bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urgent surgery for spinal instability or neurological impairment caused by spinal brown tumors occurring in the context of end-stage renal disease
Authors: Jia Qi , Gao Xin , Zhou Zhenhua , Lan Bin , Zhao Jian , Liu Tielong , Yang Xinghai , Wei Haifeng , Xiao Jianru 
Published: April 2019

OBJECTIVESpinal instability or neurological impairment caused by spinal brown tumors (BTs) with end-stage renal disease (ESRD) is an acute condition that needs urgent surgery. There is not much published information on BTs of the mobile spine given the rarity of the disease, and the literature shows inconsistent treatment options and ambiguous follow-up information. The aim of the present study was to elucidate the clinical features, anesthesia management, and surgical treatment for this rare disease through long-term follow-up observations.METHODSClinical, laboratory, radiological, and perioperative data on 6 consecutive patients with spinal BTs who had been admitted to the authors’ institution between 2010 and 2016 were retrospectively reviewed. The literature on spinal BT with secondary hyperparathyroidism was also reviewed. Summaries of the clinical features and anesthesia management are provided.RESULTSThe mean age of the 6 patients was 45.5 years (range 35–62 years). Lesions were located in the cervical segment (2 cases) and thoracic segment (4 cases). Localized pain was the most common complaint, and pathological fracture occurred in 5 patients. Elevation of serum alkaline phosphate (AKP) and parathyroid hormone (PTH) was a common phenomenon. Four patients underwent circumferential resection and 2 underwent laminectomy, with parathyroidectomy performed in all patients. The anesthesia process was uneventful for all patients. The mean follow-up was 33 months (range 26–40 months). No spinal lesion progression occurred in any patient. The Karnofsky Performance Status score improved to 80–90 by 3 months after surgery.CONCLUSIONSAlthough uncommon, spinal BTs should be a diagnostic consideration in patients with ESRD. The thoracic spine is the most frequently affected site. ESRD is not a contraindication for surgery; with the assistance of experienced anesthesiologists, urgent surgery is the preferred option to alleviate neurological impairment and restore spinal stability.
Surgical approaches and long-term outcomes of intramedullary spinal cord cavernous malformations: a single-center consecutive series of 219 patients
Authors: Ren Jian , Hong Tao , He Chuan , Li Xiaoyu , Ma Yongjie , Yu Jiaxing , Ling Feng , Zhang Hongqi 
Published: April 2019

OBJECTIVEOptimal surgical strategies for intramedullary spinal cord cavernous malformations (ISCCMs) are not optimized and remain problematic. In this study the authors identify rational surgical strategies for ISCCMs and predictors of outcomes after resection.METHODSA single-center study was performed with 219 consecutive surgically treated patients who presented from 2002 to 2017 and were analyzed retrospectively. The American Spinal Injury Association (ASIA) Impairment Scale was used to evaluate neurological functions. Patient characteristics, surgical approaches, and immediate and long-term postoperative outcomes were identified.RESULTSThe average ISCCM size was 10.5 mm. The spinal level affected was cervical in 24.8% of patients, thoracic in 73.4%, and lumbar in 1.8%. The locations of the lesions in the horizontal plane were 30.4% ventral, 41.6% dorsal, and 28.0% central. Of the 214 patients included in the cohort for operative evaluation, 62.6% had superficially located lesions, while 37.4% were embedded. Gross-total resection was achieved in 98.1% of patients. The immediate postoperative neurological condition worsened in 10.3% of the patients. Multivariate logistic regression identified mild preoperative function (p = 0.014, odds ratio [OR] 4.5, 95% confidence interval [CI] 1.4–14.8) and thoracolumbar-level lesions (p = 0.01, OR 15.7, 95% CI 1.9–130.2) as independent predictors of worsening. The mean follow-up duration in 187 patients was 45.9 months. Of these patients, 63.1% were stable, 33.2% improved, and 3.7% worsened. Favorable outcomes were observed in 86.1% of patients during long-term follow-up and were significantly associated with preoperative mild neurological and disability status (p = 0.000) and cervically located lesions (p = 0.009). The depths of the lesions were associated with worse long-term outcomes (p = 0.001), and performing myelotomy directly through a yellowish abnormal surface in moderate-depth lesions was an independent predictor of worsening (p = 0.023, OR 35.3, 95% CI 1.6–756.3).CONCLUSIONSResection performed with an individualized surgical approach remains the primary therapeutic option in ISCCMs. Performing surgery in patients with mild symptoms at the thoracolumbar level and embedded located lesions requires more discretion.
Natural history of ventriculomegaly in adults: a cluster analysis
Authors: Craven Claudia L. , Ramkumar Roshini , D’Antona Linda , Thompson Simon D. , Thorne Lewis , Watkins Laurence D. , Toma Ahmed K. 
Published: April 2019

