bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFEKTIVITAS PEMBELAJARAN MATEMATIKA REALISTIK DENGAN PERMAINAN GATRIK PADA MATERI OPERASI HITUNG CAMPURAN KELAS IV SD
Authors: Alkulub Alfatah Ibnu 
Published: November 2019

ABSTRACTThis research has purposed to find out the effectiveness of realistic mathematics education with gatrik game on arithmatic operation mix material in elementary school grade IV at Public Elementary School Palang district Tuban. The result data analysis of implementation realistic mathematics education materials revealed to: (1) Teachers be able to teaching the materials nicely, (2) Students activities during learning process is effective, (3) Students responses during learning process are positive, and (4) classical Students completeness is achieved. Based on the result of this research, Researcher concluded that realistic mathematics learning using gatrik game is effective when applied on arithmatic operation mix in elementary school grade IV. Keywords: Realistic mathematic education and gatrik games ABSTRAK Penelitian ini bertujuan mengetahui keefektifan pembelajaran matematika realistik dengan permainan gatrik pada materi operasi hitung campuran di Kelas IV Sekolah Dasar Negeri Palang Kabupaten Tuban. Hasil analisis data implementasi perangkat pembelajaran terungkap bahwa: (1) guru dapat melaksanakan pembelajaran dengan baik, (2) aktivitas siswa selama pembelajaran efektif, (3) respon siswa terhadap pembelajaran positif, dan (4) ketuntasan belajar siswa secara klasikal tercapai.Berdasarkan hasil penelitian tersebut, peneliti menyimpulkan bahwa pembelajaran matematika realistik dengan permainan gatrik efektif digunakan pada materi operasi hitung campuran di kelas IV SD. Kata Kunci: pembelajaran matematika realistik dan permainan gatrik.
PENGARUH PEMBELAJARAN BERBASIS MASALAH TERHADAP PEMAHAMAN SISWA MENGENAI HAK DAN KEWAJIBAN SISWA SEKOLAH DASAR SEBAGAI WARGA NEGARA
Authors: Prasetia Hendra 
Published: November 2019

ABSTRACTThis study aimed to research the effect of problem based learning on students' understanding of the rights and obligations of primary school students as citizenship. The type of the research was experimental research with pretest-posttest control group research design. Results of testing the hypothesis that t value obtained is equal to 5.216 and a significance value of 0.000. Thus the t value obtained is greater than t table (5.216> 2.408), while the significance value is smaller than the value of Î± (0.000 <0.05). Based on these results, the hypothesis is accepted, meaning that a significant difference between problem-based learning, the students' understanding of the rights and obligations of primary school students as citizenship. Keywords: Problem Based Learning, Students Understanding, the Rights and Duties of Students. ABSTRAK Penelitian ini bertujuan untuk mengetahui pengaruh model Pembelajaran berbasis masalah terhadap pemahaman siswa mengenai hak dan kewajiban siswa sekolah dasar sebagai warga negara. Jenis penelitian yang dilakukan adalah penelitian eksperimen dengan bentuk desain penelitian pretest-posttest control group design. Hasil pengujian hipotesis menjelaskan nilai t hitung yang didapat yaitu sebesar 5.216 dan nilai signifikansi sebesar 0,000, hasil pengujian hipotesis tersebut menunjukkan bahwa nilai t hitung yang didapat lebih besar dari nilai t dalam tabel (5,216>2,408) sedangkan nilai signifikansi tersebut lebih kecil dari nilai Î± (0,000<0,05). Berdasarkan hasil tersebut, maka hipotesis diterima, artinya terdapat pengaruh yang signifikan antara pembelajaran berbasis masalah, terhadap pemahaman siswa akan hak dan kewajiban siswa sekolah dasar sebagai warga negara. Kata Kunci : Pembelajaran Berdasarkan Masalah, Pemahaman Siswa, Hak dan kewajiban siswa.
