bluuebunny/crossref_metadata_2025_split huggingface dataset:
PENGARUH KEMAMPUAN PENALARAN MATEMATIS DENGAN MODEL PEMBELAJARAN DOUBLE LOOP PROBLEM SOLVING TERHADAP HASIL BELAJAR SISWA
Authors: Samad Irfawandi , Ali P Muhammad , Assaibin Muhammad 
Published: October 2021

Tujuan penelitian ini adalah untuk mengetahui pengaruh model pembelajaran double loop problem solving terhadap penalaran matematis siswa pada materi bangun ruang. Pada penelitian ini ditarik sampel sebanyak dua kelas, dengan jumlah peserta didik sebanya 67 peserta didik. Penelitian ini merupakan penelitian eksperimen dengan rancangan yang digunakan adalah eksperimen semu (Quasi Exsperimental Research) .Penelitian ini melibatkan dua kelas yaitu kelas eksperimen dan kelas kontrol, dimana kedua kelas ini diberikan perlakuan yang berbeda. Untuk mengetahui pengaruh model pemelajaran double loop problem solving terhadap penalaran matematis siswa kelas VIII SMP Negeri 3 Campalagian. Dilihat pada pengujian hipotesis dilakukan dengan melihat hasil uji-t. Berdasarkan uji-t diperoleh nilai sebesar 2,204. Sedangkan untuk nilai sebesar yang berarti bahwa yaitu . Hal ini menunjukkan bahwa ditolak dan diterima, bila ditinjau dari nilai taraf signifikan, diterima apabila Sig < yaitu 0,032 < 0,05. dengan demikian dapat disimpulkan bahwa pembelajaran dengan Penerapan model pemelajaran double loop problem solving terhadap penalaran matematis dalam Pembelajaran Matematika Pada Peserta didik kelas VII SMP Negeri 3 Campalagian, berpengaruh terhadap hasil belajar siswa, dalam pelaksanaan pembelajaran dan pengamatan aktivitas siswa. Sehingga bisa diterapkan di sekolah.
Percutaneous instrumentation with cement augmentation for traumatic hyperextension thoracic and lumbar fractures in ankylosing spondylitis: a single-institution experience
Authors: Trungu Sokol , Ricciardi Luca , Forcato Stefano , Miscusi Massimo , Raco Antonino 
Published: October 2021

OBJECTIVE
The typical traumatic thoracolumbar (TL) fracture in patients with ankylosing spondylitis (AS) is a hyperextension injury involving all three spinal columns, which is associated with unfavorable outcomes. Although a consensus on the management of these highly unstable injuries is missing, minimally invasive surgery (MIS) has been progressively accepted as a treatment option, since it is related to lower morbidity and mortality rates. This study aimed to evaluate clinical and radiological outcomes after percutaneous instrumentation with cement augmentation for hyperextension TL fractures in patients with AS at a single institution.

METHODS
This cohort study was completed retrospectively. Back pain was assessed at preoperative, postoperative, and final follow-up visits using the visual analog scale (VAS). Patient-reported outcomes via the Oswestry Disability Index (ODI) and the new mobility score (NMS) were obtained to assess disability and mobility during follow-up. Radiological outcomes included the Cobb angle, sagittal index (SI), union rate, and implant failure. Intra- and postoperative complications were recorded.

RESULTS
A total of 22 patients met inclusion criteria. The mean patient age was 74.2 ± 7.3 years with a mean follow-up of 39.2 ± 17.4 months. The VAS score for back pain significantly improved over the follow-up period (from 8.4 ± 1.1 to 2.8 ± 0.8, p < 0.001). At the last follow-up, all patients had minor disability (mean ODI score 24.4 ± 6.1, p = 0.003) and self-sufficiency of mobility (mean NMS 7.5 ± 1.6, p = 0.02). The Cobb angle (5.2° ± 2.9° preoperatively to 4.4° ± 3.3° at follow-up) and SI (7.9° ± 4.2° to 8.8° ± 5.1°) were maintained at follow-up, showing no loss of segmental kyphosis. Bone union was observed in all patients. The overall complication rate was 9.1%, while the reoperation rate for implant failure was 4.5%.

