bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dosimetric comparison of fractionated radiosurgery plans using frameless Gamma Knife ICON and CyberKnife systems with linear accelerator–based radiosurgery plans for multiple large brain metastases
Authors: Han Eun Young , Wang He , Luo Dershan , Li Jing , Wang Xin 
Published: April 2019

OBJECTIVEFor patients with multiple large brain metastases with at least 1 target volume larger than 10 cm3, multifractionated stereotactic radiosurgery (MF-SRS) has commonly been delivered with a linear accelerator (LINAC). Recent advances of Gamma Knife (GK) units with kilovolt cone-beam CT and CyberKnife (CK) units with multileaf collimators also make them attractive choices. The purpose of this study was to compare the dosimetry of MF-SRS plans deliverable on GK, CK, and LINAC and to discuss related clinical issues.METHODSTen patients with 2 or more large brain metastases who had been treated with MF-SRS on LINAC were identified. The median planning target volume was 18.31 cm3 (mean 21.31 cm3, range 3.42–49.97 cm3), and the median prescribed dose was 27.0 Gy (mean 26.7 Gy, range 21–30 Gy), administered in 3 to 5 fractions. Clinical LINAC treatment plans were generated using inverse planning with intensity modulation on a Pinnacle treatment planning system (version 9.10) for the Varian TrueBeam STx system. GK and CK planning were retrospectively performed using Leksell GammaPlan version 10.1 and Accuray Precision version 1.1.0.0 for the CK M6 system. Tumor coverage, Paddick conformity index (CI), gradient index (GI), and normal brain tissue receiving 4, 12, and 20 Gy were used to compare plan quality. Net beam-on time and approximate planning time were also collected for all cases.RESULTSPlans from all 3 modalities satisfied clinical requirements in target coverage and normal tissue sparing. The mean CI was comparable (0.79, 0.78, and 0.76) for the GK, CK, and LINAC plans. The mean GI was 3.1 for both the GK and the CK plans, whereas the mean GI of the LINAC plans was 4.1. The lower GI of the GK and CK plans would have resulted in significantly lower normal brain volumes receiving a medium or high dose. On average, GK and CK plans spared the normal brain volume receiving at least 12 Gy and 20 Gy by approximately 20% in comparison with the LINAC plans. However, the mean beam-on time of GK (∼ 64 minutes assuming a dose rate of 2.5 Gy/minute) plans was significantly longer than that of CK (∼ 31 minutes) or LINAC (∼ 4 minutes) plans.CONCLUSIONSAll 3 modalities are capable of treating multiple large brain lesions with MF-SRS. GK has the most flexible workflow and excellent dosimetry, but could be limited by the treatment time. CK has dosimetry comparable to that of GK with a consistent treatment time of approximately 30 minutes. LINAC has a much shorter treatment time, but residual rotational error could be a concern.
Association between weekend admissions and mortality after aneurysmal subarachnoid hemorrhage: the “weekend effect” revisited
Authors: Mikhail Mirriam , Ayling Oliver G. S. , Eagles Matthew E. , Ibrahim George M. , Macdonald R. Loch 
Published: April 2019

OBJECTIVEHigher mortality has been reported with weekend or after-hours patient admission across a wide range of surgical and medical specialties, a phenomenon termed the “weekend effect.” The authors evaluated whether weekend admission contributed to death and long-term neurological outcome in patients following aneurysmal subarachnoid hemorrhage.METHODSA post hoc analysis of the Clazosentan to Overcome Neurological Ischemia and Infarction Occurring After Subarachnoid Hemorrhage (CONSCIOUS-1) study was conducted. Univariable and stepwise multivariable logistic regression analyses were performed to assess the associations between weekend admission and mortality and long-term neurological outcome.RESULTSOf 413 subjects included in the CONSCIOUS-1 study, 140 patients had been admitted during the weekend. A significant interaction was identified between weekend admission and neurological grade on presentation, suggesting that the outcomes of patients who had initially presented with a poor grade were disproportionately influenced by the weekend admission. On stepwise multivariable logistic regression in the subgroup of patients who had presented with a poor neurological grade (29 of 100 patients), admission on the weekend was found to be independently associated with death (OR 6.59, 95% CI 1.62–26.88, p = 0.009). Weekend admission was not associated with long-term neurological outcome.CONCLUSIONSWeekend admission was an independent risk factor for death within 12 weeks following aneurysmal subarachnoid hemorrhage in patients presenting with a poor neurological grade. Further work is required to identify and mitigate any mediating factors.
Impact of an advanced practice provider–directed plagiocephaly clinic for neurosurgical practices
Authors: Hoffman Caitlin , Yuan Melissa , Boyke Andre E. , O’Connor Ashley , Haussner Therese , Perera Imali , Souweidane Mark 
Published: April 2019