OBJECTIVEChronic ventriculomegaly in the absence of raised intracranial pressure (ICP) is a known entity in adult hydrocephalus practice. The natural history and indication for treatment is, however, poorly defined. A highly heterogeneous group, some adults with ventriculomegaly are asymptomatic, while others have life-threatening deteriorations. The authors hypothesized that the various presentations can be subtyped and represent different stages of decompensation. A cluster analysis was performed on a cohort of patients with chronic ventriculomegaly with the aim of elucidating typical clinical characteristics and outcomes in chronic ventriculomegaly in adults.METHODSData were collected from 79 patients with chronic ventriculomegaly referred to a single center, including demographics, presenting symptoms, and 24-hour ICP monitoring (ICPM). A statistical cluster analysis was performed to determine the presence of subgroups.RESULTSFour main subgroups and one highly dissimilar group were identified. Patients with ventriculomegaly commonly have a perinatal event followed by one of four main presentations: 1) incidental ventriculomegaly with or without headache; 2) highly symptomatic presentation (including reduced consciousness) and raised ICP; 3) early presenting with symptoms of headache and nausea (with abnormal pulsatility); and 4) late presenting with features common to normal pressure hydrocephalus. Each symptomatic group has characteristic radiological features, ICPM, and responses to treatment.CONCLUSIONSCluster analysis has identified subgroups of adult patients with ventriculomegaly. Such groups may represent various degrees of decompensation. Surgical interventions may not be equally effective across the subgroups, presenting an avenue for further research. The identified subtypes provide further insight into the natural history of this lesser studied form of hydrocephalus.
Investigating the utility of intraoperative neurophysiological monitoring for anterior cervical discectomy and fusion: analysis of over 140,000 cases from the National (Nationwide) Inpatient Sample data set
Authors: Badhiwala Jetan H. , Nassiri Farshad , Witiw Christopher D. , Mansouri Alireza , Almenawer Saleh A. , da Costa Leodante , Fehlings Michael G. , Wilson Jefferson R. 
Published: April 2019

OBJECTIVEIntraoperative neurophysiological monitoring (IONM) is a useful adjunct in spine surgery, with proven benefit in scoliosis-correction surgery. However, its utility for anterior cervical discectomy and fusion (ACDF) is unclear, as there are few head-to-head comparisons of ACDF outcomes with and without the use of IONM. The authors sought to evaluate the impact of IONM on the safety and cost of ACDF.METHODSThis was a retrospective analysis of data from the National (Nationwide) Inpatient Sample of the Healthcare Cost and Utilization Project from 2009 to 2013. Patients with a primary procedure code for ACDF were identified, and diagnosis codes were searched to identify cases with postoperative neurological complications. The authors performed univariate and multivariate logistic regression for postoperative neurological complications with use of IONM as the independent variable; additional covariates included age, sex, surgical indication, multilevel fusion, Charlson Comorbidity Index (CCI) score, and admission type. They also conducted propensity score matching in a 1:1 ratio (nearest neighbor) with the use of IONM as the treatment indicator and the aforementioned variables as covariates. In the propensity score–matched cohort, they compared neurological complications, length of stay (LOS), and hospital charges (in US dollars).RESULTSA total of 141,007 ACDF operations were identified. IONM was used in 9540 cases (6.8%). No significant association was found between neurological complications and use of IONM on univariate analysis (OR 0.80, p = 0.39) or multivariate regression (OR 0.82, p = 0.45). By contrast, age ≥ 65 years, multilevel fusion, CCI score > 0, and a nonelective admission were associated with greater incidence of neurological complication. The propensity score–matched cohort consisted of 18,760 patients who underwent ACDF with (n = 9380) or without (n = 9380) IONM. Rates of neurological complication were comparable between IONM and non-IONM (0.17% vs 0.22%, p = 0.41) groups. IONM and non-IONM groups had a comparable proportion of patients with LOS ≥ 2 days (19% vs 18%, p = 0.15). The use of IONM was associated with an additional $6843 (p < 0.01) in hospital charges.CONCLUSIONSThe use of IONM was not associated with a reduced rate of neurological complications following ACDF. Limitations of the data source precluded a specific assessment of the effectiveness of IONM in preventing neurological complications in patients with more complex pathology (i.e., ossification of the posterior longitudinal ligament or cervical deformity).
Risk factors for 90-day reoperation and readmission after lumbar surgery for lumbar spinal stenosis
Authors: Ilyas Haariss , Golubovsky Joshua L. , Chen Jingxiao , Winkelman Robert D. , Mroz Thomas E. , Steinmetz Michael P. 
Published: April 2019

