bluuebunny/crossref_metadata_2025_split huggingface dataset:
447 Full-Endoscopic Resection of Osteoid Osteoma in the Thoracic Spine
Authors: Sandon Luiz H. , Bergamaschi João P. 
Published: March 2022

INTRODUCTION:
Common symptoms such as axial pain or nocturnal pain, associated with warning signs that are often worrisome, in addition to non-specific radiological findings can characterize benign lesions in the spine, and Osteoid Osteoma is among them.

METHODS:
This case report is the first in the literature whereby this modality, which until now has been reserved for degenerative diseases, was used successfully for diagnosis and treatment of osteoid osteoma.

RESULTS:
The patient reported immediate pain improvement without neurological changes in the postoperative period. She was discharged less than 24 hours after surgery and routine activities were resumed within 7 days. The anatomopathological examination identified osteoid osteoma. At the 1-year outpatient follow-up, the patient showed complete remission of clinical symptoms and no radiological signs of recurrence The technique allows good preservation of adjacent structures (muscle tissue and nerve roots), does not compromise spinal stability, allows good resection of the nidus, and, with the use of radiofrequency probes, allows cauterization of neovascularization, limiting tumor's recurrence.

CONCLUSION:
Endoscopy is becoming the preferred method in terms of therapeutic effectiveness and medical costs, it is important to remember, that in general (whatever the technique), the results of surgical treatment for osteoid osteoma reported in the literature are satisfactory: complete pain relief was achieved in more than 90% of the cases, and the majority (70%–90%) of patients with preoperative scoliosis evolved satisfactorily. Moreover, for good results with endoscopic techniques, experience and skill are required, which are achieved only with a considerable learning curve.
450 Minimally Invasive Multiple-Rod Constructs With Robotics Planning in Adult Spinal Deformity Surgery: A Case Series
Authors: Shah Vrajesh , Pham Martin H. , Diaz-Aguilar Luis D. , Lehman Ronald A. 
Published: March 2022

INTRODUCTION:
Multiple rod constructs (MRCs) are often used in adult spinal deformity correction for increased stability and rigidity. There are currently no reports showing minimally invasive robotic multi-rod long-segment posterior fixation and its technical feasibility through preoperative software planning.

METHODS:
Data was collected retrospectively from medical records of 6 consecutive patients who underwent minimally invasive multiple-rod constructs with robotics planning by a single surgeon at an academic center between March-August 2020.

RESULTS:
A total of 6 patients (4 females, mean age 69.7 years) underwent minimally invasive long-segment (6+) posterior fixation with multiple rods (3+) using the Mazor X Stealth Edition robotics platform. Average follow-up was 9.3 months. All patients underwent oblique lumbar interbody fusion as a first stage, followed by second stage posterior fixation in the same day. The mean number of levels posteriorly instrumented was 8.8. One patient underwent 3 rod fixation (1 iliac, 2 S2AI) and 5 patients underwent quad rod fixation (2 iliac, 2 S2AI). The mean time to secure all rods was 8 minutes 36 seconds. Mean improvement in spinopelvic parameters was -4.9 cm sagittal vertical axis, 18.0° lumbar lordosis, and -10.7° pelvic tilt with an average pelvic incidence of 62.5°. Mean EBL was 200 cc with no blood transfusions, and all but one patient ambulated on postoperative day 1 or 2.

CONCLUSION:
The preoperative software planning required of spinal robotics allows for not just the accurate placement of each pedicle screw in isolation, but the fine-detailing of an entire spine construct design. This concept is demonstrated in this case series where rod placement in a minimally invasive approach depends upon the preoperative design of the whole construct. Spinal robotics brings us into this new era of minimally invasive construct design. To our knowledge, this is the first description of the technical feasibility of multiple-rod constructs in minimally invasive adult spinal deformity surgery.
455 Predicting Outcomes Following Single-Level Lumbar Fusion
Authors: Borja Austin , Glauser Gregory , Strouz Krista , Ali Zarina S. , McClintock Scott D. , Schuster James M. , Yoon Jang W. , Malhotra Neil R. 
Published: March 2022

INTRODUCTION:
Spinal fusions represent one of the most common neurosurgical procedures. The LACE (Length of Stay, Acuity of Admission, Charlson Comorbidity Index (CCI) Score, Emergency Department (ED) visits within the previous 6 months) index was developed to predict readmissions, but has not been tested in a large, homogenous spinal fusion population.