CONCLUSIONS
Percutaneous instrumentation with cement augmentation for traumatic hyperextension TL fractures in AS demonstrated good clinical and radiological outcomes, along with a high bone union level and low reoperation rate. Accordingly, MIS reduced the complication rate in the management of these injuries of the ankylosed spine.
Single versus dual operative spine fractures in ankylosing spondylitis
Authors: Lu Alex Y. , Blitstein Jacob S. , Talbott Jason F. , Chan Andrew K. , Dhall Sanjay S. , El Naga Ashraf N. , Tan Lee A. , Clark Aaron J. , Chou Dean , Mummaneni Praveen V. , DiGiorgio Anthony M. 
Published: October 2021

OBJECTIVE
Ankylosing spondylitis, the most common spondyloarthritis, fuses individual spinal vertebrae into long segments. The unique biomechanics of the ankylosed spine places patients at unusually high risk for unstable fractures secondary to low-impact mechanisms. These injuries are unique within the spine trauma population and necessitate thoughtful management. Therefore, the authors aimed to present a richly annotated data set of operative AS spine fractures with a significant portion of patients with simultaneous dual noncontiguous fractures.

METHODS
Patients with ankylosing spondylitis with acute fractures who received operative management between 2012 and 2020 were reviewed. Demographic, admission, surgical, and outcome parameters were retrospectively collected and reviewed.

RESULTS
In total, 29 patients were identified across 30 different admissions. At admission, the mean age was 71.7 ± 11.8 years. The mechanism of injury in 77% of the admissions was a ground-level fall; 30% also presented with polytrauma. Of admissions, 50% were patient transfers from outside hospitals, whereas the other half presented primarily to our emergency departments. Fifty percent of patients sustained a spinal cord injury, and 35 operative fractures were identified and treated in 32 surgeries. The majority of fractures clustered around the cervicothoracic (C4–T1, 48.6%) and thoracolumbar (T8–L3, 37.11%) junctions. Five patients (17.2%) had simultaneous dual noncontiguous operative fractures; these patients were more likely to have presented with a higher-energy mechanism of injury such as a bicycle or motor vehicle accident compared with patients with a single operative fracture (60% vs 8%, p = 0.024). On preoperative MRI, 56.3% of the fractures had epidural hematomas (EDHs); 25% were compressive of the underlying neural elements, which dictated the number of laminectomy levels performed (no EDH, 2.1 ± 2.36; noncompressive EDH, 2.1 ± 1.85; and compressive EDH, 7.4 ± 4 [p = 0.003]). The mean difference in instrumented levels was 8.7 ± 2.6 with a mean estimated blood loss (EBL) of 1183 ± 1779.5 mL. Patients on a regimen of antiplatelet therapy had a significantly higher EBL (2635.7 mL vs 759.4 mL, p = 0.015). Overall, patients had a mean hospital length of stay of 15.2 ± 18.5 days; 5 patients died during the same admission or after transfer to an outside hospital. Nine of 29 patients (31%) had died by the last follow-up (the mean follow-up was 596.3 ± 878.9 days).

CONCLUSIONS
Patients with AS who have been found to have unstable spine fractures warrant a thorough diagnostic evaluation to identify secondary fractures as well as compressive EDHs. These patients experienced prolonged inpatient hospitalizations with significant morbidity and mortality.
Vestibular schwannoma manifesting with hemifacial spasm in a young woman: clinical considerations and tumor removal with hearing preservation. 2-Dimensional operative video
Authors: Candanedo Carlos , de Jong Marrigje A. , Michaeli Avner , Moscovici Samuel , Cohen José E. , Spektor Sergey 
Published: October 2021

Hemifacial spasm (HFS) is a rare presentation of vestibular schwannoma. The authors present their experience with a 27-year-old woman who presented with normal hearing and HFS, which was the single neurological manifestation of an 18-mm vestibular schwannoma. In this challenging situation, the treatment goals were maximal tumor removal with preservation of hearing and facial nerve function and cure of the HFS. The authors achieved these goals, performing complete tumor removal via a retrosigmoid approach, assisted with neurophysiological monitoring and a 45°-angle QEVO endoscope. In the video, they explain the clinical, radiological, and surgical considerations and demonstrate the surgical technique.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID2099
Diamond knife dissection technique for nerve preservation during resection of large vestibular schwannomas
Authors: Shawarba Julia , Med Cand , Tomschik Matthias , Roessler Karl 
Published: October 2021

Facial and cochlear nerve preservation in large vestibular schwannomas is a major challenge. Bimanual pincers or plate-knife dissection techniques have been described as crucial for nerve preservation. The authors demonstrate a recently applied diamond knife dissection technique to peel the nerves from the tumor capsule. This technique minimizes the nerve trauma significantly, and complete resection of a large vestibular schwannoma without any facial nerve palsy and hearing preservation is possible. The authors illustrate this technique during surgery of a 2.6-cm vestibular schwannoma in a 27-year-old male patient resulting in normal facial function and preserved hearing postoperatively.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21104
Right medium-sized vestibular schwannoma with trigeminal neuralgia post-fractionated radiotherapy
Authors: Vakharia Kunal , Mikula Anthony L. , Nassiri Ashley M. , Driscoll Colin L. W. , Link Michael J. 
Published: October 2021

