bluuebunny/crossref_metadata_2025_split huggingface dataset:
Should ondansetron use be a reason to admit children with isolated, nondisplaced, linear skull fractures?
Authors: Dallas Jonathan , Mercer Evan , Reynolds Rebecca A. , Wellons John C. , Shannon Chevis N. , Bonfield Christopher M. 
Published: January 2020

OBJECTIVEIsolated, nondisplaced skull fractures (ISFs) are a common result of pediatric head trauma. They rarely require surgical intervention; however, many patients with these injuries are still admitted to the hospital for observation. This retrospective study investigates predictors of vomiting and ondansetron use following pediatric ISFs and the role that these factors play in the need for admission and emergency department (ED) revisits.METHODSThe authors identified pediatric patients (< 18 years old) with a linear ISF who had presented to the ED of a single tertiary care center between 2008 and 2018. Patients with intracranial hemorrhage, significant fracture displacement, or other traumatic injuries were excluded. Outcomes included vomiting, ondansetron use, admission, and revisit following ED discharge. Both univariable and multivariable analyses were used to determine significant predictors of each outcome (p < 0.05).RESULTSOverall, 518 patients were included in this study. The median patient age was 9.98 months, and a majority of the patients (59%) were male. The most common fracture locations were parietal (n = 293 [57%]) and occipital (n = 144 [28%]). Among the entire patient cohort, 124 patients (24%) had documented vomiting, and 64 of these patients (52%) received ondansetron. In a multivariable analysis, one of the most significant predictors of vomiting was occipital fracture location (OR 4.05, p < 0.001). In turn, and as expected, both vomiting (OR 14.42, p < 0.001) and occipital fracture location (OR 2.66, p = 0.017) were associated with increased rates of ondansetron use. A total of 229 patients (44%) were admitted to the hospital, with vomiting as the most common indication for admission (n = 59 [26%]). Moreover, 4.1% of the patients had ED revisits following initial discharge, and the most common reason was vomiting (11/21 [52%]). However, in the multivariable analysis, ondansetron use at initial presentation (and not vomiting) was the sole predictor of revisit following initial ED discharge (OR 5.05, p = 0.009).CONCLUSIONSIn this study, older patients and those with occipital fractures were more likely to present with vomiting and to be treated with ondansetron. Additionally, ondansetron use at initial presentation was found to be a significant predictor of revisits following ED discharge. Ondansetron could be masking recurrent vomiting in ED patients, and this should be considered when deciding which patients to observe further or discharge.
Neuropsychological functioning following surgery for pediatric low-grade glioma: a prospective longitudinal study
Authors: Heitzer Andrew M. , Raghubar Kimberly , Ris M. Douglas , Minard Charles G. , Gragert Marsha N. , Stancel Heather H. , Orobio Jessica , Xue Judy , Whitehead William , Okcu M. Fatih , Chintagumpala Murali , Kahalley Lisa S. 
Published: January 2020

OBJECTIVEHigh survival rates have led to an increased emphasis on the functional outcomes of children diagnosed with low-grade glioma. Most outcomes research has focused on risks associated with radiotherapy, but less is known about neuropsychological risks for patients treated with surgery alone. Here, the authors sought to examine the neuropsychological trajectories of children diagnosed with a low-grade glioma and monitored up to 6 years postsurgery. Secondarily, they explored demographic and clinical predictors of neuropsychological performance.METHODSThe neuropsychological functioning of 32 patients (median age at diagnosis 10.0 years) was prospectively assessed annually for up to 6 years after surgery (median days from surgery at baseline = 72). Tumor location was predominately supratentorial (65.6%). A combination of performance-based and parent-reported measures was used to assess intelligence, memory, executive functioning, and fine motor control in all patients.RESULTSBinomial tests at the postoperative baseline revealed that the proportion of children falling below the average range (< 16th percentile) was significantly higher than the rate expected among healthy peers on measures of verbal memory, processing speed, executive functioning, and fine motor control (p < 0.05). Even so, linear mixed models indicated that neuropsychological functioning at the postoperative baseline did not significantly change over time for up to 6 years after surgery across all domains. A larger tumor size was associated with a slower reaction time (p < 0.01). A supratentorial tumor location and history of seizures were associated with more parent-reported executive difficulties (p < 0.01).CONCLUSIONSWhile radiotherapy is a known risk factor for neuropsychological deficits in pediatric brain tumor patients, findings in this study indicate that children treated for low-grade glioma with surgery alone (without radiotherapy or chemotherapy) remain susceptible to difficulties with memory, executive functioning, and motor functioning that persist over time. Over half of the children in the study sample required school support services to address neuropsychological weaknesses. Although low-grade glioma is often conceptualized as a benign tumor, children treated for this lesion require ongoing monitoring and intervention to address neuropsychological weaknesses resulting from the tumor itself as well as the surgery.
Reducing opioid usage: a pilot study comparing postoperative selective dorsal rhizotomy protocols
Authors: Pao Ludovic P. , Zhu Liang , Tariq Sarah , Hill Christine A. , Yu Bangning , Kendrick Mariana , Jungman Magdalena , Miesner Emilie L. , Mundluru Surya N. , Hall Stacey L. , Bosques Glendaliz , Thakur Nivedita , Shah Manish N. 
Published: January 2020