METHODS:
LACE+ scores were calculated for all patients with complete information who underwent single-level, posterior-only lumbar fusion at a single, university medical system (n = 1598). Logistic regression was performed to assess the ability of the LACE+ score as a continuous variable to predict hospital readmissions within 90 days (90D) of the index operation. Secondary outcome measures included ED visits and reoperations. Subsequently, the risk of adverse postsurgical events was compared between the lowest and the highest quartile of LACE+ scores, then between the bottom decile and top 4 deciles of LACE+ scores. Finally, patients with the bottom decile of LACE+ scores were exact matched to the top 4 deciles to control for sociodemographic and procedural variables.

RESULTS:
Among all patients, increased LACE+ score significantly predicted higher rates of readmissions in the 30-day (30D), 30-90-day (30-90D), and 90D postoperative windows (p < 0.001, p = 0.001, p < 0.001, respectively). LACE+ score also predicted risk of ED visits at all 3 timepoints, and reoperations at 30-90D and 90D. When comparing the lowest quartile of LACE+ scores to the highest quartile, higher LACE+ score predicted higher risk of readmissions at 30D, 30-90D, and 90D following the index surgery (p = 0.003, p = 0.016, p < 0.001, respectively). When comparing the bottom decile of LACE+ scores to the top 4 deciles, higher LACE+ score predicted higher risk of readmissions at 30D (p = 0.009) and 90D (p = 0.005). Between exact-matched cohorts, no significant difference was observed in hospital readmissions.

CONCLUSION:
The LACE+ index may be a powerful tool in predicting other important postsurgical outcomes.
467 Cost Effectiveness of Using a New Autograft Harvesting Technology in Adult Posterior Lumbar Spine Fusion Surgery
Authors: Gandhoke Gurpreet S. , Orsheln Sarah , Smith Kenneth 
Published: March 2022

INTRODUCTION:
Autograft in the form of the patient’s own bone dust can be harvested during surgery and used to facilitate fusion, or allograft can be purchased at a cost and used as an alternative.

METHODS:
We compared allograft use to the upfront investment of a new autograft harvesting technology (Bone Collector), enrolling 107 patients. In 81 patients, Bone Collector was used to collect autologous graft. We compared the allograft requirement and allograft cost to similar variables in a control group of 26 patients where the Collector was not utilized. Quality Adjusted Life Years (QALYs) were calculated as the effectiveness parameter for both groups. EQ-5D scores were used to calculate quality of life utilities pre-operatively and at 3 months, 1 year and 2 years post-operatively. The cost-effectiveness study was performed from a societal perspective with a 2-year horizon for US populations.

RESULTS:
Of the 81 patients for whom the Bone Collector was used, 58% patients required autograft only. Forty-Two percent required allograft supplementation with the harvested autograft. In the 26 patients where the bone collector was not utilized, 35% required autograft only, while 66% required both autograft and allograft. The mean allograft requirement for the Bone Collector group was 4cc, while that of the group not utilizing the Bone Collector was 7.5cc. The cost of Allograft ranged from $100 to $4000. The cost of the 2 different Bone Collectors that were used in this study ranged from $400 to $1000. Preoperative ODI and EQ-5D scores for the entire cohort improved at 3 months, one year and 2 years postoperatively. Our decision analysis revealed that using the Bone collector was dominant (cost saving and more effective) compared to non-use, saving $326 and gaining 0.04 QALYs. Results were robust in multiple sensitivity analyses, with Bone Collector remaining dominant unless its cost is >$2900.

CONCLUSION:
Our cost-effectiveness analysis revealed that Bone Collector would be cost saving and more effective in most plausible scenarios.
481 Subacute Cell Specific Gene Expression Changes After Experimental TBI Suggest Target Genes for Cognitive Dysfunction
Authors: Alfawares Yara , Correll Erika , McGuire Jennifer , Ngwenya Laura B. 
Published: March 2022

INTRODUCTION:
Approximately 1.8 million Americans suffer from traumatic brain injury (TBI) each year, many of whom develop persistent cognitive difficulties. Understanding gene expression changes in cell types important for cognitive function may provide insight for therapeutic targets.

