bluuebunny/crossref_metadata_2025_split huggingface dataset:
BIDADARI-BIDADARI SURGA INTRINSIC ELEMENTS: A NOVEL ANALYSIS
Authors: Lauren Cendy 
Published: October 2019

Abstract
This study aims to describe the intrinsic elements of Tere Liye's Bidadari-bidadari Surga novels. The method used to obtain data in this study is a qualitative descriptive method. Sources of data are excerpts of words, sentences, and discourses found in the novel Bidadari-Bidadari Surga by Tere Liye published by Republika in 2008. Related to the intrinsic elements that build literary works from within, data collection is done by reading data sources and researchers act as instruments. The researcher identifies, classifies, and codifies the data based on the problems studied. The data collection technique of this research uses textual techniques. Data analysis was carried out in a qualitative descriptive manner by reading, identifying, interpreting, and interpreting the data then drawing conclusions. The results of the analysis of this study show that the Bidadari-Bidadari Heaven novels have the theme of kinship and characters who are hard-nosed, not open, willing to sacrifice, kind-hearted, naughty, obedient, not deterred, and hardworking from several figures in the story. This novel is worth reading by teenagers, adults, the elderly and the elderly because this novel has a moral value that is very close to society.
Parafalcine subdural empyema: The unresolved controversy over the need for surgical treatment
Authors: Prieto Ruth , Ortega Celia 
Published: October 2019

Background:
Parafalcine subdural empyema (SDE) is a rare entity consisting of pus accumulating below the longitudinal sinus, between the falx cerebri and the arachnoid layer covering the medial surface of the cerebral hemisphere. Its treatment strategy is controversial, but most clinicians have the general belief that appropriate treatment consists of prompt surgery combined with long-term antibiotic therapy. Nevertheless, six reports published in the 1980s provided evidence that antibiotic therapy alone is a safe and suitable option. The treatment strategies and outcomes of the 31 well-described cases previously published, in addition to our own, are discussed.

Case Description:
We report a 21-year-old female with a right-side parafalcine SDE who presented with fever, headache, generalized tonic-clonic seizures, and contralateral hemiparesis 3 weeks after undergoing sinonasal surgery. Despite clinical symptoms almost entirely abating after starting treatment with broad-spectrum antibiotics, magnetic resonance imaging performed during the 2nd and 3rd weeks showed progressive enlargement of the interhemispheric collection (from 4 cm3 to 30 cm3). We reflect on the treatment strategy chosen for this patient, who experienced a total recovery.

Conclusion:
A nonsurgical strategy for parafalcine SDE might be contemplated for patients with a good clinical condition and no major midline shift on neuroradiological studies, given their usual indolent course and the relative difficulty in reaching the interhemispheric fissure. Conversely, surgery should be contemplated when the collection significantly enlarges despite antibiotic therapy. When surgical drainage is added to antibiotics, broad- range 16S ribosomal DNA polymerase chain reaction of the empyema is recommended to identify the causative organism as pus cultures are usually sterile.
Lung adenocarcinoma presumed to be Pott’s disease in a 28-year-old patient: A case report and review of literature
Authors: Kessler Remi A. , Steinberger Jeremy , Chen Sabrina , Baron Rebecca , Caridi John M. 
Published: October 2019

