bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary Flexor Tendon Reconstruction: Protocol for a Systematic Review and Meta-Analysis
Authors: Kamble Rituja , Shah Rushabh , Kiely Ailbhe L. , Nolan Grant S. , Wong Jason 
Published: July 2022

Introduction:
Flexor tendon injuries of the hand and wrist involve complete or partial severance of the tendon, and primary repair is standard treatment. In cases of significantly delayed presentation, rupture of the repair or segmental tendon loss may require 1- or 2-stage secondary tendon reconstruction where a tendon graft is used. There is a risk of poor functional outcome due to stiffness and reduced range of motion which may affect patient’s employment and activities of daily living. This study seeks to systematically evaluate the current evidence to determine outcomes of secondary flexor tendon reconstruction in terms of functional outcomes, complications, patient-reported outcome measures (PROMS) and costs.

Methods:
This is a PROSPERO registered study protocol for systematic review and meta-analysis of comparative and non-comparative studies. Outcomes of intrasynovial versus extrasynovial tendon grafting and seniority of the surgeon will be analysed in addition to comparing graft weaving at the wrist and palm for both single- and two-stage tendon reconstruction. The primary outcome is functional active range of motion. Secondary outcomes are complications, PROMs and resource use. A comprehensive literature search will be conducted from 2000 to present. All studies involving secondary flexor tendon repairs will be involved, without limitation on language, and will be screened by two independent reviewers. Tools to appraise the quality of study methodology and/or bias will be used (e.g., Cochrane Collaborative Risk of Bias tool) and if feasible, a random effects meta-analysis will be conducted.

Ethics and dissemination:
Ethical approval was not required for this study. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal, and presented at both national and international conferences involving hand surgeons. The data collected will allow patients to be counselled more accurately by clinicians and may suggest areas where further research could be undertaken.

Systematic review registration:
PROSPERO CRD42021296009.

Highlights
Características Clínico-Epidemiológicas de pacientes COVID 19 atendidos en las unidades operativas del Distrito de Salud 05D06, cantón Salcedo
Authors: Defaz Silvia , Escobar Natalia , Ausay Johanna , García Carmina 
Published: July 2022

Introducción: La pandemia ocasionada por COVID-19 ha provocado más de 700.000 muertes en el mundo afectando a diferentes grupos etarios y sexo. Objetivo: Describir las características clínico – epidemiológicas de los pacientes con COVID-19 atendidos en las unidades operativas del Distrito de Salud 05D06 ubicado en el cantón Salcedo, provincia del Cotopaxi. Métodos: Estudio descriptivo realizado en el cantón Salcedo, Distrito de Salud 05D06, que incluye 419 pacientes positivos para COVID-19, diagnosticados mediante RT-PCR de marzo a junio 2020. Se revisó la historia clínica, fichas epidemiológicas, buscando variables sociodemográficas, manifestaciones clínicas, de laboratorio y evolución de los pacientes. Resultados: Se identificaron 419 casos, 56% eran de sexo masculino, 44,6% se encontraban entre 20 a 40 años, el 21% realizaban actividades de agricultura y comercio, el 40% de pacientes son del sector central del Cantón Salcedo adscritos al Centro de Salud tipo B existente en el sector. Los síntomas más frecuentes incluyeron: tos, malestar general, fiebre y odinofagia. El 93% de los pacientes presentó sintomatología de leve a moderada y recibieron tratamiento analgésico y antipirético; los casos que necesitaron hospitalización en unidades de mayor complejidad y se recuperaron fueron 29 y quienes presentaron síntomas graves y fallecieron fueron 19, los mismos que correspondían al sexo masculino, mayores de 46 años de edad, de actividades laborales agrícolas y comerciantes. Conclusión: Este reporte presenta las características clínico – epidemiológicas de pacientes COVID 19 en el Distrito de Salud 05D06 Salcedo, fue más frecuente en el sexo masculino, con edad de 20 a 40 años, agricultores y comerciantes, con síntomas frecuentes tos y malestar general, que residen en sectores del Salcedo, estos datos servirán para trabajar de manera oportuna con los grupos de riesgo que constituyen la población económicamente activa.
Efectos del COVID-19 sobre los accidentes de tránsito en la provincia de Manabí
Authors: Vera Viviana , Larrea Javier , Caballero Marjory , Delgado Daniel 
Published: July 2022

