bluuebunny/crossref_metadata_2025 huggingface dataset:
Putusan MK No. 46/PUU-VIII/2010 tentang Status Anak di Luar Nikah dan Fatwa MUI No. 11 Tahun 2012 dalam Perspektif Maqashid Syari’ah Al-Khamsah
Authors: Fitriyah  , Parnomo Budi , Hidayati Rahmatul
Published: July 2023

Tujuan penelitian ini adalah menganalisis pandangan Maqashid Syari`ah al-Khamsah terhadap putusan Mahkamah Konstitusi nomor 46/PUU-VIII/2010 tentang status anak luar nikah, pendapat Fatwa Maqashid Syari'ah al-Khamsah MUI No. 11 Tahun 2012 dan perbandingan diantara kedua putusan tersebut. Untuk memecahkan isu hukum terkait penelitian tersebut, pendekatan yang digunakan dalam penelitian ini adalah pendekatan undang-undang (statute approach) dan pendekatan perbandingan (comparative approach). Hasil penelitian mengungkapkan bahwa dalam Putusan Mahkamah Konstitusi Nomor 46/PUUVIII/2010 tentang status anak luar nikah, konsep al-dharuriyat, Maqashid Syariah al-Khamsah atau hifdz nafs dibahas sangat erat, karena membahas tentang hak anak melindungi jiwa anak dengan memenuhi kebutuhannya. Sedangkan menurut pemahaman prinsip hifdz nashl Maqashid Syari'ah al-Khamsa, keturunan yang sah adalah anak yang lahir dari perkawinan yang sah secara agama. Fatwa MUI No. 11 Tahun 2012 tentang status anak luar nikah dan perlakuan terhadap kelahirannya. Hal ini sejalan dengan Maqasid Syari'ah al-Khamsah, khususnya yang berkaitan dengan hifdz nashli karena Maqasid Syari'ah al-Khamsah yang menyatakan bahwa generasi anak bagi orang tuanya adalah yang lahir dari perkawinan sah. Fatwa tersebut juga sesuai dengan Maqasid Syari’ah al-Khamsah dalam hifdz nafs yaitu dengan diwajibkannya bagi laki-laki yang mengakibatkan kelahirannya untuk memenuhi kebutuhan hidup sang anak dan memberikan harta yang dimiliki melalui wasiat wajibah.
Perlindungan Hukum terhadap Anak Korban Kekerasan Seksual menurut Hukum Positif di Indonesia (Analisis Putusan Nomor 320/Pid.Sus/2022/PN.Kpn)
Authors: Mawarni Wiwin , Hidayati Rahmatul , Rokhim Abdul
Published: July 2023

Artikel ini bertujuan untuk menganalisis dan mengkaji pengaturan perlindungan hukum terhadap anak korban kekerasan seksual di Indonesia dan untuk menganalisis dan mengkaji bagaimana pelaksanaan perlindungan hukum kekerasan seksual secara represif di Indonesia. Masalah difokuskan pada perlindungan hukum terhadap anak korban kekerasan seksual di Indonesia. Guna mendekati masalah ini dipergunakan acuan teori dari artikel atau karya yang sesuai dengan masalah penelitian. Data-data yang didapat dikumpulkan melalui studi kepustakaan dan studi dokumentasi yang bersumber dari peraturan perundang-undangan yang terkait dengan masalah penelitian, buku-buku hukum yang mengandung konsep-konsep hukum, dokumen resmi, publikasi, dan hasil penelitian dan dianalisis secara kualitatif. Kajian ini menyimpulkan bahwa, Perlindungan hukum terhadap anak korban kekerasan seksual telah diatur secara spesifik dalam berbagai peraturan perundang-undangan tentang anak. Kasus kekerasan seksual di Indonesia sangat beragam dengan berbagai motif dan tindakan yang berbeda yang melibatkan berbagai pihak. Bentuk perlindungan hukum di Indonesia dalam praktek sudah sesuai dengan peraturan yang berlaku. Hal tersebut dapat dilihat dalam Putusan Nomor 320/Pid.Sus/2022/PN.Kpn yang memutus perkara tindak pidana melakukan ancaman kekerasan terhadap anak untuk melakukan perbuatan cabul yang dilakukan oleh orang tua secara berlanjut.
Justice Aspects of Financial Service Authorities’s Competence for Bankruptcy and PKPU of Financial Service Institutions Based on Law No. 4 Year 2023
Authors: Johan Suwinto , Gunadi Ariawan
Published: July 2023

The Law on the Development and Strengthening of the Financial Sector was legalized by President Joko Widodo. The Act is known as Law No. 4 of 2023 often known as the P2SK Law, which stipulates that the Financial Services Authority or Otoritas Jasa Keuangan (OJK) is the only party that has the authority to file for bankruptcy and postpone debt payment obligations for financial service institutions. This research will provide novelty, especially on the definition of justice in the financial services sector, especially related to the interests of consumers and creditors with regulatory authority.This right has eliminated the creditor rights of insolvent financial service institutions. Creditors do not have any rights or legal action against defaulting or insolvent financial institutions. This research aims to examine the authority of OJK over bankruptcy and PKPU of Financial Services Institutions and justice for other creditors dan consumers according to the OJK’S authority. This researchers employed the normative juridical method. This study concluded that the authority of the OJK must be reviewed with consideration of the authority already possessed by the OJK, practical conditions in the business world specifically for financial service institutions, and the position and rights of creditors for loans to financial service institutions. The results of the study also found that the authority of the Financial Services Authority did not reflect the value of justice for consumers and creditors
Analisis Legalitas Kendaraan Roda Tiga sebagai Angkutan Orang dan Barang
Authors: Kusuma Wisnu Wardana , Saimima Ika Dewi Sartika , Dudung Sam Deli Imanuel
Published: July 2023