OBJECTIVESelective dorsal rhizotomy (SDR) is a surgical procedure used to treat spasticity in children with spastic cerebral palsy. Currently, there is a lack of work examining the efficacy of optimizing pain management protocols after single-level laminectomy for SDR. This pilot study aimed to compare the clinical outcomes of SDR completed with a traditional pain management protocol versus one designed for opioid dosage reduction.METHODSThe Texas Comprehensive Spasticity Center prospective database was queried for all patients who underwent SDR between 2015 and 2018. Demographic, surgical, and postoperative data for all patients who underwent SDR were collected from medical records. The study was designed as a retrospective study between the patient-controlled analgesia (PCA) and dexmedetomidine infusion (INF) groups with 80% power to detect a 50% difference at a significance level of 0.05. Patients in the INF group received perioperative gabapentin, intraoperative dexmedetomidine infusion, and scheduled acetaminophen and NSAIDs postoperatively.RESULTSMedication administration records, pain scores, and therapy notes were collected for 30 patients. Patients who underwent SDR between June 2015 and the end of December 2017 received traditional pain management (PCA group, n = 14). Patients who underwent SDR between January 2018 and the end of December 2018 received modified pain management (INF group, n = 16). No patients were lost to follow-up. Differences in age, weight, height, preoperative Gross Motor Function Classification System scores, operative duration, hospital length of stay, and sex distribution were not statistically different between the 2 groups (p > 0.05). Analysis of analgesic medication doses demonstrated that the INF group required fewer doses and lower amounts of opioids overall, and also fewer NSAIDs than the PCA group. When converted to the morphine milligram equivalent, the patients in the INF group used fewer doses and lower amounts of opioids overall than the PCA group. These differences were either statistically significant (p < 0.05) or trending toward significance (p < 0.10). Both groups participated in physical and occupational therapy similarly postoperatively (p > 0.05). Pain scores were comparable between the groups (p > 0.05) despite patients in the INF group requiring fewer opioids.CONCLUSIONSInfusion with dexmedetomidine during SDR surgery combined with perioperative gabapentin and scheduled acetaminophen and NSAIDs postoperatively resulted in similar pain scores to traditional pain management with opioids. In addition, this pilot study demonstrated that patients who received the INF pain management protocol required reduced opioid dosages and were able to participate in therapy similarly to the control PCA group.
Syringomyelia in children with closed spinal dysraphism: long-term outcomes after surgical intervention
Authors: Bruzek Amy K. , Starr Jordan , Garton Hugh J. L. , Muraszko Karin M. , Maher Cormac O. , Strahle Jennifer M. 
Published: January 2020