Los efectos del COVID-19 han sido evidentes en diversos sectores a nivel global, especialmente en el tránsito vehicular, debido a las restricciones de circulación implementadas para frenar su propagación. La presente investigación tiene como objetivo comparar la cantidad de accidentes de tránsito y sus víctimas fatales antes y durante la pandemia, como recurso para determinar los efectos generados por las limitaciones de movilidad en el comportamiento de estos indicadores dentro de la provincia de Manabí. En la metodología se analizaron los registros generales de accidentes de tránsito desde el 2008 a 2021, y posteriormente se establecieron períodos considerados prepandemia y pandemia, para ser evaluados a detalle mediante interpretación estadística implementando el coeficiente de correlación de Pearson. Los resultados permitieron identificar los principales cambios en la dinámica de accidentes de tránsito y sus víctimas fatales, como la disminución del 25% del registro de accidentes de tránsito y el 28% en el registro de víctimas fatales durante la pandemia. Las modificaciones más importantes en los comportamientos de estos dos indicadores se observaron en los registros de víctimas fatales, con un valor de r=0.77.
Artículo recibido: 16 de julio 2021
Artículo aceptado: 18 de noviembre de 2021
Editorial. Volumen 15
Authors: Leiva Lizette , Bustillos Alberto , Tubón Irvin , Mayacela Margarita , Medina Santiago 
Published: July 2022

Este volumen se ha enfocado en la recopilación de manuscritos que aportan al desarrollo de la ingeniería civil y mecánica. Como parte de este proceso se consideraron entre otras las contribuciones de autores que participaron en el “I Congreso Internacional de Ingeniería Civil y Mecánica” que se llevó a cabo en la Universidad Técnica de Ambato con la participación de académicos de varios países incluyendo España, Estados Unidos, Chile, Hungría, Inglaterra, Ecuador entre otros.
Dentro del desarrollo de una sociedad, es de gran importancia la democratización y difusión del conocimiento. La comunidad científica en la actualidad es consciente de la necesidad de divulgar los resultados de sus investigaciones, para que estos aportes se transformen en nuevos ejes de investigación que contribuyan para solventar las necesidades de la sociedad.
En este volumen a través de varios artículos se describen los desafíos, avances y soluciones fundamentales en el ámbito de la Ingeniería Civil y Mecánica. Esto permite al lector conocer las tendencias actuales a nivel mundial, basadas en la experiencia expuesta en su mayoría por autores provenientes de diversas partes del mundo, lo que permite un enfoque global.
El Comité Editorial de la Revista agradece la confianza de la comunidad científica de la universidad y reitera su compromiso editorial para continuar elevando los estándares de exigencia y calidad, con el objetivo de alcanzar impactos relevantes a nivel internacional.
Estamos seguros que los artículos de este número serán de interés y utilidad para nuestros apreciados lectores.
LoRa SV611-Based Communication System To Monitor Behaviour of Rocket Using Inertial Measurement Unit Sensor
Authors: Misbahuddin Misbahuddin , Taufik Muhamat , Suksmadana I Made Budi 
Published: July 2022

A payload is a material carried by a rocket that acts as telemetry, monitoring environmental conditions and transmitting them to earth-based receiving stations. The goal of this study is to design, build, and test a rocket payload monitoring system that will track the rocket's position, behaviour, and trajectory. The rocket payload and the Ground Control Station are designed and manufactured separately (GCS). The payload is made up of a variety of components, including an Arduino Uno, an MPU-6050 sensor, a GPS Neo-7M, and a LoRa SV611 transmitter. The GCS is made up of a raspberry Pi, a LoRa SV611 receiver, USB TTL, and python idle. Pitch, roll, yaw, longitude, latitude, and altitude are among the six characteristics that the rocket payload monitoring system can track. The results of the tests show the rocket payload monitoring system can track six parameters and trajectory in real time with a high degree of accuracy. All payload measurement parameters are clearly displayed in the GCS interface as graphs that are updated every 1000 milliseconds.
Echolalia as communication behavior
Authors: Boksa Ewa , Kominek Andrzej 
Published: July 2022

Echolalia is a natural phenomenon in the development of child speech. After 30 months of age, echolalia becomes a pathological phenomenon, most often associated with deficits in the ability to initiate and sustain social interaction. Researchers argue about the role of echolalia in the acquisition of language and communication skills of people with autism spectrum disorder. They are trying to answer the question of whether echolalia is an inhibiting factor in language acquisition or whether it can also be one of the main predictors of further speech development. The distinguishing of echolalia and echolalic speech in the communication of people with autism, proposed by Jacek Błeszyński, makes it necessary to revise the existing definitions of echolalia and present this phenomenon from the perspective of communication theories, among others, in the context of the concept formulated by Dan Sperber and Deirdre Wilson.
Studi Analisa Orientasi Kerja Dengan Budaya Kerja Terhadap Produktivitas Kerja Pada PT Jakarta Central Asia Steel
Authors: Hakim Lukman , Sabil Sabil , Lestiningsih Amin Setio , Widodo Dwiyatmoko Puji 
Published: July 2022

