Паутов Г.В. 
Published: August 2023

На основе анализа основных трудов знаменитого богослова русской эмиграции прот. Георгия Флоровского рассматриваются концепции соборности Церкви и богословского персонализма как два основных направления в его богословско-философском творчестве. Автор рассматривает оригинальность мысли Флоровского в раскрытии характеристики личности и специфики экклесиологического свойства соборности. На основании аналитического обзора указанных концепций автор устанавливает их взаимосвязь и приходит к выводу о том, что у прот. Георгия Флоровского концепция соборности Церкви является ключевой характеристикой «личности». При этом предполагается, что единство учения о соборности, как сформулированного Флоровским в результате изучения святоотеческих трудов, и персонализма, как философии Нового времени, является одним из аспектов неопатристического синтеза прот. Георгия Флоровского.
Based on the analysis of the main works of the famous Russian emigrant theologian Archpriest Georges Florovsky, the article examines the concepts of sobornost’ of the Church and of theological personalism as two main directions in Florovsky’s theological and philosophical work. The author examines the originality of Florovsky's thought in revealing the understanding of personality and the specifics of the ecclesiological property of sobornost’. On the basis of these concepts, the author establishes their relationship and concludes that Fr. Georges Florovsky's concept of sobornost’ of the Church is a key characteristic of his concept of “personality”. At the same time, the article claims the unity between the doctrine of sobornost’, as formulated by Florovsky basing on his Patristic studies, and personalism as a modern philosophy. This unity is asserted to be an aspect of Archpriest Georges Florovsky's Neo-Patristic synthesis.