Penelitian ini mengkaji legalitas kendaraan bermotor roda tiga sebagai angkutan penumpang dan barang berdasarkan hukum normatif di Indonesia. Metode penelitian yang digunakan adalah hukum normatif atau doktrinal. Hasil penelitian ini menunjukkan kendaraan bermotor roda tiga sebagai angkutan penumpang diatur dalam PM 177 Tahun 2018 Pasal 33 yang menyatakan penggunaan angkutan roda tiga hanya pada kawasan tertentu. Penggunaan kendaraan roda tiga sebagai angkutan barang dilakukan pada kondisi tertentu yang dijelaskan dalam PP 60 Tahun 2019. Berdasarkan fenomena yang terjadi di lapangan menunjukkan pelanggaran dari segi spek teknis kendaraan dan penggunaan kendaraan roda tiga yang tidak sesuai dengan kegunaan. Penelitian ini direkomendasikan sebagai kajian hukum dalam penggunaan kendaraan bermotor roda tiga sebagai angkutan penumpang dan angkutan barang di Indonesia.
Penentuan Status Korban Pemerkosaan Guna Melakukan Aborsi Pasca Pengesahan Undang-undang Nomor 1 Tahun 2023
Authors: Wahyudhi Tsabitha Afnan Putri , Harefa Beniharmoni
Published: July 2023

Artikel ini bertujuan untuk mencari penentuan kapan seseorang dapat dikatakan sebagai korban kekerasan seksual penyebab kehamilan dalam konteks korban menginginkan prosedur aborsi sesuai ketentuan Pasal 463 Ayat (2) Undang-undang Nomor 1 Tahun 2023. Penentuan ini ditetapkan agar janin tidak melewati batas waktu umur 14 minggu. Masalah difokuskan pada seharusnya penentuan kapan seseorang dapat dikatakan sebagai korban kekerasan seksual penyebab kehamilan dalam konteks korban menginginkan prosedur aborsi sesuai ketentuan Pasal 463 Ayat (2) Undang-undang Nomor 1 Tahun 2023 di masa mendatang. Guna mendekati masalah ini dipergunakan acuan teori keadilan hukum dari John Rawles dan Aristoteles. Data-data dikumpulkan melalui cara kepustakaan dan dianalisis secara kualitatif.  Kajian ini menyimpulkan bahwa pihak yang berwenang menentukan kapan seseorang dapat melakukan aborsi legal adalah penyidik dan penentuan status sebagai korban pemerkosaan adalah saat penyidikan. Hal ini disimpulkan berasarkan Undang-undang No. 12 Tahun 2022 tentang Tindakan Pidana Kekerasan Seksual dan Peraturan Kapolri (Perkap) No. 6 tahun 2019 berisi tentang Penyidikan Tindak Pidana.
Argumen Ad hominem sebagai Strategi Komunikasi para Advokat dalam Program Kontroversi Metro TV
Authors: Kami Kanisius , Nesi Antonius
Published: July 2023

Dalam pandangan tradisional, ad hominem dipahami sebagai argumen yang ditujukan kepada lawan, atau kadang dapat dimengerti sebagai serangan terhadap karakter pribadi. Penelitian ini bertujuan untuk mendeskripsikan model argumen ad hominem sebagai strategi komunikasi para advokat dalam tayangan Kontroversi Metro TV. Penelitian ini digolongkan sebagai penelitian deskriptif kualitatif. Sumber data penelitian ini adalah lima rekaman mata acara Kontroversi Metro TV yang membahas kasus kematian Brigadir Josua. Pengumpulan data penelitian ini menggunakan metode simak, yang diterapkan melalui teknik catat. Analisis data penelitian ini memanfaatkan teknik analisis isi. Berdasarkan hasil analisis data ditemukan bahwa model ad hominem yang ditemukan dalam mata acara Kontroversi Metro TV dapat diperinci menjadi tiga, yakni (1) ad hominem dalam wujud serangan terhadap psikis, (2) ad hominem dalam wujud serangan terhadap kredibilitas kompetensi, dan (3) ad hominem dalam wujud serangan terhadap sifat atau karakter.
Pola Komunikasi Polrestabes Medan untuk Membangun Citra Positif di Kalangan Masyarakat
Authors: Irwanty Ghita , Ritonga Elfi Yanti
Published: July 2023

Kepolisian bertanggung jawab memelihara hukum dan ketertiban, serta melindungi warga negara. Hubungan antara polisi dan masyarakat sangat menentukan efektivitas polisi dalam melaksanakan tugasnya. Citra polisi yang positif dalam masyarakat membangun kepercayaan dan kerja sama, yang meningkatkan hubungan dan eamanan publik. Namun dalam beberapa tahun terakhir, terdapat kekhawatiran yang berkembang terhadap kelalaian polisi, seperti: penyalahgunaan kekuasaan (abuse of power) dan kurangnya akuntabilitas. Hal ini merusak hubungan antara polisi dan masyarakat, serta mempersulit polisi untuk menjalankan tugasnya secara efektif. Untuk mengatasi tantangan ini, penting untuk memahami pola komunikasi polisi dan dampaknya dalam mempertahankan citra positif di masyarakat. Tujuan penelitian ini adalah untuk memahami pola komunikasi yang digunakan polisi saat berkomunikasi dengan masyarakat, dan untuk mengidentifikasi tantangan yang mereka hadapi dalam melaksanakannya. Teknik pengumpulan data menggunakan metode kualitatif deskriptif. Hasil penelitian ini yakni dari empat pola komunikasi, Polrestabes Medan lebih dominan dalam menggunakan pola komunikasi sekunder lewat pemanfaatan media sosial
Penemuan Unsur Tanah Langka Lumpur Lapindo
Authors: Mesti Woro Mahatmi Mesti Woro
Published: July 2023