PENGEMBANGAN MEDIA PETA 3D PADA TEMA TEMPAT TINGGALKU UNTUK MENINGKATKAN HASIL BELAJAR SISWA KELAS IV SEKOLAH DASAR
Authors: Subianto Eko Mauludin , Kasdi Aminuddin , Subroto Waspodo Tjipto 
Published: November 2019

ABSTRACTThis research is a development approach that aims to (1) describe the feasibility media 3D maps have been developed, (2) describe the effectiveness of media 3D map. This research was conducted in SDN Lidah Kulon I Surabaya, with research subjects are students of class IV A SDN Lidah Kulon I Surabaya as the control class and IV B SDN Lidah Kulon I Surabaya as an experimental class of the school year 2015/2016. Type of research is the development of the research design form 4-D. The data was obtained as follows: media 3D map developed declared eligible. This is shown by the assessment of media experts validator that shows the percentage of votes at 92.5% which is in excellent condition and the assessment of experts validator percentage material showed 90% were classified as very good. As for testing the hypothesis analyzed by t-test showed that the learning outcomes of students in the experimental class is higher than the control class. This is indicated by tcount (4713)> ttable (1.664) with a mean value of the experimental class of 78.3750 higher than the learning outcomes of students in the control class is 67.6923. Thus, the use of a 3D map media influence on student learning outcomes. Based on the analysis, it can be concluded that the media 3D map effectively improve student learning outcomes fourth grade of Elementary School. Keywords: Development, Media Map 3D, Learning Outcomes. ABSTRAK Penelitian ini merupakan pendekatan dari pengembangan yang bertujuan untuk (1) mendeskripsikan kelayakan media peta 3D yang telah dikembangkan, (2) mendeskripsikan efektivitas media peta 3D. Penelitian ini dilakukan di SDN Lidah Kulon I Surabaya, dengan subjek penelitian adalah siswa kelas IV A SDN Lidah Kulon I Surabaya sebagai kelas kontrol dan IV B SDN Lidah Kulon I Surabaya sebagai kelas eksperimen tahun pelajaran 2015/2016. Jenis penelitian yang dilakukan adalah pengembangan dengan bentuk desain penelitian 4-D. Data hasil penelitian yang diperoleh sebagai berikut: media peta 3D yang dikembangkan dinyatakan layak. Hal ini ditunjukkan dengan penilaian dari validator ahli media yang menujukkan persentase hasil penilaian sebesar 92.5% yang tergolong sangat baik dan penilaian dari validator ahli materi yang menunjukkan persentase sebesar 90%yang tergolong sangat baik. Sedangkan untuk pengujian hipotesis yang dianalisa dengan uji t menunjukkan bahwa hasil belajar siswa pada kelas eksperimen lebih tinggi dibandingkan pada kelas kontrol. Hal ini ditunjukkan dengan nilai thitung (4.713) > ttabel (1.664) dengan nilai mean pada kelas eksperimen sebesar 78.3750 lebih tinggi dibandingkan dengan hasil belajar siswa pada kelas kontrol yaitu 67.6923. Jadi, penggunaan media peta 3D berpengaruh terhadap hasil belajar siswa. Berdasarkan hasil analisis data, dapat disimpulkan bahwa media peta 3D efektif meningkatkan hasil belajar siswa kelas IV Sekolah Dasar. Kata Kunci: Pengembangan, Media Peta 3D, Hasil Belajar.
Diffusion tensor imaging reveals microstructural differences between subtypes of trigeminal neuralgia
Authors: Willsey Matthew S. , Collins Kelly L. , Conrad Erin C. , Chubb Heather A. , Patil Parag G. 
