bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences with pregnancy and child-rearing, advice for future mothers, and suggestions for improving the system: a qualitative study of women in neurosurgery
Authors: Cicalese Kyle V. , Kruszewski Kendall L. , Krishnakumar Asha , Holloway Kathryn L.
Published: April 2024

OBJECTIVE

Neurosurgery is among the most demanding and time-consuming occupations, and with diversity and inclusion initiatives only recently increasing the number of women in the field, efforts still need to be made to help neurosurgery become more accommodating for pregnancy and child-rearing. Thus, the present study sought to be the first to investigate this issue through in-depth qualitative interviews of women in neurosurgery.

METHODS

A total of 33 female neurosurgeons participated in semistructured Zoom interviews. Cocoding and thematic analysis were conducted with interview transcripts to determine themes and corresponding subthemes with regard to these women’s experiences with pregnancy and child-rearing, advice for future mothers in neurosurgery, and suggestions for improving the field of neurosurgery for those desiring children.

RESULTS

Among the 33 participants, 22 (66.7%) had given birth to or adopted at least one child, had at least one stepchild, or were pregnant at the time of the interview. Three themes emerged regarding these 22 women’s experiences with pregnancy and child-rearing: 1) challenges with the physiological changes of pregnancy, 2) feelings of guilt and anxiety, and 3) reliance on loved ones for childcare. Three themes emerged among these 22 women’s advice for future mothers in neurosurgery: 1) set realistic expectations, 2) take control of your schedule, and 3) realize that there is no "right" time to start a family. Finally, two themes emerged among all 33 participants’ suggestions for making neurosurgery more feasible for pregnancy and child-rearing: 1) revamping of on-site resources, and 2) improved guidance on family planning, childbearing, and maternity leave. The most prominent subtheme in the authors’ study was a call for improved on-site daycare under the "revamping of on-site resources" theme, with a particular emphasis on 24/7 operation.

CONCLUSIONS

The authors’ data have illustrated the themes of the experiences and thoughts of women in a field where pregnancy and child-rearing are arguably the most challenging of any occupation. Resources such as improved on-site daycare and organized, program-specific information sets for future mothers appear to comprise a consensus of suggested solutions by the women directly experiencing these challenges. The authors’ results may be useful in guiding system-wide changes that may improve the field of neurosurgery for current and future mothers.
Rates of operative intervention and in-hospital mortality following subarachnoid hemorrhage in patients with COVID-19
Authors: Dallas Jonathan , Fixman Benjamin , Ding Li , Lin Michelle , Nguyen Vincent N. , Attenello Frank J. , Mack William J.
Published: April 2024

OBJECTIVE

COVID-19 had massive effects on the healthcare system and multifactorial implications for the management of intensive care unit and cerebrovascular patients. This study aimed to assess the effect of COVID-19 on the outcomes of patients with aneurysmal subarachnoid hemorrhage (SAH).

METHODS

The National Inpatient Sample (NIS) was used to identify patients with nontraumatic SAH (ICD-10 code I60.x). Patients with nonaneurysmal cerebrovascular malformations or traumatic intracranial injuries were excluded. Only patients managed from April to December 2020 were included in the study given the availability of an ICD-10 code for COVID-19. Data on sociodemographic factors, hospital characteristics, comorbidities, NIS SAH Severity Score (NIS-SSS), surgical treatment, and death were acquired. Multivariable analysis was used to assess predictors of both surgical intervention and in-hospital mortality.

RESULTS

In total, 6984 patients met the study criteria, 359 (5.1%) of whom had COVID-19. Those with COVID-19 were more likely to be younger and male and had a higher All Patient Refined Diagnosis-Related Groups illness severity subclass, and NIS-SSS. Moreover, patients with COVID-19 were less likely to undergo surgery (10.0% vs 23.6%, OR 0.35, p < 0.0001) and had significantly higher mortality rates (48.2% vs 22.7%, p < 0.0001). When controlling for other variables, COVID-19 was an independent predictor of death (OR 1.67, p = 0.0002). Aneurysm surgery was performed in 1597 patients (317 open and 1280 endovascular procedures). There was no difference between the cohorts positive and negative for COVID-19 in terms of time to surgery or type of surgery.

CONCLUSIONS

COVID-19 had significant impacts on patients with nontraumatic SAH. Specifically, patients with COVID-19 were significantly less likely to undergo surgery and had higher in-hospital mortality rates; however, for patients who did undergo procedural intervention, there was no significant difference in the type of intervention. Multiple factors, from medical acuity to healthcare system limitations, may contribute to these findings. Further retrospective research is needed to identify both specific causes of lower intervention rates and other potential nonaneurysmal causes of SAH in patients with COVID-19.
Purely endoscopic subtemporal keyhole anterior transpetrosal approach to access the petrous apex region: surgical techniques and early results
Authors: Morisako Hiroki , Sasaki Tsuyoshi , Ikegami Masaki , Tanoue Yuta , Ohata Hiroki , Goudihalli Sachin Ranganatha , Fernandez-Miranda Juan Carlos , Ohata Kenji , Goto Takeo
Published: April 2024

OBJECTIVE

The anterior transpetrosal approach using a microscope to provide wider access to the petrous apex region has been described for radical resection of lesions of the middle and posterior skull base. The microscopic anterior transpetrosal approach (mATPA) requires a wide craniotomy and meticulous epidural procedures to minimize temporal lobe retraction. Recently, the clinical application of transcranial endoscopic keyhole approaches for minimally invasive surgery has been steadily expanding. In this study, the details of the purely endoscopic subtemporal keyhole ATPA (eATPA) for petrous apex lesions are described and its initial results are reported.

