bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bringing high-grade arteriovenous malformations under control: clinical outcomes following multimodality treatment in children
Authors: Winkler Ethan A. , Lu Alex , Morshed Ramin A. , Yue John K. , Rutledge W. Caleb , Burkhardt Jan-Karl , Patel Arati B. , Ammanuel Simon G. , Braunstein Steve , Fox Christine K. , Fullerton Heather J. , Kim Helen , Cooke Daniel , Hetts Steven W. , Lawton Michael T. , Abla Adib A. , Gupta Nalin 
Published: April 2020

OBJECTIVEBrain arteriovenous malformations (AVMs) consist of dysplastic blood vessels with direct arteriovenous shunts that can hemorrhage spontaneously. In children, a higher lifetime hemorrhage risk must be balanced with treatment-related morbidity. The authors describe a collaborative, multimodal strategy resulting in effective and safe treatment of pediatric AVMs.METHODSA retrospective analysis of a prospectively maintained database was performed in children with treated and nontreated pediatric AVMs at the University of California, San Francisco, from 1998 to 2017. Inclusion criteria were age ≤ 18 years at time of diagnosis and an AVM confirmed by a catheter angiogram.RESULTSThe authors evaluated 189 pediatric patients with AVMs over the study period, including 119 ruptured (63%) and 70 unruptured (37%) AVMs. The mean age at diagnosis was 11.6 ± 4.3 years. With respect to Spetzler-Martin (SM) grade, there were 38 (20.1%) grade I, 40 (21.2%) grade II, 62 (32.8%) grade III, 40 (21.2%) grade IV, and 9 (4.8%) grade V lesions. Six patients were managed conservatively, and 183 patients underwent treatment, including 120 resections, 82 stereotactic radiosurgery (SRS), and 37 endovascular embolizations. Forty-four of 49 (89.8%) high-grade AVMs (SM grade IV or V) were treated. Multiple treatment modalities were used in 29.5% of low-grade and 27.3% of high-grade AVMs. Complete angiographic obliteration was obtained in 73.4% of low-grade lesions (SM grade I–III) and in 45.2% of high-grade lesions. A periprocedural stroke occurred in a single patient (0.5%), and there was 1 treatment-related death. The mean clinical follow-up for the cohort was 4.1 ± 4.6 years, and 96.6% and 84.3% of patients neurologically improved or remained unchanged in the ruptured and unruptured AVM groups following treatment, respectively. There were 16 bleeding events following initiation of AVM treatment (annual rate: 0.02 events per person-year).CONCLUSIONSCoordinated multidisciplinary evaluation and individualized planning can result in safe and effective treatment of children with AVMs. In particular, it is possible to treat the majority of high-grade AVMs with an acceptable safety profile. Judicious use of multimodality therapy should be limited to appropriately selected patients after thorough team-based discussions to avoid additive morbidity. Future multicenter studies are required to better design predictive models to aid with patient selection for multimodal pediatric care, especially with high-grade AVMs.
Biomechanical analysis of occipitocervical stabilization techniques: emphasis on integrity of osseous structures at the occipital implantation sites
Authors: Cunningham Bryan W. , Mueller Kyle B. , Mullinix Kenneth P. , Sun Xiaolei , Sandhu Faheem A. 
Published: April 2020

