bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between timing of kyphoplasty and opioid prescribing risk after vertebral fracture
Authors: Nathan Jay K. , Johnson Mitchell A. , Waljee Jennifer F. , Szerlip Nicholas , Park Paul , Oppenlander Mark E. 
Published: August 2020

OBJECTIVEApproximately 550,000 Americans experience vertebral fracture annually, and most receive opioids to treat the resulting pain. Kyphoplasty of the fractured vertebra is a procedural alternative that may mitigate risks of even short-term opioid use. While reports of kyphoplasty’s impact on pain scores are mixed, no large-scale data exist regarding opioid prescribing before and after the procedure. This study was conducted to determine whether timing of kyphoplasty following vertebral fracture is associated with duration or intensity of opioid prescribing.METHODSThis retrospective cohort study used 2001–2014 insurance claims data from a single, large private insurer in the US across multiple care settings. Patients were adults with vertebral fractures who were prescribed opioids and underwent balloon-assisted kyphoplasty within 4 months of fracture. Opioid overdose risk was stratified by prescribed average daily morphine milligram equivalents using CDC guidelines. Filled prescriptions and risk categories were evaluated at baseline and 90 days following kyphoplasty.RESULTSInclusion criteria were met by 7119 patients (median age 77 years, 71.7% female). Among included patients, 3505 (49.2%) were opioid naïve before fracture. Of these patients, 31.1% had new persistent opioid prescribing beyond 90 days after kyphoplasty, and multivariable logistic regression identified kyphoplasty after 8 weeks as a predictor (OR 1.34, 95% CI 1.02–1.76). For patients previously receiving opioids, kyphoplasty > 4 weeks after fracture was associated with persistently elevated prescribing risk (OR 1.84, 95% CI 1.23–2.74).CONCLUSIONSNew persistent opioid prescribing occurred in nearly one-third of patients undergoing kyphoplasty after vertebral fracture, although early treatment was associated with a reduction in this risk. For patients not naïve to opioids before fracture diagnosis, early kyphoplasty was associated with less persistent elevation of opioid overdose risk. Subsequent trials must compare opioid use by vertebral fracture patients treated via operative (kyphoplasty) and nonoperative (ongoing opioid) strategies before concluding that kyphoplasty lacks value, and early referral for kyphoplasty may be appropriate to avoid missing a window of efficacy.
Prevalence of osteoporosis and osteopenia diagnosed using quantitative CT in 296 consecutive lumbar fusion patients
Authors: Carlson Brandon B. , Salzmann Stephan N. , Shirahata Toshiyuki , Ortiz Miller Courtney , Carrino John A. , Yang Jingyan , Reisener Marie-Jacqueline , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Hughes Alexander P. 
Published: August 2020

OBJECTIVEOsteoporosis is a metabolic bone disease that increases the risk for fragility fractures. Screening and diagnosis can be achieved by measuring bone mineral density (BMD) using quantitative CT tomography (QCT) in the lumbar spine. QCT-derived BMD measurements can be used to diagnose osteopenia or osteoporosis based on American College of Radiology (ACR) thresholds. Many reports exist regarding the disease prevalence in asymptomatic and disease-specific populations; however, osteoporosis/osteopenia prevalence rates in lumbar spine fusion patients without fracture have not been reported. The purpose of this study was to define osteoporosis and osteopenia prevalence in lumbar fusion patients using QCT.METHODSA retrospective review of prospective data was performed. All patients undergoing lumbar fusion surgery who had preoperative fine-cut CT scans were eligible. QCT-derived BMD measurements were performed at L1 and L2. The L1–2 average BMD was used to classify patients as having normal findings, osteopenia, or osteoporosis based on ACR criteria. Disease prevalence was calculated. Subgroup analyses based on age, sex, ethnicity, and history of abnormal BMD were performed. Differences between categorical groups were calculated with Fisher’s exact test.RESULTSOverall, 296 consecutive patients (55.4% female) were studied. The mean age was 63 years (range 21–89 years). There were 248 (83.8%) patients with ages ≥ 50 years. No previous clinical history of abnormal BMD was seen in 212 (71.6%) patients. Osteopenia was present in 129 (43.6%) patients and osteoporosis in 44 (14.9%). There were no prevalence differences between sex or race. Patients ≥ 50 years of age had a significantly higher frequency of osteopenia/osteoporosis than those who were < 50 years of age.CONCLUSIONSIn 296 consecutive patients undergoing lumbar fusion surgery, the prevalence of osteoporosis was 14.9% and that for osteopenia was 43.6% diagnosed by QCT. This is the first report of osteoporosis disease prevalence in lumbar fusion patients without vertebral fragility fractures diagnosed by QCT.
Preoperative bone health assessment and optimization in spine surgery
Authors: Anderson Paul A. , Kadri Aamir , Hare Kristyn J. , Binkley Neil 
Published: August 2020