Published: November 2019

OBJECTIVETrigeminal neuralgia (TN) is an uncommon idiopathic facial pain syndrome. To assist in diagnosis, treatment, and research, TN is often classified as type 1 (TN1) when pain is primarily paroxysmal and episodic or type 2 (TN2) when pain is primarily constant in character. Recently, diffusion tensor imaging (DTI) has revealed microstructural changes in the symptomatic trigeminal root and root entry zone of patients with unilateral TN. In this study, the authors explored the differences in DTI parameters between subcategories of TN, specifically TN1 and TN2, in the pontine segment of the trigeminal tract.METHODSThe authors enrolled 8 patients with unilateral TN1, 7 patients with unilateral TN2, and 23 asymptomatic controls. Patients underwent DTI with parameter measurements in a region of interest within the pontine segment of the trigeminal tract. DTI parameters were compared between groups.RESULTSIn the pontine segment, the radial diffusivity (p = 0.0049) and apparent diffusion coefficient (p = 0.023) values in TN1 patients were increased compared to the values in TN2 patients and controls. The DTI measures in TN2 were not statistically significant from those in controls. When comparing the symptomatic to asymptomatic sides in TN1 patients, radial diffusivity was increased (p = 0.025) and fractional anisotropy was decreased (p = 0.044) in the symptomatic sides. The apparent diffusion coefficient was increased, with a trend toward statistical significance (p = 0.066).CONCLUSIONSNoninvasive DTI analysis of patients with TN may lead to improved diagnosis of TN subtypes (e.g., TN1 and TN2) and improve patient selection for surgical intervention. DTI measurements may also provide insights into prognosis after intervention, as TN1 patients are known to have better surgical outcomes than TN2 patients.
Aspirin associated with decreased rate of intracranial aneurysm growth
Authors: Zanaty Mario , Roa Jorge A. , Nakagawa Daichi , Chalouhi Nohra , Allan Lauren , Al Kasab Sami , Limaye Kaustubh , Ishii Daizo , Samaniego Edgar A. , Jabbour Pascal , Torner James C. , Hasan David M. 
Published: November 2019

OBJECTIVEAspirin has emerged as a potential agent in the prevention of rupture of intracranial aneurysms (IAs). In this study, the authors’ goal was to test if aspirin is protective against aneurysm growth in patients harboring multiple IAs ≤ 5 mm.METHODSThe authors performed a retrospective review of a prospectively maintained database covering the period July 2009 through January 2019. Patients’ data were included if the following criteria were met: 1) the patient harbored multiple IAs; 2) designated primary aneurysms were treated by surgical/endovascular means; 3) the remaining aneurysms were observed for growth; and 4) a follow-up period of at least 5 years after the initial treatment was available. Demographics, earlier medical history, the rupture status of designated primary aneurysms, aneurysms’ angiographic features, and treatment modalities were gathered.RESULTSThe authors identified 146 patients harboring a total of 375 IAs. At the initial encounter, 146 aneurysms were treated and the remaining 229 aneurysms (2–5 mm) were observed. During the follow-up period, 24 (10.48%) of 229 aneurysms grew. All aneurysms observed to grow later underwent treatment. None of the observed aneurysms ruptured. Multivariate analysis showed that aspirin was significantly associated with a decreased rate of growth (odds ratio [OR] 0.19, 95% confidence interval [CI] 0.05–0.63). Variables associated with an increased rate of growth included hypertension (OR 14.38, 95% CI 3.83–53.94), drug abuse (OR 11.26, 95% CI 1.21–104.65), history of polycystic kidney disease (OR 9.48, 95% CI 1.51–59.35), and subarachnoid hemorrhage at presentation (OR 5.91, 95% CI 1.83–19.09).CONCLUSIONSIn patients with multiple IAs, aspirin significantly decreased the rate of aneurysm growth over time. Additional prospective interventional studies are needed to validate these findings.
Contemporary assessment of extent of resection in molecularly defined categories of diffuse low-grade glioma: a volumetric analysis
Authors: Kavouridis Vasileios K. , Boaro Alessandro , Dorr Jeffrey , Cho Elise Y. , Iorgulescu J. Bryan , Reardon David A. , Arnaout Omar , Smith Timothy R. 