METHODS

Between May 2022 and May 2023, the authors performed eATPA in 10 patients with petrous apex lesions, of which 6 were meningiomas, 3 were trigeminal schwannomas, and 1 was epidermoid cyst. The surgical procedure of the purely eATPA is as follows. After a small temporal craniotomy, the endoscopic procedure is started. The anterior rim of the petrous bone and Meckel’s cave are exposed via an intradural subtemporal approach. The lesion is removed with additional drilling of Kawase’s triangle, cutting the superior petrosal sinus, opening Meckel’s cave, and cutting the tentorium. The authors also compared the outcomes of mATPA versus eATPA for consecutive cases of petrous apex lesions.

RESULTS

Gross-total resection was achieved in 8 of the 10 patients. The average operative time was 4 hours 13 minutes. There were 3 cases of transient abducens nerve palsy and 1 case of trochlear nerve palsy in the postoperative period. No new-onset motor deficits or CSF leakage was noted in any of these patients. Only 1 patient exhibited postoperative asymptomatic temporal lobe edema. The Karnofsky Performance Scale (KPS) scores remained unchanged or improved for all patients postoperatively. Compared with mATPA, eATPA achieved a similar extent of resection and comparable postoperative KPS scores with a significantly shorter mean operative time, much smaller temporal craniotomy, and thus less mean blood loss during surgery with lower rates of new-onset temporal lobe edema in the postoperative period.

CONCLUSIONS

An eATPA allows a direct route to access Meckel’s cave and posterior cranial fossa lesions similar to conventional mATPA, with shortening the operative time and reducing the risk of postoperative temporal lobe edema. This eATPA is considered one of the new surgical techniques that can be expected to develop in the future.
Surgical intervention for cerebral amyloid angiopathy–related lobar intracerebral hemorrhage: a systematic review
Authors: de Bruin Ole F. , Voigt Sabine , Schoones Jan W. , Moojen Wouter A. , van Etten Ellis S. , Wermer Marieke J. H.
Published: April 2024

OBJECTIVE

The risks and benefits of surgery for cerebral amyloid angiopathy (CAA)–related lobar intracerebral hemorrhage (ICH) are unclear. The aim of this study was to systematically review the literature on this topic.

METHODS

The authors conducted a systematic review according to the 2020 PRISMA statement. PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, Emcare, and Academic Search Premier were searched (on December 27, 2022) for relevant articles. Study inclusion criteria were: 1) randomized controlled trial (RCT), cohort study, cross-sectional design, or case series with more than 5 patients; 2) possible, probable, or definite CAA according to the Boston criteria (version 1.0 or 1.5) or autopsy; 3) surgical intervention for acute ICH; and 4) data on peri- and/or postoperative outcomes. Primary outcomes were the presence of intraoperative hemorrhage (IOH), postoperative hemorrhage (POH), and early ICH recurrence. Secondary outcomes were 3-month mortality, late ICH recurrence, functional outcome at discharge, and factors associated with poor outcome. Pooled estimates were calculated, and the Joanna Briggs Institute Critical Appraisal Tool was used to assess risk of bias.

RESULTS

Four cohort studies and 15 case series (n = 738 patients, mean age 70 years, 56% women) were included. IOH occurred in 2 (0.6%) of 352 patients. Pooled estimates for POH were 13.0% (30/225) for less than 48 hours and 6.2% (3/437) for 48 hours to 14 days. Overall recurrent ICH (mean follow-up 19 months, n = 5 studies) occurred in 11% of patients. Outcome was predominantly poor with a pooled 3-month mortality rate of 19% and good outcome of 23%. Factors associated with poor outcome were advanced age, poor condition on admission, preexisting dementia, and concomitant intraventricular, subarachnoid, or subdural hemorrhage. All studies contained possible sources of bias and reporting was heterogeneous.

CONCLUSIONS

Surgery in CAA-related ICH is safe with no substantial IOH, POH, and early recurrent hemorrhage risk. Outcome appears to be poor, however, especially in older patients, although good quality of evidence is lacking. Patients with CAA should not be excluded from ongoing surgery RCTs in ICH to enable future subgroup analysis of this specific patient population.
Incidence, predictors, and outcomes of malignant cerebral edema in acute basilar artery occlusion after endovascular treatment: a secondary analysis of the ATTENTION trial
Authors: Huang Xianjun , Wang Hao , Ji Yachen , Tao Chunrong , Shang Xianjin , Ni Chuyuan , Xu Junfeng , Xu Xiangjun , Hu Wei , Zhou Zhiming
Published: April 2024

OBJECTIVE

Malignant cerebral edema (MCE) is a life-threatening complication of ischemic stroke. Few studies have evaluated MCE in patients with acute basilar artery occlusion (BAO) receiving endovascular treatment (EVT). Therefore, the authors investigated the incidence, predictors, and functional outcomes of MCE in BAO patients undergoing EVT.

METHODS

This was a post hoc analysis of the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) trial, a prospective, randomized, multicenter clinical trial that compared endovascular treatment with conventional care of patients with BAO at 36 centers in China. Brain edema was retrospectively assessed using the Jauss score for all available follow-up scans, and patients with a Jauss score ≥ 4 were classified as having MCE. Clinical functional independence was defined as a modified Rankin Scale (mRS) score of 0–2, and a good outcome was defined as an mRS score of 0–3 at the 90-day follow-up. Univariate and multivariate analyses were used to explore the predictors of MCE and the impact of MCE on prognosis.