Pada awal 2022, penemuan unsur tanah langka memicu minat kembali terhadap Lumpur Lapindo. Kemungkinan unsur tanah langka yang berguna untuk industri telah menyebabkan penemuan ini menimbulkan rasa penasaran masyarakat. Sejak terjadinya Lumpur Lapindo 16 tahun lalu, topik Lumpur Lapindo telah dihidupkan kembali. Penulis membandingkan liputan empat artikel dari Kompas.com dan Viva.co.id yang diterbitkan pada awal 2022. Penulis mengidentifikasi beberapa gaya dan elemen yang mempengaruhi berita dengan menggunakan konsep framing dari Robert Entman. Liputan tentang penemuan unsur tanah langka di Lumpur Lapindo antara Viva.co.id dan Kompas.com berbeda. Viva.co.id, yang memiliki hubungan dengan PT Lapindo Brantas Tbk dan berada di bawah kepemilikan Bakrie Group, akan menghindari memilih kata-kata yang merugikan investor-investornya. Sementara itu, Kompas.com, yang tidak memiliki hubungan dengan Bakrie Group, akan menulis berita yang lebih netral
Komunikasi Interpersonal Penggemar BTS dalam Pembentukan Cinta Diri
Authors: Sitorus Silvani Urza , Fakhrur Rozi
Published: July 2023

Penelitian ini mengkaji tentang proses komunikasi interpersonal dalam pembentukan Self-Love pada penggemar BTS (ARMY) yang tergabung dalam grup ApobangpOt7.mdn. Jenis penelitian ini adalah penelitian kualitatif dimana data dideskripsikan menggunakan rangkaian kalimat. Metode yang digunakan dalam penelitian ini adalah metode deskriptif. Metode pengumpulan data meliputi observasi, dokumentasi dan wawancara pada penggemar BTS (ARMY) yang tergabung dalam grup apobanpOt7.mdn berdasarkan purposive sampling. Hasil penelitian ini  adalah proses komunikasi interpersonal ARMY dan personel BTS berlangsung melalui aplikasi Weverse dan konsumsi karya dari BTS yang digunakan untuk mengembangkan Self-love pada ARMY. ARMY mengaku pengembangan self-love dirasakan cukup baik lewat Weverse dan karya-karya BTS. Melalui Weverse, personel BTS seringkali memberi motivasi, saling bertukar pesan lucu, memberi atau menanyakan kabar, dan mengingatkan ARMY untuk selalu bahagia dan menjaga kesehatan. Hasil penelitian ini menunjukkan melalui aplikasi Weverse, BTS bisa berkomunikasi langsung dengan ARMY tentang pentingnya mencintai diri sendiri, saling memberi motivasi dan semangat, bertukar cerita, hingga saling melemparkan pesan yang lucu Pada akhirnya, melalui Weverse, konten dan lagu-lagu karya BTS menjadi jembatan antara BTS dan ARMY untuk bisa saling berkomunikasi dan menjalin kedekatan. Dengan adanya aplikasi Weverse sebagai media komunikasi untuk lebih bisa menghargai diri sendiri dan menanamkan self-love di dalam diri penggemar BTS
REFLECTIONS ABOUT THE CRAFTSMANSHIP OF MAKING IRON AND STEEL WEAPONS IN GEORGIA
Authors: David Kuparadze  , Dimitri Pataridze
Published: July 2023

Metallurgy has always played an important role in the almost 4000-year history of Georgia's statehood. Its specificity, development, ups and downs and new reincarnations in other times and places, over and over again, is the main plot of this article. The metallurgical centers of South Georgia (the Lower Caucasus Range) are considered the birthplace of iron metallurgy in the world and throughout the ancient era played a leading role in the markets of the then world. However, during the Middle Ages, Georgian metallurgy was forced to hide in the Northern Mountains to keep away from aggressive invaders, and suffered from a limited ore base and isolation. The article attempts to analyze and clarify iron deposits in Georgia, which may have been used by ancient metal masters. In addition, those small elements were established that were added to iron to produce high-quality steel, and later Damascus steel in Georgia.
Management of Deep Neck Infection with Descending Mediastinitis using Video-Assisted Thoracoscopic Surgery
Authors: Yap Hui Jean , Mohamad Irfan , Mamat Ahmad Zuhdi
Published: July 2023

Descending mediastinitis is defined as the spread of oropharyngeal or odontogenic infection into the mediastinum. It occurs uncommonly and has a high mortality rate. Prompt commencement of broad-spectrum antibiotics combined with surgical drainage is crucial to limit further spread of infection. We report a case of extensive deep neck infection in a 66-year-old female which rapidly progressed to the contralateral neck complicated by descending anterior mediastinitis. She underwent a combined transcervical and video-assisted thoracoscopic surgery (VATS) for drainage of abscess and was put on 3 weeks of intravenous antibiotics coupled with another 3 weeks of oral antibiotics. Deep neck infection with descending mediastinitis can be successfully treated with antibiotics and early surgical drainage via a combined transcervical and VATS approach.
Knowledge of Ventilator Care Bundles among Registered Nurses in the Intensive Care Unit at Sarawak General Hospital, Malaysia
Authors: Hussein Siti Zuhaida , Hatta Mohammad Fariq , Musa Nurul Asysura , Matali Muhammad Khairulanam , Ruslan Muhammad Firdaus
Published: July 2023