Published: November 2019

OBJECTIVEWhile the effect of increased extent of resection (EOR) on survival in diffuse infiltrating low-grade glioma (LGG) patients is well established, there is still uncertainty about the influence of the new WHO molecular subtypes. The authors designed a retrospective analysis to assess the interplay between EOR and molecular classes.METHODSThe authors retrospectively reviewed the records of 326 patients treated surgically for hemispheric WHO grade II LGG at Brigham and Women’s Hospital and Massachusetts General Hospital (2000–2017). EOR was calculated volumetrically and Cox proportional hazards models were built to assess for predictive factors of overall survival (OS), progression-free survival (PFS), and malignant progression–free survival (MPFS).RESULTSThere were 43 deaths (13.2%; median follow-up 5.4 years) among 326 LGG patients. Median preoperative tumor volume was 31.2 cm3 (IQR 12.9–66.0), and median postoperative residual tumor volume was 5.8 cm3 (IQR 1.1–20.5). On multivariable Cox regression, increasing postoperative volume was associated with worse OS (HR 1.02 per cm3; 95% CI 1.00–1.03; p = 0.016), PFS (HR 1.01 per cm3; 95% CI 1.00–1.02; p = 0.001), and MPFS (HR 1.01 per cm3; 95% CI 1.00–1.02; p = 0.035). This result was more pronounced in the worse prognosis subtypes of IDH-mutant and IDH-wildtype astrocytoma, for which differences in survival manifested in cases with residual tumor volume of only 1 cm3. In oligodendroglioma patients, postoperative residuals impacted survival when exceeding 8 cm3. Other significant predictors of OS were age at diagnosis, IDH-mutant and IDH-wildtype astrocytoma classes, adjuvant radiotherapy, and increasing preoperative volume.CONCLUSIONSThe results corroborate the role of EOR in survival and malignant transformation across all molecular subtypes of diffuse LGG. IDH-mutant and IDH-wildtype astrocytomas are affected even by minimal postoperative residuals and patients could potentially benefit from a more aggressive surgical approach.
Endoscopic transorbital approach to the infratemporal fossa and parapharyngeal space: a cadaveric study
Authors: Gerges Mina M. , Godil Saniya S. , Younus Iyan , Rezk Michael , Schwartz Theodore H. 
Published: November 2019

OBJECTIVEThe infratemporal fossa (ITF) and parapharyngeal space are anatomical regions that can be challenging to access without the use of complex, cosmetically disfiguring approaches. With advances in endoscopic techniques, a new group of surgical approaches to access the intracranial space through the orbit has been recently referred to as transorbital neuroendoscopic surgery (TONES). The objective of this study was to establish a transorbital endoscopic approach utilizing the inferior orbital fissure (IOF) to gain access to the ITF and parapharyngeal space and provide a detailed endoscopic anatomical description of this approach.METHODSFour cadaveric heads (8 sides) were dissected using a TONES approach through the IOF to reach the ITF and parapharyngeal space, providing stepwise dissection with detailed anatomical findings and a description of each step.RESULTSAn inferior eyelid approach was made with subperiosteal periorbital dissection to the IOF. The zygomatic and greater wing of the sphenoid were drilled, forming the boundaries of the IOF. The upper head of the lateral pterygoid muscle in the ITF and parapharyngeal space was removed, and 7 distinct planes were described, each with its own anatomical contents. The second part of the maxillary artery was mainly found in plane 1 between the temporalis laterally and the lateral pterygoid muscle in plane 2. The branches of the mandibular nerve (V3) and middle meningeal artery (MMA) were identified in plane 3. Plane 4 was formed by the fascia of the medial pterygoid muscle (MTM) and the tensor veli palatini muscle. The prestyloid segment, found in plane 5, was composed mainly of fat and lymph nodes. The parapharyngeal carotid artery in the poststyloid segment, found in plane 7, was identified after laterally dissecting the styloid diaphragm, found in plane 6. V3 and the origin of the levator and tensor veli palatini muscles serve as landmarks for identification of the parapharyngeal carotid artery.CONCLUSIONSThe transorbital endoscopic approach provides excellent access to the ITF and parapharyngeal space compared to previously described complex and morbid transfacial or transcranial approaches. Using the IOF is an important and useful landmark that permits a wide exposure.