OBJECTIVEThe objective of the current study was to quantify and compare the multidirectional flexibility properties of occipital anchor fixation with conventional methods of occipitocervical screw fixation using nondestructive and destructive investigative methods.METHODSFourteen cadaveric occipitocervical specimens (Oc–T2) were randomized to reconstruction with occipital anchors or an occipital plate and screws. Using a 6-degree-of-freedom spine simulator with moments of ± 2.0 Nm, initial multidirectional flexibility analysis of the intact and reconstructed conditions was performed followed by fatigue loading of 25,000 cycles of flexion-extension (x-axis, ± 2.0 Nm), 15,000 cycles of lateral bending (z-axis, ± 2.0 Nm), and 10,000 cycles of axial rotation (y-axis, ± 2.0 Nm). Fluoroscopic images of the implantation sites were obtained before and after fatigue testing and placed on an x-y coordinate system to quantify positional stability of the anchors and screws used for reconstruction and effect, if any, of the fatigue component. Destructive testing included an anterior flexural load to construct failure. Quantification of implant, occipitocervical, and atlantoaxial junction range of motion is reported as absolute values, and peak flexural failure moment in Newton-meters (Nm).RESULTSAbsolute value comparisons between the intact condition and 2 reconstruction groups demonstrated significant reductions in segmental flexion-extension, lateral bending, and axial rotation motion at the Oc–C1 and C1–2 junctions (p < 0.05). The average bone mineral density at the midline keel (1.422 g/cm3) was significantly higher compared with the lateral occipital region at 0.671 g/cm3 (p < 0.05). There were no significant differences between the occipital anchor and plate treatments in terms of angular rotation (degrees; p = 0.150) or x-axis displacement (mm; p = 0.572), but there was a statistically significant difference in y-axis displacement (p = 0.031) based on quantitative analysis of the pre- and postfatigue fluoroscopic images (p > 0.05). Under destructive anterior flexural loading, the occipital anchor group failed at 90 ± 31 Nm, and the occipital plate group failed at 79 ± 25 Nm (p > 0.05).CONCLUSIONSBoth reconstructions reduced flexion-extension, lateral bending, and axial rotation at the occipitocervical and atlantoaxial junctions, as expected. Flexural load to failure did not differ significantly between the 2 treatment groups despite occipital anchors using a compression-fit mechanism to provide fixation in less dense bone. These data suggest that an occipital anchor technique serves as a biomechanically viable clinical alternative to occipital plate fixation.
Validation of the Surgical Intervention for Traumatic Injury scale in the pediatric population
Authors: Dornbos David , Monson Christy , CNP  , Look Andrew , Huntoon Kristin , Smith Luke G. F. , Leonard Jeffrey R. , Dhall Sanjay S. , Sribnick Eric A. 
Published: April 2020

OBJECTIVEWhile the Glasgow Coma Scale (GCS) has been effective in describing severity in traumatic brain injury (TBI), there is no current method for communicating the possible need for surgical intervention. This study utilizes a recently developed scoring system, the Surgical Intervention for Traumatic Injury (SITI) scale, which was developed to efficiently communicate the potential need for surgical decompression in adult patients with TBI. The objective of this study was to apply the SITI scale to a pediatric population to provide a tool to increase communication of possible surgical urgency.METHODSThe SITI scale uses both radiographic and clinical findings, including the GCS score on presentation, pupillary examination, and CT findings. To examine the scale in pediatric TBI, a neurotrauma database at a level 1 pediatric trauma center was retrospectively evaluated, and the SITI score for all patients with an admission diagnosis of TBI between 2010 and 2015 was calculated. The primary endpoint was operative intervention, defined as a craniotomy or craniectomy for decompression, performed within the first 24 hours of admission.RESULTSA total of 1524 patients met inclusion criteria for the study during the 5-year span: 1469 (96.4%) were managed nonoperatively and 55 (3.6%) patients underwent emergent operative intervention. The mean SITI score was 4.98 ± 0.31 for patients undergoing surgical intervention and 0.41 ± 0.02 for patients treated nonoperatively (p < 0.0001). The area under the receiver operating characteristic (AUROC) curve was used to examine the diagnostic accuracy of the SITI scale in this pediatric population and was found to be 0.98. Further evaluation of patients presenting with moderate to severe TBI revealed a mean SITI score of 5.51 ± 0.31 in 40 (15.3%) operative patients and 1.55 ± 0.02 in 221 (84.7%) nonoperative patients, with an AUROC curve of 0.95.CONCLUSIONSThe SITI scale was designed to be a simple, objective communication tool regarding the potential need for surgical decompression after TBI. Application of this scale to a pediatric population reveals that the score correlated with the perceived need for emergent surgical intervention, further suggesting its potential utility in clinical practice.
Clinical predictors of achieving the minimal clinically important difference after surgery for cervical spondylotic myelopathy: an external validation study from the Canadian Spine Outcomes and Research Network
Authors: Evaniew Nathan , Cadotte David W. , Dea Nicolas , Bailey Christopher S. , Christie Sean D. , Fisher Charles G. , Paquet Jerome , Soroceanu Alex , Thomas Kenneth C. , Rampersaud Y. Raja , Manson Neil A. , Johnson Michael , Nataraj Andrew , Hall Hamilton , McIntosh Greg , Jacobs W. Bradley 
Published: April 2020

