bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategy and effect of repeat bypass surgery for anterior/posterior circulation in refractory moyamoya disease
Authors: Uchino Haruto , Kashiwazaki Daina , Akioka Naoki , Koh Masaki , Kuwayama Naoya , Houkin Kiyohiro , Kuroda Satoshi 
Published: May 2019

OBJECTIVEIn this study the authors aimed to describe clinical features, surgical techniques, and long-term outcomes of repeat bypass surgery required for a certain subset of patients with moyamoya disease.METHODSThe authors retrospectively reviewed a total of 22 repeat bypass surgeries for 20 patients (age range 1–69 years) performed during the last 20 years at their institutions. The patients were classified into 2 groups. Group A included 10 patients who underwent repeat bypass surgery for anterior circulation due to insufficient revascularization on the ipsilateral side. Group B included 10 patients who underwent repeat bypass surgery for posterior circulation due to the involvement of the posterior cerebral artery (PCA) after successful initial surgery for anterior circulation.RESULTSPreoperative symptoms included headache in 3 patients, transient ischemic attack in 10, cerebral infarction in 3, and intracranial hemorrhage in 4 patients. Intervals between the initial bypass surgery and repeat bypass surgery were 0.3–30 years (median 3 years). In group A, superficial temporal artery to middle cerebral artery (MCA) anastomosis and indirect bypass were performed on 7 hemispheres. Only indirect bypass was performed on 3 hemispheres because of the lack of suitable donor or recipient arteries. In group B, occipital artery (OA) to PCA anastomosis and indirect bypass were conducted on 4 hemispheres, and OA-MCA anastomosis and indirect bypass on 1 hemisphere. Only indirect bypass was conducted on 7 hemispheres because of the lack of suitable recipient arteries. All 22 repeat bypass surgeries were successfully conducted. During follow-up periods (median 4 years), none of the patients suffered repeat stroke except 1 patient who died of recurrent intracerebral hemorrhage 3 years after repeat bypass surgery for anterior circulation.CONCLUSIONSRepeat bypass surgery was feasible and effective to reduce further incidence of headache attack, transient ischemic attack, and ischemic/hemorrhagic stroke in moyamoya disease patients. Through precise radiological analysis, surgical procedures should be planned to yield maximal therapeutic effects.
Impact of basal ganglia damage after successful endovascular recanalization for acute ischemic stroke involving lenticulostriate arteries
Authors: Horie Nobutaka , Morofuji Yoichi , Iki Yusuke , Sadakata Eisaku , Kanamoto Tadashi , Tateishi Yohei , Izumo Tsuyoshi , Anda Takeo , Morikawa Minoru , Tsujino Akira , Matsuo Takayuki 
Published: May 2019