INTRODUCTION: Ventilator Care Bundles (VCB) is a group of evidence-based highimpact interventions for mechanically ventilated patients. The study aims to identify the knowledge of VCB among Intensive Care Unit (ICU) nurses at the local hospital in Sarawak, Malaysia. MATERIALS AND METHODS: A quantitative cross-sectional survey was conducted among 30 nurses who worked in the ICU at Sarawak General Hospital, Malaysia. A modified questionnaire with 20 items was used to measure the level of knowledge. Data analysis was performed using the Statistical Package for the Social Sciences Statistics 26.0 for Windows with p< 0.05 was considered statistically significant. RESULTS: The results revealed that 86.7% (n=30) of respondents had a high-level knowledge of the VCB. There is a significant relationship between the level of knowledge of VCB and qualification as a Registered Nurse (p=0.03), ICU post-basic qualification (p=0.02), and level of nursing education (p<0.001). The level of knowledge was significantly related to the level of education (r=0.71; p<0.001), the number of years qualified as a registered nurse (r=0.38; p=0.03), and post-basic qualification (r=0.42; p=0.02). CONCLUSION: The good level of knowledge regarding VCB implementation among registered nurses indicates that they are well-equipped with the proper knowledge for caring for mechanically ventilated patients.
Malay Language Translation and Validation of the Seven-item Eustachian Tube Dysfunction Questionnaire [ETDQ-7(M)]
Authors: Tan Heng Yao , Abdullah Asma , Afandi Ahmad Nordin , Hashim Noor Dina
Published: July 2023

INTRODUCTION: Eustachian tube dysfunction (ETD) is commonly left unidentified, and clinicians often had to deal with its consequences. Hence, ETD symptoms should be routinely explored to unmask the diagnosis. The seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) is a user-friendly and disease-specific instrument introduced by McCoul et al. to assess the severity of ETD symptoms and treatment effectiveness. However, there is no Malay version of ETDQ-7 [ETDQ-7(M)] available for local population. This study aims to translate and validate the ETDQ-7 in Malay language. MATERIALS AND METHODS: The ETDQ-7 was translated and culturally adapted into Malay language. 68 adult patients with ETD and 68 healthy patients who served as control completed ETDQ-7(M). It was repeated on patients with ETD after two weeks. Statistical analysis was performed to determine the psychometric properties of ETDQ-7(M). RESULTS: ETDQ-7(M) displayed excellent internal consistency (Cronbach’s α = 0.93) which is comparable to the original questionnaire. There was excellent test-retest reliability (r= 0.86 – 0.99). No significant difference in total scores was observed between the first and second evaluations. The mean total score for patients with ETD and control group was 25.8 and 8.4 respectively. Discrimination between ETD and control group using a cut-off point of 13.5, yielded sensitivity and specificity of 100% respectively (area under curve=100%). CONCLUSION: ETDQ-7(M) is a validated questionnaire recommended for use in the management of ETD as a diagnostic tool and in treatment monitoring with excellent reliability and validity.
Development and Validation of an Educational Module on Intimate Partner Violence for Young Adults
Authors: Hazaha Hanin Syahira , Tengku Ismail Tengku Alina , Ghazali Anis Kausar , Daud Aziah , Sulaiman Zaharah
Published: July 2023

INTRODUCTION: Intimate partner violence may occur among young adults. It is influenced by their perceptions and attitudes concerning this violence. This study aims to develop and validate an educational module on intimate partner violence among young adults in Kelantan, Malaysia. MATERIALS AND METHOD: The study was conducted in three phases consisting of needs assessment, development of the educational module, and content and face validation. Face-to-face interviews were conducted with 10 young adults to identify the needs for this module. The module content was based on several guidelines, relevant literatures, and findings from needs assessment. Content validation was done by six experts and content validity index was calculated. Face validation was evaluated by 30 young adults. The percentage of agreement was calculated for each item. RESULT: The educational module contains five units covering the forms, causes, impacts, and supports in preventing intimate partner violence as well as rejecting it and willingness to disclose. The content validity was good, rated as relevant by all the experts. The percentages of participants in face validation who strongly agreed with the items assessed for all the materials ranged between 70% to 93.3%. Additional comments given by the participants were considered and the module was modified accordingly. CONCLUSION: The module has good content and face validity. It can be used to improve perceptions and attitudes toward intimate partner violence among young adults.
Bibliometric Analysis of Global Research on Long-Acting Reversible Contraception and Healthcare Workers
Authors: Jusoh Nur Nabila , Tengku Ismail Tengku Alina
Published: July 2023

INTRODUCTION: Long-acting reversible contraception (LARC) is a feasible solution to reduce unintended pregnancy and abortion rates. Nonetheless, the worldwide prevalence of LARC remains low. The LARC uptake depends heavily on healthcare workers because every LARC insertion requires a clinician’s visit, and they are a trusted source of contraceptive information. The study is aimed to explore the trend and distributions of global publications related to LARC and healthcare workers. MATERIALS AND METHODS: Articles related to LARC and healthcare workers were retrieved from the Scopus database. Eligible publications were limited to research articles, reviews, and conference papers published in the English language with no date restriction. The bibliometric data was analysed using Biblioshiny to obtain distributions in terms of the number of publications, journals, countries, institutions, citations, and keywords. RESULTS: A total of 681 eligible publications related to LARC and healthcare workers were retrieved from the Scopus database between 1967 to 2022. The number of publications was low for the first four decades but increased steadily from 2010 onwards. The leading country in this research area was the United States of America and the majority of the most productive institutions were from this country. Half of the frequently cited publications highlighted healthcare workers’ bias, attitude, and practice on LARC provision to clients. CONCLUSION: This bibliometric analysis can guide scholars to understand the global overview of research about LARC and healthcare workers. It may be useful for health practitioners and researchers who are interested in exploring this research area.
Psychological Status among the Young Muslim Community in Yogyakarta Province, Indonesia, during the COVID-19 Pandemic
Authors: Fidianingsih Ika , Arif Ismail Naufal , Adnan Muhammad Farid
Published: July 2023