OBJECTIVEIn recent years, the Weill Cornell neurosurgical team noticed an increase in referrals for plagiocephaly, likely due to increased infant back-sleeping and awareness. A plagiocephaly clinic staffed by a nurse practitioner and a physician assistant was established in 2016 to meet this demand, and to decrease the nonsurgical case burden on neurosurgeons. The purpose of this study was to examine the impact of a clinic directed by advanced nonphysician practice providers (NPPs) on parental satisfaction and nonsurgical work hours for staff neurosurgeons.METHODSOver a 1.5-year period (from January 1, 2016, to June 20, 2017), Likert scale–based surveys were administered to parents before and after their child’s visit to the NPP-staffed clinic. Clinic hours were tracked to assess impact on the neurosurgeon’s workload.RESULTSAll 185 patients seen in the plagiocephaly clinic over the 1.5-year period completed pre- and postvisit surveys. Parents all reported a significant reduction in their level of concern for their child’s diagnosis after the evaluation, and 95.5% were “very likely” to recommend the clinic. All parents felt that there was an increase in their knowledge base after an appointment with an NPP. Additionally, over 1 year in the study, 170 visits to the NPP plagiocephaly clinic were recorded, resulting in 85 hours that neurosurgeons normally would have spent in the clinic that they now were able to spend in the operating room.CONCLUSIONSThis research provides evidence that an NPP-directed clinic can positively impact parental satisfaction and decrease nonsurgical case burden on neurosurgeons.
Feasibility of intraoperative monitoring of motor evoked potentials obtained through transcranial electrical stimulation in infants younger than 3 months
Authors: Yi You Gyoung , Kim Keewon , Shin Hyung-Ik , Bang Moon Suk , Kim Hee-Soo , Choi Jinwoo , Wang Kyu-Chang , Kim Seung-Ki , Lee Ji Yeoun , Phi Ji Hoon , Seo Han Gil 
Published: April 2019

OBJECTIVEThis study aimed to investigate the feasibility and safety of intraoperative motor evoked potential (MEP) monitoring in infants less than 3 months of age.METHODSThe authors investigated 25 cases in which infants younger than 3 months (mean age 72.8 days, range 39–87) underwent neurosurgery between 2014 and 2017. Myogenic MEPs were obtained through transcranial electrical stimulation. In all cases, surgery was performed under total intravenous anesthesia, maintained with remifentanil and propofol.RESULTSMEPs were documented in 24 infants, the sole exception being 1 infant who was lethargic and had 4-limb weakness before surgery. The mean stimulation intensity maintained during monitoring was 596 ± 154 V (range 290–900 V). In 19 of 24 infants MEP signals remained at ≥ 50% of the baseline amplitude throughout the operation. Among 5 cases with a decrease in intraoperative MEP amplitude, the MEP signal was recovered in one during surgery, and in the other case a neurological examination could not be performed after surgery. In the other 3 cases, 2 infants had relevant postoperative weakness and the other did not show postoperative neurological deficits. Postoperative weakness was not observed in any of the 20 infants who had no deterioration (n = 19) or only temporary deterioration (n = 1) in MEP signal during surgery.CONCLUSIONSTranscranial electrical MEPs could be implemented during neurosurgery in infants between 1 and 3 months of age. Intraoperative MEP monitoring may be a safe adjunct for neurosurgical procedures in these very young patients.
What is the treatment effect of surgery compared with nonoperative treatment in patients with lumbar spinal stenosis at 1-year follow-up?
Authors: Held Ulrike , Steurer Johann , Pichierri Giuseppe , Wertli Maria M. , Farshad Mazda , Brunner Florian , Guggenberger Roman , Porchet François , Fekete Tamás F. , Schmid Urs D. , Gravestock Isaac , Burgstaller Jakob M. 
Published: April 2019