RESULTS

A total of 189 patients were analyzed, and 13.2% of patients developed MCE. Multivariate analysis showed that the baseline Glasgow Coma Scale (GCS) score (OR 0.722, 95% CI 0.548–0.950; p = 0.020) and the number of procedures (OR 1.594, 95% CI 1.051–2.419; p = 0.028) were significantly associated with MCE. After adjusting for confounding factors, the presence of MCE was significantly associated with a lower rate of functional independence (OR 0.115, 95% CI 0.023–0.563; p = 0.008), a lower rate of good outcome (OR 0.092, 95% CI 0.023–0.360; p = 0.001), and a higher rate of mortality (OR 5.373, 95% CI 2.055–14.052; p = 0.001) at the 90-day follow-up.

CONCLUSIONS

MCE is not uncommon in BAO patients undergoing EVT and is associated with poor outcomes. Baseline GCS score and the number of procedures were predictors of MCE. In clinical practice, it is crucial that physicians identifying MCE after EVT in patients with BAO and identification of MCE will help in the selection of an appropriate pharmacological treatment strategy and close monitoring.
Development and validation of machine learning models to predict postoperative infarction in moyamoya disease
Authors: Fuse Yutaro , Ishii Kazuki , Kanamori Fumiaki , Oyama Shintaro , Imaizumi Takahiro , Araki Yoshio , Yokoyama Kinya , Takasu Syuntaro , Seki Yukio , Saito Ryuta
Published: April 2024

OBJECTIVE

Cerebral infarction is a common complication in patients undergoing revascularization surgery for moyamoya disease (MMD). Although previous statistical evaluations have identified several risk factors for postoperative brain ischemia, the ability to predict its occurrence based on these limited predictors remains inadequately explored. This study aimed to assess the feasibility of machine learning algorithms for predicting cerebral infarction after revascularization surgery in patients with MMD.

METHODS

This retrospective study was conducted across two centers and harnessed data from 512 patients with MMD who had undergone revascularization surgery. The patient cohort was partitioned into internal and external datasets. Using perioperative clinical data from the internal cohort, three distinct machine learning algorithms—namely the support vector machine, random forest, and light gradient-boosting machine models—were trained and cross-validated to predict the occurrence of postoperative cerebral infarction. Predictive performance validity was subsequently assessed using an external dataset. Shapley additive explanations (SHAP) analysis was conducted to augment the prediction model’s transparency and to quantify the impact of each input variable on shaping both the aggregate and individual patient predictions.

RESULTS

In the cohort of 512 patients, 33 (6.4%) experienced postrevascularization cerebral infarction. The cross-validation outcomes revealed that, among the three models, the support vector machine model achieved the largest area under the receiver operating characteristic curve (ROC-AUC) at mean ± SD 0.785 ± 0.052. Notably, during external validation, the light gradient-boosting machine model exhibited the highest accuracy at 0.903 and the largest ROC-AUC at 0.710. The top-performing prediction model utilized five input variables: postoperative serum gamma-glutamyl transpeptidase value, positive posterior cerebral artery (PCA) involvement on preoperative MRA, infarction as the rationale for surgery, presence of an infarction scar on preoperative MRI, and preoperative modified Rankin Scale score. Furthermore, the SHAP analysis identified presence of PCA involvement, infarction as the rationale for surgery, and presence of an infarction scar on preoperative MRI as positive influences on postoperative cerebral infarction.

CONCLUSIONS

This study indicates the usefulness of employing machine learning techniques with routine perioperative data to predict the occurrence of cerebral infarction after revascularization procedures in patients with MMD.
The first neurosurgical service in Texas: neurosurgery at the University of Texas Medical Branch (1937–2023)
Authors: Valdés Pablo A. , Husain Adam , Alonzo Alejandro , Price Anthony , Nia Anna M , Maynard Ken , Costa Matias , Karas Patrick J. , Lall Rishi R. , Briner Rudy P. , Kan Peter
Published: April 2024

The authors present a historical analysis of the first neurosurgical service in Texas. Initially established as a subdivision within the Department of Surgery in the early 1900s, this service eventually evolved into the Department of Neurosurgery at the University of Texas Medical Branch (UTMB). The pivotal contributions of individual chiefs of neurosurgery throughout the years are highlighted, emphasizing their roles in shaping the growth of the neurosurgery division. The challenges faced by the neurosurgical division are documented, with particular attention given to the impact of hurricanes on Galveston Island, Texas, which significantly disrupted hospital operations. Additionally, a detailed account of recent clinical and research expansions is presented, along with the future directions envisioned for the Department of Neurosurgery. This work offers a comprehensive historical narrative of the neurosurgical service at UTMB, chronicling its journey of growth and innovation, and underscoring its profound contributions to Galveston’s healthcare services, extending its impact beyond the local community.
Efficacy and safety of tranexamic acid in the management of chronic subdural hematoma: a systematic review and meta-analysis
Authors: Musmar Basel , Orscelik Atakan , Salim Hamza , Adeeb Nimer , Spellicy Samantha , Abdelgadir Jihad , Azar Jehad , Cuellar-Saenz Hugo H. , Guthikonda Bharat , Jabbour Pascal , Hasan David
Published: April 2024

OBJECTIVE

Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition, particularly among the elderly. Various treatment options exist, but recurrence rates remain high. This systematic review and meta-analysis aims to assess the efficacy and safety of tranexamic acid (TXA) in the management of CSDH.

METHODS

The authors conducted a comprehensive literature search adhering to the 2020 PRISMA guidelines, involving three primary databases (Scopus, PubMed, and Web of Science) that were searched for articles compiled from inception until October 20, 2023. The primary outcome was recurrence of CSDH, and secondary outcomes included complications and SDH volume following TXA treatment. The mean difference and odds ratios with 95% confidence intervals were calculated using the random-effects model.

