bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simple wound closure compared with surgery for civilian cranial gunshot wounds
Authors: Krueger Evan M. , Benveniste Ronald J. , Lu Victor M. , Taylor Ruby R. , Kumar Rahul , Cordeiro Joacir G. , Jagid Jonathan R. 
Published: July 2022

OBJECTIVE
A carefully selected subset of civilian cranial gunshot wound (CGSW) patients may be treated with simple wound closure (SWC) as a proactive therapy, but the appropriate clinical scenario for using this strategy is unknown. The aim of this study was to compare SWC and surgery patients in terms of their neurological outcomes and complications, including infections, seizures, and reoperations.

METHODS
This was a single-center, retrospective review of the prospectively maintained institutional traumatic brain injury and trauma registries. Included were adults who sustained an acute CGSW defined as suspected or confirmed dural penetration. Excluded were nonfirearm penetrating injuries, patients with an initial Glasgow Coma Scale (GCS) score of 3, patients with an initial GCS score of 4 and nonreactive pupils, and patients who died within 48 hours of presentation.

RESULTS
A total of 67 patients were included; 17 (25.4%) were treated with SWC and 50 (74.6%) were treated with surgery. The SWC group had a lower incidence of radiographic mass effect (3/17 [17.6%] SWC vs 31/50 [62%] surgery; absolute difference 44.4, 95% CI −71.9 to 16.8; p = 0.002) and lower incidence of involvement of the frontal sinus (0/17 [0%] SWC vs 14/50 [28%] surgery; absolute difference 28, 95% CI −50.4 to 5.6; p = 0.01). There were no differences in the frequency of Glasgow Outcome Scale–Extended scores ≥ 5 between the SWC and surgery groups at 30 days (4/11 [36.4%] SWC vs 12/35 [34.3%] surgery; OR 1.1, 95% CI 0.3–4.5; p > 0.99), 60 days (2/7 [28.6%] SWC vs 8/26 [30.8%] surgery; OR 0.9, 95% CI 0.3–3.4; p > 0.99), and 90 days (3/8 [37.5%] SWC vs 12/26 [46.2%] surgery; OR 0.7, 95% CI 0.1–3.6; p > 0.99). There were no differences in the incidence of infections (1/17 [5.9%] SWC vs 6/50 [12%] surgery; OR 0.5, 95% CI 0.1–4.1; p = 0.67), CSF fistulas (2/11 [11.6%] SWC vs 3/50 [6%] surgery; OR 2.1, 95% CI 0.3–13.7; p = 0.60), seizures (3/17 [17.6%] SWC vs 9/50 [18%] surgery; OR 1, 95% CI 0.2–4.1; p > 0.99), and reoperations (3/17 [17.6%] SWC vs 4/50 [8%] surgery; OR 2.5, 95% CI 0.5–12.4; p = 0.36) between the SWC and surgery groups.

CONCLUSIONS
There were important clinically relevant differences between the SWC and surgery groups. SWC can be considered a safe and efficacious proactive therapy in a carefully selected subset of civilian CGSW patients.
The importance of thoracolumbar junctional orientation, change in thoracolumbar angle, and overcorrection of lumbar lordosis in development of proximal junctional kyphosis in adult spinal deformity surgery
Authors: Ham Dae-Woong , Kim Ho-Joong , Park Sang-Min , Park Se Jin , Park Jiwon , Yeom Jin S. 
Published: July 2022

OBJECTIVE
Changes in the thoracolumbar angle (TLA) would play a pivotal role in the reciprocal changes following spine realignment surgery, thereby leading to the development of proximal junctional kyphosis (PJK). This study aimed to investigate the association between TLA and the development of PJK following adult spinal deformity surgery.

METHODS
A total of 107 patients were divided into PJK+ and PJK− groups according to the development of PJK within 12 months after surgery. The TLA and spinopelvic radiological parameters were compared between the PJK+ and PJK− groups. A multivariate logistic regression model was used to identify the risk factors for PJK. The receiver operating characteristic curves of the regression models were used to investigate the cutoff values of significant parameters needed so that PJK would not occur.