OBJECTIVEThe purpose of this investigation was to characterize the bone health in preoperative spine surgery patients. This information will provide a framework to understand the needs and methods for providing bone health optimization in elective spine surgery patients.METHODSA retrospective study of 104 patients undergoing bone health optimization was performed. Patients were selected based on risk factors identified by the surgeon and suspected compromised bone health. Evaluation included history and examination, laboratory investigations, and bone mineral density (BMD) at 3 sites (femoral neck, lumbar spine, and radius). Patients’ bone status was classified using WHO criteria and expanded criteria recommended by the National Osteoporosis Foundation (NOF). The 10-year Fracture Risk Assessment Tool (FRAX) scores of the hip and major osteoporotic fracture (MOF) were calculated with and without femoral neck BMD, with spine BMD, and with the trabecular bone score (TBS). Antiresorptive and anabolic agents were provided in accordance with meeting NOF criteria for treatment of osteoporosis.RESULTSThe mean patient age was 69.0 years, and 81% of patients were female. The mean historical height loss was 5.6 cm, and 54% of patients had a history of fracture. Secondary osteoporosis due to chronic renal failure, inflammatory arthritis, diabetes, and steroid use was common (51%). The mean 25-hydroxy vitamin D was 42.4 ng/ml and was normal in 81% of patients, with only 4 patients being deficient. The mean T-scores were −2.09 (SD 0.71) of the femoral neck, −0.54 (1.71) of the lumbar spine, and −1.65 (1.38) of the distal radius. These were significantly different. The 10-year FRAX MOF score was 20.7%, and that for hip fracture was 6.9% using the femoral neck BMD and was not significantly different without the use of BMD. The FRAX risk-adjusted score using the lumbar spine BMD and TBS was significantly lower than that for the hip. Osteoporosis was present in 32.1% according to WHO criteria compared with 81.6% according to NOF criteria. Antiresorptive medications were recommended in 31 patients and anabolic medications in 44 patients.CONCLUSIONSSurgeons can reliably identify patients with poor bone health by using simple criteria, including historical height loss, history of fracture, comorbidities associated with osteoporosis, analysis of available imaging, and calculation of FRAX score without BMD. High-risk patients should have BMD testing and bone health assessment. In patients with osteoporosis, a comprehensive preoperative bone health assessment is recommended and, if warranted, pharmacological treatment should be started.
Does the use of preoperative bisphosphonates in patients with osteopenia and osteoporosis affect lumbar fusion rates? Analysis from a national spine registry
Authors: Guppy Kern H. , Chan Priscilla H. , Prentice Heather A. , Norheim Elizabeth P. , Harris Jessica E. , Brara Harsimran S. 
Published: August 2020