METHODS:
The dentate gyrus was dissected from the hippocampi of adult Sprague Dawley rats three weeks after either control or moderate lateral fluid percussion injury. Nuclei were isolated, the RNA was extracted, and sequenced using 10X Genomics technology. The RNA sequences were mapped to the rat genome (Rnor 6.0), quantified, and their expression normalized. Clustering of nuclei based on their gene expression profiles was done using Seurat (v4.0.1; R version 4.0.5). The granule cell cluster from each sample was identified based on expression of Prox1 and Rfx3, along with other neuronal markers. Genes with significant negatively correlated expressions between conditions were identified as differentially expressed and their functions were explored through Gene Ontology (GO).

RESULTS:
We identified a total of 14819 genes expressed in the granule cell clusters. Of these, 85 were differentially expressed. We identified twelve statistically significant biological processes using GO terms. GO terms with implications for cognitive function included: memory (p=0.000191, GO:0007613), negative regulation of amyloid-beta formation (p=0.000192, GO:1902430), and protein-lipid complex assembly (p=0.000192, GO:0065005). Statistically significant genes of interest associated with GO terms were under-expressed in the TBI condition: Apoe (p=0.00039), Atad1 (p=0.000013), Cpe (p=0.000438), and Dbn1 (0.002505).

CONCLUSION:
Three weeks after experimental TBI, hippocampal dentate granule cells under-express genes important for neurotransmitter receptor trafficking and neuronal survival. Future studies with cell-specific methodologies may yield targets for therapeutic strategies to improve cognitive dysfunction after TBI.
482 Traumatic Brain Injury and Hemorrhage in a Juvenile Rat Model of Polytrauma Leads to Immunosuppression and Splenic Alterations
Authors: Sribnick Eric A. , Warner Timothy , Hall Mark 
Published: March 2022

INTRODUCTION:
Traumatic brain injury (TBI) is a common cause of morbidity and mortality for which there are no pharmacotherapeutic agents. We have previously shown, with clinical data and in an animal model, that TBI with a concurrent extra-cranial injury can reliably lead to post-injury immunosuppression.

METHODS:
To assess the clinical relevance of our combined model, we examined lungs for evidence of spontaneous bacterial colonization. Prepubescent (28 day old) rats were injured with a moderately severe controlled cortical impact model and then had 25% blood volume removed by arteriotomy. Blood and spleen samples at post-injury day 1 were incubated with T or B cell immunostimulant and were examined for IFN-G production using an Eli-Spot assay. Spleen samples were examined at this timepoint for apoptosis using Annexin V staining. Lungs were also harvested and plated on blood agar to examine spontaneous bacterial colonization.

RESULTS:
Stimulation of whole blood samples and spleen with PMA at post-injury day 1 were associated with significant decreases in IFN-G-positive cells/million, as compared with samples from sham animals. As compared to sham, spleen samples from injured animals showed a marked increase in splenocyte apoptosis in the white pulp of the spleen. Lung samples, plated on blood agar, showed a 300% increase in colonies per plate in injured animals.

CONCLUSION:
These data add to a growing body of literature suggesting that severe trauma can lead to immunosuppression. Our findings further suggest a potential role for the spleen in altering leukocyte function following injury.
500 Fluorescein-guided Resection of High Grade Gliomas: A Meta-analysis
Authors: Smith Emily J. , Gohil Kavita , Mostafa Wael H. , Thompson Charee 
Published: March 2022

INTRODUCTION:
High grade gliomas (HGGs) have a poor prognosis despite current standard of care of surgery, chemotherapy, and radiation therapy. Achieving gross total resection (GTR) has been found to prolong survival in these patients. Intraoperative fluorescent agents are often used to aid resection of HGGs. Currently, 5-ALA is the only FDA-approved fluorescent agent but can be inconvenient to use, requiring ingestion hours before surgery, dark room isolation for 1-2 days post-operatively, and high cost. Another fluorescent agent commonly used is fluorescein sodium which is FDA approved for ocular surgeries and has a better side effect profile and is less costly than 5-ALA. Many studies have been published documenting the use of fluorescein in HGG resection, reporting rates of GTR and with some studies comparing it to a non-fluorescent or 5-ALA arm. In this meta-analysis, we provide statistical evidence of the efficacy in using fluorescein for HGG resection.

METHODS:
Following the PRISMA framework, we assessed 119 articles from Pubmed, Medline (Ovid), and BIOSIS Citation Index and found 23 eligible studies for meta-analysis, assessing the rates of GTR with fluorescein-guided resection of HGGs.