A patient with trigeminal neuralgia secondary to a vestibular schwannoma underwent fractionated radiotherapy without relief of her pain. She was then effectively treated with microsurgical resection of her tumor. Early identification of the lower cranial nerves and the origin of the facial and vestibulocochlear nerves is key to determining the operative corridors for vestibular schwannoma resection. To effectively treat trigeminal neuralgia, the trigeminal nerve root entry zone and motor branch are clearly identified and decompressed. Fractioned radiotherapy does not effectively treat trigeminal neuralgia secondary to vestibular schwannoma compression.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21112
Hearing preservation middle fossa approach for intracanalicular vestibular schwannoma in a NF2 patient
Authors: Vidal Claudio H. F. , Hahn Yoav , Leal Mariana C. , Medeiros Kiara , Hazin Gabriela F. , Coimbra Caetano J. 
Published: October 2021

Hearing preservation is a cornerstone in the management of intracanalicular vestibular schwannomas. This video demonstrates a middle fossa approach to an intracanalicular schwannoma and highlights some technical and anatomical nuances relevant to the procedure. The patient had sustained hearing preservation in the postoperative period. There are potential benefits in favor of the middle fossa when the tumor reaches the fundus of the internal auditory canal, but the surgeon’s individual experience plays a decisive role in the choice of approach.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21121
Combined translabyrinthine, anterior petrosal approach for resection of collision vestibular schwannoma and petrous apex meningioma in neurofibromatosis type 2, with auditory brainstem implant placement
Authors: Khan Usman A. , Plonsker Jillian H. , Friedman Rick A. , Schwartz Marc S. 
Published: October 2021

The natural history of neurofibromatosis type 2 (NF2) is profound bilateral hearing loss. The decision to pursue microsurgery may be more complicated in NF2 than with sporadic tumors. Schwannomas in NF2 often occur with other skull base tumors. Treatment should be tailored to preserve auditory perception for as long as possible. The authors present the case of a man with NF2 and a vestibular schwannoma who has poor hearing on the same side as a large petrous apex meningioma, both opposite to a well-hearing ear. This case highlights surgical decision-making and technical nuances during resection of collision tumors in NF2.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21130
Removal of Koos IV acoustic neuroma and auditory brainstem implant in NF2 patient
Authors: Scala Maria Rosaria , Spennato Pietro , Volpe Antonio Della , Santoro Claudia , Picariello Stefania , Varricchio Alfonso Maria , Ruggiero Claudio , dé Santi Serena , Cinalli Giuseppe 
Published: October 2021

The authors present the case of removal of a Koos grade IV right acoustic neuroma in a neurofibromatosis type 2 (NF2) patient, already operated on for left cerebellopontine angle meningioma at 7 years of age and a left acoustic neuroma at 16 years of age. A transpetrosal approach allowed cochlear sensor implantation to detect residual hearing. An enlarged retrosigmoid approach then allowed subtotal microsurgical removal of the lesion; consequently, the authors illustrate the technical nuances of an auditory brainstem implant (ABI). One month after surgery, the ABI was successfully switched on, giving back hearing perception to the patient.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID2188
Endoscopic-assisted resection of vestibular schwannomas in high-riding jugular bulb
Authors: Roser Florian , Maiti Tanmoy , Elhammady Mohamed Samy 
Published: October 2021

The present surgical video demonstrates safe opening of the internal auditory canal (IAC) during vestibular schwannoma surgery via a retrosigmoid approach in the sitting position. Resection of the intrameatal portion of a tumor is important for progression-free survival. Preoperative thin-sliced CT revealed a high-riding jugular bulb obscuring the trajectory. After dural opening, the IAC was approached anteriorly and superiorly. The posterior margin of IAC drilling was above the Tubingen line. Drilling was performed under continuous jugular compression. The vein was pushed down to augment visibility. An angled endoscope was helpful. IAC can be drilled safely in a high-riding jugular bulb with the technique mentioned in the video.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID2198
Measuring the effects of institutional pediatric traumatic brain injury volume on outcomes for rural-dwelling children
Authors: Patel Pious D. , Kelly Katherine A. , Chen Heidi , Greeno Amber , Shannon Chevis N. , Naftel Robert P. 
Published: October 2021

OBJECTIVE
Rural-dwelling children may suffer worse pediatric traumatic brain injury (TBI) outcomes due to distance from and accessibility to high-volume trauma centers. This study aimed to compare the impacts of institutional TBI volume and sociodemographics on outcomes between rural- and urban-dwelling children.