OBJECTIVERegional ischemic vulnerability of the brain reportedly differs between the cortex and basal ganglia and has been poorly assessed in the setting of endovascular mechanical thrombectomy. This study was conducted to determine the fate of an ischemic basal ganglia and its contribution to the clinical outcome after successful endovascular recanalization for acute ischemic stroke with large vessel occlusion involving the lenticulostriate arteries.METHODSClinical and radiological findings were retrospectively analyzed in consecutive patients with acute ischemic stroke characterized by large vessel occlusion involving the lenticulostriate arteries. Mechanical thrombectomy was performed in all patients using a stent retriever. The fate of ischemic basal ganglia based on location (lentiform nucleus, caudate nucleus, and internal capsule) and insular cortex was assessed according to the Alberta Stroke Programme Early CT Score (ASPECTS).RESULTSOf 170 patients with large intracranial vessel occlusion who achieved successful endovascular recanalization, defined as a thrombolysis in cerebral infarction grade of ≥ 2B, involvement of the lenticulostriate arteries was seen in 55 patients (internal carotid artery, n = 35; proximal middle cerebral artery, n = 20). Preoperative infarction was detected in the lentiform nucleus (66.7%), internal capsule (11.1%), and caudate nucleus (33.3%), all of which showed secondary advancement despite successful recanalization (85.4%, 27.3%, and 54.5%, respectively; p < 0.05). Lenticulostriate arteries with a lateral proximal and/or medial proximal origin significantly affected the development of mature infarction in the lentiform nucleus. Postoperative hemorrhagic transformation was detected in 25 of 55 patients, mostly in the lentiform nucleus. Involvement of insular ribbon infarction was significantly high in patients with hemorrhagic transformation in the basal ganglia. Age, initial National Institutes of Health Stroke Scale (NIHSS) score, initial ASPECTS, postoperative ASPECTS, postoperative infarction in the insular ribbon, and lesions in the middle cerebral artery area (M1–M6) were significantly different between patients with good and poor modified Rankin Scale scores. Interestingly, no differences were detected in postoperative infarction or hemorrhagic transformation in the basal ganglia. Multivariate analysis showed that only age (p = 0.02, OR 0.88) and the initial NIHSS score (p = 0.01, OR 0.86) independently affected favorable clinical outcomes.CONCLUSIONSThe basal ganglia are vulnerable and readily develop secondary infarction and hemorrhagic transformation despite successful recanalization. However, this does not have a significant impact on the clinical outcome of acute ischemic stroke with large vessel occlusion involving the lenticulostriate arteries.
Burden of cerebral hypoperfusion in patients with delayed cerebral ischemia after subarachnoid hemorrhage
Authors: Jafri Hussain , Diringer Michael N. , Allen Michelle , Zazulia Allyson R. , Zipfel Gregory J. , Dhar Rajat 
Published: May 2019

OBJECTIVEDelayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) may result in focal neurological deficits and cerebral infarction, believed to result from critical regional rather than global impairments in cerebral blood flow (CBF). However, the burden of such regional hypoperfusion has not been evaluated by gold-standard voxel-by-voxel CBF measurements. Specifically, the authors sought to determine whether the proportion of brain affected by hypoperfusion was greater in patients with DCI than in SAH controls without DCI and whether the symptomatic hemisphere (in those with lateralizing deficits) exhibited a greater cerebral hypoperfusion burden.METHODSSixty-one patients with aneurysmal SAH underwent 15O PET to measure regional CBF during the period of risk for DCI (median 8 days after SAH, IQR 7–10 days). Regions of visibly abnormal brain on head CT studies, including areas of hemorrhage and infarction, were excluded. Burden of hypoperfusion was defined as the proportion of PET voxels in normal-appearing brain with CBF < 25 ml/100 g/min. Global CBF and hypoperfusion burden were compared between patients with and those without DCI at the time of PET. For patients with focal impairments from DCI, the authors also compared average CBF and hypoperfusion burden in symptomatic versus asymptomatic hemispheres.RESULTSTwenty-three patients (38%) had clinical DCI at the time of PET. Those with DCI had higher mean arterial pressure (MAP; 126 ± 14 vs 106 ± 12 mm Hg, p < 0.001) and 18 (78%) were on vasopressor therapy at the time of PET study. While global CBF was not significantly lower in patients with DCI (mean 39.4 ± 11.2 vs 43.0 ± 8.3 ml/100 g/min, p = 0.16), the burden of hypoperfusion was greater (20%, IQR 12%–23%, vs 12%, 9%–16%, p = 0.006). Burden of hypoperfusion performed better than global CBF as a predictor of DCI (area under the curve 0.71 vs 0.65, p = 0.044). Neither global CBF nor hypoperfusion burden differed in patients who responded to therapy compared to those who had not improved by the time of PET. Although hemispheric CBF was not lower in the symptomatic versus contralateral hemisphere in the 13 patients with focal deficits, there was a trend toward greater burden of hypoperfusion in the symptomatic hemisphere (21% vs 18%, p = 0.049).CONCLUSIONSThe burden of hypoperfusion was greater in patients with DCI, despite hemodynamic therapies, higher MAP, and equivalent global CBF. Similarly, hypoperfusion burden was greater in the symptomatic hemisphere of DCI patients with focal deficits even though the average CBF was similar to that in the contralateral hemisphere. Evaluating the proportion of the brain with critical hypoperfusion after SAH may better capture the extent of DCI than averaging CBF across heterogenous brain regions.
An advanced protocol for intraoperative visualization of sinunasal structures: experiences from pituitary surgery
Authors: Micko Alexander , Hosmann Arthur , Wurzer Aygül , Maschke Svenja , Marik Wolfgang , Knosp Engelbert , Wolfsberger Stefan 
Published: May 2019