RESULTS:
Of the 23 eligible studies, 22 reported GTR rates. A pooled cohort of 336 patients underwent fluorescein-guided HGG resection with a GTR rate of 81% (95% CI, 73-89%; p<.001). 11 case-controlled studies were analyzed, showing a 23.6% increase in GTR rate in the fluorescein group compared to non-fluorescein-guided surgeries.

CONCLUSION:
This meta-analysis shows significantly increased GTR rates in fluorescein-guided resection of HGGs when compared to resection without fluorescein. This is comparable to GTR rates found with 5-ALA (76.8%) in previous meta-analyses. Though our results are statistically significant, there was significant heterogeneity in the fluorescein studies analyzed, so we cannot definitively conclude an association between fluorescein-guidance and GTR.
Sustainability of Islamic Rural Banks: A Social Qardh Financing Approach
Authors: Al-Banna Hasan , Nurdany Achmad 
Published: March 2022

Unlike Islamic commercial banks, Islamic rural bank emphasizes on small-medium enterprise financing along with providing a unique contract feature, namely social qardh financing. This paper investigates a way of finding the sustainability of Islamic rural banks through social financing and halal small-medium enterprise lending. We use OLS (ordinary least squares) and TSLS (two-stage least square) analysis. The time-series data is used from the period of 2010 to 2020. The result revealed that social qardh financing and small-medium halal enterprise lending have a positive and significant impact on the sustainability of Islamic rural banks. The Islamic rural banks' ratios are also found to be negative in influencing sustainability except the liquidity ratio that has a significant positive effect. Besides, the macroeconomic variables are also significant in explaining sustainability of Islamic rural banks. Recommendation for the policymaker that the regulation is needed to push Islamic rural banks in enhancing the social qardh financing toward small-medium enterprises.
Resonancias históricas y biográficas. La construcción de la subjetividad política en los movimientos sociales
Authors: Tamayo Sergio , Olivier Guadalupe 
Published: March 2022

Las consecuencias históricas de los movimientos y del activismo es un aspecto que supone atender el efecto de la historicidad de los movimientos en el cambio político, tanto sistémico como biográfico. Existen otras categorías, como proceso de acumulación de fuerzas, trayectoria de eventos contenciosos, transiciones políticas, intertextualidad hermenéutica, ciclos y periodos de protesta, que han acercado distintas dimensiones analíticas para tratar de explicar la lógica del desarrollo histórico del cambio social y político.
En América Latina, este proceso puede estudiarse al rastrear las trayectorias de eventos y experiencias sociales que constituyen periodos o transiciones políticas. Pero la explicación de estos fenómenos se torna lineal y evolutiva, algunos hablan de contínuum, y en el peor de los casos, como resultado causal de rígidas variables independientes. Pensar en resonancias históricas es abrir la puerta a la comprensión teórica de narrativas entrecruzadas que a diferentes grados y con distintas olas de frecuencia e intensidad tocan puntos sensibles de la historicidad de los movimientos sociales; dan sentido a los objetivos, motivaciones y expectativas de emancipación, y definen su trayectoria hacia el cambio político.
Determinants of immunisation of children under 2 years of age in Rural Barak Valley: An explorative study
Authors: Roy Dipankar , Sarma Munmi , Roy Joydeep , Das Kinnor 
Published: March 2022

In 1978, India launched the "Expanded Programme on Immunisation" (EPI) to minimise the prevalence of "Vaccine-Preventable Diseases" (VPDs). Despite years of health and medical progress, children in India continue to suffer from VPDs, and significant disparities in immunisation coverage may be seen among regions, states, socioeconomic groups, and other factors. Barak Valley's socioeconomic and environmental characteristics reveal an overall underdevelopment pattern. Furthermore, in the valley, healthcare services such as comprehensive immunisation institutional delivery are underutilised, resulting in poor immunisation coverage. Despite this evidence, there have been limited studies to identify the factors that influence child immunisation. In this context, this article is a modest attempt to identify and quantify the inequality in socio-economic factors in explaining inequality in Child immunisation in rural Barak Valley. A multistage stratified random sampling was used to collect information on immunisation and related variables by using a pre-tested questionnaire from the universe of children aged between 12-23 months of rural Barak Valley. And, binary logistic regression model has been used to analyse the data and draw inferences. The immunisation coverage is the Barak Valley region is very poor. The highest immunisation coverage has been observed for the BCG vaccine, around 90%. And with 64% coverage, vaccination against measles stands at the bottom of the list. The extent of full immunisation in the valley is not satisfactory at all. Around 54% of children aged 12-23 months have received all the WHO recommended vaccines, implying half of the eligible children are left out. The study identifies religion, a strong cultural affiliation that significantly influences the immunisation coverage of the child. Furthermore, the gender of the child, unequal access to ante-natal care, and birth order of the child are the prime factors associated with inequality in child immunisation in the region.
Clinical, etiological and hematological profile of pancytopenic childern admitted in balchikitsalaya of RNT medical college, Udaipur Rajasthan
Authors: Sharma Shivani , Maru Lipika , Gurjar Mukesh Kumar , Goyal Suresh , Jain Bhupesh 
Published: March 2022