OBJECTIVEThe aim of this study was to obtain an unbiased causal treatment estimate of the between-group difference of surgery versus nonoperative treatment with respect to outcomes on quality of life, pain, and disability in patients with degenerative lumbar spinal stenosis (DLSS) 12 months after baseline.METHODSThe authors included DLSS patients from a large prospective multicenter observational cohort study. Propensity score matching was used, including 15 demographic, clinical, and MRI variables. Linear and logistic mixed-effects regression models were applied to quantify the between-group treatment effect. Unmeasured confounding was addressed in a sensitivity analysis, assessing the robustness of the results.RESULTSA total of 408 patients were included in this study, 222 patients after matching, with 111 in each treatment group. Patients with nonoperative treatment had lower quality of life at the 12-month follow-up (−6.21 points, 95% CI −9.93 to −2.49) as well as lower chances of reaching a minimal clinically important difference in Spinal Stenosis Measure (SSM) symptoms (OR 0.26, 95% CI 0.13 to 0.53) and SSM function (OR 0.26, 95% CI 0.14 to 0.49), than patients undergoing surgery. These results were very robust in case of unmeasured confounding. The surgical complication rate was low; 5 (4.5%) patients experienced a durotomy during intervention, and 5 (4.5%) patients underwent re-decompression.CONCLUSIONSThe authors used propensity score matching to assess the difference in treatment efficacy of surgery compared with nonoperative treatment in elderly patients with DLSS. This study delivers strong evidence that surgical treatment is superior to nonoperative treatment. It helps in clinical decision-making, especially when patients suffer for a long time, sometimes over many years, hoping for a spontaneous improvement of their symptoms. In light of these new results, the number of years with disability can hopefully be reduced by providing adequate treatment at the right time for this ever-growing elderly and frail population.
Analisis Penerapan Trading Strategy dan Investment Strategy Terhadap Saham yang Tergabung Dalam Indeks LQ 45
Authors: Wilson Timothy , Kurniasari Florentina 
Published: April 2019

ABSTRACT
The aim of this research is to determine the performance of Trading and Investment Strategy in buying and selling decisions for shares listed in the LQ45 index consistently for period of January 1st 2015 – December 31st, 2017. There are 32 companies selected as sample using purposive sampling method. The research using secondary data which had taken from the stock price in opening and closing market. As a quantitive descriptive research, this research is also analyzed the stock that reached highest and lowest price in the market during that period.
The result of this research shows that Investment strategy is the best strategy to produce higher return than Trading strategy, in which UNVR is the best performer.
Keywords: Stock Return, Technical Indicator, Investment, Trading, MACD
Penerapan Algoritma ACO untuk Penjadwalan Kuliah Pengganti pada Perguruan Tinggi (Studi Kasus: Program Studi Informatika, Universitas Multimedia Nusantara)
Authors: Noviasari Indah , Rusli Andre , Hansun Seng 
Published: April 2019

Students and scheduling are both essential parts in a higher educational institution. However, after schedules are arranged and students has agreed to them, there are some occasions that can occur beyond the control of the university or lecturer which require the courses to be cancelled and arranged for replacement course schedules. At Universitas Multimedia Nusantara, an agreement between lecturers and students manually every time to establish a replacement course. The agreement consists of a replacement date and time that will be registered to the division of BAAK UMN which then enter the new schedule to the system. In this study, Ant Colony Optimization algorithm is implemented for scheduling replacement courses to make it easier and less time consuming. The Ant Colony Optimization (ACO) algorithm is chosen because it is proven to be effective when implemented to many scheduling problems. Result shows that ACO could enhance the scheduling system in Universitas Multimedia Nusantara, which specifically tested on the Department of Informatics replacement course scheduling system. Furthermore, the newly built system has also been tested by several lecturers of Informatics UMN with a good level of perceived usefulness and perceived ease of use.
Keywords—scheduling system, replacement course, Universitas Multimedia Nusantara, Ant Colony Optimization
Pengenalan Pola Tulang Daun Dengan Jaringan Syaraf Tiruan Backpropagation
Authors: Tandrian Alvin Hanjaya , Kusnadi Adhi 
Published: April 2019