Background:Tuberculous spondylitis (Pott’s disease), a common extrapulmonary manifestation of tuberculosis (TB), typically presents with back pain, tenderness, paraparesis/paraplegia, and various constitutional symptoms. Due to radiological similarities between Pott’s disease and lung cancer, some lung cancer patients may initially be erroneously diagnosed and treated for TB, allowing for extensive progression of their cancer.Case Description:A 28-year-old male presented with a chronic dry cough, weight loss, and 2 months of increased back pain accompanied by bilateral lower extremity weakness. Magnetic resonance imaging revealed an epidural collection causing compression of the spinal cord at the T5-T6 level. The initial diagnosis wasMycobacterium tuberculosis/Pott’s disease. A thoracic T4-T8 decompression fusion was performed; however, pathologic examination of the tissue revealed adenocarcinoma. Postoperatively, after the patient experienced several episodes of acute respiratory distress and a tension pneumothorax, lung imaging confirmed multiple tumor infiltrates along with lung cancer extending into the thoracic vertebrae. Pelvic studies also confirmed the presence of pelvic metastases. The patient passed away 3 weeks following surgery.Conclusion:In this case report, a 28-year-old male was treated for thoracic Pott’s disease that proved to be metastatic lung adenocarcinoma. To avoid such misdiagnoses in the future, physicians should better differentiate spinal TB from other malignancies that may affect the spine. This study underscores the importance of obtaining at least a chest X-ray in any patient with suspected Pott’s disease, irrespective of age, to help rule out lung cancer or other pathologies.
A direct comparison of prophylactic low-molecular-weight heparin versus unfractionated heparin in neurosurgery: A meta-analysis
Authors: Macki Mohamed , Fakih Mohamed , Anand Sharath Kumar , Suryadevara Raviteja , Elmenini Jaafar , Chang Victor 
Published: October 2019

Background:Several studies have confirmed the role of prophylactic low-molecular-weight heparin (LMWH) for venous thromboembolism (VTE) in neurosurgery; however, a paucity of literature has assessed its safety and efficacy versus prophylactic unfractionated heparin (UFH). The objective is to present a meta-analysis directly comparing prophylactic LMWH to UFH for the prevention of VTE in neurosurgery.Materials and Methods:Relevant studies that directly compared LMWH to UFH for prophylaxis of VTE in neurosurgery and/or spine surgery were identified by MEDLINE and EMBASE searches plus a scrutiny of references from the original articles and reviews. Three randomized trials were included in the meta-analysis. Efficacy and safety were ascertained per three primary outcome measures: VTE, minor complications (decline in hemoglobin/hematocrit), and major complications. Forest plot analysis provided odds ratio (OR), 95% confidence intervals (CIs), andP-values.Results:Of the 429 patients in the pooled analysis, the postoperative VTE rate of 5.6% (12/213) after LMWH chemoprophylaxis was equivalent to 3.7% (8/216) after UFH chemoprophylaxis (OR = 1.42, 95% CI 0.62–3.75,P= 0.308). Minor complications of 4.7% versus 4.6%, respectively, were nearly equal (OR = 1.01, 95% CI 0.41– 2.50,P= 0.929). All four major complications included intracranial hemorrhages: three after LMWH (1.4%) and one after UFH (0.5%) (OR = 2.32, 95% CI 0.34–16.01,P= 0.831). Tests for heterogeneity were nonsignificant in all three outcome measures.Conclusion:Rates of VTE, minor complications, and major complications were equivalent between prophylactic LMWH and UFH in neurosurgery. Further, randomized clinical trials comparing the two heparin products are required to elucidate superior safety and efficacy in neurosurgical patients.
DergiPark Akademik
Authors: ASLAN Ahmet 
Published: October 2019

DergiPark, Açık Dergi Sistemleri temelinde, ülkemizdeki dergilere
barındırma ve yayımlama hizmeti veren, dergi yayımlama sürecinin daha
kolay ve hızlı gerçekleştirilebilmesine olanak sağlayan, Tübitak Ulakbim
projesidir. Bu makalede DergiPark ve Açık
Dergi Sistemleri (ADS) konusu ele alınmıştır.
Análise de ruído em marcenarias na cidade de Vargem Alta-ES
Authors: Carmo Flávio Cipriano de Assis do , Cesar Fiedler Nilton , Lemos Moreira Giselle , Paes Guimarães Pompeu , Nicó de Medeiros Neto Pedro , Melo Joanna Letícia Diniz 
Published: October 2019