METHODS
This retrospective study identified patients 0–19 years of age with ICD-9 codes for TBI in the 2012–2015 National Inpatient Sample database. Patients were characterized as rural- or urban-dwelling using United States Census classification. Logistic and linear (in log scale) regressions were performed to measure the effects of institutional characteristics, patient sociodemographics, and mechanism/severity of injury on occurrence of medical complications, mortality, length of stay (LOS), and costs. Separate models were built for rural- and urban-dwelling patients.

RESULTS
A total of 19,736 patients were identified (median age 11 years, interquartile range [IQR] 2–16 years, 66% male, 55% Caucasian). Overall, rural-dwelling patients had higher All Patient Refined Diagnosis Related Groups injury severity (median 2 [IQR 1–3] vs 1 [IQR 1–2], p < 0.001) and more intracranial monitoring (6% vs 4%, p < 0.001). Univariate analysis showed that overall, rural-dwelling patients suffered increased medical complications (6% vs 4%, p < 0.001), mortality (6% vs 4%, p < 0.001), and LOS (median 2 days [IQR 1–4 days ] vs 2 days [IQR 1–3 days], p < 0.001), but multivariate analysis showed rural-dwelling status was not associated with these outcomes after adjusting for injury severity, mechanism, and hospital characteristics. Institutional TBI volume was not associated with medical complications, disposition, or mortality for either population but was associated with LOS for urban-dwelling patients (nonlinear beta, p = 0.008) and cost for both rural-dwelling (nonlinear beta, p < 0.001) and urban-dwelling (nonlinear beta, p < 0.001) patients.

CONCLUSIONS
Overall, rural-dwelling pediatric patients with TBI have worsened injury severity, mortality, and in-hospital complications, but these disparities disappear after adjusting for injury severity and mechanism. Institutional TBI volume does not impact clinical outcomes for rural- or urban-dwelling children after adjusting for these covariates. Addressing the root causes of the increased injury severity at hospital arrival may be a useful path to improve TBI outcomes for rural-dwelling children.
Transport zwierząt egzotycznych w UE a multicentryczność systemów prawnych (na przykładzie regulacji odnoszących się do transportu tygrysów z Włoch przez terytorium Rzeczypospolitej Polskiej w 2019 r.)
Authors: Lubelska-Sazanów Małgorzata Maria 
Published: October 2021

Głównym założeniem publikacji jest ocena norm prawnych dotyczących przewozu zwierząt egzotycznych obowiązujących na terenie Unii Europejskiej, ze szczególnym uwzględnieniem ich obowiązywania i przestrzegania w krajach, w których doszło do ich naruszenia lub nieskutecznego zastosowania w opisywanym przypadku. Na podstawie analizy zależności pomiędzy nieprawidłowościami w stosowaniu regulacji prawnych dotyczących przewozu zwierząt egzotycznych w Europie, a wystąpieniem sytuacji faktycznej, w której doszło do śmierci jednego z tygrysów i zagrożenia życia pozostałych osobników, możliwe jest także znalezienie odpowiedzi na pytanie, czy w przedstawianym stanie prawnym występuje tzw. luka prawna, jak również zaproponowanie subiektywnych rozwiązań prawnych mających na celu uniknięcie podobnych sytuacji w przyszłości. Zawarte w tekście rozważania dokonywane są na podstawie rozporządzeń i dyrektyw UE oraz przepisów krajowych (przy czym w odniesieniu do stosowania przepisów prawnych UE – zachodzą także odniesienia do ich stosowania przez włoskie organy prawa, jako kraju w którym rozpoczął się transport tygrysów). W zakończeniu przedstawione zostały wnioski, mające na celu zapewnić większą ochronę zwierzętom egzotycznym w czasie ich transportu (przede wszystkim transgranicznego).
Autorka wykazuje, że w opisywanym przypadku nie występuje luka prawna, a doszło jedynie do błędnej interpretacji, a następnie stosowania prawa UE przez organy państwowe Włoch i Polski, wskazując podstawowe zagrożenia dobrostanu dzikich zwierząt podczas transportu przez kraje UE. Po pierwsze: brak jest odgórnego systemu kontroli na poziomie UE; po drugie: uwidocznione zostały wady funkcjonowania systemu TRACES, po trzecie: dużą trudność sprawia wskazanie norm prawnych na poziomie ponadnarodowym dotyczących zwierząt egzotycznych.
Assessment of High Risk for Alzheimer’s Disease Using Plasma Biomarkers in Subjects with Normal Cognition in Taiwan: A Preliminary Study
Authors: Hu Chaur-Jong , Chiu Ming-Jang , Pai Ming-Chyi , Yan Sui-Hing , Wang Pei-Ning , Chiu Pai-Yi , Lin Chin-Hsien , Chen Ta-Fu , Yang Fu-Chi , Huang Kuo-Lun , Hsu Yi-Ting , Hou Yi-Chou , Lin Wei-Che , Lu Cheng-Hsien , Huang Li-Kai , Yang Shieh-Yueh 
Published: October 2021