Peningkatan produktivitas kerja merupakan masalah klasik yang sering dihadapi oleh perusahaan. Banyak faktor yang berperan dalam meningkatkan produktivitas kerja antara lain orientasi kerja dan budaya kerja yang ada di perusahaan tersebut sehingga perlu menambah jumlah tenaga kerja yang dibutuhkan untuk mengisi bagian-bagian yang masih membutuhkan tenaga kerja untuk meningkatkan produksi yang ditargetkan. Dengan bertambahnya jumlah tenaga kerja maka diperlukan suatu cara untuk meningkatkan kualitas pengetahuan dan keterampilan bagi tenaga kerja baru salah satunya dengan melaksanakan orientasi kerja di tempat kerja agar para karyawan baru dapat beradaptasi dengan proses kerja masing-masing bagian. Selain orientasi kerja, diperlukan penyesuaian budaya kerja yang ada di dalam perusahaan yang telah dibentuk oleh lingkungan kerja dan organisasi yang melakukan kegiatan tersebut. Kegiatan penelitian menggunakan sampling yang dilakukan di PT Jakarta Central Asia Steel dengan jumlah populasi 520 karyawan di area kerja produksi dengan sebaran sampel sebanyak 226 dengan cara mengisi kuesioner yang berisi beberapa komponen pertanyaan yang dapat mewakili setiap variabel dalam melakukan penelitian. Penelitian ini menggunakan pendekatan deskriptif kuantitatif untuk menjelaskan hasil penelitian. Hasil penelitian membuktikan kalau arah kegiatan serta budaya kerja dengan cara bersama- sama mempunyai ikatan yang kuat dengan produktivitas kerja karyawan PT Jakarta Central Asia Steel di Jakarta, maksudnya produktivitas kerja semakin meningkat jika orientasi kerja dan budaya kerja yang diciptakan menyenangkan bagi karyawan.
Multimodal monitoring to guide neurosurgical intervention in high-grade aneurysmal subarachnoid hemorrhage: illustrative case
Authors: Kolb Bradley , Wolfson Daniel , Da Silva Ivan , Munich Stephan A. 
Published: July 2022

BACKGROUND
Multimodal monitoring to guide medical intervention in high-grade aneurysmal subarachnoid hemorrhage (aSAH) is well described. Multimodal monitoring to guide surgical intervention in high-grade aSAH has been less studied.

OBSERVATIONS
Intracranial pressure (ICP), brain lactate to pyruvate ratio (L/P ratio), and brain parenchymal oxygen tension (pO2) were used as surrogates for clinical status in a comatose man after high-grade aSAH. Acute changes in ICP, L/P ratio, and pO2 were used to identify brain injury from both malignant cerebral edema and delayed cerebral ischemia, respectively, and decompressive hemicraniectomy with clot evacuation and intraarterial nimodipine were used to treat these conditions. The patient showed marked improvement in multimodal parameters following each intervention and eventually recovered to a modified Rankin score of 2.

LESSONS
In patients with a limited neurological examination due to severe acute brain injury in the setting of aSAH, multimodal monitoring can be used to guide surgical treatment. With prompt, aggressive, maximal medical and surgical interventions, otherwise healthy individuals may retain the capacity for close to full recovery from seemingly catastrophic aSAH.
Robot-assisted atlantoaxial fixation: illustrative cases
Authors: Sacino Amanda N. , Materi Joshua , Davidar A. Daniel , Judy Brendan , Liu Ann , Hwang Brian , Theodore Nicholas 
Published: July 2022

BACKGROUND
Placing screws in the high cervical spine can be challenging because of the vital anatomical structures located in that region. Precision and accuracy with screw placement is needed. The use of robotics in the cervical spine has been described before; however, here the authors describe the use of a new robotic setup.

OBSERVATIONS
The authors describe 2 cases of robot-assisted placement of C2 pars screws and C1–2 transarticular screws. The operative plans for each patient were as follows: placement of C2 pars screws with C2–4 fusion for hangman’s fracture and placement of C1–2 transarticular screws for degenerative disease. Intraoperative computed tomography (CT) was used to plan and navigate the screws. Postoperative CT showed excellent placement of hardware. Both patients presented for initial postoperative clinic visits with no recurrence of prior symptoms.