OBJECTIVEBisphosphonates are used to increase bone strength in treating osteopenia and osteoporosis, but their use for increasing lumbar fusion rates has been controversial. The objective of this study was to determine if preoperative treatment with bisphosphonates affects the reoperation rates for nonunions (operative nonunion rates) following lumbar fusions in patients with osteopenia or osteoporosis.METHODSThe authors conducted a cohort study using data from the Kaiser Permanente Spine Registry. Patients (aged ≥ 50 years) with a diagnosis of osteopenia or osteoporosis who underwent primary elective lumbar fusions for degenerative disc disease, deformity, or spondylolisthesis were included in the cohort. Repeated spinal procedures at the index lumbar levels were noted through chart review. Reoperations for symptomatic nonunions (operative nonunions), time to nonunion, and the nonunion spine level(s) were also identified. The crude 2-year cumulative incidence of operative nonunions was calculated as 1 minus the Kaplan-Meier estimator. Cox proportional hazard regression was used to evaluate the association between preoperative bisphosphonate use and operative nonunion after adjustment for covariates. Analysis was stratified by osteopenia and osteoporosis diagnosis.RESULTSThe cohort comprised 1040 primary elective lumbar fusion patients, 408 with osteopenia and 632 with osteoporosis. Ninety-seven (23.8%) patients with osteopenia and 370 (58.5%) patients with osteoporosis were preoperative bisphosphonate users. For the osteopenia group, no operative nonunions were observed in patients with preoperative bisphosphonate, while the crude 2-year incidence was 2.44% (95% CI 0.63–4.22) in the nonuser group. For the osteoporotic group, after adjustment for covariates, no difference was observed in risk for operative nonunions between the preoperative bisphosphonate users and nonusers (HR 0.96, 95% CI 0.20–4.55, p = 0.964).CONCLUSIONSTo the authors’ knowledge, this study presents one of the largest series of patients with the diagnosis of osteopenia or osteoporosis in whom the effects of preoperative bisphosphonates on lumbar fusions were evaluated using operative nonunion rates as an outcome measure. The results indicate that preoperative bisphosphonate use had no effect on the operative nonunion rates for patients with osteoporosis. Similar indications were not confirmed in osteopenia patients because of the low nonunion frequency. Further studies are warranted to the determine if preoperative and postoperative timing of bisphosphonate use has any effect on lumbar fusion rates.
Osteoporosis in spine surgery patients: what is the best way to diagnose osteoporosis in this population?
Authors: St. Jeor Jeffery D. , Jackson Taylor J. , Xiong Ashley E. , Kadri Aamir , Freedman Brett A. , Sebastian Arjun S. , Currier Bradford L. , Nassr Ahmad , Fogelson Jeremy L. , Kennel Kurt A. , Anderson Paul A. , Elder Benjamin D. 
Published: August 2020

OBJECTIVEThe goal of this study was to compare different recognized definitions of osteoporosis in patients with degenerative lumbar spine pathology undergoing elective spinal fusion surgery to determine which patient population should be considered for preoperative optimization.METHODSA retrospective review of patients in whom lumbar spine surgery was planned at 2 academic medical centers was performed, and the rate of osteoporosis was compared based on different recognized definitions. Assessments were made based on dual-energy x-ray absorptiometry (DXA), CT Hounsfield units (HU), trabecular bone score (TBS), and fracture risk assessment tool (FRAX). The rate of osteoporosis was compared based on different definitions: 1) the WHO definition (T-score ≤ −2.5) at total hip or spine; 2) CT HU of < 110; 3) National Bone Health Alliance (NBHA) guidelines; and 4) “expanded spine” criteria, which includes patients meeting NBHA criteria and/or HU < 110, and/or “degraded” TBS in the setting of an osteopenic T-score. Inclusion criteria were adult patients with a DXA scan of the total hip and/or spine performed within 1 year and a lumbar spine CT scan within 6 months of the physician visit.RESULTSTwo hundred forty-four patients were included. The mean age was 68.3 years, with 70.5% female, 96.7% Caucasian, and the mean BMI was 28.8. Fracture history was reported in 53.8% of patients. The proportion of patients identified with osteoporosis on DXA, HUs, NBHA guidelines, and the authors’ proposed “expanded spine” criteria was 25.4%, 36.5%, 75%, and 81.9%, respectively. Of the patients not identified with osteoporosis on DXA, 31.3% had osteoporosis based on HU, 55.1% had osteoporosis with NBHA, and 70.4% had osteoporosis with expanded spine criteria (p < 0.05), with poor correlations among the different assessment tools.CONCLUSIONSLimitations in the use of DXA T-scores alone to diagnose osteoporosis in patients with lumbar spondylosis has prompted interest in additional methods of evaluating bone health in the spine, such as CT HU, TBS, and FRAX, to inform guidelines that aim to reduce fracture risk. However, no current osteoporosis assessment was developed with a focus on improving outcomes in spinal surgery. Therefore, the authors propose an expanded spine definition for osteoporosis to identify a more comprehensive cohort of patients with potential poor bone health who could be considered for preoperative optimization, although further study is needed to validate these results in terms of clinical outcomes.
PENGGUNA EDMODO DALAM MEDIA PEMBELAJARAN BAGI GURU SMK SWAKARYA PALEMBANG
Authors: Putri Meidyan Permata , Hartati Eka 
Published: August 2020

