Summary of your 'study carrel' ============================== This is a summary of your Distant Reader 'study carrel'. The Distant Reader harvested & cached your content into a collection/corpus. It then applied sets of natural language processing and text mining against the collection. The results of this process was reduced to a database file -- a 'study carrel'. The study carrel can then be queried, thus bringing light specific characteristics for your collection. These characteristics can help you summarize the collection as well as enumerate things you might want to investigate more closely. This report is a terse narrative report, and when processing is complete you will be linked to a more complete narrative report. Eric Lease Morgan Number of items in the collection; 'How big is my corpus?' ---------------------------------------------------------- 57 Average length of all items measured in words; "More or less, how big is each item?" ------------------------------------------------------------------------------------ 1927 Average readability score of all items (0 = difficult; 100 = easy) ------------------------------------------------------------------ 51 Top 50 statistically significant keywords; "What is my collection about?" ------------------------------------------------------------------------- 21 COVID-19 9 covid-19 8 patient 5 SARS 3 resident 3 pandemic 3 case 2 practice 2 pain 2 Latin 2 ICU 2 Coronavirus 1 ward 1 video 1 technology 1 system 1 surgery 1 spinal 1 smart 1 round 1 respondent 1 report 1 procedure 1 present 1 operative 1 neurosurgeon 1 multidisciplinary 1 lateral 1 knowledge 1 interview 1 hospital 1 glass 1 fusion 1 figure 1 drape 1 device 1 depression 1 covid 1 bone 1 base 1 african 1 WFNS 1 United 1 Plan 1 OPD 1 Neurosurgical 1 March 1 LSC 1 LAMP 1 July Top 50 lemmatized nouns; "What is discussed?" --------------------------------------------- 798 patient 756 % 521 case 481 pandemic 304 care 284 surgery 270 resident 227 neurosurgeon 223 practice 219 health 216 hospital 203 study 195 time 185 system 177 program 177 procedure 172 disease 157 risk 148 survey 147 number 144 video 140 spine 139 training 138 respondent 136 period 134 author 132 country 125 volume 124 r 124 datum 123 change 122 emergency 122 education 119 treatment 118 resource 118 coronavirus 115 year 111 result 110 infection 109 response 106 center 105 o 104 level 104 impact 103 use 103 surgeon 101 clinic 99 experience 93 stroke 92 week Top 50 proper nouns; "What are the names of persons or places?" -------------------------------------------------------------- 584 COVID-19 163 neurosurgery 151 SARS 130 CoV-2 113 Neurosurgery 105 Coronavirus 102 World 96 EDNAC 82 COVID 81 Pandemic 78 Neurosurgical 76 PPE 71 Neurosurg 64 China 61 • 58 Italy 58 ICU 57 DOI 56 Health 54 United 52 States 52 Disease 50 March 42 New 42 J 41 Letter 40 al 40 India 37 April 35 sha 34 University 34 Medical 34 Impact 32 Hospital 31 nan 31 et 31 Department 29 York 29 LSC 28 neuro 28 Wuhan 28 Table 28 Care 28 CT 26 Education 25 American 24 Society 23 Organization 23 May 23 Lombardy Top 50 personal pronouns nouns; "To whom are things referred?" ------------------------------------------------------------- 433 we 298 it 133 they 55 them 26 us 21 he 16 itself 12 you 10 she 8 i 6 themselves 3 one 2 ourselves 1 interest.https://doi.org/10.1016/j.wneu.2020.07.018 1 her Top 50 lemmatized verbs; "What do things do?" --------------------------------------------- 3374 be 958 have 251 use 207 report 154 include 141 do 140 provide 118 increase 118 follow 116 perform 109 require 102 present 95 base 88 need 87 reduce 80 show 79 affect 78 find 76 compare 73 regard 72 develop 71 continue 69 consider 68 make 67 allow 66 lead 66 covid-19 66 confirm 63 relate 61 remain 58 see 58 limit 56 receive 56 give 56 associate 51 take 51 know 50 expect 49 treat 48 change 47 cause 46 recommend 45 learn 45 involve 45 describe 44 decrease 42 work 42 undergo 42 identify 42 ensure Top 50 lemmatized adjectives and adverbs; "How are things described?" --------------------------------------------------------------------- 403 neurosurgical 375 not 257 surgical 232 also 227 - 224 covid-19 177 most 175 more 170 high 162 other 160 medical 145 clinical 131 only 130 elective 128 well 117 such 115 significant 112 spinal 111 non 106 resident 101 operative 100 as 95 many 94 however 85 positive 84 new 84 first 82 social 81 acute 80 low 75 covid 74 current 72 even 69 emergent 67 same 64 different 63 urgent 63 potential 60 virtual 60 therefore 59 possible 58 patient 58 likely 58 great 57 overall 56 severe 56 less 55 personal 55 essential 53 educational Top 50 lemmatized superlative adjectives; "How are things described to the extreme?" ------------------------------------------------------------------------- 72 most 30 Most 24 good 17 high 14 least 10 large 10 great 6 big 5 low 5 bad 2 long 2 late 1 small 1 sick 1 safe 1 poor 1 old 1 harsh 1 easy 1 early 1 deadly 1 dark 1 criteria"-very 1 cord-317965-pini4eqw 1 common 1 close Top 50 lemmatized superlative adverbs; "How do things do to the extreme?" ------------------------------------------------------------------------ 105 most 6 least 1 well 1 hard Top 50 Internet domains; "What Webbed places are alluded to in this corpus?" ---------------------------------------------------------------------------- 9 doi.org 4 jhuspine3.shinyapps.io 1 www.premierguard.com 1 www.northwell.edu 1 rstudio.com 1 ieeexplore.ieee.org 1 covstat.it 1 cloud.r-project.org Top 50 URLs; "What is hyperlinked from this corpus?" ---------------------------------------------------- 4 http://jhuspine3.shinyapps.io/SpineUrgencyCalculator/ 1 http://www.premierguard.com 1 http://www.northwell.edu/northwell-health-labs/labfly 1 http://rstudio.com 1 http://ieeexplore.ieee.org/document/6876017 1 http://doi.org/10.1016/j.wneu.2020.08.116 1 http://doi.org/10.1016/j.wneu.2020.08.060 1 http://doi.org/10.1016/j.wneu.2020.08.059 1 http://doi.org/10.1016/j.wneu.2020.07.145 1 http://doi.org/10.1016/j.wneu.2020.07.019 1 http://doi.org/10.1016/j.wneu.2020.07.018 1 http://doi.org/10.1016/j.wneu.2020.06.202 1 http://doi.org/10.1016/j.wneu.2020.06.142 1 http://doi.org/10.1016/j.wneu.2020.05.003 1 http://covstat.it/analisi-regioni/#trasmissione-varie-regioni 1 http://cloud.r-project.org/package=rstatix Top 50 email addresses; "Who are you gonna call?" ------------------------------------------------- 1 spina.alfio@hsr.it Top 50 positive assertions; "What sentences are in the shape of noun-verb-noun?" ------------------------------------------------------------------------------- 3 pandemic has also 3 patients had lbp 3 programs are increasingly 2 % did not 2 % had headaches 2 % had suicidal 2 % were unhappy 2 covid-19 is not 2 pandemic has consistently 2 patients are able 2 patients requiring treatment 2 patients was remarkably 2 practice were significantly 2 program has not 2 residents was also 2 surgeries were also 2 survey did not 1 % continued work 1 % had auditory 1 % had difficulty 1 % had previously 1 % had satisfactory 1 % provided educational 1 % reported additional 1 % reported basic 1 % reported use 1 % required intensive 1 % required surgical 1 % were covid-19 1 % were negative 1 % were unable 1 % were unsure 1 authors are increasingly 1 authors found mild 1 authors have rightly 1 care are not 1 care are only 1 care is essential 1 care is not 1 care is often 1 care was definitely 1 care was not 1 care were feasible 1 case are also 1 case are weak 1 case is then 1 case presented here 1 case report covid 1 case report date 1 case report dural Top 50 negative assertions; "What sentences are in the shape of noun-verb-no|not-noun?" --------------------------------------------------------------------------------------- 3 authors report no conflict 1 % reported no change 1 % reporting no loss 1 authors have no conflict 1 care are not directly 1 care was not negatively 1 case report not only 1 covid-19 is not clear 1 neurosurgeons were not worried 1 neurosurgery being no exception 1 periods was not possible 1 practice is not untouched 1 study are not comparable 1 survey did not specifically 1 survey showed no difference 1 systems are not well A rudimentary bibliography -------------------------- id = cord-355271-zynnr776 author = Agrawal, Amit title = Letter to the editor– “Staying Home - Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic date = 2020-08-09 keywords = COVID-19 summary = title: Letter to the editor– "Staying Home Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic Additionally, our apparent impression is that there is decrease in the number cases who are requiring neurosurgical interventions for neurotrauma related conditions. 