OBJECTIVEThe objective of this study was to evaluate the incidence and risk factors for 90-day readmission and reoperation after elective surgery for lumbar spinal stenosis (LSS).METHODSThe authors performed a retrospective consecutive cohort analysis of patients undergoing posterior lumbar decompression with or without fusion for LSS with claudication from January 2014 through December 2015.RESULTSData were collected on 1592 consecutive patients. The mean age at surgery was 67.4 ± 10.1 years and 45% of patients were female. The 90-day reoperation rate was 4.7%, and 69.3% of the reoperations occurred within the first 30 days. The 90-day readmission rate was 7.2%. Multivariable analysis showed that postoperative development of a surgical site infection (SSI; odds ratio [OR] 14.09, 95% confidence interval [CI] 7.86–25.18), acute kidney injury (AKI; OR 6.76, 95% CI 2.39–19.57), and urinary tract infection (UTI; OR 3.96, 95% CI 2.43–6.37), as well as a history of congestive heart failure (CHF; OR 3.03, 95% CI 1.69–5.28), were significant risk factors for readmission within 90 days. Male sex (OR 0.60, 95% CI 0.38–0.92) was associated with decreased odds for readmission. With regards to reoperation, development of SSI (OR 25.06, 95% CI 13.54–46.51), sepsis (OR 7.63, 95% CI 1.52–40.59), UTI (OR 2.54, 95% CI 1.31–4.76), and increased length of stay (LOS; OR 1.25, 95% CI 1.17–1.33) were found to be significant risk factors. A subsequent analysis found that morbid obesity (OR 6.99), history of coronary artery disease (OR 2.263), increased duration of surgery (OR 1.004), and LOS (OR 1.07) were significant risk factors for developing an SSI.CONCLUSIONSOverall, this study found rates of 4.7% and 7.2% for reoperation and readmission, respectively, within 90 days: 30.7% of the reoperations and 44.7% of the readmissions occurred beyond the first 30 days. A diagnosis of SSI, AKI, UTI, and history of CHF were significant factors for readmission, while male sex was associated with decreased odds for readmission. A diagnosis of SSI, sepsis, UTI, and increased LOS were found to be significant predictors for reoperation. Understanding 90-day complication rates is imperative because there has been increased discussion and healthcare policy extending the global postoperative window to 90 days. Current literature supports a readmission rate of 3%–9% after spine surgery. However, this literature either is limited to a 30-day window or does not stratify between different types of spine surgeries.
First clinical experience with DRD2/3 antagonist ONC201 in H3 K27M–mutant pediatric diffuse intrinsic pontine glioma: a case report
Authors: Hall Matthew D. , Odia Yazmin , Allen Joshua E. , Tarapore Rohinton , Khatib Ziad , Niazi Toba N. , Daghistani Doured , Schalop Lee , Chi Andrew S. , Oster Wolfgang , Mehta Minesh P. 
Published: April 2019

Diffuse intrinsic pontine gliomas (DIPGs) frequently harbor the histone H3 K27M mutation. Gliomas with this mutation commonly overexpress dopamine receptor (DR) D2 and suppress DRD5, leading to enhanced sensitivity to DRD2 antagonism. This study reports the first clinical experience with the DRD2/3 antagonist ONC201 as a potential targeted therapy for H3 K27M–mutant DIPG. One pediatric patient (a 10-year-old girl) with H3 K27M–mutant DIPG was enrolled in an investigator-initiated, IRB-approved compassionate-use study and began single-agent ONC201 treatment 1 month after completing radiotherapy. The study endpoints were clinical and radiographic response (primary) and toxicities (secondary).The patient presented with House-Brackmann grade IV facial palsy and unilateral hearing loss. MRI demonstrated a 2.3 × 2.1 × 2.8–cm pontomedullary tumor. Stereotactic biopsy confirmed H3 K27M–mutated DIPG. The tumor was treated with radiotherapy, but 1 month after completion of that treatment, the tumor and neurological symptoms showed only minimal change, and ONC201 treatment was initiated as described above. The tumor volume sequentially decreased by 26%, 40%, and 44% over the next 6 months, and remained stable at 18 months. Ipsilateral hearing normalized and the facial palsy improved to House-Brackmann grade I by 4 months. After 1 year of ONC201 treatment, 2 new lesions were identified outside of the prior high-dose radiotherapy volume. The patient was treated with dexamethasone, bevacizumab, and additional focal radiotherapy to these new tumors. These tumors remained stable in size over the subsequent 6 months on MRI. To date, no adverse events have been observed or reported due to ONC201. The patient remains clinically improved as of the latest follow-up visit, 19 months after starting ONC201 and 22 months from diagnosis. This case supports further investigation of this novel agent targeting H3 K27M–mutated DIPG.
PEMBELAJARAN BAHASA PADA ANAK USIA DINI MELALUI CERITA BERGAMBAR
Authors: Deiniatur Much 
Published: April 2019