OBJECTIVEThe nature of the relationship between spinal cord syrinx and tethered cord is not well known. It is unclear if surgical cord untethering results in resolution or improvement of an associated syrinx. The objective of this study was to report the response of spinal cord syrinx to surgical cord untethering.METHODSThe authors retrospectively reviewed all patients with a syrinx and tethered cord who presented to a single institution over an 11-year interval. Patients with open neural tube defects were excluded. Thirty-one patients were identified, 25 of whom had both clinical and imaging follow-up after surgery. Patients were grouped according to etiology of the tethered cord. Clinical outcomes and syrinx characteristics were recorded.RESULTSOf the 25 patients with tethered cord, 68% (n = 17) were male. The average age at presentation was 2.5 years (0–10.1 years) and age at surgery was 3.7 years (range 1 day to 17 years). Etiologies of tethered cord were lipomyelomeningocele (n = 8), thickened/fatty filum (n = 7), intradural lipoma (n = 5), myelocystocele (n = 2), meningocele (n = 2), and diastematomyelia (n = 1). Twenty-three of the patients underwent primary untethering, whereas 2 patients had received untethering previously at another institution. The average syrinx length and width prior to surgery were 4.81 vertebral levels (SD 4.35) and 5.19 mm (SD 2.55 mm), respectively. Conus level ranged from L1 to S3. Patients were followed for an average of 8.4 years (1.35–15.85 years). Overall there was no significant change in syrinx length or width postoperatively; the average syrinx length increased by 0.86 vertebral levels (SD 4.36) and width decreased by 0.72 mm (SD 2.94 mm). Seven of 25 patients had improvement in at least one presenting symptom, including scoliosis, weakness, bowel/bladder dysfunction, and pain. Eight patients had stable presenting symptoms. Six patients were asymptomatic and 5 patients had new or worsening symptoms, which included scoliosis, pain, or sensory changes.CONCLUSIONSAlthough some syrinxes improved after surgery for tethered cord, radiological improvement was not consistent and did not appear to be associated with change in clinical symptoms. The decision to surgically untether a cord should be focused on the clinical symptoms and not the presence of a syrinx alone. Further studies are needed to confirm this finding.
Effect of concentrated Kurozu, a traditional Japanese vinegar, on expression of hepatic miR-34a, -149-3p, and -181a-5p in high-fat diet-fed mice
Authors: Shibayama Yoshihiko 
Published: January 2020

Background: Long-term high-fat diet (HFD) feeding, which can induce obesity, can also induce nonalcoholic steatohepatitis (NASH) and liver tumorigenesis. A previous study reported that concentrated Kurozu (CK) supplementation reduced the incidence of HFD-induced hepatic steatosis in mice. It was showed that CK supplementation improved dyslipidemia in animal and clinical study. Small noncoding RNAs, micro RNAs (miRs), play crucial roles in the biology of cell functions, lipid metabolism and neoplasms. However, the effect of CK treatment on the relationship between HFD and expression of miRs is unclear.Objective: To evaluate changes in the expression of hepatic miRs and lipid metabolism- associated genes on administering a HFD for 60 weeks in C57BL6J mice. The onset of hepatic steatosis induced by HFD treatment was also observed.Methods: The mice received a HFD, HFD with CK, or standard diet (SD) for 60 consecutive weeks. The effect of CK treatment on the expression levels of lipid metabolism-associated genes in the liver was evaluated.Results: HFD feeding significantly increased expression of Tnf, and significantly decreased Adipoq and Mlxipl in the liver. The ingestion of CK elevated the expression levels of Pgc-1α and Igfbp1 in the liver compared with the SD group. HFD feeding significantly increased the expression of miR-488-5p, and significantly decreased miR-29b and -122a-5p in the liver. The ingestion of CK elevated the expression levels of miR-34a, -149-3p, and -181a-5p in the liver compared with the SD group. Expression levels of miR-488-3p in the serum HFD group were significantly higher than in the SD group. The ingestion of CK elevated the expression levels of miR-181a-5p in the serum compared with the SD group.Conclusion: These results suggest that CK supplementation reduced the onset of hepatic hyperplasia, and increased hepatic miR-34a, -149-3p, and -181a-5p. These miRs may function as suppressors of tumors caused by HFD feeding.Key Words: High-fat diet, carcinogenesis, Kurozu, microRNA, miR-34a, miR-122a-5p, miR-149, miR-181a, miR-488
MANAGEMENT OF BLADDER STONE WITH HOLMIUM-YAG LASER AT KARDINAH HOSPITAL TEGAL
Authors: Abshari Fatan , Ali Zulfikar 
Published: January 2020