6, 7 Furthermore, comparative reduction in the number of surgeries may be due to overall decrease in neurotrauma cases and also due to DNR (do not resuscitate) strategies in terminally sick patients. We also observe that probably the reduction in the incidence in neurotrauma cases (needs more studies and objective to support) is due to restriction of nonessential activities, social distancing, less crowding and restricted public as well as private transportation. An epidemiological study of traumatic brain injury cases in a trauma centre of New Delhi (India) Staying Home" -Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic doi = 10.1016/j.wneu.2020.08.035 id = cord-256117-t9v1hng5 author = Al Kasab, Sami title = Acute Stroke Management During the Coronavirus Disease 2019 (COVID-19) Pandemic: From Trough of Disillusionment to Slope of Enlightenment date = 2020-06-03 keywords = patient summary = Even for patients in whom an LVO is confirmed, the criteria for transfer to the thrombectomy capable center should be decided on by a multidisciplinary team. Pre-thrombectomy screening for COVID-19 is a major challenge; often these patients are unable to provide a history and collateral information is typically lacking. Although extending the CT to capture the entire chest entails additional radiation, identifying a lung infiltrate suggestive of likely COVID-19 infection in an asymptomatic patient affords the health care team the ability to don the proper precautions before the procedure. Thrombectomy in and of itself is a low-risk procedure for contracting the virus, whereas the intubation and extubation are by far the greatest-risk components and would incur additional risk to your ED and neuro-intensive care unit (ICU) colleagues, respectively. The lowest-risk pathway to the system as a whole is to get the LVO patient through the thrombectomy awake and cooperative without requiring pre-procedure intubation. doi = 10.1016/j.wneu.2020.04.153 id = cord-317965-pini4eqw author = Al Saiegh, Fadi title = Virtual Residency Training Interviews in the Age of COVID-19 and Beyond date = 2020-10-06 keywords = interview summary = Because this is not a practice the medical community is accustomed to, we simulated virtual residency training interviews and compared 2 models to assess the feasibility and uncover the technical challenges in preparation for the upcoming interview season. Using 5 interviewers and 10 interviewees consisting of senior neurosurgery residents and fourth-year medical students, respectively, we authors devised 2 models using the Zoom platform (Zoom Inc., San Jose, California, USA) to simulate the interviews ( Figure 1 ). The "static model" followed the traditional on-site interview structure, in which the interviewees rotate through several rooms meeting with different interviewers for w10 minutes each. The goal of our simulation was to find a model that would give applicants the most natural feel and allowing interviewers an adequate opportunity to assess their prospective residents. They reported that the dynamic model provided smoother transitions, allowed the applicants to be more comfortable, and gave participants a more natural feel. doi = 10.1016/j.wneu.2020.08.144 id = cord-303000-tmk2c9eh author = Alhaj, Ahmad Kh. title = Neurosurgery Residents Perspective on the COVID-19: Knowledge, Readiness, and Impact of this Pandemic. date = 2020-05-16 keywords = covid-19; knowledge; resident summary = The aim is to identify the level of knowledge, readiness, and the impact of this virus among neurosurgery residents in different programs. To our best knowledge, this is the first study regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and the impact it has on their training. The aim of this study is to identify the level of knowledge, readiness, practices, as well as the impact of this virus among neurosurgery residents in various neurosurgical programs. The final section (6 items) focuses on the impact of this pandemic on the resident in terms of neurosurgical training, studying, mental health, as well as whether their social life was affected or not. Table 3 demonstrates the association of this score about the virus with gender, age, year of residency training, location of the neurosurgery program. Our study is the first regarding the readiness of neurosurgery residents towards the COVID-19 pandemic and the impact it has on their training. doi = 10.1016/j.wneu.2020.05.087 id = cord-337269-bh3qbn3q author = Bajracharya, Aliza title = Scoping the perplexing effect of the COVID pandemic in Nepal, and the appraisal for precautionary measures from its lurking aftermath date = 2020-06-11 keywords = COVID summary = title: Scoping the perplexing effect of the COVID pandemic in Nepal, and the appraisal for precautionary measures from its lurking aftermath Scoping the perplexing effect of the COVID pandemic in Nepal, and the appraisal for precautionary measures from its lurking aftermath The coronavirus 2019 (COVID-19) pandemic has led to the global health crisis. By far to contain this infection, the government has ensured isolation facilities, quarantined the suspected cases, and contact tracing of the exposed patient, increased the screening tests, but all these steps are at a snail''s pace. To at least make a start, there needs to be a provision of rapid testing of every high-risk emergency case so as to safeguard the health workers. The referral cases need to have the facility of conducting the test prior to the referral to the center so that it avoids unnecessary delay and the environment of fearful uncertainty while managing them. doi = 10.1016/j.wneu.2020.06.027 id = cord-322052-zsbisk3b author = Bohórquez-Rivero, José title = Letter to the Editor: Humanization of Neurosurgery: Incorporation of a New Concept in Times of COVID-19 date = 2020-08-24 keywords = patient summary = Challenges neurosurgeons are facing include, among others, the advent of new technologies, an increasingly impersonal physician-patient relationship, loss of interest in the emotional aspects of the patient, differences in public versus private care, loss of autonomy to make decisions about patients, loss of interest in performing an adequate physical examination, and hospitals becoming increasingly less humanized. As a result, in daily neurosurgical practice and during the process of training new neurosurgeons, humanistic principles receive little attention, and scientific and technical aspects dominate. 3 Therefore, the humanization of the neurosurgeon must begin from the first years of residency, medical school, and even high school, as the development of the ability to communicate and interact with patients and their family members requires time and preparation. Moreover, neurosurgical centers should advocate for the design of models of humanization, including an environment for neurosurgeons, patients, and families that allows informal physician-patient contacts not related to the disease (e.g., conversations on current topics, humanistic use of patient consciousness, and spheres of subconsciousness). doi = 10.1016/j.wneu.2020.06.142 id = cord-287237-fobek8ak author = Bond, Jacob D. title = Clinical anatomy of the extradural neural axis compartment: a literature review date = 2020-07-22 keywords = EDNAC; LSC; figure; lateral summary = This intermediate region of the EDNAC represents an adipose corridor between the meningeal and periorbital dura which transmits the lacrimal and frontal branches of the ophthalmic nerve (CN V 1 ), the trochlear nerve (CN IV), the superior ophthalmic vein as well as fat and orbital veins from the orbit to the lateral sellar compartment. While this compartment possesses a significant mass of fat, and contains a number of neurovascular structures, it is roofed by the orbital muscle of Müller and communicates with the cavernous sinus via the foramen rotundum, but is not considered an anteroinferior extension of the EDNAC. 27 It is highly likely that the hypoglossal canal (transmitting CN XII, the posterior meningeal artery and anterior condylar vein) may also contain an extension of EDNAC seeing that it is immediately adjacent to a significant deposition of fat in the spinal epidural space. doi = 10.1016/j.wneu.2020.07.095 id = cord-318897-7bq0nhwm author = Borsa, Stefano title = Impact of COVID-19 outbreak on acute low back pain date = 2020-05-29 keywords = pain summary = We would like to bring our contribution from one of the most affected regions of the world by the SARS-CoV-2 on how pandemic has influenced the number of visits for low back pain and to provide food for thought for a reorganization of low back pain management in the post-COVID-19 era. We collected data from 4 hospitals in Milan on Emergency Ward (EW) and on Outpatient Department (OD) visits for acute low back pain (ALBP) for the period March 8 th , 2020 -April 8 th , 2020 and for the same period of the previous year. Last month 103 patients came for ALBP, 73 in the EWs and 30 in the ODs. In the EWs 45 patients had LBP, 22 presented sciatica, 5 had fractures (porotics) and 1 a tumor (prostate cancer). In the ODs 52 patients had LBP, 89 presented sciatica, 8 had fractures (porotics) and 6 tumors (2 breast cancers, 3 prostate cancers and 1 colorectal cancer). doi = 10.1016/j.wneu.2020.05.218 id = cord-320991-nkkmzymu author = Cabrera, Juan P. title = Letter to the Editor: Is COVID-19 the Cause of Delayed Surgical Treatment of Spine Trauma in Latin America? date = 2020-05-18 keywords = Latin summary = Before SARS-CoV-2 arrived in Latin America, the ideal timing for surgical treatment of spine trauma cases was highly influenced by local conditions with great heterogeneity, including differences in access to health care between public and private systems. When these patients present with spine trauma, there is no knowledge regarding SARS-CoV-2 status, including in low-risk or asymptomatic patients, thereby impacting the final outcome if the patient treated has COVID-19, 8 and sometimes the surgery is already performed, having the potential to spread the infection to health care workers. A potential side effect of the COVID-19 pandemic for patients with spinal trauma is a delay in surgical treatment in patients with less severe injuries, who may develop late deformities or neurologic deterioration, owing to limited health care resources. doi = 10.1016/j.wneu.2020.05.003 id = cord-277801-auq3msc6 author = Deora, Harsh title = Adapting Neurosurgery Practice During The Covid-19 Pandemic In The Indian Subcontinent date = 2020-07-15 keywords = COVID-19; OPD; pandemic; practice summary = Material and Methods An online questionnaire-based survey was prepared, with questions related to the COVID specific themes of precautions taken in outpatient services and operation theaters, the influence of social media, the economic loss incurred, and the perceptible impact of telemedicine and webinars. An online questionnaire-based survey was prepared, with questions related to the COVID specific themes of precautions taken in outpatient services