Esta pesquisa teve o objetivo de analisar os níveis de ruído a que estão expostos os trabalhadores de marcenarias no município de Vargem Alta, sul do Espírito Santo. As marcenarias em estudo utilizavam como matéria-prima madeira maciça predominando as espécies Angelim Pedra (Pithecolobium racemosum Ducke) e Parajú (Manilkara longifólia). Os dados foram coletados com o uso de um dosímetro de ruído de marca Instrutherm, modelo RS232 e datalogger modelo DOS–500, onde o aparelho ficava acoplado a calça do operador e o sensor próximo ao ouvido conforme exigido pela NR15. Para o ruído também foi medido também com um decibelímetro digital modelo DEC - 460, com sensor posicionado próximo ao nível do ouvido do trabalhador enquanto operava a máquina . De acordo com os resultados, foi obtido o nível equivalente de ruído (1,06) considerado muito alto (inaceitável) necessitando de intervenção urgente. Os níveis de ruído por máquina (decibelímetro) mostraram que todas as máquinas apresentaram níveis altos de ruído, excedendo o nível máximo permitido pela legislação, sendo as piores situações encontradas para as máquinas serra circular e traçador.
Pediatric nonoperative skull fractures: delayed complications and factors associated with clinic and imaging utilization
Authors: Northam Weston , Chandran Avinash , Quinsey Carolyn , Abumoussa Andrew , Flores Alex , Elton Scott 
Published: October 2019

OBJECTIVESkull fractures represent a common source of morbidity in the pediatric trauma population. This study characterizes the type of follow-up that these patients receive and discusses predictive factors for follow-up.METHODSThe authors reviewed cases of nonoperative pediatric skull fractures at a single academic hospital between 2007 and 2017. Clinical patient and radiological fractures were recorded. Recommended neurosurgical follow-up, follow-up appointments, imaging studies, and fracture-related complications were recorded. Statistical analyses were performed to identify predictors for outpatient follow-up and imaging.RESULTSThe study included 414 patients, whose mean age was 5.2 years; 37.2% were female, and the median length of stay was 1 day (IQR 0.9–4 days). During 438 clinic visits and a median follow-up period of 8 weeks (IQR 4–12, range 1–144 weeks), 231 imaging studies were obtained, mostly head CT scans (55%). A total of 283 patients were given recommendations to attend follow-up in the clinic, and 86% were seen. Only 12 complications were detected, including 7 growing skull fractures, 2 traumatic encephaloceles, and 3 cases of hearing loss. Primary care physician (PCP) status and insurance status were associated with a recommendation of follow-up, actual follow-up compliance, and the decision to order outpatient imaging in patients both with and without intracranial hemorrhage. PCP status remained an independent predictor in each of these analyses. Follow-up compliance was not associated with a patient’s distance from home. Among patients without intracranial hemorrhage, a follow-up recommendation and actual follow-up compliance were associated with pneumocephalus and other polytraumatic injuries, and outpatient imaging was associated with a bilateral fracture. No complications were found in patients with linear fractures above the skull base in those without an intracranial hemorrhage.CONCLUSIONSPediatric nonoperative skull fractures drive a large expenditure of clinic and imaging resources to detect a relatively small profile of complications. Understanding the factors underlying the decision for clinic follow-up and additional imaging can decrease future costs, resource utilization, and radiation exposure. Factors related to injury severity and socioeconomic indicators were associated with outpatient imaging, the decision to follow up patients in the clinic, and patients’ subsequent attendance. Socioeconomic status (PCP and insurance) may affect access to appropriate neurosurgical follow-up and deserves future research attention. Patients with no intracranial hemorrhage and with a linear fracture above the skull base do not appear to be at risk for delayed complications and could be candidates for reduced follow-up and imaging.
Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series
Authors: Bhatia Kartik , Kortman Hans , Blair Christopher , Parker Geoffrey , Brunacci David , Ang Timothy , Worthington John , Muthusami Prakash , Shoirah Hazem , Mocco J , Krings Timo 
Published: October 2019

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.
Perioperative acute neurological deficits in instrumented pediatric cervical spine fusions
Authors: Verhofste Bram P. , Glotzbecker Michael P. , Hresko Michael T. , Miller Patricia E. , Birch Craig M. , Troy Michael J. , Karlin Lawrence I. , Emans John B. , Proctor Mark R. , Hedequist Daniel J. 
Published: October 2019