Objective: Transurethral lithotripsy using Holmium-YAG laser has been reported to be beneficial in breaking up bladder stones with large size (>4cm in diameter) with lower risk of mucosal injury and hematuria. The aim of this study is to evaluate the utilization of Holmium-YAG laser for the management of bladder stones at Kardinah General Hospital, Tegal. Material & Methods: This is a cross-sectional study conducted from January 2017 to March 2017. Patient’s demography, which included age, sex, length of surgery, stone size, and laser’s energy count were recorded. Results: We included 120 patients in this study. Mean of patients age in this study was 51.93 years old with age range were 41-85 years old. Most of the patients were male (109 vs 11) with a mean size of stone 25.09 ± 3.04 mm. Length of surgery ranges from 15 to 75 minutes and mean energy of the laser 28.99 ± 19.34 kJ. There was 100% stone’s clearance following surgery with no major complication occurred. Conclusion: Holmium-YAG laser is effective in managing bladder stones at Kardinah General Hospital particularly for large size stones. Length of surgery and energy of laser used depend on the stone size in which bigger stone size is associated with longer surgery time and bigger laser energy needed.
The effect of hydrogen on the physical properties of natural gas and the metrological characteristics of its metering systems
Authors: Stetsenko A. A. , Nedzelsky S. D. , Naumenko V. A. 
Published: January 2020

Given the promise of the concept of using a mixture of hydrogen and natural gas as an energy source, studies were conducted in the following areas:

determination of the effect of hydrogen impurities on the physical properties of natural gas;
study of the effect of adding hydrogen to natural gas on the metrological characteristics of its consumption metering systems.

To solve these problems, the following was carried out:

determination of the dependence of the physical parameters of natural gas on the percentage of hydrogen in its composition:
determination of the permissible fraction (permissible concentration) of hydrogen in natural gas in modern gas transmission and gas consuming systems.
study of the effect of hydrogen additions on the metrological characteristics of measuring instruments and gas commercial metering systems.

To conduct objective research and modeling, natural gas samples having different component composition were prepared. An analysis of the physical properties of these gases was carried out — their physical parameters were calculated: adiabatic index and sound velocity, density, compressibility factor, higher calorific value and Wobbe number. Based on these samples, modeling was performed — the physical parameters of the gases were calculated by adding hydrogen at different concentrations (from 2 to 23 %).
Based on the research results, the following conclusions are made:

When hydrogen is added to natural gas in an amount of from 2 to 10 %, the physical parameters of the resulting mixture change slightly (within acceptable limits), therefore, the addition of hydrogen to natural gas in an amount of up to 10 % allows the use of existing gas transmission and gas-consuming systems without any reconstructions, improvements, changes in algorithms for calculating the physical parameters of the gas mixture and calculating (volume) volumetric flow for commercial accounting. The impact on gas meters of consumers will be within the acceptable ranges of accuracy and repeatability and, therefore, will not require the cost of updating the meters.
The addition of up to 25 % hydrogen by volume does not require a radical new technology of burners and gas transmission systems. Safety will not be compromised by adding 25 % hydrogen by volume to the natural gas network. Changes in the physical properties in the gas mixture have a number of disadvantages, but, in the aggregate, they do not pose any additional safety risk.
The addition of hydrogen in a volume of more than 25 %, as well as the use of the mixture at high pressures, requires additional research and the development of new algorithms.
Edukasi Kesehatan Reproduksi pada Remaja untuk Menghadapi 1000 Hari Pertama Kehidupan
Authors: Desmawati Desmawati 
Published: January 2020

Reproductive health education in female adolescent to face the first 1000 days of human life involving: knowledge about 270 days of pregnancy such as knowledge of pregnancy, assestment of pregnancy in health services, breast care, body and clothes hygiene, dental hygiene, imunization before and during of pregnancy, nutrition for female adolescent and pregnant women, taking early breastfeeding initiation, and continue to give exclusive breastfeeding. Knowledge for 730 days after delivery involving knowledge about health card for toddlers, immunization for baby, growth and development of child 0 - 23 months, providing nutrition for 0-6 months and 7-24 months.The aim of this health services to improve knowledge of female adolescent about the first 1000 days of human life. This study methode using health education to increase knowledge of adolescent. The results revealed that health education and demonstration can improve the knowledge of female adolescent about the first 1000 days of human life.
РУЧНА ОБРОБКА МЕДИЧНИХ ЗОБРАЖЕНЬ ЛІКАРЕМ-ДІАГНОСТОМ У СИСТЕМІ РОЗПІЗНАВАННЯ ТОМОГРАФІЧНИХ І РЕНТГЕНІВСЬКИХ ЗНІМКІВ ДЛЯ ПОШУКУ І ЛОКАЛІЗАЦІЇ ПАТОЛОГІЙ
Authors: А.І. Поляченко  
Published: January 2020