and operation theaters, the influence of social media, the economic loss incurred, and the perceptible impact of telemedicine and webinars. Suspension of elective procedures, severe curtailment of the regular outpatient appointments, drastic modifications of the normal OPD/OR practices and apprehensions related to inadequacy of safety provided by PPE usage and financial losses of private establishments were some of the visible themes in our survey results. doi = 10.1016/j.wneu.2020.07.038 id = cord-313503-wvgwf9n3 author = D’Amico, Randy S. title = Neurosurgical/Head and Neck drape to Prevent Aerosolization of COVID-19 - The Lenox Hill Hospital/Northwell Health solution. date = 2020-07-23 keywords = COVID-19; drape summary = title: Neurosurgical/Head and Neck drape to Prevent Aerosolization of COVID-19 The Lenox Hill Hospital/Northwell Health solution. Although COVID-19 screening and testing guidelines have been proposed and adopted by many hospitals, these may not adequately protect the operating room personnel who are in proximity to the patient for prolonged periods. There are concerning reports of especially high transmission rates of COVID-19 in trans-mucosal head and neck procedures conducted by otolaryngologists and neurosurgeons, despite attempts at wearing what constitutes appropriate PPE. 3 Here we describe the simple intraoperative technique we utilize at Lenox Hill Hospital/Northwell Health for all cranial, endonasal, spinal, and neuro-interventional cases to limit the intraoperative transmission COVID-19 to essential staff in the operating rooms and the endovascular suite who are at a substantially higher risk of exposure to the disease. doi = 10.1016/j.wneu.2020.07.133 id = cord-289111-6725jg29 author = Field, Nicholas C. title = Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt date = 2020-06-25 keywords = COVID-19 summary = In order to demonstrate the degree of change, we wish to report the dramatic decrease in operative, outpatient clinic, and consult volume at our institution, Albany Medical Center, an Academic Level 1 Trauma Center in upstate New York. 2 We rapidly trialed and implemented a video conference telehealth system by the end of March and have seen a dramatic shift in our clinic practice while continuing to provide appropriate patient care ( Figure 1 ). Our resident service was split into an on-call and backup team due to the decrease in case volume, and also to limit exposure to COVID-19, and provide coverage in the Neuro ICU. Our program has seen a significant reduction in consults and operations over the past three months despite being in a region with a linear case rise that has not been overwhelmed by the pandemic. The COVID-19 pandemic has led to a dramatic decline in elective neurosurgical procedures, consults, and clinic visits. doi = 10.1016/j.wneu.2020.06.141 id = cord-275926-rj23z7po author = Fontanella, Marco M. title = Neurosurgical practice during the SARS-CoV-2 pandemic: a worldwide survey date = 2020-05-05 keywords = CoV-2; Italy; SARS summary = 3. Institutional plans for the SARS-CoV-2 outbreak: any special measures adopted for SARS-CoV-2 positive neurosurgical patients were investigated, i.e. their screening rate and method, any changes in surgical indications, planning and activity for oncologic procedures, non-emergency surgeries, and subarachnoid hemorrhages (SAHs). The same correlation was found with regards to the medical perception of disease activity (Q2) in different countries, and only few respondents (3%) claimed their country was not facing the outbreak during the time period studied: among them, neurosurgeons from Germany were probably the most "wrong", since their country had between 10 4 to 10 5 SARS-CoV2 patients during the study period (Fig. 4A) . 5 India and Pakistan have been reported to be the world''s best respondents to the SARS-COV-2 pandemic, 22-24 thus reflecting high rates of neurosurgical activity reorganizations. doi = 10.1016/j.wneu.2020.04.204 id = cord-311588-ocz2rzy7 author = Gilligan, Jeffrey title = Collateral Damage During the COVID-19 Pandemic date = 2020-05-14 keywords = COVID-19 summary = At our institution, similarly, we have seen both a huge decline in patients seeking care for neurological and neurosurgical diagnoses, as well as late presentation of life-threatening conditions. She refused to seek care at the hospital due specifically to fear of contracting COVID-19. What remains unknown is how many patients with known or unknown pathologies are having progression of a deficit (i.e. worsening vision secondary to a supersellar mass or worsening cervical myelopathy) that would otherwise have brought them to seek urgent medical care. In our own institution, resources and staff are finally being able to assist with non-COVID patient duties. The untold toll -The pandemic''s effects on patients without COVID-19 As the pandemic subsides, we will need to ask our leaders, public health officials, and the media to send a message to patients at risk: please seek help if you''re not well or having worsening symptoms. doi = 10.1016/j.wneu.2020.05.091 id = cord-328869-2qmgjdc1 author = Goyal, Anshit title = Survey of Academic US Programs Regarding the Impact of the COVID-19 Pandemic on Clinical Practice, Education and Research in Neurosurgery date = 2020-06-10 keywords = report; respondent summary = 1 However, a few weeks following this directive, multiple state administrations lifted the embargo on elective procedures after ongoing evaluation of case numbers and considering the potential adverse impact of persistent cancellation on other non-COVID patients and financial risk to hospitals. To understand how different academic neurosurgery departments across the US responded to this devastating COVID19 pandemic, we conducted a national survey of program leaders to determine the measures taken for ensuring patient and personnel safety and adapting to teaching and research needs. Certainly, there are limitations to this survey given the low response rate (~20%).While most departments pursued important policies such as cancellation of non-urgent surgeries and performed COVID testing preoperatively, we did find a small number of respondents who reported not offering preoperative testing routinely. doi = 10.1016/j.wneu.2020.06.028 id = cord-293166-gkzebyda author = Hoz, Samer S. title = Letter to the Editor: “Beyond Containment: Tracking the Impact of Coronavirus Disease 2019 (COVID-19) on Neurosurgery Services in Iraq” date = 2020-11-03 keywords = Coronavirus; covid-19 summary = title: Letter to the Editor: "Beyond Containment: Tracking the Impact of Coronavirus Disease 2019 (COVID-19) on Neurosurgery Services in Iraq" Letter to the Editor: "Beyond Containment: Tracking the Impact of Coronavirus Disease 2019 (COVID-19) on Neurosurgery Services in Iraq" LETTER: The Neurosurgery Teaching Hospital (NTH) in Baghdad, Iraq, provides neurosurgical care for 4.2 million people-approximately 50% of the population in Baghdad, with a total capacity of 102 beds, 16 neurosurgical intensive care unit (NICU) beds, and 7 operating rooms. Cases requiring less immediate care are only admitted if the condition is deemed to be "urgent." This decision is the responsibility of a newly assembled local hospital committee, composed of 3 senior neurosurgeons. As for patients, a total of 25 acute trauma cases have been confirmed to be positive by immediate postoperative polymerase chain reaction. Such situations are hazardous and require urgent legislative change that determines the COVID-19 status of all admitted patients to be positive unless proven otherwise. doi = 10.1016/j.wneu.2020.08.060 id = cord-334280-qs40g1fz author = Jella, Tarun K. title = Geospatial Distribution of Neurosurgeons Age 60 and Above Relative to the Spread of COVID-19 date = 2020-10-14 keywords = July; covid-19 summary = Objective To perform an ecological study in order to analyze the geospatial distribution of neurosurgeons ≥ 60 years old and compare these data with the spread of COVID-19 across the; U.S. Methods Data regarding the distribution of COVID-19 cases was collected from the Environmental Systems Research Institute and demographic statistics from the American Association of Medical Colleges 2019State Workforce Reports. Results As of July 5, 2020, the 10 states with the highest number of COVID-19 cases showed older neurosurgical workforce proportions (the proportion of active surgeons aged 60 years or older) ranging from 20.6% to 38.9%. As 80 a result, this study was performed in order to establish first the geographical distribution of 81 neurosurgeons aged 60 years or older and, secondly, to compare this data to the distribution of 82 COVID-19 cases across the country. doi = 10.1016/j.wneu.2020.10.037 id = cord-276829-c1krlejx author = José Antonio, Soriano Sánchez title = EARLY REPORT ON THE IMPACT OF COVID-19 OUTBREAK IN NEUROSURGICAL PRACTICE AMONG MEMBERS OF THE LATIN AMERICAN FEDERATION OF NEUROSURGICAL SOCIETIES date = 2020-05-07 keywords = Latin; covid-19 summary = Abstract Background The COVID-19 pandemic has caused severe economic consequences by local governmental measures to contain the outbreak1 We provide insight on the impact that healthcare restriction has made on neurosurgical activity in Latin Iberoamerica. By using the FLANC as a 53 platform, we aimed to provide an insight on the socioeconomic impact that healthcare 54 restriction has made on Latin Iberomerican neurosurgical practice as a baseline to 55 understand the potential financial burden it will imply (especially to other physicians 56 involved in non-essential treatment) in terms of sustainability if these measures are to be 57 overcome) this crisis. The medical praxis has also been affected, as the World Health Organization has 181 recommended reducing activity with the advance of epidemy in local countries to provide 182 essential care to give the best use of resources to contain the outbreak and reduce infection 183 rates 5 . doi = 10.1016/j.wneu.2020.04.226 id = cord-276067-3io0xux2 author = Kanmounye, Ulrick Sidney title = COVID-19 and Neurosurgical Education in Africa: Making lemonade from lemons date = 2020-05-21 keywords = african summary = In the face of this new reality, and in order to limit the impact of the current COVID-19 pandemic, multiple programs have implemented physical distancing which reduces in-person interactions. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents and young Neurosurgeons during and after the COVID-19 pandemic. initiative to advance the education of African residents and young Neurosurgeons during and after the COVID-19 pandemic. African residents and young neurosurgeons are already learning from and about world renowned neurosurgeons via online medical education platforms (3). In order to limit the impact of the current COVID-19 pandemic, multiple programs have implemented physical distancing which reduces in-person interactions. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents during and after the COVID-19 pandemic. Impact of COVID-19 on neurosurgery resident training and education doi = 10.1016/j.wneu.2020.05.126 id = cord-312345-gn6mwun0 author = Kanmounye, Ulrick Sidney title = Letter to the Editor: COVID-19 & Neurosurgical Training in Low- and Middle-Income Countries date = 2020-09-23 keywords = WFNS summary = Letter to the Editor: COVID-19 & Neurosurgical Training in Low-and Middle-Income Countries O n June 11, 2020, the World Federation of Neurosurgical Societies (WFNS)'' Global Neurosurgery Committee (GNC) and Young Neurosurgeons Forum (YNF) discussed the effects of coronavirus disease 2019 (COVID-19) on training in low-and middle-income countries (LMICs). During this event, the leadership of the WFNS and stakeholders of global neurosurgery identified challenges and proposed solutions to the issues faced by trainees during the pandemic. Although the current COVID-19 pandemic has had a sudden and negative effect on the ability to train neurosurgeons, especially in LMICs, the increased use of social media and virtual platforms (in our case, Zoom) is markedly improving the interactions between the leadership of the WFNS and neurosurgeons around the globe. doi = 10.1016/j.wneu.2020.07.018 id = cord-339478-v7by6dnp author = Kessler, Remi A. title = Changes in Neurosurgery Resident Education During the COVID-19 Pandemic: An Institutional Experience from a Global Epicenter date = 2020-05-08 keywords = ICU summary = Here we present our detailed institutional experience -from an 1,141-bed, tertiary care academic center and six other affiliate hospitals of the Mount Sinai Health System in NYC-on how the re-organization efforts changed our neurosurgical graduate medical education program from the heart of the pandemic. The changes to neurosurgery resident education at Mount Sinai were borne out of a necessity for re-deployment of our physicians to assist in the fight against COVID-19, given the sheer abundance of positive patients in NYC. The Emory University Department of Neurosurgery reported similar changes for residents covering their neurosurgical service and each resident is to spend one week during the month of April caring for COVID-19 patients. The COVID-19 pandemic has required our department to change resident education to an exceptional degree, but we are continuing neurosurgical learning in innovative ways while heeding the call to care for NYC''s sickest patients. doi = 10.1016/j.wneu.2020.04.244 id = cord-258344-55n3wwle author = Khalafallah, Adham M. title = In Reply to the Letter to the Editor Regarding “Impact of COVID-19 on an Academic Neurosurgery Department: The Johns Hopkins Experience” date = 2020-08-08 keywords = COVID-19 summary = title: In Reply to the Letter to the Editor Regarding "Impact of COVID-19 on an Academic Neurosurgery Department: The Johns Hopkins Experience" The authors thank Dr. Venkataram and colleagues for their thoughtful and thorough 1 analysis of our recent study "Impact of COVID-19 on an Academic Neurosurgery Department: 2 The Johns Hopkins Experience." 1 As stated in our paper, we believe that publishing the unique 3 experiences of different academic medical centers during the COVID-19 pandemic is essential in 4 clarifying the many challenges facing both American neurosurgery as well as neurosurgery 5 across the world, and we also believe sharing such information is important for establishing a 6 consensus regarding best practices as the situation continues to evolve. Impact of COVID-19 on an Academic Neurosurgery Department: The Johns Hopkins Experience Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans doi = 10.1016/j.wneu.2020.08.033 id = cord-274408-3q6jibl8 author = Knopf, Joshua D. title = Neurosurgical operative videos: an analysis of an increasingly popular educational resource date = 2020-09-02 keywords = Neurosurgical; operative; video summary = Objective Surgical education has increasingly relied upon electronic learning, and in particular, online operative videos have become a core resource within the field of neurosurgery. 23 Using edited J o u r n a l P r e -p r o o f operative videos to continually review the technical steps performed by master neurosurgeons is key to refining the science, as well as the art of neurosurgery throughout our careers. 15 Whether used by neurosurgical trainees or established attendings, web-based operative videos appear to play an important role globally, particularly in low-to-middle income countries where limited resources restrict the access of many surgeons to journals, cadaver labs, workshops, and conferences. Our study also demonstrates that in addition to geographic consolidation, the operative videos are heavily weighted toward several neurosurgical subspecialties-tumor, vascular, and skull base in particular-which account for 35.2%, 48.3%, and 27.5% of the videos, respectively. doi = 10.1016/j.wneu.2020.08.187 id = cord-322497-hdy3va8e author = LUBANSU, Alphonse title = COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center. date = 2020-09-03 keywords = COVID-19; patient summary = title: COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center. limited clinical neurosurgical experience including COVID-19 patients have been reported. A cohort of all neurosurgical patients managed during the lockdown period is presented and analyzed assessing suspected nosocomial infection risk factors. 69 Patients initially admitted to the neurosurgical ward were less likely to be suspected for a 70 COVID-19 infection when compared to patients admitted for critical emergencies, 71 particularly with neurovascular and stroke-related pathologies. 69 Patients initially admitted to the neurosurgical ward were less likely to be suspected for a 70 COVID-19 infection when compared to patients admitted for critical emergencies, 71 particularly with neurovascular and stroke-related pathologies. Accordingly, the health ministry guidelines reserved biochemical tests of nasopharyngeal 103 samples only for suspected COVID-19 patients requiring hospital admission, and no targeted 104 screening strategy was defined for healthcare providers. The management of emergency spinal surgery 372 during the COVID-19 pandemic in Italy doi = 10.1016/j.wneu.2020.08.168 id = cord-343322-vx3lub3s author = LUBANSU, Alphonse title = Reply to the Letter to the Editor Regarding " COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center ". date = 2020-11-02 keywords = covid-19 summary = key: cord-343322-vx3lub3s title: Reply to the Letter to the Editor Regarding " COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center ". cord_uid: vx3lub3s for their interest and valuable questions regarding our recently published paper "COVID-19 impact on neurosurgical practice: lockdown attitude and experience of a European academic center". We noted and appreciated that the protocol and workflow for the management of neurosurgical patients that we applied at the early onset of the COVID 19 pandemic, at our institute, seems to be also effectively applied in larger and different countries such as India. On pandemics: the impact of COVID-19 on the practice of neurosurgery Preliminary Recommendations for Surgical Practice of Neurosurgery Department in the Central Epidemic Area of 2019 Coronavirus Infection Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response Countries where Coronavirus has spread -Worldometer doi = 10.1016/j.wneu.2020.10.143 id = cord-310144-s25do8cb author = Lara-Reyna, Jacques title = “Staying Home” - Early Changes in Patterns of Neurotrauma in New York City during the COVID-19 Pandemic date = 2020-07-27 keywords = March; case; covid-19 summary = In an attempt to slow the progression of COVID-19 pandemic, New York state and city governments enacted strict social distancing policies starting on March 12th, which included a progressive restriction and cancellation of non-fundamental activities, like the closure of schools, restaurants, bars, and business; as well as the cancellation of all elective surgical procedures. To assess these possible changes, we reviewed all neurotrauma admissions to our trauma center during the early COVID-19 period, and assessed changes in frequency, demographics, and mechanisms, in order to highlight any changes due to social distancing policies. 