RESULTS

A total of 5 studies, involving 643 patients in the TXA group and 736 patients in the non-TXA group, met the inclusion criteria. The meta-analysis revealed that TXA use led to a significantly lower CSDH recurrence (OR 0.35, 95% CI 0.23–0.53; p < 0.01) without increasing complications (OR 1.84, 95% CI 0.43–7.95; p = 0.42). Additionally, TXA users had a significantly lower CSDH volume compared to the non-TXA group at 3-month follow-up (mean difference −4.56, 95% CI −8.76 to −0.36; p = 0.03).

CONCLUSIONS

The findings suggest that TXA might be a promising agent for reducing the risk of CSDH recurrence without elevating the risk of complications. However, these results should be interpreted cautiously due to the limited number of studies included and the methodological heterogeneity. Further large-scale randomized controlled trials are needed to confirm these findings.
The intersection of race and social determinants of health on clinical outcome of glioblastoma patients
Authors: Asfaw Zerubabbel K. , Hernandez-Marquez Gianina C. , Naik Anant , Young Tirone , Vega Perez Ruben , Bickell Nina , Germano Isabelle M.
Published: April 2024

OBJECTIVE

Resection, chemotherapy, radiation therapy, and tumor treating fields significantly increase the overall survival (OS) of glioblastoma (GBM) patients. Yet, cost and healthcare disparities might limit access. Multiple studies have attributed more than 80% of the GBM disease burden to White patients. The aim of this study was to explore the intersections of race and social determinants of health (SDoH) with healthcare access and outcomes of GBM patients in a large metropolitan area.

METHODS

In this retrospective single-center study, the tumor registry at the authors’ institution (2011–2019) was queried to identify a GBM cohort according to the updated WHO criteria. Data were supplemented by electronic health records to include demographics, outcome, National Cancer Institute Comorbidity Index (NCI-CI), and the Agency for Healthcare Research and Quality (AHRQ) socioeconomic status (SES) index.

RESULTS

A total of 276 unique patients met the study inclusion criteria; 46% of the cohort was female, and 45% was non-White. This racial proportion differs from previous reports indicating that 80% of patients with GBM are White. The proportion of non-White patients in this study was similar to that of the general US population and significantly lower than that of New York City (p < 0.05). Non-White patients predominantly composed the lowest AHRQ SES index quartile, while White patients constituted the highest quartile (p < 0.001). White patients were older at diagnosis compared with non-White patients (63 vs 58 years, p = 0.001). Older age (p = 0.03), higher NCI-CI (p = 0.0006), and lack of insurance (p = 0.03) reduced the odds of a home discharge. Private insurance (p = 0.005), younger age (p = 0.02), and the highest ("wealthiest") AHRQ SES index quartile (p = 0.02) predicted a lower hospital length of stay (LOS). Patients who underwent gross-total resection had greater OS than those who received a subtotal resection or biopsy, independent of race and SDoH (1.68 vs 1.4 years, p = 0.022).

CONCLUSIONS

This study is the first to report on race and SDoH of a cohort using the latest WHO criteria for GBM classification. In contrast to previous literature, the study cohort exhibits a higher proportion of non-White patients with GBM, similar to the representation of non-White individuals in the general US population. This study corroborates the impact of SDoH and not race on LOS and discharge location. Initiatives to identify and address these barriers are crucial for enhancing the care of all GBM patients.
Factors associated with increased length of stay in degenerative cervical spine surgery: a cohort analysis from the Canadian Spine Outcomes and Research Network
Authors: Moskven Eryck , McIntosh Greg , Nataraj Andrew , Christie Sean D. , Kumar Rajesh , Phan Philippe , Wang Zhi , Tarabay Bilal , Weber Michael H. , Singh Supriya , Bailey Christopher S. , Manson Neil A. , Abraham Edward , Paquet Jérôme , Wilson Jefferson R. , Rampersaud Y. Raja , Fisher Charles G. , Dea Nicolas , Charest-Morin Raphaële
Published: April 2024

OBJECTIVE

Postoperative length of stay (LOS) significantly contributes to healthcare costs and resource utilization. The primary goal of this study was to identify patient, clinical, surgical, and institutional variables that influence LOS after elective surgery for degenerative conditions of the cervical spine. The secondary objectives were to examine the variability in LOS and institutional practices used to decrease LOS.

METHODS

This was a multicenter observational retrospective cohort study of patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) between January 2015 and October 2020 who underwent elective anterior cervical discectomy and fusion (ACDF) (1–3 levels) or posterior cervical fusion (PCF) (between C2 and T2) with/without decompression for degenerative conditions of the cervical spine. Prolonged LOS was defined as LOS greater than the median for the ACDF and PCF populations. The principal investigators at each participating CSORN healthcare institution completed a survey to capture institutional practices implemented to reduce postoperative LOS.

RESULTS

In total, 1228 patients were included (729 ACDF and 499 PCF patients). The median (IQR) LOS for ACDF and PCF were 1.0 (1.0) day and 5.0 (4.0) days, respectively. Predictors of prolonged LOS after ACDF were female sex, myelopathy diagnosis, lower baseline SF-12 mental component summary score, multilevel ACDF, and perioperative adverse events (AEs) (p < 0.05). Predictors of prolonged LOS after PCF were nonsmoking status, education less than high school, lower baseline numeric rating scale score for neck pain and EQ5D score, higher baseline Neck Disability Index score, and perioperative AEs (p < 0.05). Myelopathy did not significantly predict prolonged LOS within the PCF cohort after multivariate analysis. Of the 8 institutions (57.1%) with an enhanced recovery after surgery (ERAS) protocol or standardized protocol, only 3 reported using an ERAS protocol specific to patients undergoing ACDF or PCF.