INTRODUCTION: Since the COVID-19 pandemic, psychological well-being has become a growing concern. Coping strategies, including religious activities, are needed to deal with psychological distress. This study aimed to evaluate the prevalence of psychological status and its relationship with religious activities among young Muslims in Yogyakarta province, Indonesia, during the COVID-19 pandemic. MATERIALS AND METHODS: Our cross-sectional study was conducted during the second and third waves of the COVID-19 pandemic in Indonesia. A total of 268 young Muslim from Islamic boarding schools in Yogyakarta province, Indonesia, were included in the study. A selfreported questionnaire containing sociodemographic information, religious activity, and Depression, Anxiety, and Stress Scales-21 (DASS-21) was filled up by the study participants. A descriptive and bivariate analysis was performed accordingly. RESULTS: Out of 312 people screened, a total of 268 participants were included in this study. The majority of participants were male (64.6%), aged between 14 to 18 years (55.2%), studying in high school (53.0%), memorised 1 to 10 juz (section) (79.1%), recited the Al-Quran 1 to 3 hours/day (59.3%), and fasted every Monday and Thursday (47.4%). The prevalence of depression, anxiety, and stress were 24.6%, 46.6%, and 29.1%, respectively. Young Muslims with high religious activities were noted to be less suffering from depression, anxiety, and stress, but it was not statistically significant (p=0.57). CONCLUSIONS: This study reported a high prevalence of depression, anxiety, and stress (from mild to extremely severe) among the young Muslim community in Yogyakarta, Indonesia. Our findings should raise awareness of the educational institutions, government, and public and trigger them to prepare appropriate preventive strategies for psychological distress in the young population.
Correlations of Estimated Serum Small Dense Low-Density Lipoprotein and Isoprostane with Metabolic Syndrome Criteria between Metabolic Syndrome and Non-Metabolic Syndrome Subjects in Selangor
Authors: Razali Nur Atiqah Auni , Shibraumalisi Nur Amirah , Ismail Zaliha , Sheikh Abdul Kadir Siti Hamimah , Abdul Razak Suraya , Raja Shariff Raja Ezman Faridz , Abdul Rahman Thuhairah
Published: July 2023

Introduction: Metabolic syndrome (MetS) is a global healthcare burden associated with increased risk of atherosclerosis (ATH). The relationship between atherogenic lipoprotein and oxidative stress biomarkers with clinical risk factors of MetS have not been fully explored.  Therefore, the objective of this study is to determine the correlation between small dense low-density lipoprotein (sdLDL-c) and isoprostane (ISP) with MetS criteria and comparing these biomarkers between MetS and non-MetS. Materials and Methods: This was a cross sectional study involving 67 MetS and 43 non-MetS diagnosed by JIS criteria 2009. Demographic details and anthropometric measurements were recorded. Blood samples were collected to analyse serum plasma glucose, direct LDL, calculated sdLDL-c and ISP. Results: Mean serum sdLDL-c and ISP levels were significantly higher among those with MetS compared to non-MetS (1.14+0.44 mmol/L vs 0.87±0.38 mmol/L respectively, p=0.005).  Similarly, mean serum ISP concentration was higher among MetS compared to non-MetS (884.40+602.69 ng/L vs 657.89±616.42 ng/L respectively, p= 0.054). sdLDL-c was positively correlated with TG in the MetS (Pearson correlation 0.501, p<.001) whilst HDL-c was positively correlated with sdLDL-c among the non-MetS (Pearson Correlation 0.422, p<.005). Conclusion: This study highlights the correlation between sdLDL-c and TG in among MetS, emphasizing the need to closely monitor and manage TG among this cohort to reduce the risk of ATH. It was also noted that HDL-c showed positive correlation with sdLDL-c among non-MetS. This discordant finding suggests that HDL-c itself may not be causally associated with cardiovascular benefits and that perhaps HDL-c subfractions may be a better approach to determine cardioprotective effects of HDL-c.
Awake craniotomies in the pediatric population: a systematic review
Authors: Bhanja Debarati , Sciscent Bao Y. , Daggubati Lekhaj C. , Ryan Casey A. , Pahapill Natalie K. , Hazard Sprague W. , Rizk Elias B.
Published: July 2023

OBJECTIVE

Awake craniotomy (AC) is employed to maximize tumor resection while preserving neurological function in eloquent brain tissue. This technique is used frequently in adults but remains poorly established in children. Its use has been limited due to concern for children’s neuropsychological differences compared with adults and how these differences may interfere with the safety and feasibility of the procedure. Among studies that have reported pediatric ACs, complication rates and anesthetic management vary. This systematic review was performed to comprehensively analyze outcomes and synthesize anesthetic protocols of pediatric ACs.

METHODS

The authors followed PRISMA guidelines to extract studies that reported AC in children with intracranial pathologies. The Medline/PubMed, Ovid, and Embase databases were searched from database inception to 2021, using the terms ("awake") AND ("Pediatric*" OR "child*") AND (("brain" AND "surgery") OR "craniotomy"). Data extracted included patient age, pathology, and anesthetic protocol. Primary outcomes assessed were premature conversion to general anesthesia, intraoperative seizures, completion of monitoring tasks, and postoperative complications.

RESULTS

Thirty eligible studies published from 1997 to 2020 were included that described a total of 130 children ranging in age from 7 to 17 years who had undergone AC. Of all patients reported, 59% were male and 70% had left-sided lesions. Procedure indications included the following etiologies: tumors (77.6%), epilepsy (20%), and vascular disorders (2.4%). Four (4.1%) of 98 patients required conversion to general anesthesia due to complications or discomfort during AC. In addition, 8 (7.8%) of 103 patients experienced intraoperative seizures. Furthermore, 19 (20.6%) of 92 patients had difficulty completing monitoring tasks. Postoperative complications occurred in 19 (19.4%) of 98 patients and included aphasia (n = 4), hemiparesis (n = 2), sensory deficit (n = 3), motor deficit (n = 4), or others (n = 6). The most commonly reported anesthetic techniques were asleep-awake-asleep protocols using propofol, remifentanil or fentanyl, a local scalp nerve block, and with or without dexmedetomidine.