Language Skill consists of four components of speaking, writing, listening and reading. The most important thing for children is speaking, because it provides enormous benefits, one of which so that children can interact with peers and others around them and add new knowledge.
Storytelling is a popular communication medium for children, training their ability to focus attention for some time on certain objects. Children are able to express themselves through a process that makes them happy and fosters a sense of satisfaction that makes them more confident. Tale or story telling is something human, that is, fairy tale or story using eye, hearing, motion, and touching heart.

The benefits of storytelling activities are: 1.) Storytelling can develop children's imagination, 2.) Increasing experience, 3.) Train concentration power, 4.) Increasing the vocabulary, 5.) Creating a familiar atmosphere, 6.) comprehending, 7.) Developing social feelings, 8.) Developing children's emotions, 9.) Practicing listening, 10.) Knowing positive and negative values. 11.) Adding knowledge
Keywords: language, early childhood, story, picture
PENGEMBANGAN SISTEM INFORMASI PELATIHAN BERBASIS WEB MENGGUNAKAN TEKNOLOGI WEB SERVICE DAN FRAMEWORK LARAVEL
Authors: Somya Ramos , Nathanael Tan Michelle Esmeralda 
Published: April 2019

Pincher ID is a local startup that engaged in the education sector especially for providing training classes. For now, Pincher ID based on a mobile application that causes only a third party (Google Play store/ App Store) who can access it. Furthermore, mobile application Pincher ID is not indexed by search engine so it makes difficult for people to find it. In this research, training information system web-based with web service technology and framework Laravel will be built. Web service technology applied to the system for data integration so data can be stored centrally. The architecture of web service used in the system is REST because accessing REST with URL address on browser application, give easy access to the application. In this research, prototype method used to develop an information system based on a website that can be used by Pincher ID. The test result showed that the training information system worked well and in accordance with the user’s wishes.
Emergency laparoscopic exploration of postpartum spontaneous rupture of the urinary bladder:A case report and review of literature
Authors: Xu Zhichao , Wang Xiaoqing , Wang Jun , Li Zhiayan , Du Junkai 
Published: April 2019

Introduction:
Spontaneous rupture of the urinary bladder(SRUB)
is a relatively rare cause of acute abdomen disease, whcih was easily
complicated with diffuse peritonitis, septic shock, acute renal failure.
Athough a few cases about postpartum
patient sufferred from SRUB have been reported recently,the management of postpartum SRUB was
not well established. Case
Report: The subject
of this case was a 37-year-old postpartum woman who presented with abdominal pain for one day.Based on his clinical presentation,
investigation results, it
was highly
suspected for urinary
disease complicated with diffuse peritonitis, such as SRUB, ureteral rupture. Given that vital signs were unstable and peritonitis signs were aggravating gradually, emergency laparoscopic exploration were performed.
There was a visible rupture in the left posterior of the bladder wall, with a
diameter of 2cm.Laparoscopic repair was employed and patient recovered well. In
this article, we
also reviewed relevant literatures to
initially establish main
diagnostic basis for
postpartum SRUB.

Conlcusion:
Postpartum
women with a complaint of acute abdomen pain maybe caused by SRUB, especially
companied with oliguria and dysuria. And laparoscopy have an obvious advantage
to the diagnosis and treatment for highly suspected postpartum
SRUB.
HUBUNGAN BAYI LAHIR PREMATUR DENGAN INFEKSI NEONATORUM DI RSUD DR. MOEWARDI SURAKARTA
Authors: Rakhmawati Nur , Pangesti Christiani Bumi 
Published: April 2019