CONCLUSIONS

Patient and clinical factors predictive of prolonged LOS after ACDF and PCF are highly variable, warranting individual consideration for possible mitigation. Perioperative AEs remained a consistent independent predictor of prolonged LOS in both cohorts, highlighting the importance of preventing intra- and postoperative complications.
Impact of bilateral facet joint violation on radiographic degeneration of superior adjacent segments and clinical outcomes
Authors: Ding Zhiguo , Di Derun , Wang Lianlei , Liu Xinyu
Published: April 2024

OBJECTIVE

Facet joint violation (FJV) is associated with postoperative low-back pain and is a confirmed risk factor for adjacent-segment degeneration, a long-term complication of lumbar fusion surgery. The authors’ knowledge of its mechanisms comes from in vitro biomechanical research only; there is a lack of radiographic evidence of the effects of violation on the superior adjacent-segment facet joint, intervertebral disc, and other local radiographic parameters. Furthermore, any differences between unilateral and bilateral violation remain relatively unclear. The authors therefore aimed to explore the effects of nonviolation and unilateral and bilateral violation on radiographic degeneration of the facet joint and intervertebral disc at the fusion and superior adjacent segment. Patient-reported clinical outcomes were compared at the 2-year follow-up.

METHODS

The authors retrospectively analyzed data from 148 patients with lumbar degenerative diseases who underwent single-segment minimally invasive transforaminal lumbar interbody fusion between 2016 and 2020. FJV and facet joint degeneration were evaluated and graded using Shah’s method and Pathria’s standard, respectively. Radiographic parameters, including disc height and intervertebral Cobb angle at the fusion and superior adjacent segment, were measured. Clinical outcomes were evaluated using visual analog scale (VAS) and Japanese Orthopaedic Association scores.

RESULTS

Preoperative data were comparable among the 3 groups (nonviolation, unilateral violation, and bilateral violation) (p > 0.05). Patient-reported clinical outcomes were followed up for at least 2 years (average duration 28.17 ± 6.17 months). At the last follow-up, facet joint degeneration grades were sequentially increased in the nonviolation, unilateral violation, and bilateral violation groups (p = 0.006). The unilateral (2.45 ± 2.17 mm) and bilateral (2.70 ± 1.94 mm) violation groups had more severe losses of disc height in the superior adjacent segment than did the nonviolation group (1.31 ± 2.01 mm). The VAS low-back pain and Japanese Orthopaedic Association scores in the bilateral (2.57 ± 1.44 and 19.83 ± 2.84, respectively) and unilateral (2.26 ± 0.79 and 20.43 ± 3.85, respectively) violation groups were significantly worse than in the nonviolation group (1.69 ± 1.12 and 21.80 ± 3.36, respectively) (p < 0.05). By contrast, there were no significant between-group differences in disc height, intervertebral Cobb angle in the fusion segment, or VAS leg pain scores (p > 0.05).

CONCLUSIONS

FJV was associated with postoperative low-back pain and worse functional outcomes. It also aggravated facet joint and intervertebral disc changes in the superior adjacent segment, especially when bilateral violation occurred; this may be part of the mechanisms of adjacent-segment degeneration.
Understanding proficiency-oriented silence in the context of EAL
Authors: Ekici Gail
Published: April 2024

This mixed methods, case study focuses on adult second language learning and their silences in a pre-intermediate level class, where they experience a potentially difficult time reaching the point of Target language proficiency. The findings of this study respond to the paucity of research on the problem adult student silence in a pre-intermediate language classroom by investigating the pre-intermediate language learning experiences of competent bilingual adults reflecting back on learning English as a second language (EAL) in Australia.  The findings give reason for why students are silent in class. Analysis of student reflections combined with the EAL teachers’ interviews identified a pedagogical barrier. These barriers caused them to be silent because most of the teachers teaching content at this level were not trained to teach students who approximately break their silence at this level, and need a particular teaching approach to help them. The findings show that there needs to be a reform in approach during adult silent period which happens to be approximately at pre-intermediate level (Ekici, 2022). The need for teacher professional development on being able to adapt their English language classroom talk to foster spoken interactions was seen as priority. Finings have shown that the nuanced dynamic between what teachers think they are doing and what students know they are trying to achieve in many cases fail to match. Teacher and learner confusion about each other’s' styles, the struggle to teach and learner in which both pedagogy and silence are mutually problematic, and above all else, the need for empathy for student learning and the need to customise a pedagogy to suit it to avoid untreated proficiency silence which can be detrimental (Ekici, 2022).
PELATIHAN PEMBUATAN ASESMEN DIGITAL DENGAN APLIKASI QUIZ-MAKER I-SPRING BAGI GURU-GURU SMA
Authors: Rahmawati Henny , Zauri Ahmad Sufyan , Azami Moh. Imron , Ilmi Yuli Ismi Nahdiyati
Published: April 2024