Endoscopic endonasal cyst fenestration into the sphenoid sinus using the mucosa coupling method for symptomatic Rathke’s cleft cyst: a novel method for maintaining cyst drainage to prevent recurrence
Authors: Kino Hiroyoshi , Akutsu Hiroyoshi , Tanaka Shuho , Hara Takuma , Miyamoto Hidetaka , Sakamoto Noriaki , Takano Shingo , Masumoto Tomohiko , Shiigai Masanari , Ishikawa Eiichi , Matsumura Akira 
Published: November 2019

OBJECTIVERathke’s cleft cyst (RCC) is a benign cystic lesion with a relatively high incidence of local recurrence that occasionally requires repeat surgery. To prevent recurrence, simple cyst fenestration and drainage of the cyst contents to the sphenoid sinus is recommended, but it occasionally recurs. The authors postulated that obstruction of fenestration is a main cause of recurrence, and they developed a method, named the “mucosa coupling method (MC method),” that maintains persistent drainage. In this method, the RCC epithelium and the mucosa of the sphenoid sinus are connected, which promotes re-epithelialization between the two epithelia, maintaining persistent drainage. The outcome of this method was compared with that of conventional cyst fenestration.METHODSIn a consecutive series of 40 patients with RCC, the surgical strategy was changed during the study period: from December 2009 to September 2014 (the conventional period), 24 patients were scheduled to be treated using the conventional fenestration method, whereas from September 2014 to September 2017 (the MC period), 16 patients were scheduled to be treated using the MC method. However, because of an intraoperative CSF leak, the fenestration was closed during surgery in 3 patients in the conventional period and 2 in the MC period; therefore, these 5 patients were excluded from the analysis. Twenty-one patients treated with the conventional fenestration method (conventional group) and 14 patients treated with the MC method (MC group) were analyzed. All patients regularly underwent MRI after surgery to detect reaccumulation of cyst contents. The rate of reaccumulation with and without reoperation, visual outcomes, endocrinological outcomes, and postoperative complications were compared between these two groups.RESULTSThe median follow-up period in all 35 patients was 48.0 months (range 1–96 months), 54.0 months (range 1–96 months) in the conventional group and 35.5 months (range 12–51 months) in the MC group. No reaccumulation was detected on MRI in the 14 patients in the MC group, whereas it was noted in 9 (42.9%) of 21 patients in the conventional group, and 2 of these 9 patients required repeat surgery. There were no significant differences in visual and endocrinological outcomes and complications between these two groups.CONCLUSIONSThe MC method for RCC is effective for preventing obstruction of cyst fenestration, which contributes to preventing cyst reaccumulation. Furthermore, this method is equivalent to the conventional fenestration method in terms of visual and endocrinological outcomes and the complication rate.
Risk of internal carotid artery stenosis or occlusion after single-fraction radiosurgery for benign parasellar tumors
Authors: Graffeo Christopher S. , Link Michael J. , Stafford Scott L. , Parney Ian F. , Foote Robert L. , Pollock Bruce E. 