Seiring dengan pesatnya perkembangan zaman, seluruh aspek kehidupanpun ikut berubah. Era globalisasi yang ditandai dengan tidak adanya sekat dimensi ruang dan waktu, mengharuskan seluruh aspek kehidupan bersentuhan dengan informasi dan teknologi. Seorang guru dituntut memiliki keterampilan berupa strategi dalam meramu pembelajarannya. Guru tidak hanya memiliki strategi pembelajaran tetapi juga mengkombinasikan TIK dalam pembelajarannya. Kegiatan ini bertujuan untuk membantu guru dalam membuat media pembelajaran dengan menggunakan Edmodo. Diharapkan kepada para peserta pelatihan agar dapat memanfaatkan penggunaan Edmodo dalam pembuatan media pembelajaran di SMK Swakarya Palembang. Bertempat di SMK Swakarya Palembang, yang telah dilakukan pada tanggal 7 – 9 Februari 208. Metode yang digunakan adalah metode ceramah dan tanya jawab. Diharapkan dari telah terlaksananya kegiatan ini peserta dapat menerapkan pengetahuan yang sudah diperoleh dalam proses pembuatan media pembelajaran.
PELATIHAN SKILL PENGURUS SANGGAR BACA TRILOGI BERBASIS INTERNET MELALUI SISTEM INFORMASI DESA (SID)
Authors: Kuncoro Bagus , Budiyono Kodrad 
Published: August 2020

Taman bacaan masyarakat adalah salah satu tempat untuk mengembangkan kemampuan dan menambah khasanah mengenai ilmu dari buku yang dibacanya. Salah satu bentuk kegiatan untuk mengembangkan kemampuan dan pemahaman masyarakat terhadap perkembangan ilmu yang selalu berkembang tersebut salah satunya melalui perpustakaan umum yang dikemas melalui kegiatan taman bacaan masyarakat. Kegiatan ini dihadiri 5 orang peserta pengurus sanggar baca trilogi dan 5 pemuka RT. Kegitan berupa penyampaian materi dan praktek langsung skill pengurus Sanggar baca Trilogi melalui sistem dokumentasi dan administrasi. Sedangkan untuk penambahan fasilitas sarana dan prasarana melalui penyampaian materi, FGD (focus groub discussion) dan diakhiri musyawarah bersama antara pelaksana kegiatan pengabdian masyarakat, pengurus sanggar baca dan Pemuka Rt. Serta penyampaian materi dari narasumber (tim pengabdian masyarakat) ditambah narasumber luar melalui zoom meeting mengenai publikasi berbasis internet melalui sistem web SID (sistem Informasi Desa). Kegiatan ini menghasilkan: 1. Pelatihan skill pada pengurus sanggar baca melalui sistem dokumentasi dan administrasi berjalan dengan baik. 2. Memberikan implementasi berupa modifikasi sarana dan prasarana pendukung kegiatan membaca, menulis dan bermain pada area fasilitas umum (fasum) yang sesuai. 3. Memberikan pelatihan pengurus sanggar Baca TriLogi mengenai publikasi berbasis internet melalui sistem web yang dimiliki RT 03/27 Perumahan Griya Winong baru 2, Ngringo.
SOSIALISASI DAN PENDAMPINGAN DALAM UPAYA PENINGKATAN EKSISTENSI OLAHRAGA PETANQUE DI KOTA YOGYAKARTA PADA MASA COVID-19
Authors: Srianto Widha , Sari Yudi Karisma 
Published: August 2020