Abstrak: Kebutuhan akan penilaian berbasis digital akhir-akhir ini melatarbelakangi kegiatan pelatihan ini. Pelatihan ini terutama ditujukan untuk mendampingi para guru-guru SMA Islam Nusantara dari semua mata pelajaran untuk membuat asesmen digital menggunakan aplikasi Quiz-maker I-Spring. Dalam pelatihan ini, metode yang dipakai adalah pelatihan. Dalam pelatihan ini pengabdi bermitra dengan SMA Islam Nusantara, tempat pengabdian ini berlangsung, dengan partisipan sebanyak 13 guru. Dalam proses pengumpulan data sekaligus evaluasi dari pelatihan yang dilaksanakan, kami membagikan kuesioner kepada peserta sebelum dan sesudah pelatihan. Di samping itu, kami juga mengumpulkan data berupa observasi dari kegiatan yang sedang berlangsung dalam bentuk data lapangan. Data yang terkumpul kemudian dianalisis secara deskriptif kualitatif. Hasil dari analisis data yang terkumpul menunjukkan bahwa peserta sangat antusias dalam mengikuti pelatihan yang dinilai sangat bermanfaat untuk menyiapkan guru-guru menghadapi era digital. Di akhir pelatihan, dari hasil observasi menunjukkan bahwa kemampuan guru-guru dalam membuat asesmen digital dengan aplikasi Quiz-maker I Spring mengalami peningkatan. Selain untuk guru, pelatihan ini dinilai juga sangat bermanfaat untuk siswa di kemudian hari.Abstract: The recent need for digital-based assessments has prompted the initiation of this training program. This training primarily aims to assist the teachers of SMA Islam Nusantara in creating digital assessments using the Quiz-maker I-Spring application. The method employed is hands-on, taking place in SMA Islam Nusantara, involving fifteen teachers from across subjects. In the process of data collection and evaluation during the training, we distributed questionnaires to participants both before and after the training sessions. Additionally, we gathered observational data from the ongoing activities. The collected data were then analyzed descriptively and qualitatively. The results of the data analysis indicate that participants were highly enthusiastic about the training, considering that it’s very beneficial in preparing teachers to face the digital era. At the end of the training, observations showed that the ability of teachers to make digital assessments with the Quiz-maker I Spring application experienced an improvement. Moreover, the training was deemed highly valuable not only for teachers but also for students in the future.
PENYULUHAN INVESTASI SAHAM DAN PENGEMBANGAN APLIKASI KALKULATOR SAHAM PEMULA BAGI GURU HONORER
Authors: Setyawan Anton Agus , Abas Novel Idris , Kurniawan Muhammad Randhy , Imaduddin Helmi , Setyawan Muhammad Arkan
Published: April 2024

Abstrak: Pendapatan bagi guru honorer yang tidak sebanding dengan guru berstatus PNS telah menjadi salah satu tantangan dalam memenuhi kebutuhan hidup, terutama untuk investasi pada aset di masa depan. Pentingnya pengelolaan keuangan yang efektif, termasuk di dalamnya strategi investasi. Tujuan dari program pengabdian masyarakat ini adalah meningkatkan skill berinvestasi para guru. Mitra dalam program ini adalah 15 guru dari sekolah Al Mujahiddin Surakarta. Berdasarkan data yang terhimpun, penyuluhan dan pengembangan aplikasi saham memberikan manfaat signifikan kepada para guru, di mana setelah penyuluhan, pemahaman para guru terkait investasi saham meningkat. Proses evaluasi dilakukan dengan melakukan pre dan post test. Hasil dari post-test menunjukkan adanya peningkatan hingga 185%.Abstract: The income disparity between honorary teachers and those with permanent status as civil servants has become one of the challenges in meeting their living needs, especially for investing in future assets. The importance of effective financial management, including investment strategies, cannot be overstated. The objective of this community service program is to enhance the investment skills of teachers. The partners in this program are 15 teachers from Al Mujahiddin Surakarta School. Based on the gathered data, the counseling and development of stock application have provided significant benefits to the teachers, wherein after the counseling sessions, the teachers' understanding of stock investments improved. Evaluation processes were conducted through pre and post-tests. The results from the post-test indicated an increase of up to 185%.
PENINGKATKAN KESADARAN PERSILANGAN BUDAYA DAN DIGITALISASI PEMBELAJARAN PADA SISWA SMA MELALUI PENYULUHAN
Authors: Syahputri Rahmalia , Nurfiana Nurfiana , Trisnawati Sherli , Rafles Zhahza , Alex Zedric Pagdilao
Published: April 2024