The development of technology has affected many areas of life. Progress in the field of Computer Science can reach other aspect of science. This research apply the knowledge of Computer Science in Biological Science, the one is the morphology of leaf venation. Leaf venation is an important aspect in the process of identification. Therefore, in this research developed thesystem that classify the type of leaf venation. This application is used as means of research on the performance of pattern recognition on backpropagation neural network. The system designed using the Java programming and socket programming to transfer data from the mobile device into the computer. Data testing is implemented using Android to facilitate process oftaking the picture. While in the process of training data for the optimal weight applied directly on the server computer by using Java Eclipse. In the stage of image processing is implemented by using the library of Canny edge detection. Data consisted of five categories of leaf vein pattern, with a sample of three leaves for each pattern. Training data using two of the three leaves for each pattern, with 10 images each leaf so that there are 20 images for each pattern, with a total of 100 images for all patterns. Data testing use 10 images from the third leaf to count the accuracy. The system managed to getthe best accuracy by using an image size of 200 x 200 with 100 hidden node with the average accuracy of 76%.
Index Terms— Android, Canny Edge Detection, Java, Neural Networks Backpropagation, Socket Programming
Algoritma Fisher-Yates Shuffle dan Flood Fill sebagai Maze Generator pada Game Labirin
Authors: Hoetama D.J. Owen , Putri Farica Perdana , Winarno P.M. 
Published: April 2019

Maze game is an interesting game and used to spend time. However, in the maze game, the level used forthis game still uses static levels. Static levels make the maze shape stay the same if we play the same level. Thus, players will quickly feel bored because it finds the same complexity. Maze generator is a static level problem solution on the maze game. This research uses Fisher-Yates Shuffle algorithm and Flood Fill algorithm to make maze generator. Fisher-Yates Shuffle algorithm is used for wall position randomization and Flood Fill algorithm to keep the maze results to remain resolved. The results of the application implementation yielded 30 mazes and were tested using the Hamming Distance algorithm, yielding that the result of the maze formed is always different. The average percentage rate difference produced 48% each time the maze was formed. The results of the maze that was formed performed perfect maze checking with the result of 83.33% percentage.
Index Terms— Fisher-Yates Shuffle, Flood Fill, MazeGenerator, Hamming Distance
Strategi Komunikasi Band Indie Elephant Kind dalam Perkembangan Subsektor Musik Indonesia
Authors: Prakoso Kevin Septanto K. , Putri Dhita Widya 
Published: April 2019

Musik merupakan produk komunikasi massa yang tumbuh di bawah naungan industri rekaman. Saat ini, industri musik semakin tumbuh seiring dengan berkembangnya teknologi dan komunikasi yang semakin pesat. Di Indonesia, musik termasuk ke dalam subsektor yang dibina oleh lembaga non-kementerian Badan Ekonomi Kreatif dan dianggap sebagai salah satu industri yang menjanjikan, karena di dalamnya terdapat aktivitas kreatif yang berkaitan dengan kreasi, produksi, distribusi, dan promosi. Dari fenomena inilah tren industri musik indie muncul, yang melakukan segala aktivitasnya secara independen, seperti Band Elephant Kind. Penelitian ini menilik bagaimana Elephant Kind berkontribusi dalam kancah permusikan indie di Indonesia dengan pendekatan strategi komunikasi yang digunakannya. Dengan metode kualitatif, wawancara mendalam, dan pengamatan, terlihat bahwa Elephant Kind sudah membangun strategi untuk mencapai tujuan sesuai tujuan sentral berdasarkan Pace, Peterson, dan Burnett yaitu to secure understanding, to establish acceptance, dan to motivate action. Penelitian selanjutnya diharapkan untuk mengukur dampak dari strategi melalui persepsi pendengarnya.
Kata Kunci: strategi komunikasi, musik, band indie, komunikasi massa
Urgensi Komunikasi dalam Pengembangan Organisasi Modern
Authors: Fensi Fabianus 
Published: April 2019

Organisasi modern membutuhkan model komunikasi yang partisipastif, yaitu komunikasi yang memberi ruang bagi keterlibatan semua komponen organisasi. Hierarki peran diperlukan, tetapi itu bertujuan memperlancar arus distribusi informasi dalam organisasi. Lemahnya standar komunikasi organisasi sering menimbulkan konflik tersendiri dalam sebuah organisasi. Konflik bisa terjadi antara anggota dengan organisasi, antaranggota dalam organisasi, atau antara organisasi dengan anggota. Karena itu diperlukan mekanisme penyelesaian konflik yang memenangkan kepentingan bersama. Atasan dan bawahan adalah perangkat organisasi penyalur atau aktor komunikasi dalam organisasi sehingga perjalanan roda organisasi berjalan sesuai kesepakatan bersama dalam organisasi tersebut. Tidak ada konflik yang tidak memiliki jalan keluar. Pentingnya bagi sebuah organisasi adalah melakukan negosiasi egaliter untuk memenangkan kepentingan bersama sebagai visi dan misi organisasi.