CONCLUSIONS

The findings of this systematic review suggest the tolerability and safety of ACs in the pediatric population. Although pediatric intracranial pathologies pose etiologies that certainly may benefit from AC, there is a need for surgeons and anesthesiologists to perform individualized risk-benefit analyses due to the risks associated with awake procedures in children. Age-specific, standardized guidelines for preoperative planning, intraoperative mapping, monitoring tasks, and anesthesia protocols will help to continue minimizing complications, while improving tolerability, and streamlining workflow in the treatment of this patient population.
High-volume facilities are not always low risk: comparing risk-standardized mortality rates versus facility volume as quality measures in surgical neuro-oncology
Authors: Chalif Eric J. , Young Jacob S. , Villa Genaro R. , Aghi Manish K. , Lenzi Jacopo , Berger Mitchel S.
Published: July 2023

OBJECTIVE

Risk-standardized mortality rates (RSMRs) have recently been shown to outperform facility case volume as a proxy for surgical quality in lung and gastrointestinal cancer. The aim of this study was to investigate RSMR as a surgical quality metric in primary CNS cancer.

METHODS

This retrospective observational cohort study used data from the National Cancer Database, a population-based oncology outcomes database sourced from more than 1500 institutions in the United States, and included adult patients 18 years of age and older who were diagnosed with glioblastoma, pituitary adenoma, or meningioma and were treated with surgery. For each group, RSMR quintiles and annual volume were calculated in a training set (2009–2013) and these thresholds were applied to the validation set (2014–2018). In this paper, the authors compared the effectiveness and efficiency of facility volume–based versus RSMR-based hospital centralization models and evaluated the overlap between the two systems. A patterns-of-care analysis was also performed to explore socioeconomic predictors of being treated at better-performing treating facilities.

RESULTS

A total of 37,838 meningioma, 21,189 pituitary adenoma, and 30,788 glioblastoma patients were surgically treated from 2014 to 2018. There were substantial differences between RSMR and facility volume classification schemes among all tumor types. In an RSMR-based centralization model, an average of 36 patients undergoing glioblastoma surgery would need to relocate to a low-mortality hospital to prevent one 30-day mortality following surgery, whereas 46 would need to relocate to a high-volume hospital. For pituitary adenoma and meningioma, both metrics were inefficient in centralizing care to reduce surgical mortality. Additionally, overall survival for glioblastoma patients was better modeled in an RSMR classification scheme. Analyses to investigate the impact of care disparities found that Black and Hispanic patients, patients earning less than $38,000, and uninsured patients were more likely to be treated at high-mortality hospitals.

CONCLUSIONS

RSMR is more effective and efficient than a traditional volume-based approach for preventing early postoperative death in glioblastoma surgery. These data have important implications for future quality-related studies in neurosurgical oncology and may be relevant for healthcare/insurance payments, hospital evaluation assessments, healthcare disparities, and the standardization of care across hospitals.
Clinical decision-making based on 11C-methionine PET in recurrent Cushing’s disease with equivocal MRI findings
Authors: Ishida Atsushi , Kaneko Koichiro , Minamimoto Ryogo , Hotta Masatoshi , Inoshita Naoko , Takano Koji , Yamada Shozo
Published: July 2023

OBJECTIVE

Diagnosis and accurate localization of recurrent tumors in Cushing’s disease (CD) are challenging, especially after multiple transsphenoidal surgeries (TSSs) or radiosurgery. Even experts face difficulties in detecting these recurrent tumors, and a favorable surgical outcome is not guaranteed. In this report, the authors aimed to determine the usefulness of 11C-methionine positron emission tomography (MET-PET) for evaluating patients with recurrent CD with inconclusive magnetic resonance imaging (MRI) lesions and to develop a treatment protocol for these cases.

METHODS

In this retrospective study of patients with recurrent CD in the period between April 2018 and December 2022, the authors assessed the usefulness of MET-PET in determining whether equivocal MRI findings were recurrent tumors or postsurgical cavities and deciding further treatment options. All patients had undergone at least one TSS, and most had undergone multiple TSSs and had pathologically confirmed corticotroph tumors with hypercortisolemia.

RESULTS

Overall, 15 patients with recurrent CD (10 females and 5 males) were included, all of whom had undergone MET-PET. All patients had been subjected to multiple treatments, including TSSs or radiosurgeries. Their MRI scans demonstrated less-enhanced lesions that were not confirmed as recurrences even with cutting-edge MRI because they could not be distinguished from postsurgical changes with confidence. MET uptake was positive in 8 patients (9 examinations) and negative in 7. Following MET-PET, repeat TSS was performed in 5 patients. Corticotroph tumors were identified in all 5 patients, even though one of them had negative MET uptake. The MET uptake precisely identified a tumor location on the opposite side of the MRI-suspected lesion in 2 patients. Meanwhile, patients with negative uptake and mild hypercortisolism were only observed. Nonsurgical options were also used in other patients: temozolomide (TMZ) was administered in 2 patients owing to a prior history of multiple TSSs and radiosurgery and the drug-resistant nature of the disease. TMZ was highly effective in these patients; their Cushing’s symptoms ameliorated, and their adrenocorticotropic hormone and cortisol levels continued to decline. Interestingly, MET uptake disappeared following TMZ treatment.