Abstrak: Kegiatan pengabdian masyarakat ini bertujuan untuk meningkatkan pemahaman dan kesiapan digital siswa dalam menghadapi lintas budaya budaya dan digitalisasi pembelajaran. Hal ini penting dilakukan untuk memastikan dampak positif dari digitalisasi dan litas budaya tersebut dapat dimanfaatkan secara optimal oleh siswa dan menekan aspek negatif. Mitra kegiatan pengabdian ini adalah SMA Tunas Mekar Indonesia yang yang berlokasi di daerah Bandar Lampung. Kegiatan diikuiti 90 siswa dan didampingi oleh 9 Guru. Kegiatan dilakukan dengan metode penyuluhan dan diskusi kelompok. Hasil kuisioner pra kegiatan menunjukkan bahwa mayoritas siswa merasa yakin dalam menggunakan teknologi digital dan internet, serta menyatakan setuju bahwa kesiapan digital dapat meningkatkan kemampuan mereka untuk terhubung dengan orang-orang dari berbagai latar belakang. Sementara itu, hasil diskusi dijadikan sebagai bahan evaluasi yaitu kesesuaian tema dan kemampuan presentasi yang mendapatkan angka rata-rata % siswa berada di angka 80,78 dan 79. Hal ini menunjukkan bahwa siswa memiliki pemahaman yang baik tentang dampak teknologi dalam kehidupan sehari-hari. Berdasarkan hal tersebut, kegiatan ini memberikan kontribusi dalam meningkatkan pemahaman dan kesiapan digital siswa dalam menghadapi tantangan global yang semakin kompleks, serta memberikan wawasan tentang pentingnya literasi digital dan kesiapan dalam menghadapi tuntutan dunia digital.Abstract: This community service initiative aims to enhance students' comprehension of digital concepts and their preparedness to face the intersection of technology with different cultures in the context of education. The activity began with planning, including discussions between the team and school leadership to identify the actual needs of teachers and students for digital readiness. The next step involved students filling out a questionnaire to assess their understanding of the intersection of culture and technology in education. The supplementary material included topics such as the intersection of culture and artificial intelligence, followed by group discussions among students about the potential impact of technology in different industries and professions. The activity concluded with student presentations and evaluations. The questionnaire revealed that most students felt confident in using digital technology and agreed that digital readiness could enhance their ability to interact with people from diverse backgrounds. The group discussions demonstrated that students have a good understanding of the impact of technology on everyday life. This activity contributes to increasing students' digital comprehension and readiness to face complex global challenges while also emphasizing the significance of digital literacy and preparedness in meeting the demands of the digital world.
PEMANFAATAN MEDIA DIGITAL BERBASIS BUDAYA SEBAGAI UPAYA PENINGKATAN LITERASI DAN PEMAHAMAN KONSEP MATEMATIKA SISWA
Authors: Khasanah Binti Anisaul , Nurmitasari Nurmitasari , Hartono Susilo , Mutoharoh Nur , Syahputra Robby Kurniawan , Fahrurrozi Fahrurrozi , Aziz Umar Abdul , Monika Kasih Dua
Published: April 2024

Abstrak: Prioritas permasalahan mitra adalah keterbatasan kemampuan guru dalam mengembangkan media digital yang terintegrasi dengan budaya untuk meningkatkan literasi dan pemahaman konsep matematika. Tujuan kegiatan PKM ini adalah meningkatkan kemampuan guru matematika SMA se kabupaten Pringsewu yang tergabung dalam MGMP dalam membuat media digital berbasis budaya yang layak dan efektif sebagai upaya peningkatan literasi dan pemahaman konsep. Metode pelaksanaan PKM adalah penyuluhan, workshop dan pendampingan. Adapun sistem evaluasi yang digunakan pada PKM ini adalah tes (pretest dan posttest). Tes digunakan untuk mengetahui peningkatan kemampuan guru dalam membuat media digital yang terintegrasi dengan budaya. Mitra PKM ini adalah guru matematika SMA sekabupaten Pringsewu sebanyak 40 orang. Kegiatan PKM ini menghasilkan (1) pemahamanan dalam mengembangkan media pembelajaran terintegrasi budaya pada mata pelajaran matematika meningkat sebesar 22%; dan (2) guru mampu merancang dan mengembangkan media pembelajaran matematika yang terintegrasi dengan budaya lampung.Abstract: The partner's priority problem is the limited ability of teachers to develop digital media that is integrated with culture to increase literacy and understanding of mathematical concepts. The aim of this PKM activity is to improve the ability of high school mathematics teachers in Pringsewu district who are members of the MGMP to create appropriate and effective culture-based digital media in an effort to increase literacy and understanding of concepts. The methods for implementing PKM arecounseling, workshops and mentoring. The evaluation system used in PKM is a test (pretest and posttest). The test is used to determine the increase in teachers' abilities in creating digital media that is integrated with culture. The PKM partners are 40 high school mathematics teachers in Pringsewu Regency. This PKM activity resulted in (1) increased understanding of developing culturally integrated learning media in mathematics subjects by 22%; and (2) teachers are able to design and develop mathematics learning media that is integrated with Lampung culture.
PELATIHAN PENGELOLAAN ADMINISTRASI MENGGUNAKAN MICROSOFT OFFICE BAGI PEGAWAI UNTUK MENINGKATKAN KINERJA
Authors: Azhar Zulfi , Mulyani Neni , Hutahaean Jeperson
Published: April 2024

Abstrak: Microsoft Office merupakan software yang harus dikuasai oleh perangkat desa, namun tidak semua perangkat desa menguasainya. Hal tersebut disebabkan belum adanya pelatihan dan kurangnya pengetahuan tentang aplikasi teknologi informasi di sehingga pelayanan kepada masyarakat cenderung memerlukan waktu yang lama untuk membuat laporan atau surat menyurat. Maka pelatihan Microsoft Office perlu diberlakukan kepada pegawai Desa Sei Silau Timur Kabupaten Asahan dalam melaksanakan tugas administrasi dan pengelolaan laporan dalam mengoperasikan Microsoft Office. Metode pelatihan dengan cara diskusi dan praktek untuk dalam Microsot Office, khususnya microsoft word, excel dan powerpoint dalam memudahkan pekerjaan administrasi kepada pegawai dari Desa Sei Silau Timur Kabupaten Asahan yang berjumlah 25 orang. Peserta pelatihan berhasil menyelesaikan pencapaian pelatihan ini dengan baik dari hasil nilai posttest rata-rata 90,88%. dengan penyampaian materi dengan penjelasan, praktek dan diskusi.Abstract: Microsoft Office is software that must be mastered by village officials, but not all village officials master it. This is due to the lack of training and lack of knowledge about the application of information technology so that services to the public tend to take a long time to make reports or correspondence. So Microsoft Office training needs to be given to employees of East Sei Silau Village, Asahan Regency in carrying out administrative tasks and managing reports in operating Microsoft Office. Training method using discussion and practice for Microsoft Office, especially Microsoft Word, Excel and Powerpoint to facilitate administrative work for employees from East Sei Silau Village, Asahan Regency totaling 25 people. The training participants successfully completed this training achievement with an average posttest score of 90.88%. By delivering material with explanation, practice and discussion.
OPTIMALISASI PENGELOLAAN SAMPAH MELALUI PELATIHAN PEMBUATAN PUPUK ORGANIK DARI SAMPAH RUMAH TANGGA
Authors: Susilawati Tri , Darmawan Indra , Ardiansyah Eka
Published: April 2024