neonatorum merupakan masalah kesehatan masyarakat yang penting pada bayi di Indonesia, baik bayi baru lahir dengan infeksi neonatorum merupakan penyebab langsung kematian bayi di Indonesia meliputi: Asfiksia (44-46%), infeksi (24-25 %), prematur (15-20%), infeksi neonatorum (2-7%), dan cacat bawaan (1-3 %). Tujuan penelitian adalah menganalisis hubungan bayi berat lahir rendah, prematur dan kejadian ikterus dengan infeksi neonatorum. Jenis penelitian ini adalah penelitian analitik observasional dengan pendekatan cross-sectional (potong-lintang). Sampel dipilih secara random sampling. Penelitian ini dilaksanakan bulan Maret 2016. Teknik pengumpulan data menggunakan data rekam medik. Data dianalisis menggunakan Analisis korelasi bivariat, dikatakan signifikan apabila nilai p<0,05. Hasil penelitian ada hubungan yang signifikan prematur dengan infeksi neonatorum dengan p < 5% (p=0.000, χ: 31,438 ).Kesimpulan terdapat hubungan bayi lahir prematur dengan infeksi neonatorum..

Kata Kunci: bayi lahir prematur, infeksi neonatorum

ABSTRACT
Newborns with neonatal infections are an important public health problem infants in Indonesia, both newborns with neonatal infections are the direct cause of infant mortality in Indonesia include: Asphyxia (44-46%), infection (24-25% ), Premature (15-20%), neonatal infection (2-7%), and congenital defects (1-3%). The objectives were to analyze the relationship between low birth weight, premature and jaundice with neonatal infection. This type of research is an observational analytic study with a cross-sectional (cross-sectional) approach. Samples were chosen by random sampling. Data collection techniques use medical record data. Data were analyzed using bivariate correlation analysis, it is said significant if the value of p <0,05. There was a significant association of preterm with neonatal infection with p <5% (p
= 0.000, χ: 31,438). Conclusion there is a premature infant relationship with neonatal infection.

Keywords: premature baby, neonatal infection
PERAN TENAGA KESEHATAN DALAM USAHA PENCEGAHAN KESAKITAN DAN KEMATIAN BAYI BARU LAHIR
Authors: Sujana Treesia , Dary D , Longi Jenlti Dwi Elsa 
Published: April 2019

ABSTRAK Kesehatan dan kelangsungan hidup bayi baru lahir sangat penting untuk menjamin optimalitas pertumbuhan dan perkembangan anak-anak. Menurut Profil Kesehatan Kabupaten Semarang 2014, tercatat sebanyak 8,15% per 1000 Kelahiran Hidup (KH) angka kematian bayi baru lahir. Kasus kematian bayi baru lahir mendominasi kasus kematian bayi di Kabupaten Semarang. Tujuan dari penelitian ini adalah mendeskripsikan peran tenaga kesehatan dalam usaha pencegahan kesakitan dan kematian bayi baru lahir di wilayah binaan Puskesmas Getasan. Penelitian ini menggunakan metode kualitatif deskriptif dengan menggunakan teknik pengumpulan data wawancara mendalam. Teknik analisa data dilakukan dengan model Miles and Huberman, yaitu Data Reduction (reduksi data), Data Display (penyajian data) dan Conclusion Drawing/verification. Penelitian ini dilakukan selama 1 bulan pada Mei 2017 di Puskesmas Getasan. Hasil penelitian ini menyimpulkan bahwa peran tenaga kesehatan dalam usaha pencegahan kesakitan dan kematian bayi baru lahir yang terutama adalah sebagai pelaksana program yang telah dicanangkan pemerintah serta lebih berfokus pada layanan bayi neonatal & bayi dengan risiko. Dalam menjalankan perannya tenaga kesehatan melakukan berbagai inisiatif dalam usaha menurunkan angka kematian bayi baru lahir di wilayah binaan Puskesmas Getasan. Kata Kunci: Kematian bayi baru lahir, peran tenaga kesehatan, layanan kesehatan primer. ABSTRACT The health and survival of newborns are important to ensure the optimality of children’s growth and development. Semarang District Health Profile 2014, recorded that there were 8.15% deaths of newborns on every 1000 live births. The death cases of newborns dominated the contribution of infant mortality in Semarang District. The purpose of this research is to describe roles of health workers in the effort to descrease the morbidity and mortality numbers of newborns in Puskesmas Getasan’s target areas. This research used a qualitative descriptive method with in-depth interviews as the data collection method. The data analyzed with the Miles and Huberman model, which emphasized in the data reduction, data display and conclusion drawing/verification. This research was held for a month started from May 2017 at Puskesmas Getasan. The results of this study concluded that the main role of health workers in the effort to descrease the morbidity and mortality numbers of newborns is as implementer of programs that have been declared by the government and more focused on the services especially for neonatal with high risk of illness. However, strategies and initiatives had been done by health workers and resulted in the decrease of the mortality number of newborns in Puskesmas Getasan’s target area. Keywords: Newborn deaths , role of health workers, primary health care.