To study the Clinical, Etiological and Hematological profile of Pancytopenic Children age group from 1 month to 18 years admitted in BalChikitsalay of MBGH, RNT Medical college, Udaipur. A Hospital based prospective study on children age group from 1month to 18 years admitted having pancytopenia and consenting for study were enrolled in study. Children who had received blood transfusion in previous 3 months, not consenting for study and known case of acute leukemia, aplastic anemia were excluded from study. Study was conducted in Balchikitsalay, MBGH, RNT Medical college, Udaipur, Rajasthan for a period of 1 year. 42 children were enrolled in this study among this 22 were male and 20 were female. Most of the children presented with pallor (100%) fever (88%), bleeding manifestations (78.5%), pain abdomen (35.7%). On examination all these were anemic (100%), had splenomegaly(64.2%) ,hepatomegaly(59.5%) and bleeding manifestation in the form of hematemesis(21.4%) ,petechiae(26.1%) ,bleeding gums(21.4%) . Hematological findings in majority of children were anemia 4 to 7mg/dl, WBC count 2000to 4000/mm and Platelet count20,000 to 50,000/mm. Peripheral Blood smear revealed blast cells in 11patients, megaloblasts in 8 patients and malarial parasite in 3 children. Serum Vitamin B12 levels were &#60;200 pg/ml in 20 children and &#60;100 pg/ml in12 children. Bone marrow examination was performed in 36 children which revealed hypercellular marrow (28),normocellular marrow (5), hypocellular marrow(3). Most common cause of pancytopenia was vitamin B12 deficiency (40.4%). Other common causes were ALL (21.4%), Aplastic anemia (7.1%), Scrub typhus (7.1%), falciparum malaria (7.1%), CLD (7.1%), AML two patient Dengue & SLE one patient each. Vitamin B 12 deficiency is the commonest cause of pancytopenia, followed by ALL (21.4%) & Aplastic anemia (7.1%).
Urzędnik kontra menadżer – przemiany roli kierownika instytucji kultury
Authors: Kruczkowska Patrycja 
Published: March 2022

Artykuł prezentuje sylwetki dyrektorów jednej instytucji kultury – zatrudnionego w latach 80. organizatora placówki i jego następcy – wyłaniające się z ustrukturyzowanych wywiadów. Ich wypowiedzi szkicują obraz przemian, jakie dotknęły tego typu placówki w wyniku transformacji ustrojowej i gospodarczej, związanych między innymi z reformą samorządową i decentralizacją polityki kulturalnej po 1989 roku.
Pierwsza część artykułu zawiera opis założeń i metodologii projektu, z którego pochodzą omawiane wywiady oraz opis materiału empirycznego. Porównawcze zestawienie wypowiedzi obu dyrektorów poprzedzają krótkie metryki. Prezentacja mikronarracji podzielona jest na 4 obszary tematyczne: analizę przebiegu karier zawodowych obu narratorów (droga do instytucji), wizję instytucji rekonstruującą sposób ujmowania przez badanych roli ośrodków kultury i przypisanych im zadań, funkcjonowanie instytucji i potencjalne przeszkody w jej działalności oraz obraz odbiorców kulturalnej oferty. Całość zamyka analiza zestawiająca najbardziej interesujące wątki, które pojawiły się w wypowiedziach obu dyrektorów, pomagające odpowiedzieć na pytania związane z charakterem transformacji instytucji kultury. Jednym z ważniejszych jest to, w jaki sposób obecny kształt tego typu ośrodków jest wypadkową istniejących już struktur zderzonych z nowymi wymaganiami stawianymi przed zinstytucjonalizowaną kulturą, a związanymi z takimi obszarami, jak funkcjonowanie społeczeństwa obywatelskiego czy nastawienie na rozwój przemysłów kreatywnych.