CONCLUSIONS

MET-PET is extremely useful for confirming equivocal lesions on MRI in patients with recurrent CD and for deciding further treatment options. The authors propose a novel protocol based on MET-PET results for treating patients with relapsing CD in whom the recurrent tumors cannot be confirmed with MRI.
Brain plasticity and age after restoring elbow flexion with distal nerve transfers in neonatal brachial plexus palsy and nonneonatal traumatic brachial plexus injury using the plasticity grading scale
Authors: Socolovsky Mariano , Lovaglio Ana , Bonilla Gonzalo , Masi Gilda Di , Barillaro Karina , Malessy Martijn
Published: July 2023

OBJECTIVE

Ulnar and/or median nerve fascicle to musculocutaneous nerve (MCN) transfers are used to restore elbow flexion following severe neonatal and nonneonatal brachial plexus injuries (BPIs). Restoring volitional control requires plastic changes in the brain. To date, whether the potential for plasticity is influenced by a patient’s age remains unknown.

METHODS

Patients who had presented with a traumatic upper (C5–6 or C5–7) BPI were divided into two groups: neonatal brachial plexus palsies (NBPPs) and nonneonatal traumatic BPIs (NNBPIs). Both groups underwent ulnar or median nerve transfers to the MCN for elbow flexion restoration between January 2002 and July 2020. Only those who attained a British Medical Research Council strength rating of 4 were reviewed. The primary comparison between the two groups was the plasticity grading scale (PGS) score to determine the level of independence of elbow flexion (target) from forearm motor muscle movement (donors). The authors also assessed patient compliance with rehabilitation using a 4-point Rehabilitation Quality Scale. Bivariable and multivariable analyses were used to identify intergroup differences.

RESULTS

In total, 66 patients were analyzed: 22 with NBPP (mean age at surgery 10 months) and 44 with NNBPI (age range at surgery 3–67 years, mean 30.2 years; mean time to surgery 7 months, p < 0.001). All NBPP patients obtained a PGS grade of 4 at the final follow-up versus just 47.7% of NNBPI patients (mean 3.27, p < 0.001). On ordinal regression analysis, after nature of the injury was excluded because of excessive collinearity with age, age was the only significant predictor of plasticity (β = −0.063, p = 0.003). Median rehabilitation compliance scores were not statistically different between the two groups.

CONCLUSIONS

The extent of plastic changes that occur for patients to regain volitional control over elbow flexion after upper arm distal nerve transfers following BPI is influenced by patient age, with complete plastic rewiring more likely in younger patients and virtually ubiquitous in infants. Older patients should be informed that elbow flexion after an ulnar or median nerve fascicle transfer to the MCN might require simultaneous wrist flexion.
Treatment of symptomatic sacral arachnoid cysts in the pediatric population
Authors: Özen Ali , Özek M. Memet
Published: July 2023

OBJECTIVE

Symptomatic sacral arachnoid cysts are extremely rare in pediatric patients, resulting in a lack of consensus regarding optimal treatment measures. The current study evaluated the clinical symptoms and surgical indications, techniques, and outcomes of pediatric patients who underwent treatment for sacral arachnoid cysts with the aim of developing recommendations for follow-up and treatment.

METHODS

This retrospective study included pediatric patients who underwent surgical treatment for sacral arachnoid cysts between January 2000 and December 2020 at the Department of Pediatric Neurosurgery, Acıbadem University Faculty of Medicine.

RESULTS

Thirteen patients were included in the study, 9 of whom were girls and 4 were boys. Five patients presented with urinary incontinence, 2 of whom also exhibited constipation. Other chief complaints included recurrent urinary tract infections (UTIs) and low-back pain (n = 4 patients each). Urological evaluation was performed in all patients, followed by urodynamic examination in those with urinary symptoms. Spinal MRI showed extra- and intradural sacral cysts in 12 patients and 1 patient, respectively. The latter patient exhibited recurrence during follow-up and underwent reintervention. Samples from the excised cyst walls were sent for pathological examination. Five patients with urinary incontinence, 2 with constipation, 4 with recurrent UTIs, and 3 with low-back pain exhibited resolution of symptoms after treatment. However, 1 patient with low-back pain did not show any improvement in symptoms. No postoperative complications were observed in the current study. The patients were followed-up regularly after surgery, and the mean follow-up duration was 4 years.

CONCLUSIONS

Sacral arachnoid cysts in pediatric patients may be associated with urinary system dysfunction and low-back pain. Surgery is the treatment of choice for symptomatic patients and those with enlarged cysts with radiological evidence of compression, and the morbidity and mortality rates associated with surgery are low.
Survival and prognostic factors in pediatric patients with medulloblastoma treated at a national pediatric hospital in Peru: a retrospective cohort
Authors: Flores-Sanchez Jose D. , Perez-Chadid Daniela A. , Diaz-Coronado Rosdali Y. , Hernandez-Broncano Eddy , Ugas-Charcape Carlos F. , Ramirez Alberto , Racchumí-Vela Augusto E. , Boop Frederick A. , Preguntegui Ivethe
Published: July 2023

OBJECTIVE

The objectives of this study were to determine the overall survival (OS) and event-free survival (EFS) rates of patients with medulloblastoma treated in a national pediatric hospital in Peru, as well as to identify demographic, clinical, imaging, postoperative, and histopathological characteristics and prognostic factors associated with OS and EFS.

METHODS

The authors conducted a retrospective study analyzing information from the medical records of children with a diagnosis of medulloblastoma who underwent surgical treatment at the Instituto Nacional de Salud del Niño—San Borja, a public hospital in Lima, Peru, from 2015 to 2020. Clinical-epidemiological variables, degree of disease extension, risk stratification, extent of resection, postoperative complications, status of oncological treatment received, histological subtype, and neurological sequelae were taken into account. The Kaplan-Meier method and Cox regression analysis were used to estimate OS, EFS, and prognostic factors.