OBJECTIVERecently identified prognostic variables among patients undergoing surgery for cervical spondylotic myelopathy (CSM) are limited to two large international data sets. To optimally inform shared clinical decision-making, the authors evaluated which preoperative clinical factors are significantly associated with improvement on the modified Japanese Orthopaedic Association (mJOA) scale by at least the minimum clinically important difference (MCID) 12 months after surgery, among patients from the Canadian Spine Outcomes and Research Network (CSORN).METHODSThe authors performed an observational cohort study with data that were prospectively collected from CSM patients at 7 centers between 2015 and 2017. Candidate variables were tested using univariable and multiple binomial logistic regression, and multiple sensitivity analyses were performed to test assumptions about the nature of the statistical models. Validated mJOA MCIDs were implemented that varied according to baseline CSM severity.RESULTSAmong 205 patients with CSM, there were 64 (31%) classified as mild, 86 (42%) as moderate, and 55 (27%) as severe. Overall, 52% of patients achieved MCID and the mean change in mJOA score at 12 months after surgery was 1.7 ± 2.6 points (p < 0.01), but the subgroup of patients with mild CSM did not significantly improve (mean change 0.1 ± 1.9 points, p = 0.8). Univariate analyses failed to identify significant associations between achieving MCID and sex, BMI, living status, education, smoking, disability claims, or number of comorbidities. After adjustment for potential confounders, the odds of achieving MCID were significantly reduced with older age (OR 0.7 per decade, 95% CI 0.5–0.9, p < 0.01) and higher baseline mJOA score (OR 0.8 per point, 95% CI 0.7–0.9, p < 0.01). The effects of symptom duration (OR 1.0 per additional month, 95% CI 0.9–1.0, p = 0.2) and smoking (OR 0.4, 95% CI 0.2–1.0, p = 0.06) were not statistically significant.CONCLUSIONSSurgery is effective at halting the progression of functional decline with CSM, and approximately half of all patients achieve the MCID. Data from the CSORN confirmed that older age is independently associated with poorer outcomes, but novel findings include that patients with milder CSM did not experience meaningful improvement, and that symptom duration and smoking were not important. These findings support a nuanced approach to shared decision-making that acknowledges some prognostic uncertainty when weighing the various risks, benefits, and alternatives to surgical treatment.
STRATEGI MENINGKATKAN KOMPETENSI GURU DALAM MENYUSUN RENCANA PROGRAM PEMBELAJARAN HARIAN MELALUI BIMBINGAN BERKELANJUTAN
Authors: Sopiah Yayah 
Published: April 2020

Guru merupakan faktor yang paling dominan karena di tangan gurulah keberhasilan pembelajaran dapat dicapai. Kualitas mengajar guru secara langsung maupun tidak langsung dapat mempengaruhi kualitas pembelajaran pada umumnya. Karena itulah diperlukan adanya bimbingan berkelanjutan untuk memastikan kualitas pembelajaran yang dilaksanakan guru sesuai dengan standar yang ditetapkan. Penelitian ini bertujuan untuk meningkatkan kompetensi guru melalui bimbingan berkelanjutan. Penelitian ini dilaksanakan di Taman Kanak-kanak Kusuma Bangsa. Berdasarkan temuan hasil penelitian diperoleh kesimpulan Bimbingan berkelanjutan dapat meningkatkan kompetensi guru dalam menyusun Rencana Pelaksanaan Pembelajaran Harian. Hal itu dapat dibuktikan dari hasil observasi /pengamatan yang memperlihatkan bahwa terjadi peningkatan kompetensi guru dalam menyusun Rencana Pelaksanaan Pembelajaran Harian dari siklus ke siklus
PENDEKATAN COMMUNICATIVE LANGUAGE TEACHING DALAM VIDEO PROJECT YOUTUBE UNTUK MENINGKATKAN MOTIVASI BELAJAR SISWA
Authors: Kustini Titin 
Published: April 2020