RESULTS
The change in TLA (ΔTLA) in the PJK+ group was significantly larger than in the PJK− group (6.7° ± 7.9° and 2.2° ± 8.1°, respectively; p = 0.006). Multivariate logistic regression analysis demonstrated that age, postoperative pelvic incidence–lumbar lordosis, and ΔTLA were significant risk factors for PJK. The risk of developing PJK was higher when the postoperative pelvic incidence–lumbar lordosis was < 5.2 and the ΔTLA was > 3.58°.

CONCLUSIONS
The present study highlights the thinking that extensive correction of TLA and lumbar lordosis should be avoided in patients with adult spinal deformity. Overcorrection of TLA of > 3.58° could result in higher odds of PJK.
Novel artificial intelligence algorithm: an accurate and independent measure of spinopelvic parameters
Authors: Orosz Lindsay D. , Bhatt Fenil R. , Jazini Ehsan , Dreischarf Marcel , Grover Priyanka , Grigorian Julia , Roy Rita , Schuler Thomas C. , Good Christopher R. , Haines Colin M. 
Published: July 2022

OBJECTIVE
The analysis of sagittal alignment by measuring spinopelvic parameters has been widely adopted among spine surgeons globally, and sagittal imbalance is a well-documented cause of poor quality of life. These measurements are time-consuming but necessary to make, which creates a growing need for an automated analysis tool that measures spinopelvic parameters with speed, precision, and reproducibility without relying on user input. This study introduces and evaluates an algorithm based on artificial intelligence (AI) that fully automatically measures spinopelvic parameters.

METHODS
Two hundred lateral lumbar radiographs (pre- and postoperative images from 100 patients undergoing lumbar fusion) were retrospectively analyzed by board-certified spine surgeons who digitally measured lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope. The novel AI algorithm was also used to measure the same parameters. To evaluate the agreement between human and AI-automated measurements, the mean error (95% CI, SD) was calculated and interrater reliability was assessed using the 2-way random single-measure intraclass correlation coefficient (ICC). ICC values larger than 0.75 were considered excellent.

RESULTS
The AI algorithm determined all parameters in 98% of preoperative and in 95% of postoperative images with excellent ICC values (preoperative range 0.85–0.92, postoperative range 0.81–0.87). The mean errors were smallest for pelvic incidence both pre- and postoperatively (preoperatively −0.5° [95% CI −1.5° to 0.6°] and postoperatively 0.0° [95% CI −1.1° to 1.2°]) and largest preoperatively for sacral slope (−2.2° [95% CI −3.0° to −1.5°]) and postoperatively for lumbar lordosis (3.8° [95% CI 2.5° to 5.0°]).

CONCLUSIONS
Advancements in AI translate to the arena of medical imaging analysis. This method of measuring spinopelvic parameters on spine radiographs has excellent reliability comparable to expert human raters. This application allows users to accurately obtain critical spinopelvic measurements automatically, which can be applied to clinical practice. This solution can assist physicians by saving time in routine work and by avoiding error-prone manual measurements.
A phase 1/2a dose-escalation study of oligodendrocyte progenitor cells in individuals with subacute cervical spinal cord injury
Authors: Fessler Richard G. , Ehsanian Reza , Liu Charles Y. , Steinberg Gary K. , Jones Linda , Lebkowski Jane S. , Wirth Edward D. , McKenna Stephen L. 
Published: July 2022

OBJECTIVE
The primary objective of this study was to evaluate the safety of 3 escalating doses of oligodendrocyte progenitor cells (LCTOPC1; previously known as GRNOPC1 and AST-OPC1) administered at a single time point between 21 and 42 days postinjury to participants with subacute cervical spinal cord injuries (SCIs). The secondary objective was to evaluate changes in neurological function following administration of LCTOPC1.