LESSONS
Intraoperative robotic assistance with instrumentation of the high cervical spine, particularly C2 pars and C1–2 transarticular screws, may ensure proper screw placement and help avoid injury.
Endoscopic endonasal approach for simultaneously treating a pituitary adenoma coexisting with a paraclinoid aneurysm: illustrative case
Authors: Gu Ye , Zhong Xiangping , Gao Yikuan , He Lijin 
Published: July 2022

BACKGROUND
There is a certain incidence of pituitary adenomas coexisting with intracranial aneurysms, but a concurrent therapeutic strategy of tumor removal and aneurysm clipping via endoscopic endonasal approach is rarely reported. The indications and limitations of endoscopic endonasal approach surgery for this type of lesions are worth discussing.

OBSERVATIONS
The case of a pituitary tumor coexisting with a paraclinoid aneurysm was reviewed. Using an endoscopic endonasal approach, the pituitary adenoma was completely excised with extrapseudocapsular separation technique, the aneurysm was clipped at the same time, and the skull base defect was reconstructed in multilayer fashion. No tumor recurrence was found, and aneurysm clipping was complete at the 6-month follow-up after surgery.

LESSONS
For patients harboring a pituitary adenoma with a selected paraclinoid aneurysm, simultaneous tumor resection and aneurysm clipping via endoscopic endonasal approach are feasible. This strategy has the advantages of saving medical resources, promoting the patient’s rapid postoperative recovery, and reducing possible antiplatelet therapy after interventional therapy. However, surgery needs to strictly follow the indications in experienced hands, and the therapeutic effect needs to be verified by more cases and longer follow-up results.
Intermediate nerve neuralgia developed during hemifacial spasm follow-up: illustrative case
Authors: Onoda Keisuke , Sashida Ryohei , Fujiwara Ren , Wakamiya Tomihiro , Michiwaki Yuhei , Tanaka Tatsuya , Shimoji Kazuaki , Suehiro Eiichi , Yamane Fumitaka , Kawashima Masatou , Matsuno Akira 
Published: July 2022

BACKGROUND
Intermediate nerve neuralgia (INN) is a rare condition believed to be caused by vascular compression, with external auditory canal pain as the chief symptom. The authors reported a rare case of a 78-year-old woman who developed INN during follow-up for hemifacial spasm (HFS).

OBSERVATIONS
The patient had been receiving Botox treatment for right HFS for 20 years when she developed paroxysmal electric shock pain in the right external auditory canal and tinnitus induced by opening her mouth. A three-dimensional magnetic resonance fusion image showed the cisternal portion of the facial-vestibulocochlear nerve complex to be compressed by the meatal loop of the anterior inferior cerebellar artery (AICA), which was pressed against by the posterior inferior cerebellar artery. The authors diagnosed INN, and microvascular decompression (MVD) was performed. Surgical findings were consistent with preoperative neuroimaging. In addition, the proximal portion of the meatal loop of the AICA had passed between the facial and vestibulocochlear nerves, compressing both. The AICA was moved and the nerve completely decompressed. All symptoms improved immediately following surgery.

LESSONS
When INN occurs during HFS follow-up, aggressive MVD should be considered based on detailed neuroimaging. This treatment is a very effective single-stage cure for INN, HFS, and vestibulocochlear symptoms.
Cerebral protection during retrograde brachiocephalic artery stenting using a single filter and increased subclavian steal phenomenon: illustrative case
Authors: Yanagihara Wataru , Akamatsu Yosuke , Shibanai Kazuo , Fujimoto Kentaro , Kojima Daigo , Kashimura Hiroshi , Kubo Yoshitaka , Ogasawara Kuniaki 
Published: July 2022

BACKGROUND
Cerebral protection during brachiocephalic artery (BCA) stenting is important. However, the maneuver is sometimes challenging because both the internal carotid artery (ICA) and vertebral artery (VA) should be protected. Herein, the authors present an alternative cerebral protection technique involving filter protection for the ICA and hemodynamic protection for the VA during retrograde BCA stenting.

OBSERVATIONS
A 64-year-old man with a thoracic aortic aneurysm presented with cold sensation and numbness in his right arm due to BCA stenosis. Endovascular stenting under cerebral protection was planned. Cerebral protection was attempted through the brachial access. Despite the successful placement of the filter in the ICA, selective catheterization of the VA failed. Furthermore, repeated transfemoral catheterization of the BCA was unsuccessful. Concerning a thoracic aortic aneurysm injury, the authors performed retrograde BCA stenting using a transbrachial approach. Hemodynamic protection of the VA was provided by increasing the subclavian steal phenomenon that resulted in successful recanalization of the BCA.