Abstrak: Pengolahan sampah dengan sistem konvensional yaitu dibuang, dibakar serta ditimbun bukan merupan solusi terbaik dari masalah sampah yang selama ini menjadi masalah utama hampir di setiap daerah di Indonesia. Model pengelolaan terbaik yaitu menerapkan sistem 3R. Sampah organik yang dihasilkan di rumah tangga merupakan sampah yang sangat berpotensi diolah kembali sesuai kaidah 3R. Tujuan kegiatan ini adalah mensosialisasikan terkait pentingnya pengolahan sampah berbasis rumah tangga serta melatih warga mengolah sampah rumah tangga menjadi pupuk organik. Dengan adanya pelatihan ini diharapkan mampu meningkatkan kemampuan ibu-ibu rumah tangga dalam mengelola sampah rumah tangga menjadi pupuk organik yang nantinya bisa bernilai ekonomi. Selain itu, dengan adanya pelatihan ii diharapkan ada kesadaran di masyarakat terkait pentingnya pengelolaan sampah secara maksimal berbasis rumah tangga. Metode yang digunakan yaitu dengan pelatihan dan sosialisasi. Mitra pengabdian ini adalah pemerintah Desa Berora Kecamatan Lopok Kabupaten Sumbawa. Jumlah peserta yang ikut dalam kegiatan ini sebanyak 30 orang. Evaluasi dilakukan dengan memberikan pre test dan post test serta dilakukan pendampingan pasca kegiatan. Hasil yang diperoleh dari kegiatan ini menunjukkan ada peningkatan pemahaman dari 45% sebelum sosialisasi dan pelatihan menjadi 85% setelah kegiatan. Selain itu, kegiatan ini juga menghasilkan 30 botol 600ml pupuk organic cair serta 10kg pupuk padat.Abstract: Processing waste using conventional systems, namely throwing away, burning and landfilling, is not the best solution to the waste problem which has been a major problem in almost every region in Indonesia. The best management model is implementing the 3R system. Organic waste produced in households is waste that has the potential to be reprocessed according to 3R principles. The aim of this activity is to socialize the importance of household-based waste processing and train residents to process household waste into organic fertilizer. The method used is training and socialization. This service partner is the government of Berora Village, Lopok District, Sumbawa Regency. The number of participants who took part in this activity was 30 people. Evaluation is carried out by providing pre-tests and post-tests as well as providing post-activity assistance. The results obtained from this activity showed that there was an increase in understanding from 45% before socialization and training to 85% after the activity. Apart from that, this activity also produced 30 bottles of 600ml liquid organic fertilizer and 10kg of solid fertilizer.
PELATIHAN DAN PENDAMPINGAN DIGITAL MARKETING DENGAN MENGGUNAKAN SOFTWARE CANVA GUNA PENGEMBANGAN BISNIS
Authors: Amegia Marissa Winimetha , Hidayatulloh Amir
Published: April 2024

Abstrak: Perkembangan teknologi saat ini yang sangat pesat mengubah metode komunikasi pemasaran, yang sebelumnya bersifat tradisional/konvensional menjadi digital. Saat ini, metode pemasaran digital adalah metode yang diminati oleh konsumen. Beberapa hal yang dapat dilakukan guna meningkatkan dampak media marketing saat pemasaran yaitu dengan menggunakan media sosial dan memanfaatkan perangkat lunak “canva” agar konten yang dihasilkan lebih menarik. Hal ini yang mendorong pengabdi untuk melaksanakan pengabdian dengan tujuan untuk meningkatkan softskill dengan memberikan edukasi, pelatihan, dan pendampingan terkait strategi promosi digital marketing menggunakan perangkat lunak “canva”. Pelatihan dan pendampingan ini ditujukan untuk UPT Logam Yogyakarta. Metode pengabdian menggunakan metode pelatihan dan pendampingan untuk admin media sosial UPT Logam Yogyakarta. Pelatihan dan pendampingan ini berhasil memberikan edukasi digital marketing dan penggunaan perangkat lunak “canva” yang diterapkan di UPT Logam Yogyakarta untuk kegiatan promosi. Pengabdian ini meningkatkan 88% kemampuan softskill desain admin media sosial UPT Logam Yogyakarta. Pelatihan dan pendampingan ini diharapkan dapat terus dilakukan untuk meningkatkan produktivitas usaha.Abstract: Current very rapid technological developments are changing marketing communication methods, which were previously traditional/conventional, to digital. Currently, digital marketing methods are methods that are in demand by consumers. Several things that can be done to increase the impact of marketing media when marketing are by using social media and utilizing "Canva" software so that the resulting content is more interesting. This is what encourages service members to carry out community service with the aim of improving soft skills by providing education, training and assistance related to digital marketing promotion strategies using "canva" software. This training and mentoring is aimed at UPT Logam Yogyakarta. The service method uses training and mentoring methods for UPT Logam Yogyakarta social media admins. This training and mentoring succeeded in providing digital marketing education and the use of the "canva" software implemented at UPT Logam Yogyakarta for promotional activities. This service increases 88% of UPT Logam Yogyakarta's social media admin design soft skills. It is hoped that this training and mentoring can continue to be carried out to increase business productivity.