METHODS
This study was designed as an open-label, dose-escalation, multicenter clinical trial. Twenty-five participants with C4–7 American Spinal Injury Association Impairment Scale grade A or B injuries received a single dose of either 2 × 106, 1 × 107, or 2 × 107 LCTOPC1 delivered via intraparenchymal injection into the spinal cord at the site of injury using a custom-designed syringe positioning device. Low-dose tacrolimus was administered until day 60. Outcome measures included adverse event (AE) monitoring and neurological function as measured by the International Standards for Neurological Classification of Spinal Cord Injury.

RESULTS
All 25 participants experienced at least one AE, with a total of 534 AEs (32 study-related vs 502 study-unrelated anticipated complications of SCI) reported at the completion of 1-year follow-up. There were 29 serious AEs reported. Two grade 3 serious AEs (CSF leak in one participant and a bacterial infection in another) were considered related to the injection procedure and to immunosuppression with tacrolimus, respectively. The CSF leakage resolved with sequelae, including self-limited altered mental status, and the infection resolved with antibiotic therapy. For all participants, MRI scans demonstrated no evidence of an enlarging mass, spinal cord damage related to the injection procedure, inflammatory lesions in the spinal cord, or masses in the ventricular system. At 1-year follow-up, 21/22 (96%) of the intention-to-treat group recovered one or more levels of neurological function on at least one side of their body, and 7/22 (32%) recovered two or more levels of neurological function on at least one side of their body.

CONCLUSIONS
LCTOPC1 can be safely administered to participants in the subacute period after cervical SCI. The injection procedure, low-dose temporary immunosuppression regimen, and LCTOPC1 were well tolerated. The safety and neurological function data support further investigation to determine the efficacy of LCTOPC1 in the treatment of SCI.
Clinical trial registration no.: NCT02302157 (ClinicalTrials.gov)
Simple and actionable preoperative prediction of postoperative healthcare needs of single-level lumbar fusion patients
Authors: Borja Austin J. , Farooqi Ali S. , Golubovsky Joshua L. , Glauser Gregory , Strouz Krista , Burkhardt Jan-Karl , McClintock Scott D. , Malhotra Neil R. 
Published: July 2022

OBJECTIVE
Preoperative prediction of a patient’s postoperative healthcare utilization is challenging, and limited guidance currently exists. The objective of the present study was to assess the capability of individual risk-related patient characteristics, which are available preoperatively, that may predict discharge disposition prior to lumbar fusion.

METHODS
In total, 1066 consecutive patients who underwent single-level, posterior-only lumbar fusion at a university health system were enrolled. Patients were prospectively asked 4 nondemographic questions from the Risk Assessment and Prediction Tool during preoperative office visits to evaluate key risk-related characteristics: baseline walking ability, use of a gait assistive device, reliance on community supports (e.g., Meals on Wheels), and availability of a postoperative home caretaker. The primary outcome was discharge disposition (home vs skilled nursing facility/acute rehabilitation). Logistic regression was performed to analyze the ability of each risk-related characteristic to predict likelihood of home discharge.

RESULTS
Regression analysis demonstrated that improved baseline walking ability (OR 3.17), ambulation without a gait assistive device (OR 3.13), and availability of a postoperative home caretaker (OR 1.99) each significantly predicted an increased likelihood of home discharge (all p < 0.0001). However, reliance on community supports did not significantly predict discharge disposition (p = 0.94).

CONCLUSIONS
Patient mobility and the availability of a postoperative caretaker, when determined preoperatively, strongly predict a patient’s healthcare utilization in the setting of single-level, posterior lumbar fusion. These findings may help surgeons to streamline preoperative clinic workflow and support the patients at highest risk in a targeted fashion.
Biomechanical assessment of the effect of sublaminar band tensioning on lumbar motion
Authors: Park Brian J. , Gold Colin J. , Christianson David , DeVries Watson Nicole A. , Nourski Kirill V. , Woodroffe Royce W. , Hitchon Patrick W. 
Published: July 2022

OBJECTIVE
Adjacent-segment disease (ASD) proximal to lumbosacral fusion is assumed to result from increased stress and motion that extends above or below the fusion construct. Sublaminar bands (SBs) have been shown to potentially mitigate stresses in deformity constructs. A similar application of SBs in lumbar fusions is not well described yet may potentially mitigate against ASD.