Motivasi belajar terkorelasi erat dengan peningkatan prestasi belajar bahasa Inggris. Karena pentingnya motivasi bagi peningkatan belajar siswa maka perlu terus dicari cara yang dirasakan tepat bagi siswa. Keaktifan siswa dalam menggunakan bahasa Inggris dapat ditingkatkan dengan menggunakan pendekatan Communicative Language Teaching (CLT). Tujuan dari CLT adalah pengajaran kompetensi berbahasa komunikatif. Di samping itu kemajuan ilmu pengetahuan khususnya internet dan teknologi informasi dalam hal ini media sosial termasuk Youtube yang telah menjadi bagian keseharian generasi muda sekarang ini, bisa menjadi alternatif cara meningkatkan motivasi siswa dalam belajar bahasa Inggris. Penugasan membuat video project yang kemudian diupload ke Youtube diharapkan bisa meningkatkan motivasi siswa belajar bahasa Inggris dan sekaligus merangsang kreatifitas siswa agar tidak hanya menjadi penonton tetapi bisa memetik manfaat dari adanya Youtube. Manfaat pertama yang diharapkan adalah meningkatnya motivasi siswa untuk mempelajari bahasa Inggris ketika video mereka di Youtube ditonton oleh banyak viewers. Manfaat kedua adalah menumbuhkan jiwa wirausaha siswa dengan menjadikan Youtube sebagai salah satu alternatif yang bisa mendatangkan keuntungan ekonomis. Metode yang digunakan dalam peneliti ini adalah kualitatif. Penelitian kualitatif merupakan upaya untuk memperoleh data berupa deskripsi tentang hal-hal yang diamati. Hasil penelitian menunjukkan bahwa penugasan video project dapat meningkatkan motivasi belajar siswa sehingga meningkatkan prestasi belajar bahasa Inggris namun tidak mampu menjadi salah satu alternatif cara mendatangkan keuntungan ekonomis karena mereka menemui banyak hambatan dalam mencari jumlah viewers yang signifikan terkait kondisi mayoritas siswa yang berasal dari kalangan ekonomi menengah ke bawah
PENERAPAN MODEL PEMBELAJARAN KOOPERATIF TIPE TGT (TEAMS GAMES TOURNAMENTS) DALAM MENINGKATKAN MOTIVASI BELAJAR SISWA
Authors: Sobandi Sobandi 
Published: April 2020

Tujuan Penelitian ini adalah untuk mengetahui peningkatan motivasi belajar siswa Kelas V SDN Wangkelang I pada mata pelajaran Pendidikan Agama Islam. Metode dalam penelitian ini menggunakan penelitian tindakan kelas. Penelitian ini dilakukan pada program pengajaran tahun 2016/2017 di SDN Wangkelang I, dengan subyek penelitian siswa kelas V Semester 1 sebanyak 30 siswa, kondisi kekhususan siswa ini memungkinkan tingkat kemampuan dan daya serap siswa tersebut sangat bervariasi. Hasil penelitian menunjukkan hasil belajar siswa Kelas V SDN Wangkelang I Kecamatan Banjaran pada kompetensi dasar tentang Mengartikan QS Al Lahab dan Al Kafirun mengalami peningkatan yang cukup signifikan setelah diterapkan Model Pembelajaran Kooperatif Tipe TGT (Teams Games Tournaments). Dengan demikian dapat disimpulkan penerapan Model Pembelajaran Kooperatif Tipe TGT (Teams Games Tournaments) dapat meningkatkan motivasi belajar siswa kelas V SDN Wangkelang I.
UPAYA MENINGKATKAN KEMAMPUAN BELAJAR SISWA MELALUI PENDEKATAN KETERAMPILAN PROSES
Authors: Bidayah Ii 
Published: April 2020