OBJECTIVEPediatric cervical deformity is a complex disorder often associated with neurological deterioration requiring cervical spine fusion. However, limited literature exists on new perioperative neurological deficits in children. This study describes new perioperative neurological deficits in pediatric cervical spine instrumentation and fusion.METHODSA single-center review of pediatric cervical spine instrumentation and fusion during 2002–2018 was performed. Demographics, surgical characteristics, and neurological complications were recorded. Perioperative neurological deficits were defined as the deterioration of preexisting neurological function or the appearance of new neurological symptoms.RESULTSA total of 184 cases (160 patients, 57% male) with an average age of 12.6 ± 5.30 years (range 0.2–24.9 years) were included. Deformity (n = 39) and instability (n = 36) were the most frequent indications. Syndromes were present in 39% (n = 71), with Down syndrome (n = 20) and neurofibromatosis (n = 12) the most prevalent. Eighty-seven (48%) children presented with preoperative neurological deficits (16 sensory, 16 motor, and 55 combined deficits).A total of 178 (96.7%) cases improved or remained neurologically stable. New neurological deficits occurred in 6 (3.3%) cases: 3 hemiparesis, 1 hemiplegia, 1 quadriplegia, and 1 quadriparesis. Preoperative neurological compromise was seen in 4 (67%) of these new deficits (3 myelopathy, 1 sensory deficit) and 5 had complex syndromes. Three new deficits were anticipated with intraoperative neuromonitoring changes (p = 0.025).Three (50.0%) patients with new neurological deficits recovered within 6 months and the child with quadriparesis was regaining neurological function at the latest follow-up. Hemiplegia persisted in 1 patient, and 1 child died due a complication related to the tracheostomy. No association was found between neurological deficits and indication (p = 0.96), etiology (p = 0.46), preoperative neurological symptoms (p = 0.65), age (p = 0.56), use of halo vest (p = 0.41), estimated blood loss (p = 0.09), levels fused (p = 0.09), approach (p = 0.07), or fusion location (p = 0.07).CONCLUSIONSAn improvement of the preexisting neurological deficit or stabilization of neurological function was seen in 96.7% of children after cervical spine fusion. New or progressive neurological deficits occurred in 3.3% of the patients and occurred more frequently in children with preoperative neurological symptoms. Patients with syndromic diagnoses are at higher risk to develop a deficit, probably due to the severity of deformity and the degree of cervical instability. Long-term outcomes of new neurological deficits are favorable, and 50% of patients experienced complete neurological recovery within 6 months.
Endovascular stenting for rescue of a failed donor graft during superficial temporal artery to middle cerebral artery bypass surgery: case report
Authors: LoPresti Melissa A. , Srinivasan Visish M. , North Robert Y. , Ravindra Vijay M. , Johnson Jeremiah , Burkhardt Jan-Karl , Lam Sandi K. , Kan Peter 
Published: October 2019

Direct bypass has been used to salvage failed endovascular treatment; however, little is known of the reversed role of endovascular management for failed bypass.The authors report the case of a 7-year-old patient who underwent a superficial temporal artery to middle cerebral artery (STA-MCA) bypass for treatment of a giant MCA aneurysm and describe the role of endovascular rescue in this case. Post-bypass catheter angiogram showed occlusion of the proximal extracranial STA donor with patent anastomosis, possibly due to STA dissection. A self-expanding Neuroform Atlas stent was deployed across the dissection flap, and follow-up images showed revascularization of the STA with good MCA runoff.This case demonstrates that direct extracranial-intracranial bypass failure can infrequently originate from the STA donor vessel and that superselective angiogram can be useful for identification and treatment in such cases. With more advanced endovascular techniques the tide has turned in the treatment of complex cerebrovascular cases, with this case being an early example of successful rescue stenting for endovascular management of a failed donor after STA-MCA bypass.
Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series
Authors: McAvoy Malia , McCrea Heather J. , Chavakula Vamsidhar , Choi Hoon , Bi Wenya Linda , Mekary Rania A. , Stone Scellig , Proctor Mark R. 
Published: October 2019

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.