У статті запропоновано та побудовано систему розпізнавання томографічних і рентгенівських знімків для пошуку і локалізації патологій. У даній статті необхідно розробити систему розпізнавання томографічних і рентгенівських знімків для пошуку і локалізації патологій та розглянути принципи ручної обробки медичних зображень лікарем-діагностом.
Для пошуку і локалізації аномалій на томографічних і рентгенівських знімках пропонується система, яка буде складатися з наступних блоків : блок введення інформації про пацієнта; блок обробки медичних зображень, що включає: згорткову нейронну мережу (ЗНМ) для класифікації томографічних і рентгенівських знімків; ЗНМ для визначення залежностей значень просторового фактора від стандартизованих -значень і з наступним розрахунком коефіцієнту загальної просторової автокореляції; ЗНМ для сегментації томографічних і рентгенівських знімків; підсистему ручної обробки медичних зображень, що представлена лікарем-діагностом;блок для встановлення висновку, що включає нейронну мережу (НМ), призначену для порівняння отриманих результатів; блок для класифікації виявлених патологій, що включає НМ; базу даних, як вже існуючих знімків, так і нових, у т.ч. з результатом оброблення; блок підготовки звіту.
Perbandingan Kecepatan Konvergensi Akar Persamaan Non Linier Metode Titik Tetap dengan Metode Newton Raphson Menggunakan Matlab
Authors: Ritonga Januari , Suryana Dede 
Published: January 2020

Metode Numerik adalah suatu teknik yang digunakan untuk memformulasikan persoalan matematika, sains dan rekayasa sedemikian sehingga dapat diselesaikan dengan cara operasi perhitungan aritmatika biasa. Tujuan penelitian ini adalah membandingkan kecepatan konvergensi penentuan akar persamaan atau fungsi non linier metode Titik Tetap dengan metode Newton Raphson menggunakan Matlab. Hasil perhitungan dengan program aplikasi Matlab menunjukkan bahwa, kecepatan konvergensi menuju akar dengan metode Newton Raphson lebih cepat dibanding metode Titik Tetap. Kecepatan rata-rata iterasi dengan tingkat kesalahan atau galat pada 0,00001, sebesar 64% lebih cepat.
Programas de habilidades sociais para universitários: uma revisão de literatura
Authors: Gouveia Thamires Gaspar , Polydoro Soely Aparecida Jorge 
Published: January 2020

As transformações que o Ensino Superior no Brasil vem passando nos últimos 20 anos geraram a necessidade de ajustes das instituições a fim de atender as novas demandas educacionais. Diversos autores defendem a ideia de que o Ensino Superior é um espaço de formação integral. Isso inclui, por exemplo, o desenvolvimento de habilidades sociais que estão relacionados com melhor desempenho acadêmico, como também o sucesso na inserção profissional. O presente artigo se propõe a analisar produções que tiveram como objetivo de desenvolver habilidades sociais em universitários quanto aos aspectos conceituais do termo habilidades sociais adotados, tipos de habilidades desenvolvidas, avaliação do programa, instrumentos utilizados e aspectos metodológicos do estudo. Foram analisados 13 artigos e 3 teses, publicados entre 1999 e abril de 2019 disponíveis nas bases de dados Scielo Brasil, PEPSIC, LILACS e Google Acadêmico. Os resultados apontaram consenso na compreensão sobre o conceito, predominância do uso de escalas de autorrelato, variação na quantidade e tipo de habilidades trabalhadas, predomínio do treino das habilidades de assertividade, comunicação, falar em público e empatia e efeito de melhora no repertório dos participantes, indicando a eficácia desse tipo de intervenção. Diante dos resultados, discute-se a importância do desenvolvimento de tal iniciativa nas Instituições de Ensino Superior, visto que tais habilidades são fundamentais para a formação universitária.