Penelitian ini berawal dari permasalahan yang dirasakan peneliti bahwa selama ini pembelajaran IPA di Sekolah Dasar (SD) pada umumnya masih menekankan pada pengembangan aspek kognitif. Siswa dituntut untuk menguasai bahan ajar yang disampaikan oleh guru tanpa diberi kesempatan untuk mengembangan aspek lainnya. Akibat dari gaya belajar seperti ini membuat siswa mengalami kesulitan dalam belajar dan prestasi belajar siswa masih ditentukan oleh penguasaan materi yang disampaikan tanpa memperhatikan aspek lainnya (afektif dan psikomotor). Metode penelitian yang digunakan adalah metode Penelitian Tindakan Kelas (PTK) yaitu suatu tindakan untuk memperbaiki dan meningkatkan kualitas pembelajaran. Instrumen yang digunakan adalah lembar observasi dan tes hasil belajar. Teknik analisis data yang digunakan adalah kualitatif dan kuantitatif deskriptif. Peningkatan kinerja guru dalam merancang pembelajaran secara berturut-turut meningkat dari siklus I hingga siklus II, begitu kinerja guru dalam menerapkan pendekatan keterampilan proses sains. Peningkatan tersebut berdampak pula pada peningkatan kemampuan belajar siswa
Імплементація міжнародно-правових норм Ради Європи щодо охорони культурної спадщини у законодавство України
Authors: Mazur T. V. 
Published: April 2020

Україна стала членом Ради Європи в 1995 році, взявши на себе зобов’язання дотримуватися основоположних принципів діяльності організації. У сфері культурної політики наша держава активно впроваджує основні положення Ради Європи в національне законодавство.
Метою статті є аналіз основних міжнародно-правових пам’яткоохоронних актів Ради Європи та імплементації їх норм у законодавство України у контексті сучасних викликів і загроз національній культурній спадщині.
Наукова новизна статті полягає в аналізі міжнародно-правових норм Ради Європи щодо захисту культурних цінностей і відповідності національного законодавства України цим нормам, а також тим викликам і загрозам, які постали перед Україною та її культурними цінностями після окупації Росією Криму й початку збройного конфлікту на Донбасі.
Висновки. Україна активно співпрацює з Радою Європи у сфері захисту культурних цінностей та є учасницею основних міжнародних конвенцій, прийнятих цією організацією. Наша держава ратифікувала Європейську культурну конвенцію 1954 р., Конвенцію про охорону архітектурної спадщини Європи 1985 р., Європейську конвенцію про охорону археологічної спадщини (переглянуту) 1992 р., Рамкову конвенцію про захист національних меншин 1995 р., Рамкову Конвенцію Ради Європи про значення культурної спадщини для суспільства 2005 р. тощо.
Водночас українське законодавство потребує подальших змін у зв’язку з розвитком міжнародного права охорони культурної спадщини та з метою протидії руйнуванню, викраденням і знищенню об’єктів культурної спадщини в окупованому Криму та зоні збройного конфлікту на Донбасі. Серед документів Ради Європи у цьому контексті важливою є Конвенція про правопорушення, пов’язані з культурними цінностями 2017 р., яка підписана нашою державою, однак ще не ратифікована. Так само важливими для України є й документи Ради Європи рекомендаційного характеру, положення яких варто враховувати під час внесення змін до національного пам’яткоохоронного законодавства.
Precision COVID-19 Vaccine with Companion Diagnostics
Authors: Lisziewicz Julianna , Lori Franco 
Published: April 2020