Published: November 2019

OBJECTIVEStereotactic radiosurgery (SRS) is an accepted treatment option for patients with benign parasellar tumors. Here, the authors’ objective was to determine the risk of developing new or progressive internal carotid artery (ICA) stenosis or occlusion after single-fraction SRS for cavernous sinus meningioma (CSM) or growth hormone–secreting pituitary adenoma (GHPA).METHODSThe authors queried their prospectively maintained registry for patients treated with single-fraction SRS for CSM or GHPA in the period from 1990 to 2015. Study criteria included no prior irradiation and ≥ 12 months of post-SRS radiological follow-up. Pre-SRS grading of ICA involvement was applied according to the 1993 classification schemes of Hirsch for CSM or Knosp for GHPA.RESULTSThe authors conducted a retrospective review of 283 patients, 155 with CSMs and 128 with GHPAs. Ninety-three (60%) CSMs were Hirsch category 2 and 3 tumors; 97 (76%) GHPAs were Knosp grade 2–4 tumors. Median follow-up after SRS was 6.6 years (IQR 1–24.9 years). No GHPA or category 1 CSM developed ICA stenosis or occlusion. Three (5.2%) patients with category 2 CSMs had asymptomatic ICA stenosis (n = 2) or occlusion (n = 1); 1 (1.1%) category 2 CSM patient had transient ischemic symptoms. Five (14.3%) category 3 CSMs progressed to ICA occlusion (4 asymptomatic, 1 symptomatic). The median time to stenosis/occlusion was 4.8 years (IQR 1.8–7.6). Five- and 10-year risks of ICA stenosis/occlusion in category 2 and 3 CSM patients were 7.5% and 12.4%, respectively. Five- and 10-year risks of ischemic stroke from ICA stenosis/occlusion in category 2 and 3 CSM patients were both 1.2%. Multivariate analysis showed patient age (HR 0.92, 95% CI 0.86–0.98, p = 0.01), meningioma pathology (HR and 95% CI not defined, p = 0.03), and pre-SRS carotid category (HR 4.51, 95% CI 1.77–14.61, p = 0.004) to be associated with ICA stenosis/occlusion. Internal carotid artery stenosis/occlusion was not related to post-SRS tumor growth (HR and 95% CI not defined, p = 0.41).CONCLUSIONSNew or progressive ICA stenosis/occlusion was common after SRS for CSM but was not observed after SRS for GHPA, suggesting a tumor-specific mechanism unrelated to radiation dose. Pre-SRS ICA encasement or constriction increases the risk of ICA stenosis/occlusion; however, the risk of ischemic complications is very low.
Dual BRAF/MEK therapy in BRAF V600E-mutated primary brain tumors: a case series showing dramatic clinical and radiographic responses and a reduction in cutaneous toxicity
Authors: Bernstein Aaron , Mrowczynski Oliver D. , Greene Amrit , Ryan Sandra , Chung Catherine , Zacharia Brad E. , Glantz Michael 
Published: November 2019

OBJECTIVEBRAF V600E is a common oncogenic driver in a variety of primary brain tumors. Dual inhibitor therapy using dabrafenib (a selective oral inhibitor of several mutated forms of BRAF kinase) and trametinib (a reversible inhibitor of MEK1 and MEK2) has been used successfully for treatment of metastatic melanoma, anaplastic thyroid cancer, and other tumor types, but has been reported in only a few patients with primary brain tumors and none with pleomorphic xanthoastrocytoma. Here, the authors report on the substantial clinical response and reduction in cutaneous toxicity in a case series of BRAF V600E primary brain cancers treated with dual BRAF/MEK inhibitor therapy.METHODSThe authors treated 4 BRAF V600E patients, each with a different type of primary brain tumor (pilocytic astrocytoma, papillary craniopharyngioma, ganglioglioma, and pleomorphic xanthoastrocytoma) with the combination of dabrafenib and trametinib.RESULTSThe patients with pilocytic astrocytoma, pleomorphic xanthoastrocytoma, and papillary craniopharyngioma experienced near-complete radiographic and complete clinical responses after 8 weeks of therapy. A substantial partial response (by RANO [Response Assessment in Neuro-Oncology] criteria) was observed in the patient with ganglioglioma. The patient with craniopharyngioma developed dramatic, diffuse verrucal keratosis within 2 weeks of starting dabrafenib. This completely resolved within 2 weeks of adding trametinib.CONCLUSIONSDual BRAF/MEK inhibitor therapy represents an exciting treatment option for patients with BRAF V600E primary brain tumors. In addition to greater efficacy than single-agent dabrafenib, this combination has the potential to mitigate cutaneous toxicity, one of the most common and concerning BRAF inhibitor–related adverse events.