METHODS
Eight fresh-frozen human cadaveric spine specimens were instrumented with transforaminal lumbar interbody fusion (TLIF) cages at L3–4 and L4–5, and pedicle screws from L3 to S1. Bilateral SBs were applied at L2 and tightened around the rods extending above the L3 pedicle screws. After being mounted on a testing frame, the spines were loaded at L1 to 6 Nm in all 3 planes, i.e., flexion/extension, right and left lateral bending, and right and left axial rotation. Motion and intradiscal pressures (IDPs) at L2–3 were measured for 5 conditions: intact, instrumentation (L3–S1), band tension (BT) 30%, BT 50%, and BT 100%.

RESULTS
There was significant increase in motion at L2–3 with L3–S1 instrumentation compared with the intact spine in flexion/extension (median 8.78°, range 4.07°–10.81°, vs median 7.27°, range 1.63°–9.66°; p = 0.016). When compared with instrumentation, BT 100% reduced motion at L2–3 in flexion/extension (median 8.78°, range 4.07°–10.81°, vs median 3.61°, range 1.11°–9.39°; p < 0.001) and lateral bending (median 6.58°, range 3.67°–8.59°, vs median 5.62°, range 3.28°–6.74°; p = 0.001). BT 50% reduced motion at L2–3 only in flexion/extension when compared with instrumentation (median 8.78°, range 4.07°–10.81°, vs median 5.91°, range 2.54°–10.59°; p = 0.027). There was no significant increase of motion at L1–2 with banding when compared with instrumentation, although an increase was seen from the intact spine with BT 100% in flexion/extension (median 5.14°, range 2.47°–9.73°, vs median 7.34°, range 4.22°–9.89°; p = 0.005). BT 100% significantly reduced IDP at L2–3 from 25.07 psi (range 2.41–48.08 psi) before tensioning to 19.46 psi (range −2.35 to 29.55 psi) after tensioning (p = 0.016).

CONCLUSIONS
In this model, the addition of L2 SBs reduced motion and IDP at L2–3 after the L3–S1 instrumentation. There was no significant increase in motion at L1–2 in response to band tensioning compared with instrumentation alone. The application of SBs may have a clinical application in reducing the incidence of ASD.
Protocolized management of isolated linear skull fractures at a level 1 pediatric trauma center
Authors: Reynolds Rebecca A. , Kelly Katherine A. , Ahluwalia Ranbir , Zhao Shilin , Vance E. Haley , Lovvorn Harold N. , Hanson Holly , Shannon Chevis N. , Bonfield Christopher M. 
Published: July 2022

OBJECTIVE
Isolated linear skull fractures without intracranial findings rarely require urgent neurosurgical intervention. A multidisciplinary fracture management protocol based on antiemetic usage was implemented at our American College of Surgeons–verified level 1 pediatric trauma center on July 1, 2019. This study evaluated protocol safety and efficacy.

METHODS
Children younger than 18 years with an ICD-10 code for linear skull fracture without acute intracranial abnormality on head CT were compared before and after protocol implementation. The preprotocol cohort was defined as children who presented between July 1, 2015, and December 31, 2017; the postprotocol cohort was defined as those who presented between July 1, 2019, and July 1, 2020.

RESULTS
The preprotocol and postprotocol cohorts included 162 and 82 children, respectively. Overall, 57% were male, and the median (interquartile range) age was 9.1 (4.8–25.0) months. The cohorts did not differ significantly in terms of sex (p = 0.1) or age (p = 0.8). Falls were the most common mechanism of injury (193 patients [79%]). After protocol implementation, there was a relative increase in patients who fell from a height > 3 feet (10% to 29%, p < 0.001) and those with no reported injury mechanism (12% to 16%, p < 0.001). The neurosurgery department was consulted for 86% and 44% of preprotocol and postprotocol cases, respectively (p < 0.001). Trauma consultations and consultations for abusive head trauma did not significantly change (p = 0.2 and p = 0.1, respectively). Admission rate significantly decreased (52% to 38%, p = 0.04), and the 72-hour emergency department revisit rate trended down but was not statistically significant (2.8/year to 1/year, p = 0.2). No deaths occurred, and no inpatient neurosurgical procedures were performed.