<img src=” https://s3.amazonaws.com/production.scholastica/article/12561/medium/prnano_412020_figure_1.jpg?1586516744”> Although disease enhancement by antibodies has been described for corona and other viruses, nobody can predict whether such antibodies induced by the vaccine will not be harmful, especially after reinfection with a different strain. Alternative vaccines could induce memory T-cell responses, in the absence of antibodies, to kill newly infected cells. Preclinical testing of such precision vaccines is performed in silico without animal experiments since epitopes predicted to bind to three HLA class I molecules of a subject activate cytotoxic T-cell response with more than 80% probability. Data science can be utilized to select the immunogenic vaccine peptides from the coronavirus replicase protein and estimate the immune response rate in an HLA-genotyped population. Employing accessible platform technologies, a set of precision vaccines could be co-developed with an HLA-genotype based companion diagnostic to identify the vaccine that most likely induces responses in the subject. The goal of precision vaccination is to convert the deadly COVID-19 into asymptomatic disease and to avoid the potential risk of disease enhancement. READ ARTICLE (https://precisionnanomedicine.com/article/12561)
Soft‐tissue sarcoma in adults: An update on the current state of histiotype‐specific management in an era of personalized medicine
Authors: Gamboa Adriana C. , Gronchi Alessandro , Cardona Kenneth 
Published: April 2020

AbstractSoft‐tissue sarcomas (STS) are rare tumors that account for 1% of all adult malignancies, with over 100 different histologic subtypes occurring predominately in the trunk, extremity, and retroperitoneum. This low incidence is further complicated by their variable presentation, behavior, and long‐term outcomes, which emphasize the importance of centralized care in specialized centers with a multidisciplinary team approach. In the last decade, there has been an effort to improve the quality of care for patients with STS based on anatomic site and histology, and multiple ongoing clinical trials are focusing on tailoring therapy to histologic subtype. This report summarizes the latest evidence guiding the histiotype‐specific management of extremity/truncal and retroperitoneal STS with regard to surgery, radiation, and chemotherapy.
Heat and mass transfer at condensate–vapor interfaces
Authors: Kryukov P , Levashov V Yu , Zhakhovskii V V , Anisimov S I 
Published: April 2020

Abstract

Evaporation and condensation processes are intensely used in various fields of technology. Efforts to understand the features of film boiling of various liquids, primarily superfluid helium, inevitably lead to studying the strongly nonequilibrium processes of heat transfer from the heating surface through the vapor to the condensed phase. Theoretical studies of evaporation and condensation of single-component substances are briefly reviewed. Corresponding experimental data are analyzed and compared with calculations. We explore the important, yet unresolved and actively studied problems of condensation from vapor–gas media, the formulation of boundary conditions, and the application of molecular dynamics and kinetic theory methods to the study of heat and mass transfer at phase interfaces.
A MULTIMODAL DISCOURSE ANALYSIS OF FAST FOOD ADVERTISEMENTS IN ENGLISH
Authors: Du Nguyễn Trọng , Yến Dương Hồng , Phượng Nguyễn Thị 
Published: April 2020

Quảng cáo trực tuyến là một trong số những loại hình quảng cáo truyền thông mà con người thường xuyên tiếp xúc trong thời đại hiện nay. Mục đích của bài báo là tìm ra các yếu tố ngôn ngữ và phi ngôn ngữ đã được sử dụng trong quảng cáo thức ăn nhanh bằng tiếng Anh và tác dụng thuyết phục của chúng đối với việc tiêu thụ sản phẩm của người xem. Nghiên cứu này áp dụng mô hình phân tích diễn ngôn đa phương thức (Norris, 2004) làm cơ sở lý thuyết và đường hướng phân tích. Qua phân tích hai video quảng cáo của hai chuỗi thức ăn nhanh nổi tiếng thế giới (Kentucky Fried Chicken và McDonald), kết quả của nghiên cứu cho thấy ngoài ngôn ngữ, còn có nhiều phương thức giao tiếp khác ảnh hưởng đến việc tiêu thụ các sản phẩm thức ăn nhanh như khoảng cách không gian, tư thế, cử chỉ, ánh mắt, chuyển động đầu, âm nhạc, in ấn và bố cục. Mức độ ảnh hưởng của mỗi phương thức trong từng quảng cáo là khác nhau và có tác dụng nhất định trong việc thuyết phục người xem.