8 During this time period, we observed a decrease in the frequency of neurotrauma at the early phase after the strict limitation of non-essential activities in the city, compared to the pre-COVID-19 period. Interestingly, transit-related neurotrauma, as well as TBIs related to violence (direct head trauma with an object) increased in frequency in the COVID-19 period showing significant difference. doi = 10.1016/j.wneu.2020.07.155 id = cord-335642-i0a1si8k author = Lozada-Martínez, Ivan title = Letter to the Editor: ”Role of the Neurosurgeon in Times of Coronavirus Disease 2019 (COVID-19): The Importance of Focus in Critical Care” date = 2020-11-03 keywords = COVID-19 summary = title: Letter to the Editor: "Role of the Neurosurgeon in Times of Coronavirus Disease 2019 (COVID-19): The Importance of Focus in Critical Care" Some authors who have reported the execution of similar changes point out that these transformations have implied real challenges, since they have needed to be rapidly trained in critical care to be able to establish and provide quality support treatment. This consensus in particular sets a road map for the diagnosis and treatment of patients with COVID-19 in a didactic way, as well as a protocol to be followed in intensive care units to facilitate the patient admission process, triage establishment, isolation management, disinfection of the medical equipment and the environment, waste disposal, highly specialized personal protective equipment use, airway management, and ventilatory support, and finally evaluation of neurologic diseases such as stroke, epileptic status, and neuroimmune and neuromuscular diseases, among others. doi = 10.1016/j.wneu.2020.08.059 id = cord-307013-80dup4sr author = Lu, Victor M. title = Letter to the Editor: Lessons to Learn from the Coronavirus Disease 2019 (COVID-19) Pandemic for International Medical Graduate Applicants and United States Neurosurgery Residency Programs date = 2020-08-24 keywords = United summary = title: Letter to the Editor: Lessons to Learn from the Coronavirus Disease 2019 (COVID-19) Pandemic for International Medical Graduate Applicants and United States Neurosurgery Residency Programs In light of the current COVID-19 pandemic, a number of changes affecting the visa process in the United States has revealed particular immigration policies that are subject to change without notice. Therefore, being present in the United States before Match Day is recommended to ensure that if an IMG candidate is successful, changes in travel policies and plans will not impact their ability to start residency on time. As lockdowns in the United States began, the U.S. Citizenship and Immigration Services suspended premium processing of H1-B visas, 5 which would have greatly impacted incoming IMG residents. The current COVID-19 pandemic has shed light on how difficult the immigration process can be for prospective IMG applicants and U.S. neurosurgery programs, as well as how unpredictable it can be. doi = 10.1016/j.wneu.2020.06.202 id = cord-271840-cw2xy1m6 author = Majmundar, Neil title = Incidence, Pathophysiology, and Impact of Coronavirus Disease 2019 (COVID-19) on Acute Ischemic Stroke date = 2020-09-23 keywords = COVID-19 summary = 4 reported 5 patients positive for COVID-19 in a New York City hospital system who presented with strokes secondary to largevessel occlusions (LVOs) over a 2-week period despite very few or no risk factors for stroke. Due to the high rates of nosocomial transmission as well as the potential for overwhelming hospital resources, stroke centers across the world implemented new protocols for the triaging of patients with stroke, particularly those with LVOs requiring MT. 8 A recent study from a single center in New Jersey, one of the most heavily COVID-impacted states in the country, corroborated the decrease in overall stroke volume but also found a greater proportion of patients with stroke presenting with LVOs during the COVID-19 period. Although the overall incidence of AIS in COVID-19 is not clear, there is emerging evidence that the rate of LVOs is increased in patients with COVID-19 who may not have the typical stroke risk factors. doi = 10.1016/j.wneu.2020.07.158 id = cord-258293-7q9zj8c2 author = Marini, Alessandra title = Letter to the Editor Regarding ''Coronavirus Disease 2019 (COVID-19) and Neurosurgery: Literature and Neurosurgical Societies Recommendations Update'' date = 2020-05-26 keywords = patient summary = with intracranial or spinal oncological pathology (rapidly evolving intracranial hypertension with deteriorating 4 state of consciousness, acute hydrocephalus, spinal cord compression with rapid tetra or paraparesis); Class A + 5 are the patients who requirie treatment within a maximum of 7-10 days, with intracranial tumors with mass 6 effect or with progressive neurological deficit, without deterioration of consciousness and patients requiring 7 treatment within a month, namely Class A, with neurological alteration or suspected malignant lesion, related 8 This resulted in progression of the neurological 4 symptoms, without an early neurosurgical evaluation, until the onset of acute deficit which actually led to the 5 emergency room access. symptoms were consciousness alteration and seizures; in our survey approximately 10,7 % of the acute-onset 0 patients reported to have previously refused the surgical treatment, in the weeks before, correlated to concerns 1 about the hospitalization during the Coronavirus emergency. In conclusion, during the COVID-19 pandemic the neurosurgical urgent and emergency onset of neuro-6 oncological cases increased, in comparison to 2019. Illustrative Table regarding the epidemiological variations in neuro-oncological patients'' onset during the COVID-19 crisis doi = 10.1016/j.wneu.2020.05.160 id = cord-265172-rn9pkk52 author = Michiwaki, Yuhei title = Emergent carotid artery stenting following intravenous alteplase infusion after rapid negative diagnosis for COVID-19 by loop-mediated isothermal amplification assay: A case report date = 2020-10-09 keywords = LAMP; covid-19 summary = title: Emergent carotid artery stenting following intravenous alteplase infusion after rapid negative diagnosis for COVID-19 by loop-mediated isothermal amplification assay: A case report Conclusions This case report suggests that eCAS for hAIS due to ICS following intravenous alteplase can be an effective treatment, along with appropriate antiplatelet medication and management in select patients. This case report suggests that eCAS for hAIS due to ICS following intravenous alteplase can be an effective treatment, along with appropriate antiplatelet medication and management in select patients. Carotid artery stenting (CAS) is a standard treatment procedure for internal carotid artery stenosis (ICS) 8 ; however, the efficacy and safety of emergent CAS (eCAS) for hyperacute ischemic stroke (hAIS) due to ICS have not been sufficiently established. This case report demonstrates that eCAS for AIS due to ICS following intravenous alteplase infusion can be an effective treatment option along with appropriate antiplatelet medication and management in select patients. doi = 10.1016/j.wneu.2020.09.166 id = cord-292429-28mwv9f7 author = Miranda, Stephen P. title = Incorporating telehealth to improve neurosurgical training during the COVID-19 pandemic date = 2020-05-17 keywords = ACGME; resident summary = At our institution, we have found that involving residents in telehealth clinic and supplementing this time with virtual, case-based conferences have already enhanced resident education, by taking learning models classically used in surgical skills training and applying them to surgical decision-making and management instead. Nevertheless, outpatient clinical experience provides a critical opportunity for trainees to develop the non-operative skills emphasized by the ACGME Milestones, including information gathering and interpretation, evidence-based practice, critical thinking for diagnosis and therapy, and awareness of healthcare systems (Table 1) . Residents have the autonomy to conduct clinical encounters and deliberately practice their approach (Ericsson''s theory, mastery learning model). Prior to COVID-19, at our weekly case conference with all residents and faculty present, patients from each clinical site are presented and residents have the opportunity to simulate an oral boards examination, practicing surgical decision-making with each case scenario. doi = 10.1016/j.wneu.2020.05.116 id = cord-267618-ots27qks author = Molliqaj, Granit title = How Neurosurgeons Are Coping with COVID-19 and How It Impacts Our Neurosurgical Practice: Report from Geneva University Medical Center date = 2020-05-08 keywords = COVID-19; Geneva summary = title: How Neurosurgeons Are Coping with COVID-19 and How It Impacts Our Neurosurgical Practice: Report from Geneva University Medical Center How Neurosurgeons Are Coping with COVID-19 and How It Impacts Our Neurosurgical Practice: Report from Geneva University Medical Center Q1Q11 Q12 Q13 Q10 Granit Molliqaj and Karl Schaller BACKGROUND Who could have imagined that a virus in the 21st century could so quickly destabilize the world? 1 Nonetheless, on 30 January in Geneva, Switzerland, the Director-General of the World Health Organization made public that the outbreak of the new coronavirus 2019 met the criteria of a public health emergency of international concern. To date, Easter Monday (13 April 2020), more than 25,000 COVID-19Àpositive cases have been confirmed in laboratories and 884 deaths have been recorded for COVID-19 according to the Federal Office of Public Health (Figures 1 and 2) , and these numbers are steadily increasing. doi = 10.1016/j.wneu.2020.04.149 id = cord-027854-o511h1my author = Moscote-Salazar, Luis Rafael title = Letter to the Editor: SARS-CoV-2 and Traumatic Cervical Acute Spinal Cord Injury: An Appraisal date = 2020-06-25 keywords = spinal summary = authors: Moscote-Salazar, Luis Rafael; Galindo-Velasquez, Hather; Garcia-Ballestas, Ezequiel; Agrawal, Amit; Rahman, Md Moshiur; Sarwar, A.S.M. title: Letter to the Editor: SARS-CoV-2 and Traumatic Cervical Acute Spinal Cord Injury: An Appraisal In patients infected with coronavirus and suffering from a traumatic spinal injury. We have to remember the importance of neurogenic shock, defined as the autonomic dysregulation due to the sudden loss of control of the sympathetic tone and the overlapping of a parasympathetic response that appears in the context of a spinal cord injury. 