LESSONS
Retrograde BCA stenting performed while protecting the ICA with a filter and the right VA by increasing the subclavian steal phenomenon was successful. This simple technique is feasible, especially in patients with steno-occlusive lesions of the BCA concurrent with the dominant vertebra/vertebral collateral pathway.
Diplopia outcomes following stereotactic radiosurgery for petroclival or cavernous sinus meningiomas: patient series
Authors: Levy Bennett R. , Berger Assaf , Kondziolka Douglas 
Published: July 2022

BACKGROUND
Skull base meningiomas (SBM) often present with diplopia due to compression of the abducens cranial nerve (CN VI). The authors evaluated outcomes in 13 patients diagnosed with SBMs who were experiencing diplopia to determine if Gamma Knife surgery (GKS) resulted in resolution of their symptoms.

OBSERVATIONS
Fourteen patients who were diagnosed with SBMs located in the cavernous sinus, clivus, or petroclival regions and presented with diplopia were treated by GKS. Demographic and clinical data as well as the duration of diplopia prior to GKS were documented. Of the 13 patients included in the study, 1 was excluded because he was lost to follow-up. For the remaining 12, diplopia was resolved in 10 (83%) and no change was noted in 2 (17%). Time to resolution was measured in months, varying from 1 to 30 months, with a median resolution time of 4.5 ± 9.7 months. Of the patients with documented postradiosurgical resolution (n = 10), the median amount of time with diplopia prior to GKS was 1.5 months (range, 1 to 20).

LESSONS
This study showed that diplopia, related to a basal meningioma, may improve following GKS. An earlier time course to radiosurgery after diplopia onset was associated with better outcomes.
Lessons for the pathogenesis of vasospasm from a patient with sickle cell disease, moyamoya disease, subarachnoid hemorrhage, and 1 month of persistent vasospasm: illustrative case
Authors: Haselden William D. , Drew Patrick J. , Church Ephraim W. 
Published: July 2022

BACKGROUND
The mechanism of vasospasm post–subarachnoid hemorrhage (post-SAH) is a poorly understood yet devastating complication that can result in delayed ischemic neurological damage. High concentrations of free hemoglobin present in hemolytic conditions reduce nitric oxide (NO) availability which may disrupt vascular dynamics and contribute to the extent of vasospasm.

OBSERVATIONS
The authors describe the clinical course of a sickle cell disease (SCD) patient with spontaneous SAH who suffered an abnormally long duration of vasospasm. The authors then present a focused review of the pathology of intravascular hemolysis and discuss the potential key role of intravascular hemolysis in the pathogenesis of cerebral vasospasm as illustrated in this case lesson.

LESSONS
Abnormally prolonged and severe vasospasm in SCD with SAH may provide clues regarding the mechanisms of vasospasm. Intravascular hemolysis limits NO availability and may contribute to the development of vasospasm following SAH.
Intracranial tuberculoma: a rare complication of extrapulmonary tuberculosis. Illustrative case
Authors: Letchuman Vijay , Guillotte Andrew R. , Lundy Paige A. , Dharia Anand , Lakis Nelli S. , Camarata Paul J. 
Published: July 2022

BACKGROUND
Intracranial tuberculomas are rare entities commonly seen only in low- to middle-income countries where tuberculosis remains endemic. Furthermore, following adequate treatment, the development of intracranial spread is uncommon in the absence of immunosuppression.

OBSERVATIONS
A 22-year-old man with no history of immunosuppression presented with new-onset seizures in the setting of miliary tuberculosis status post 9 months of antitubercular therapy. Following a 2-month period of remission, he presented with new-onset tonic-clonic seizures. Magnetic resonance imaging demonstrated interval development of a mass concerning for an intracranial tuberculoma. After resection, pathological analysis of the mass revealed caseating granulomas within the multinodular lesion, consistent with intracranial tuberculoma. The patient was discharged after the reinitiation of antitubercular medications along with a steroid taper.

LESSONS
To the best of the authors’ knowledge, this case represents the first instance of intracranial tuberculoma occurring after the initial resolution of a systemic tuberculosis infection. The importance of retaining a high level of suspicion when evaluating these patients for seizure etiology is crucial because symptoms are rapidly responsive to resection of intracranial tuberculoma masses. Furthermore, it is imperative for surgeons to recognize the isolation steps necessary when managing these patients within the operating theater and inpatient settings.