CONCLUSIONS
Protocolization of isolated linear skull fracture management is safe and feasible at a high-volume level 1 pediatric trauma center. Neurosurgical consultation can be prioritized for select patients. Further investigation into criteria for admission, need for interfacility transfers, and healthcare costs is warranted.
Contributions of Caregiver Management Styles to the Discrepancy Between Reported and Observed Task Performance in People with Dementia
Authors: Camino Julieta , Khondoker Mizanur , Trucco Ana Paula , Backhouse Tamara , Kishita Naoko , Mioshi Eneida 
Published: July 2022

Background: The identification and understanding of the discrepancy between caregivers’ reports of people with dementia’s (PwD) performance of activities of daily living (ADLs) and observed performance, could clarify what kind of support a PwD effectively needs when completing tasks. Strategies used by caregivers have not been included in the investigation of this discrepancy. Objective: To (1) investigate if caregivers’ report of PwD’s ADL performance are consistent with PwD’s observed performance; (2) explore if caregiver management styles, depression, and anxiety, contribute to this discrepancy. Methods: PwD ( n = 64) were assessed with standardized performance-based (Assessment of Motor and Process Skills, AMPS) and informant-based (Disability Assessment for Dementia, DAD) ADL assessments. Caregivers completed depression (PHQ-9), anxiety (GAD-7), and dementia management style (DMSS: criticism, active-management, and encouragement) questionnaires. Cohen’s kappa determined agreement/disagreement in ADL performance. To investigate the potential discrepancy between the DAD and AMPS, a continuous variable was generated: comparative ADL score. Multiple linear regression analysis explored whether caregivers’ management styles, depression or anxiety could explain the ADL discrepancy. Results: Poor level of agreement between observed and reported ADL performance [ k = –0.025 (95% CI –0.123 –0.073)] was identified, with most caregivers underestimating ADL performance. The combined model explained 18% (R2 = 0.18, F (5,55)  = 2.52, p≤0.05) of the variance of the comparative ADL score. Active-management (β= –0.037, t (60)  = –3.363, p = 0.001) and encouragement (β= 0.025, t (60)  = 2.018, p = 0.05) styles made the largest and statistically significant contribution to the model. Conclusion: Encouragement style could be advised for caregivers who underestimate ADL performance, while active management style for those who overestimate it. Findings have scope to increase caregivers’ abilities to support PwD activity engagement in daily life.
The Role of the Motor Cortex in Tremor Suppression in Parkinson’s Disease
Authors: Leodori Giorgio , De Bartolo Maria Ilenia , Fabbrini Andrea , Costanzo Matteo , Mancuso Marco , Belvisi Daniele , Conte Antonella , Fabbrini Giovanni , Berardelli Alfredo 
Published: July 2022

Background: Patients with Parkinson’s disease (PD) and rest tremor may also have tremor during posture holding, with tremor being transiently suppressed during the transition between resting and posture holding. Other PD patients show no tremor suppression between resting and posture holding. The mechanisms responsible for tremor suppression in PD are unknown. Understanding the mechanisms of tremor suppression would expand our knowledge of tremor pathophysiology in PD. Objective: To investigate whether tremor suppression reflects the activity of the primary motor cortex (M1) and assess whether tremor features are different in patients with and without tremor suppression. Methods: We compared corticomuscular coherence (CMC) at tremor frequency and transcranial magnetic stimulation tremor resetting between 10 PD patients with tremor suppression and 10 patients without suppression. We also compared tremor spectral features between the two groups. Results: Patients with tremor suppression had higher CMC at tremor frequency during both rest tremor and postural tremor, and a higher postural tremor resetting index and stability when compared with patients without tremor suppression. Rest tremor frequency was similar between the two groups, but postural tremor frequency was lower in patients with tremor suppression as compared to patients without. Conclusion: M1 plays a major role in tremor suppression in PD, and the mechanisms of postural tremor may differ between patients with and without tremor suppression.
Revitalisasi Program Siaga Bencana Pada Korps Sukarela (KSR) UM Jember
Authors: Susilo Cipto , Komarudin Komarudin , Azza Awatiful 
Published: July 2022