RESULTS

Of the 57 children evaluated with complete medical records, only 22 children (38.6%) underwent complete oncological treatment. OS was 37% (95% CI 0.25–0.55) at 48 months. EFS was 44% (95% CI 0.31–0.61) at 23 months. High-risk stratification—meaning patients with ≥ 1.5 cm2 of residual postoperative tumor, those younger than 3 years, those with disseminated disease (HR 9.69, 95% CI 1.40–67.0, p = 0.02), and those who underwent subtotal resection (HR 3.78, 95% CI 1.09–13.2, p = 0.04)—was negatively associated with OS. Failure to receive complete oncological treatment was negatively associated with OS (HR 20.0, 95% CI 4.84–82.6, p < 0.001) and EFS (HR 7.82, 95% CI 2.47–24.7, p < 0.001).

CONCLUSIONS

OS and EFS of patients with medulloblastoma in the author’s milieu are below those reported in developed countries. Incomplete treatment and treatment abandonment in the authors’ cohort were also high compared with high-income country statistics. Failure to complete oncological treatment was the most important factor associated with poor prognosis, both in terms of OS and EFS. High-risk patients and subtotal resection were negatively associated with OS. Interventions are needed to promote the completion of adjuvant oncological therapy for medulloblastoma in the disadvantaged Peruvian population.
Supraorbital minicraniotomy for open Ommaya reservoir placement in pediatric craniopharyngiomas: a case series and technical report
Authors: Greuter Ladina , Richards Oliver L. , Malik Noor , Breitbart Sara , Riesel Johanna N. , Bartels Ute , Ibrahim George M. , Kulkarni Abhaya V.
Published: July 2023

OBJECTIVE

Craniopharyngiomas with a predominant cystic component are often seen in children and can be treated with an Ommaya reservoir for aspiration and/or intracystic therapy. In some cases, cannulation of the cyst can be challenging via a stereotactic or transventricular endoscopic approach due to its size and proximity to critical structures. In such cases, a novel placement technique for Ommaya reservoirs via a lateral supraorbital incision and supraorbital minicraniotomy has been used.

METHODS

The authors conducted a retrospective chart review of all children undergoing supraorbital Ommaya reservoir insertion from January 1, 2000, to December 31, 2022, at the Hospital for Sick Children, Toronto. The technique involves a lateral supraorbital incision and a 3 × 4–cm supraorbital craniotomy, with identification and fenestration of the cyst under the microscope and insertion of the catheter. The authors assessed baseline characteristics and clinical parameters of surgical treatment and outcome. Descriptive statistics were conducted. A review of the literature was performed to identify other studies describing a similar placement technique.

RESULTS

A total of 5 patients with cystic craniopharyngioma were included (3 male, 60%) with a mean age of 10.20 ± 5.72 years. The mean preoperative cyst size was 11.6 ± 3.7 cm3, and none of the patients suffered from hydrocephalus. All patients suffered from temporary postoperative diabetes insipidus, but no new permanent endocrine deficits were caused by the surgery. Cosmetic results were satisfactory.

CONCLUSIONS

This is the first report of lateral supraorbital minicraniotomy for Ommaya reservoir placement. This is an effective and safe approach in patients with cystic craniopharyngiomas, which cause local mass effect but are not amenable to traditional Ommaya reservoir placement stereotactically or endoscopically.
Evaluation of patients referred to the spine clinic via telemedicine and the impact on diagnosis and surgical decision-making
Authors: Melnick Kaitlyn , Porche Ken , Sriram Sai , Goutnik Michael , Cuneo Micaela , Murad Gregory , Chalouhi Nohra , Polifka Adam , Hoh Daniel J. , Decker Matthew
Published: July 2023

OBJECTIVE

Telemedicine encounters are expanding in utility for outpatient care and evaluation, partially as a necessity during the COVID-19 pandemic. It is unclear if telemedicine evaluation is comparable to in-person assessment of patients with spinal pathology undergoing surgical consultation. The objective of this study was to determine if treatment plans change for spine patients evaluated in person following an initial telemedicine consultation.

METHODS

Patients referred to the authors’ comprehensive spine center were evaluated first via telemedicine and then in clinic. Telemedicine evaluations were conducted via video evaluation with an attending surgeon. Demographic data including age, gender, and distance traveled from the clinic were retrospectively recorded. A chart review retrieved symptoms, radiographic details, and past medical history. The primary outcome was if the treatment plan changed (plan change [PC]) after seeing the patient in the clinic. Chi-square tests and binary logistical regression produced uni- and multivariate analyses.

RESULTS

There were 152 new patients seen via telemedicine and in person. Pathology was present in the cervical (28.3%), thoracic (9.9%), and lumbar (61.8%) spine. The most common symptom was pain (72.4%), followed by radiculopathy (66.4%), weakness (26.3%), myelopathy (15.1%), and claudication (12.5%). There were 37 patients (24.3%) for whom there was a PC after clinic evaluation, and of those, only 5 (3.3%) were due to physical examination (PCPE) findings. On univariate analysis, a longer duration between telemedicine and clinic visit (odds ratio [OR] 1.094 per 7 days, p = 0.003), having pathology in the thoracic spine (OR 3.963, p = 0.018) and lack of sufficient imaging (OR 25.455, p < 0.0001) were predictive of a PC. Having pathology in the cervical spine (OR 9.538, p = 0.047) and adjacent-segment disease (OR 11.471, p = 0.010) were predictive of a PCPE.

CONCLUSIONS

This study demonstrates that telemedicine may be an effective modality for the initial evaluation of spine surgical patients, without compromising decision-making in the absence of an in-person physical examination.