11 Regarding the latter, it should be thoroughly investigated what is the actual role of the virus during the pathophysiology of the acute spinal cord injury and how it can affect the outcomes, and prognosis of the patient. Emergency Neurological Life Support: Traumatic Spine Injury Early neurological care of patients with spinal cord injury doi = 10.1016/j.wneu.2020.06.134 id = cord-266764-q2vtrs95 author = Munusamy, Thangaraj title = Telemedicine via Smart Glasses in Critical Care of the Neurosurgical Patient – A COVID-19 Pandemic Preparedness and Response in Neurosurgery date = 2020-09-18 keywords = glass; round; smart; ward summary = title: Telemedicine via Smart Glasses in Critical Care of the Neurosurgical Patient – A COVID-19 Pandemic Preparedness and Response in Neurosurgery The goal of our study was to determine if telemedicine delivered through smart glasses was feasible and effective in an alternative method of conducting ward round on neurocritical care patients during the pandemic. A virtual ward round was first conducted remotely by a specialist who received real-time audiovisual information from a resident wearing smart glasses integrated with telemedicine. Conclusions Virtual ward rounds using telemedicine via smart glasses on neurosurgical patients in critical care were feasible, effective and widely accepted as an alternative to physical ward rounds during the COVID-19 pandemic. By using the smart glasses, specialists monitoring the ward rounds were able to direct residents and junior staff members through the routine daily review of patients requiring critical care. doi = 10.1016/j.wneu.2020.09.076 id = cord-258562-raubqnko author = Murlimanju, Bukkambudhi V. title = Letter to Editor Regarding: “Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt” date = 2020-09-23 keywords = COVID-19 summary = title: Letter to Editor Regarding: "Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt" Letter to Editor Regarding: "Decrease in Neurosurgical Program Volume During COVID-19: Residency Programs Must Adapt" C oronavirus disease 2019 has undoubtedly placed many unprecedented restrictions on the life of current generations globally. The effects have been adverse in several aspects, including the decreased number of clinical cases per specialty, staff reductions, cancellation of academic conferences, and the difficulty in conducting training and licensing examinations. 1 that to address the decrease in learning resources during neurosurgery residency training and, as the authors have rightly suggested, that the residency program must be able to adapt such unforeseen circumstances. The global leaders in academia should take this COVID-19 pandemic as an opportunity to formulate long-term policies and appropriate pathways to address the new challenges faced by resident training programs. Decrease in neurosurgical program volume during COVID-19: residency programs must adapt Decrease in trauma admissions with COVID-19 pandemic doi = 10.1016/j.wneu.2020.07.019 id = cord-270525-nmebqrb1 author = Núñez-Velasco, Santiago title = Response to SARS-CoV-2 Pandemic in a Non-COVID-19 Designated Latin-American Neurosurgery Department date = 2020-05-11 keywords = covid-19; patient summary = METHODS An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. Based on the epidemiological and biological information available in the literature on COVID-19, specific measures adapted to our resources were implemented to design a protocol of organized administration of human resources both assistant and administrative, optimized surgical procedures, proper handling of personal protective equipment and adaptation of the facilities of the neurosurgery department of the FAAHC when treating neurosurgical patients with no SARS-CoV-2 known condition. This would lead us to a catastrophic scenario because there are reports of a 12% of hospital-associated transmission of the virus as the mechanism of infection of patients, that in our case are weak and many of them immunosuppressed; thus, cases of contamination of health-care personnel have also been reported, especially in non-designated COVID areas in which precautions might relax. doi = 10.1016/j.wneu.2020.05.019 id = cord-348442-nk3mbwdj author = O''Kelly, Cian title = Letter to the Editor: Pandemic (COVID-19) Proctoring for eCLIPs Neurointervention date = 2020-09-23 keywords = device summary = With rapid introduction of novel technology in the field of neurointervention, in-person case proctoring has traditionally been used for the effective and safe dissemination of the use of new endovascular devices. Unfortunately, in-person case proctoring poses numerous challenges in the COVID-19 pandemic environment with proctors needing to travel to treatment centers and work in close proximity with the local neurointerventionalists. As a proof of concept, we present a recent endovascular repair of an aneurysm using a novel device that was proctored virtually using a videoconferencing app. At the treatment center, one device was setup to face the control room monitors allowing remote participants to WORLD NEUROSURGERY 142: 575-576, OCTOBER 2020 www.journals.elsevier.com/world-neurosurgery view the live fluoroscopic images. We have demonstrated successful virtual proctoring of a remote endovascular procedure without the need for specialized videoconferencing equipment. This approach allows proctoring to continue during current pandemic restrictions, but also has implications for supporting training and cases in remote and disadvantaged environments. doi = 10.1016/j.wneu.2020.07.145 id = cord-268939-ws74xprt author = Ozoner, Baris title = Neurosurgery Practice During Coronavirus Disease 2019 (COVID-19) Pandemic date = 2020-05-28 keywords = COVID-19; China; Coronavirus; SARS; patient summary = The increased burden has substantially impacted the neurosurgery practice and intensive modifications were required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even academic activities. Operations of COVID-19 positive patients, and emergency cases, where screening can not be obtained, should be performed following level 3 protective measures. [5] [6] [7] In neurosurgery practice, intensive modifications were required in surgical scheduling, administration of inpatient and outpatient clinics, management of emergency cases, and even academic & educational activities. 26 A recent study from Wuhan City, China reported that some severe COVID-19 patients developed neurologic manifestations, such as acute cerebrovascular diseases (5.7%), and impaired consciousness (14.8%). 76, 80 Also, a patient with a mass lesion in the sellar region that underwent endonasal endoscopic surgery in Neurosurgery Department, Tongji Medical College, Wuhan City, China was diagnosed with COVID-19 after surgery, and disease was confirmed in 14 healthcare professionals in the same clinic afterwards. doi = 10.1016/j.wneu.2020.05.195 id = cord-320065-zxh8u4eg author = Patel, Pious D. title = Tracking the Volume of Neurosurgical Care during the COVID-19 Pandemic date = 2020-06-27 keywords = COVID-19; procedure summary = Abstract Objective This study quantifies the impact of COVID-19 on the volume of adult and pediatric neurosurgical procedures, inpatient consults, and clinic visits at an academic medical center. This was the 776 week time period immediately following the signing of a Tennessee gubernatorial executive 77 order preventing "non-essential procedures." 9 Patient records from an analogous 7-week period 78 from March 25, 2019 through May 10, 2019 were collected and categorized as "before COVID-79 19." In addition to these time periods, data were collected from the 59 week period spanning Hydrocephalus was defined as ventriculoperitoneal shunt insertion or revision or endoscopic 140 third ventriculostomy. The COVID-19 pandemic led to significant, measurable decreases in neurosurgical caseload, 392 inpatient consults, and outpatient clinic visits. As elective 396 procedures and in-person clinical encounters resume, the effects of reduced volume during 397 COVID-19 on long-term patient outcomes warrants further investigation. doi = 10.1016/j.wneu.2020.06.176 id = cord-329704-vnazexhj author = Pelargos, Panayiotis E. title = An Evaluation of Neurosurgical Practices During the COVID-19 Pandemic date = 2020-10-13 keywords = pandemic; practice summary = Methods A survey consisting of twenty-two questions assessing respondent''s operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic as compared to their colleagues. Neurosurgeons in practice less than 20 163 years were significantly more likely to be willing to provide non-neurosurgical care to COVID-164 19 patients than those in practice greater than 20 years (73.1% vs. Overall, nearly three-fourths of neurosurgeons experienced greater than 50% decline in 216 outpatient clinic volume with just over 5% of respondents closing their outpatient clinics during 217 the pandemic. doi = 10.1016/j.wneu.2020.10.025 id = cord-295029-zki5ac2g author = Pena, Robert C.F. title = In Reply to the Letter to the Editor Regarding “Coronavirus Neurosurgical/Head and Neck Drape to Prevent Aerosolization of Coronavirus Disease 2019 (COVID-19): The Lenox Hill Hospital/Northwell Health Solution” date = 2020-11-03 keywords = SARS; covid-19 summary = 1 This simple, cost-effective method can be easily assembled and is flexible with minimal disruption of the surgery being performed, while offering the ability to shield essential personnel in the operating room during procedures involving drilling of air-cells potentially harboring SARS-CoV-2 virions. 