Background: In Alzheimer’s disease (AD), cognitive impairment begins 10–15 years later than neurodegeneration in the brain. Plasma biomarkers are promising candidates for assessing neurodegeneration in people with normal cognition. It has been reported that subjects with the concentration of plasma amyloid-β 1-42×total tau protein higher than 455 pg2/ml2 are assessed as having a high risk of amnesic mild impairment or AD, denoted as high risk of AD (HRAD). Objective: The prevalence of high-risk for dementia in cognitively normal controls is explored by assaying plasma biomarkers. Methods: 422 subjects with normal cognition were enrolled around Taiwan. Plasma Aβ1-40, Aβ1-42, and T-Tau levels were assayed using immunomagnetic reduction to assess the risk of dementia. Results: The results showed that 4.6% of young adults (age: 20–44 years), 8.5% of middle-aged adults (age: 45–64 years), and 7.3% of elderly adults (age: 65–90 years) had HRAD. The percentage of individuals with HRAD dramatically increased in middle-aged and elderly adults compared to young adults. Conclusion: The percentage of HRAD in cognitively normal subjects are approximately 10%, which reveals that the potentially public-health problem of AD in normal population. Although the subject having abnormal levels of Aβ or tau is not definitely going on to develop cognitive declines or AD, the risk of suffering cognitive impairment in future is relatively high. Suitable managements are suggested for these high-risk cognitively normal population. Worth noting, attention should be paid to preventing cognitive impairment due to AD, not only in elderly adults but also middle-aged adults.
3D PRINTING OF A LOWELL MAKES MASK IN PLA
Authors: Nidal Elmoutawakkil , Alae-Eddine Seffar , Dalal Elmoutawakkil , Nabil Hacib , Samira Bellemkhannate 
Published: October 2021

Relevance: The new pandemic crisis caused by the Covid19 virus has led to a global shortage of personal protective equipment including FFP2 masks necessary for the exercise of professionals in direct contact with positive patients.
Objective: 3D print a PLA mask similar to the FFP2 mask with the addition of an ULPA filter
Methods. The designed mask is based on the general morphology of the FFP2 standard. This is how we downloaded the prototype of the «LOWELL MAKES». We have adapted this prototype to our craniofacial dimensions on the «Meshmixer» software, to finally export the prototype in STL format to print it by fused deposition modeling (FDM) via the 3D printer «XYZ Junior 1.0» equipped with a PLA (polylactic acid) filament.
Results. The total duration of the printing of the full mask (the cover, the body of the mask, and the retentive filter grid) was around 4h30 min. Regarding the choice of the filter, we opted for two solutions, the first to cut an FFP2 mask and to use the parts obtained as being filters (doubled), the second being a commercial ULPA or HEPA filter. A ULPA (Ultra Low Penetration Air) filter can theoretically filter dust, pollen, and bacteria from the air with an efficiency of 99.999 % thanks to a size of 0.1 microns. Remember that the average size of the Covid-10 virus is around 0.1 µm and that the porosity of the FFP2 mask allows particles to be filtered with a diameter of around 0.6 µm at 94 %. In order to maximize the filtering effect while wearing this mask, we opted for the interposition of a ULPA filter covered by an FFP2 filter. We tested the tightness of this mask by checking for side leaks by maintaining a stabilized sheet on the outer cover by suction during inhalation. We have also added to the edges of the mask in contact with the face a peripheral silicone seal, polymerized on the face, to avoid any marks or scars after removal of this mask while increasing the comfort of the practitioner. The protocol that we chose by superimposing two filters (the first having a porosity of 0.6µm and the second of 0.1µm) allowed us to potentiate the filtration. This allowed the filter to be used for 40 hours. The total cost price of the mask is around 9 €.
Conclusions. The «open source» community makes it possible to popularize 3D printing while making it easier for any 3D printer owner to appropriate their protective equipment at a reduced price, however, intellectual property remains a concern, in particular for medical parts that cannot be procured promptly during a pandemic crisis similar to that caused by the Covid-19 virus.