Masa pandemi covid-19 menjadikan semua kegiatan tidak bisa dilakukan dengan optimal, baik aktifitas kerja, aktifitas pendidikan, aktifitas social maupun aktifitas olahraga, hal ini berdampak pada kegiatan-kegiatan yang dilakukan oleh Fopi Kota Yogykarta, sehingga perlu upaya untuk tetap menjaga eksitensi dan tetap memberikan motivasi pecinta olahraga petanque dengan kegiatan-kegiatan positif, maka dengan ini perlu dilakukan kegiatan sosialisasi dan pendampingan dalam upaya peningkatan eksistensi olahraga petanque di Kota Yogyakarta, Peserta kegiatan dari unsur pengurus Fopi Kota Yogyakarta ini terdiri dari unsur dosen, guru, mahasiswa, dan masyarakat umum. Metode yang digunakan dalam pengabdian meliputi ceramah dan tanya jawab, dan diberikan kuesioner untuk mengetahui respon dari peserta, analisis data berupa skor 1 untuk jawaban (ya) dan 0 untuk jawaban (tidak) kemudian diprosentase. Berdasarkan rangkaian kegiatan pengabdian ini, maka dapat ditarik kesimpulan sebagai berikut: (1) Kegiatan pengabdian ini dapat memberikan dampak positif bagi semua unsur Fopi Kota Yogyakarta baik pengurus, pelatih, maupun atlet karena pengabdian ini dinilai sebagai sesuatu yang baru dan mampu menambah wawasan tentang olahraga petanque. (2) Peserta termotivasi untuk melakukan kegiatan positif dimasa pandemi covid-19 melalui olahraga petanque. (3) Kegiatan ini sarana dalam menjalin silaturahmi antar pecinta olahraga Petanque Kota Yogyakarta pada masa covid-19 dengan meeting online.
PELATIHAN PEMBUATAN HANDICRAFT DARI LIMBAH RUMAH TANGGA ANORGANIK UNTUK MENINGKATKAN KREATIFITAS IBU-IBU DESA BLIMBINGAN
Authors: Asfuri Ninda Beny , Sasmito Luncana Faridhoh 
Published: August 2020

Waste of household waste becomes a problem in the environment of Blimbingan village because there are many household waste waste that accumulate and pollute the surrounding environment. Household needs products mostly plastic waste where plastic waste (inorganic) handling is relatively more complicated than organic waste, because inorganic waste can not be degradable naturally. Inorganic garbage originating from the household of Blimbingan village various such as plastic waste packaging of a household products, Kresek, aqua bottles are many of which are not utilized and only dumped in the trash. The villagers of Blimbingan, Baturan, especially mothers are less aware of the dangers posed by each day they continue to throw away their household garbage. This dedication activities aims to provide counselling and training of handicraft-value, valuable and economical value by utilizing household waste in Blimbingan village and provide guidance on how to sell to increase family income and can be a new job opportunities for the mothers of the village Blimbingan, Baturan. The methods used in this activity are by counseling, training/practice, monitoring and mentoring. Based on several series of events can be concluded that (1) of all participants carried out in the home mom Lurah in Blimbingan village is increased by 95% in terms of understanding and mastery of handicraft-like bags, flowers made, plastic bottles used for the category of good pencils. (2) teamwork and mothers are very compact and extraordinary proven to always attend training well until the event is over
Keywords: Household waste, Handicraft
PELATIHAN PEMBUATAN AKSESORIS DARI LIMBAH KAIN PERCA OLEH IBU-IBU RUMAH TANGGA DESA BLIMBINGAN,BATURAN
Authors: Wahyuningsih Diana Dewi , Asfuri Ninda Beny 
Published: August 2020