1,10 This draping method may therefore provide additional protection to surgeons against multiple viruses aerosolized by a wide range of drill settings, although further research should be conducted regarding COVID-19 aerosol generation in relation to drill speed in neurosurgical and otolaryngology-based procedures. Finally, whereas other researchers have proposed various methods of mask modification or alternate materials to provide barrier protection against COVID-19 aerosol transmission, 9 this and prior draping techniques may offer additional simple, easy to assemble, and cost-effective intraoperative protection. Specifically, this method provides protection to neurosurgical staff during high-speed drilling in the posterior fossa, whereas previously described drapes focus more on the restricted dissemination of COVID-19-laden aerosols during intubation, extubation, positive pressure ventilation, and endonasal endoscopic procedures. doi = 10.1016/j.wneu.2020.08.116 id = cord-252661-wa0hdg1u author = Pennington, Zach title = Letter: Changes to neurosurgery resident education following onset of the COVID-19 pandemic date = 2020-05-22 keywords = COVID-19; covid; resident summary = Here we surveyed program directors 6 (PDs) to ascertain how they have altered the education and clinical care responsibilities of 7 residents in response to the COVID-19 pandemic. Continuing education in spite of decreased case 21 volume and maintaining resident morale are cited as the most common concerns of PDs. 22 23 Conclusion 24 Here we find that there is great homogeneity in the responses of neurosurgical residency 25 programs to the COVID-19 pandemic. Continuing education in spite of decreased case 21 volume and maintaining resident morale are cited as the most common concerns of PDs. 22 23 Conclusion 24 Here we find that there is great homogeneity in the responses of neurosurgical residency 25 programs to the COVID-19 pandemic. Here we present the results of a survey of PDs for ACGME-accredited neurosurgery residency 126 programs regarding their responses to the COVID-19 pandemic. doi = 10.1016/j.wneu.2020.05.139 id = cord-352388-t0tv0lxs author = Pressman, Elliot title = The Return Back to Typical Practice from the ‘Battle Plan’ of the COVID-19 Pandemic: A Comparative Study date = 2020-07-19 keywords = Battle; Plan summary = The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 Battle Plan at an academic tertiary care referral center too provide insights for other departments going through the same transition. The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 ''Battle Plan'' 13 at an academic tertiary care referral center to provide insights for other departments planning to go through a similar transition. Data of patients who underwent neurosurgical interventions over a six-month period (January 1 -June 30, 2019), was retrospectively collected from the medical records as a control group for the same neurosurgical service before the COVID-19 pandemic began and averaged to four weeks for proper comparison of the four-week data collected after discontinuing the ''Battle Plan''. doi = 10.1016/j.wneu.2020.07.083 id = cord-324719-gecu1ksa author = Rahman, Md Moshiur title = Letter to the Editor: Pain Management Strategy in Neurosurgical Patients During the Coronavirus Pandemic date = 2020-08-24 keywords = pain summary = title: Letter to the Editor: Pain Management Strategy in Neurosurgical Patients During the Coronavirus Pandemic Not only neurosurgeons, but also various specialists, provide both invasive or noninvasive methods to control or relieve pain. It plays a significant role in the patients who do not respond to conservative methods of pain management. Neurosurgeons need to anticipate that because the coronavirus disease 2019 pandemic continues growing, the increasing literature will also attempt to characterize the neurologic manifestations. 4, 5 Because many of the nonurgent neurosurgical procedures have been deferred during this pandemic, there is a need to develop guidelines for the management of painful syndromes (these conditions may not be life-threatening but can be quite disabling). Evidence suggesting the relative efficacy of several therapeutic alternatives might be pretty helpful for patients with disabling pain. Intravenous acetaminophen (paracetamol) for postcraniotomy pain: systematic review and meta-analysis of randomized controlled trials Non-drug non-invasive treatment in the management of low back pain doi = 10.1016/j.wneu.2020.06.225 id = cord-319268-mqxwwwcd author = Raj, Sumit title = Letter to the Editor Regarding: “Case Volumes and Perioperative COVID-19 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC” date = 2020-11-03 keywords = COVID-19 summary = title: Letter to the Editor Regarding: "Case Volumes and Perioperative COVID-19 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC" Letter to the Editor Regarding: "Case Volumes and Perioperative COVID-19 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC" W e read the article by Dowlati et al., 1 in which the authors shared their thought-provoking observations to determine the risk of a neurosurgical patient becoming infected with coronavirus disease 2019 in the perioperative period and the effect of COVID-19 on the neurosurgical case volumes. The results and findings from their study have shown that a real risk of perioperative transmission exists and have summarized how the current COVID-19 pandemic has been changing the neurosurgical caseload patterns. Case volumes and perioperative COVID-19 incidence in neurosurgical patients during a pandemic: experiences at two tertiary care centers in doi = 10.1016/j.wneu.2020.08.117 id = cord-334521-sa0eyzq7 author = Ramos-Fresnedo, Andres title = Neurosurgical Interactive Teaching Series: A Multidisciplinary Educational Approach date = 2020-09-18 keywords = case; multidisciplinary; present summary = Conclusion: As the world of medicine is constantly changing, we are in need of developing new 18 tools to enhance our ability to relay knowledge through accredited and validated methods onto 19 physicians-in-training, such as the implementation of structured, multi-disciplinary, case-based 20 lectures as presented in this manuscript. Conclusion: As the world of medicine is constantly changing, we are in need of developing new 18 tools to enhance our ability to relay knowledge through accredited and validated methods onto 19 physicians-in-training, such as the implementation of structured, multi-disciplinary, case-based 20 lectures as presented in this manuscript. 13, 14 Based on 23 the multidisciplinary approach, we created a separate weekly lecture format, that is broadcast 24 internationally, where trainees are encouraged to critically prepare (with the help of multiple 25 experts) and review surgical cases for educational purposes. doi = 10.1016/j.wneu.2020.09.074 id = cord-325649-zzhsrytw author = Rispoli, Rossella title = Spine surgery in Italy in the COVID-19 era: Proposal for assessing and responding to the regional state of emergency date = 2020-08-07 keywords = COVID-19; ICU; patient summary = By the time of the World Health Organization (WHO) classification of the novel coronavirus as a global pandemic (1) , many hospitals in northern Italy were already overcrowded by COVID-19 patients, especially intensive care units, where about 50% of all available ICU beds were occupied by COVID-19 patients ( 2 ) . These include postponing elective surgical procedures until a more appropriate time, putting in place strategies to ensure urgent/emergency operations during the pandemic, defining type of hospital and the assistance pathways, designating COVID-19 operating rooms for urgent procedures with guidance information posted conspicuously to all the professionals, ensuring systematic and correct use of appropriate PPE, controlling and limiting the number of patients'' visitors, developing support strategies for healthcare professionals, and treating outpatients through telemedicine (teleorientation, telemonitoring, and teleinterconsultation) (5) . doi = 10.1016/j.wneu.2020.08.001 id = cord-253318-nlk8pjv2 author = Roberti, Fabio title = Minimally invasive lumbar decompression and removal of symptomatic Heterotopic bone formation after spinal fusion with rhBMP-2 date = 2020-05-06 keywords = bone; fusion; surgery summary = Abstract We present a case of symptomatic heterotopic bone formation following revision of posterolateral lumbar fusion/instrumentation and "off-label" use of recombinant human bone morphogenetic protein-2 (rhBMP-2), treated successfully with the use of a minimally invasive tubular approach. We report a case of symptomatic heterotopic bone formation following lumbar spinal revision surgery and posterolateral fusion with rhBMP-2, successfully treated using a minimally invasive tubular approach and provide documentation of the technical aspect of the procedure. In light of the absence of significant low back pain, the predominance of radicular symptoms, the absence of mechanical instability and the presence of bilateral facet arthrodesis, as well as the history of previous lumbar surgeries and associated medical comorbidities, we felt a minimally invasive approach was an appropriate option to be selected in this case and the patients concurred with this informed decision. In the presented case we found the use of minimally invasive techniques to be of benefit for the removal of heterotopic bone formation following lumbar spine fusion with rhBMP-2. doi = 10.1016/j.wneu.2020.04.235 id = cord-273522-ygd19p05 author = Rothrock, Robert J. title = By the Numbers Analysis of COVID-19’s Effect on a Neurosurgical Residency at the Epicenter date = 2020-07-17 keywords = COVID-19 summary = Objective To present areal-world analysis of neurosurgical volumes, resident deployment, and unique challenges encountered during the SARS-CoV-2 outbreak peak in New York City. Methods Daily census and case volume data were prospectively collected throughout the Spring 2020SARS-CoV-2 outbreak. Conclusion These data provide real-world guidance on neurosurgical infrastructure needs during a COVID-19 outbreak. Daily census and case volume data were prospectively collected throughout the Spring 12 2020SARS-CoV-2 outbreak. These data provide real-world guidance on neurosurgical infrastructure needs during a COVID-27 19 outbreak. 