Bencana adalah peristiwa atau rangkaian peristiwa yang mengancam dan mengganggu kehidupan dan penghidupan masyarakat yang disebabkan, baik oleh faktor alam dan/atau faktor non alam maupun faktor manusia, sehingga mengakibatkan timbulnya korban jiwa manusia, kerusakan lingkungan, kerugian harta benda, dan dampak psikologis. Jember sebagai salah satu kabupaten yang ada di Jawa Timur secara demografi memiliki potensi bencana yang lebih besar dibandingkan dengan kabupaten yang lain. Kondisi ini tentunya dibutuhkan keterlibatan dan kerjasama semua pihak terutama masyarakat untuk selalu siaga bencana. Tujuan program siaga bencana pada korpss sukarela agar tercapainya kemandirian korps sukarela dalam membantu penanganan bencana di masyarakatt, khususnya pada area terdampak bencana baik pada pre bencana, saat bencana, maupun paska bencana. Kegiatan pendidikan dan pelatihan tentang penanganan korban bencana mampu meningkatkan pemahaman dan skill anggota korps sukarela dalam memberikan bantuan menangani korban bencana dengan benar
Pembuatan Pakan Alternatif Ternak Sapi Melalui Fer-mentasi Gedebog Untuk Cadangan Musim Kemarau
Authors: Hadi Syamsul , Prayuginingsih Henik , Suroso Bejo , Oktarina Oktarina , Warisaji Taufiq Timur 
Published: July 2022

Permintaan akan daging ternak sapi pada tahun 2021 ini cenderung semakin banyak sejalan dengan bertambahnya laju pertumbuhan penduduk di Kabupaten Bondowoso yang mencapai sebesar 0,52 persen. Pada tahun yang sama jumlah ternak sapi di Kabupten Bondowoso sebanyak 234.300 ekor dan sebagian berada di Kecamatan Pakem yaitu sebanyak 9.214 ekor yang tersebar salah satunya di Desa Pakem dengan jumlah sekitar lebih dari 700 ekor. Kondisi ini tentunya membutuhkan ketersediaan pakan ternak yang cukup memadai agar pertumbuhan dan perkembangan ternak sapi akan berlangsung normal, terutama pada saat musim kemarau. Oleh karena itu, tujuan program pengabdian pada masyarakat ini secara ekonomi untuk meningkatkan keuntungan dan efisiensi biaya produksi ternak sapi. Metode pelaksanaan ini berupa rekayasa teknologi dan sosial melalui pelatihan dengan pendekatan partisipatif dan pendampingan. Pelatihan dimaksud adalah berupa pelatihan pada aspek teknis pembuatan pakan alternatif fermentasi gedebog dan manajemen pakan. Proses pendampingan kepada mitra peternak bertujuan untuk menjamin terlaksananya program sesuai pedoman dan tercapainya indikator keberhasilan program. Hasil evaluasi di lapangan menunjukkan tingkat keberhasilan program dengan uraian sebagai berikut: a) rata-rata perkembangan produksi (bobot kambing) per bulan mencapai 21,99%, b) efisiensi biaya produksi penggemukan ternak sebelum program (1,21) sesudah program (1,90), dan tingkat keuntungan sesudah pelaksanaan program naik sebesar 91.31%, dan c) mitra tidak kesulitan untuk memberikan pakan ternak rumput pada musim kemarau, karena cukup hanya dengan satu sampai dua kali per minggu, sehingga dapat mengurangi waktu untuk mencari rumput pada musim penghujan sebesar ± 35%.