Kata Kunci: Konflik, komunikasi, negosiasi, organisasi
MERANCANG MODEL BLENDED LEARNING DESIGNING BLENDED LEARNING MODEL
Authors: Chaeruman Uwes Anis 
Published: April 2019

Dalam era komunikasi instan dewasa ini, cara belajar dan proses pembelajaran telah berubah. Kondisi ini membawa pembelajaran ke era e-learning di mana upaya belajar dan membelajarkan dapat difasilitasi dengan teknologi informasi dan komunikasi. Mengkombinasikan teknologi informasi dan komunikasi yang tepat (blended learning) merupakan salah satu isu penting dalam merancang e-learning yang baik. Oleh karena itu diperlukan semacam panduan (framework) yang dapat menjadikan acuan dalam memilih dan menentukan blended learning yang tepat sesuai kondisi dan tujuan yang ingin dicapai. Artikel ini mencoba memberikan framework untuk menjawab permasalahan tersebut. Framework yang coba ditawarkan dalam artikel ini mengacu pada konsep e-learning, empat kuadran seting belajara menurut Noord, dua kontinum strategi pembelajaran menurut Smaldino dkk., dan empat standar proses pembelajaran yang penulis adaptasi dari Horton. Framewrok tersebut adalah bahwa dam merancang blneded learning perlu mempertimbangkan beberapa unsur sebagai berikut: 1) upaya memfasilitasi pengalaman belajar sebagai esensi dari e-learning; 2) optimalisasi empat standar proses pembelajaran dalam konteks e-learning; 3) pemilihan dan penentuan strategi pembelajaran yang tepat; dan 4) pemilihan dan penentuan teknologi dan tool TIK yang tepat dalam empat kuadran seting belajar.Â In the era of instant communication, today, learning and instructional process has changed. This condition has led learning into a new era called e-learning, where learning process can be facilitated with proper use of information and communication technology. Combining information and communication technology appropriately to facilitate learning has become an impportant issue in e-learning design context. Therefore, we need such a kind of framework as a guidance in selecting and determining the appropritae blended learning strategy to address the learning objectives to be achieved. The framework offered in this article refered to the essential concept of e-learning itself, four quadrants of learning seting offered by Noord, two continuum of instructional strategy offerd by Smaldino et. al., and four standard of e-learning process adapted by author from the work of Norton. The framework offered are that in designing blended learning, we should consider the following aspects: 1) efforts to facilitate learning experiences as the essence of e-learning; 2) optimalization of the four learning process standard in the context of e-learning; 3) selection and determination of appropriate learning strategies; and 4) selection and determination of apropriate learning seting and ICTs used in four quadrants of learning seting.Â
Facilitated group work for people with long-term conditions: a systematic review of benefits from studies of group-work interventions
Authors: Jackson Margaret , Jones Daniel , Dyson Judith , Macleod Una 
Published: April 2019

BackgroundAbout 15.4 million people in the UK live with a long-term condition. Of the health and social care spend, 70% is invested in caring for this population. Evidence suggests that group-work interventions offer patient support, improved outcomes, and reduce the costs of care.AimTo review the current evidence base examining the effectiveness of group work in long-term physical disease where such groups are facilitated by healthcare professionals.Design and settingSystematic review and narrative synthesis of studies of group-work interventions led by health professionals for adults with specified long-term illnesses.MethodMEDLINE, EMBASE, PsycINFO, and Cochrane databases were systematically searched using terms relating to group work and long-term conditions. Studies were included if they were randomised controlled trials (RCTs) with a control group that did not include group work.ResultsThe 14 included studies demonstrated a high degree of heterogeneity in terms of participant characteristics, interventions, and outcome measures and were of varying quality. The studies demonstrated some statistically significant improvements in pain, psychological outcomes, self-efficacy, self-care, and quality of life resulting from intervention.ConclusionThis review demonstrates significant benefits resulting from group participation, in adults with long-term disease. Results were mixed and some benefits were short-lived. Nevertheless, these results suggest that group work should be more widely used in the management and support of adults with long-term illness. There is a need for larger and better-quality studies to explore this potentially important area further.