55 We report numerical real-world analysis of our neurosurgical resident experience during 56 the peak of the SARS-CoV-2 outbreak in New York City. Understanding volume and case mix 57 of operative and neurointerventional procedures, daily patient census, ICU coverage needs, and 58 rate of resident safety concerns and sick days during this period will aid in understanding 59 resource allocation during future outbreaks. doi = 10.1016/j.wneu.2020.07.063 id = cord-310288-onr700ue author = Sciubba, Daniel M. title = Scoring system to triage patients for spine surgery in the setting of limited resources: Application to the COVID-19 pandemic and beyond date = 2020-05-29 keywords = COVID-19; case; system summary = title: Scoring system to triage patients for spine surgery in the setting of limited resources: Application to the COVID-19 pandemic and beyond Methods Using a modified Delphi technique, a cohort of 16 fellowship-trained spine surgeons from 10 academic medical centers constructed a scoring system for the triage and prioritization of emergent and elective spine surgeries. Results The devised scoring system included 8 independent components: neurological status, underlying spine stability, presentation of a high-risk post-operative complication, patient medical comorbidities, expected hospital course, expected discharge disposition, facility resource limitations, and local disease burden. Conclusion Here we present the first quantitative urgency scoring system for the triage and prioritizing of spine surgery cases in resource-limited settings. The devised scoring system included 8 independent components: neurological status, underlying 19 spine stability, presentation of a high-risk post-operative complication, patient medical 20 comorbidities, expected hospital course, expected discharge disposition, facility resource 21 limitations, and local disease burden. doi = 10.1016/j.wneu.2020.05.233 id = cord-285226-4ydvjmr3 author = Sekhar, Laligam N. title = The Future of Skull Base Surgery: A View Through Tinted Glasses date = 2020-06-27 keywords = base; hospital; patient summary = This leads to an examination of recent developments in the field and outlines several promising areas of future improvement in skull base surgery, per se, as well as identifying new hospital support systems needed to accommodate these changes. These include, but are not limited to advances in imaging, Raman Spectroscopy and Microscopy, 3-dimensional printing and rapid prototyping, master-slave and semi-autonomous robots, artificial intelligence applications in all areas of medicine, tele-medicine, and green technologies in hospitals. 44 45 More recent technological introductions have proceeded to revolutionize the 46 treatment of challenging skull base pathology including the introduction of 47 endoscopic surgery, advances in neuroimaging, radiosurgery and high energy 48 focused radiotherapy, the perfection of vascular bypasses for replacement of 49 major arteries and venous sinuses involved by tumors 1,2,3 , and the use of skull 50 base approaches to treat complex vascular lesions. Humanoid robotic nursing assistants 558 will be developed and widely used in future due to health care worker shortages, 559 patients'' desire to have 24x7 nursing assistance, and the needs created by 560 infectious diseases wherein human-human contact must be minimized. doi = 10.1016/j.wneu.2020.06.172 id = cord-322277-mbe9dt3v author = Sharif, Salman title = COVID 19-Depression and Neurosurgeons date = 2020-06-06 keywords = depression; neurosurgeon; pandemic summary = The rapid increase in cases and evolving guidelines regarding protection and prevention of the spread of pandemic, with no confirmed treatment or approved vaccine has caused apprehension and anxiety among health care workers. The goal of this survey was to determine the prevalence and factors associated with anxiety and depression among neurosurgeons during the COVID-19 pandemic. Although, a recent Chinese study reported a much higher prevalence of depression (50.4%), anxiety (44.6%) and insomnia (34%) among frontline health care workers. Therefore a feeling of self-protection with provided PPE had a significant negative association with anxiety/depression while a positive COVID colleague increased the likelihood of depression among neurosurgeons. To our knowledge, this is the first study ever to determine the frequency and factors associated with anxiety and depression among 375 neurosurgeons from 52 countries. The prevalence of depression and anxiety among neurosurgeons was found to be lower than the frequency reported among other frontline workers during the COVID pandemic. doi = 10.1016/j.wneu.2020.06.007 id = cord-275784-n6jv72l7 author = Spina, Alfio title = The Management Of Neurosurgical Patients During The Covid-19 Pandemic date = 2020-04-30 keywords = COVID-19; SARS summary = An adequate management protocol can reduce hospital viral spread, improving safety both for patients and healthcare professionals. 1 The management of an ever-increasing number of patients, particularly those suffering from coronavirus disease 2019 (COVID-19) pneumonia has deeply affected the organization of healthcare facilities. 11 In a single-center Chinese case series of 138 hospitalized patients, presumed hospitalrelated infection of COVID-19 was suspected in 41% of patients, with a reported mortality of 4.3% and an intensive care unit admission rate of 26%. 12 Furthermore, COVID-19 transmission rate to healthcare worker was reported up to 20% 13 These data suggest that, inadequate hospital setting may represent a relevant route of SARS-CoV-2 spread both for patients and healthcare professionals. Whenever possible, elective surgery for confirmed cases (i.e. Group 1) should be rescheduled, because of this class of patients show higher risks of intensive care need and death. doi = 10.1016/j.wneu.2020.04.161 id = cord-326089-8234mcdk author = Sweid, Ahmad title = Incidence of Acute Ischemic Stroke and Rate of Mechanical Thrombectomy During the COVID-19 Pandemic in a Large Tertiary Care Telemedicine Network date = 2020-06-13 keywords = COVID-19 summary = title: Incidence of Acute Ischemic Stroke and Rate of Mechanical Thrombectomy During the COVID-19 Pandemic in a Large Tertiary Care Telemedicine Network The precipitous decrease in AIS admissions and telestroke consults may be a consequence of patients not reporting neurological manifestations due to the fear of contracting the virus by visiting the Emergency Room. Such outcomes are consistent with previous reports by the World Stroke Organization (50%-70% decline in AIS admission) and the cardiology experience from the USA (38% decrease in cardiac catheterization lab STEMI activations). 1, 2 The higher incidence of COVID-19 patients in the overall stroke group can be supported by recent theories that systemic COVID-19 may contribute to a hyper-thrombotic state and increase the risk of AIS. Of the 6 COVID-19 patients, 4 had tandem occlusions or multiple arterial occlusions (67%) compared to historic controls in our stroke series of 15%. Stroke care and the COVID19 pandemic words from our President. doi = 10.1016/j.wneu.2020.06.053 id = cord-267579-gkvd0fol author = Yang, Xiaoyu title = Asymptomatic Carrier Transmission of COVID-19 and The Multi-Point Aerosol Sampling to Assess Risks in OR During Pandemic Period date = 2020-07-27 keywords = SARS summary = title: Asymptomatic Carrier Transmission of COVID-19 and The Multi-Point Aerosol Sampling to Assess Risks in OR During Pandemic Period The 2019 novel coronavirus disease (COVID-19) causing acute infectious pneumonia has widely spread in China and other countries in the world. Studies have documented that novel coronavirus spread through human-to-human transmission in hospital and family setting 2,3 . Nevertheless, the transmission of the novel coronavirus from an asymptomatic carrier should be considered as a source of the infection of COVID-19 as well 4 . Therefore, it is of significance to identify and isolate asymptomatic carriers as well as patients with mild symptoms to prevent the spread of the virus. Clinical Characteristics of Coronavirus Disease 2019 in China Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients doi = 10.1016/j.wneu.2020.07.144 id = cord-330728-tul659fr author = Zaed, Ismail title = How is COVID-19 going to affect education in neurosurgery? A step toward a new era of educational training date = 2020-06-11 keywords = COVID-19; technology summary = Many medical offices have either made the 40 transition to telemedicine or greatly reduced their patient volumes to accommodate the widely accepted 41 "social distancing" recommendation by the World Health Organization (WHO) and the United States COVID-19 has forced us to rapidly adapt, integrate, and use technology to help us survive during these 46 challenging times. Despite being a very promising 110 technology able to influence neurosurgical training, several barriers still need to be defeated, such as the 111 expensiveness of the acquisition, the significant amount of space that many hospitals and programs do not 112 have for its installation and the fact that even the most modern simulators allow the performance of only a 113 few specific procedures. In more recent times, VR technologies started to be used also 124 in surgical fields, allowing an enhanced training of surgical skills. doi = 10.1016/j.wneu.2020.06.032