he village of Blimbingan is one of the villages in Baturan village, Colomadu District, Karanganyar Regency. The Housewives of the village Blimbingan actually have the skill of sewing but the potential they have is not developed. There are 5 handyman in Blimbingan village so that many of the patchwork fabric that should be used, but the citizen of Blimbingan village does not know the benefits of patchwork. Patchwork fabric in Blimbingan village is more often discarded and burned so it pollutes the environment of the surrounding community especially air pollution, and also many still good batik patchwork that should still be utilized to be processed into goods that have a high economic value. The majority of the community of Blimbingan Village are less concerned about environmental issues, they do not know the benefits that will be gained if they are able to utilize patchwork, their view of not the importance of a supposed patchwork cloth should be changed so that they should be adapted by being given socialization and counseling. This community service aims to provide socialization as well as training on making accessories by utilizing patchwork waste in Blimbingan village as well as providing guidance to develop into a productive economic business in order to become a new opportunity for the group of Mothers-Housewives village Blimbingan. The methods used in this activity are by counseling, training, monitoring and mentoring. This community devotion activity is a partner of mother-housewife Group has effectively understood the utilization of waste patchwork for beneficial products such as the manufacture of accessories and many people in need. Knowledge and skills of partners increased by 98%, which was marked by the success of making accessories products.
Keywords: Accessories, Waste patchwork
Análise de ações empreendedoras na Feira Livre de Messias/AL
Authors: Dias Lucas Victor , Levino Natallya 
Published: August 2020

O objetivo do artigo é analisar as ações adotadas pelos comerciantes da feira livre do município de Messias/AL, buscando identificar ações empreendedoras e práticas de gestão. Foi aplicado um questionário estruturado em abril de 2018, com a participação de quarenta comerciantes. Verificaram-se fracos indícios de um ambiente propício ao estimulo do empreendedorismo local; inadequada utilização dos recursos pessoais e falho planejamento das atividades organizacionais. Foi observado pouco suporte recebido dos órgãos governamentais para o desenvolvimento da atividade, assim como o de outros agentes locais. O estudo pode fomentar discussões para a manutenção da feira livre como fomento do desenvolvimento local.
Desafios e oportunidades para manutenção da ISO 9001/2015 em uma empresa de mineração do Vale do Jequitinhonha
Authors: Siqueira Nilton Ramalho , Santos Nayara Teixeira , Júnior Ismael Mendes dos Santos , Rodrigues Lucas Pazolini Dias 
Published: August 2020

O objetivo desse trabalho foi identificar os desafios e oportunidades para manutenção do processo de gestão da qualidade ISO 9001/2015 em uma empresa de mineração localizada na região do Vale do Jequitinhonha. Foi aplicado um questionário estruturado a cinquenta funcionários da empresa. O desenvolvimento desta pesquisa permitiu compreender como a empresa certificada pelo ISO 9001, obtém vantagens e enfrenta seus desafios. Foi possível constar que os maiores desafios encontrados pela empresa para a manutenção da norma ISO 9001 de 2015, foram: resistência a mudanças por parte dos funcionários; baixa escolaridade dos funcionários; burocratização; treinamento da equipe: ansiedade por resultados. Palavras-chave: Desafios. Manutenção ISO 9001. Mineração.