OBJECTIVEThe transsphenoidal route to pituitary adenomas challenges surgeons because of the highly variable sinunasal anatomy. Orientation may be improved if the appropriate information is provided intraoperatively by image guidance. The authors developed an advanced image guidance protocol dedicated to sinunasal surgery that extracts information from multiple modalities and forms it into a single image that includes fine sinunasal structures and arteries.The aim of this study was to compare the advantages of this novel image guidance protocol with the authors’ previous series, with emphasis on anatomical structures visualized and complication rate.METHODSThis retrospective analysis comprised 200 patients who underwent surgery for pituitary adenoma via a transnasal transsphenoidal endoscopic approach. The authors’ standard image guidance protocol consisting of CT for solid bone, T1CEMRI for soft tissues, and MRA for the carotid artery was applied in 100 consecutive cases. The advanced image guidance protocol added a first-hit ray casting of the CT scan for visualization of fine sinunasal structures, and adjustments to the MRA to visualize the sphenopalatine artery (SPA) were applied in a subsequent 100 consecutive cases.RESULTSA patent sphenoid ostium—i.e., an ostium not covered by a mucosal layer—was visualized significantly more often by the advanced protocol than the standard protocol (89% vs 40%, p < 0.001) in primary surgeries. The SPA and its branches were only visualized by the advanced protocol (87% and 91% of cases in primary surgeries and reoperations, respectively) and not once by the standard protocol. The number of visualized complete and incomplete sphenoid septations matched significantly more commonly with the surgical view when using the advanced protocol than the standard protocol at primary operation (mean 1.9 vs 1.6, p < 0.001). However, in 25% of all cases a complex and not a simple sinus anatomy was present. In comparison with the intraoperative results, a complex sphenoid sinus anatomy was always detected by the advanced but not by the standard protocol (25% vs 8.5%, p = 0.001).Furthermore, application of the advanced protocol reduced the cumulative rate of complications (25% vs 18% [standard vs advanced group]). Although an overall significant difference could not be determined (p = 0.228), a subgroup analysis of reoperations (35/200) revealed a significantly lower rate of complications in the advanced group (5% vs 30%, p = 0.028).CONCLUSIONSThe data show that the advanced image guidance protocol could intraoperatively visualize the fine sinunasal sinus structures and small arteries with a high degree of detail. By improving intraoperative orientation, this may help to reduce the rate of complications in endoscopic transsphenoidal surgery, especially in reoperations.
Pengembangan Kemampuan Komunikasi Matematik melalui Pembelajaran Take and Give
Authors: Luritawaty Irena Puji 
Published: May 2019

AbstrakLatar belakang penelitian ini yaitu fakta bahwa kemampuan komunikasi matematik terbukti berperan strategis dalam berbagai kegiatan pembelajaran, termasuk matematika. Tetapi, pencapaiannya belum optimal. Penelitian ini diantaranya bertujuan menemukan sulusi untuk pengembangan kemampuan komunikasi dalam matematika melalui pembelajaran berbasis Take and Give di kalangan mahasiswa agar mempunyai kompetensi untuk berkomunikasi matematika dengan baik sebagai persiapan untuk menjadi guru. Metode kuasi eksperimen digunakan dalam penelitian ini. Adapun populasi yang dipilih yaitu mahasiswa prodi pendidikan matematika pada institut pendidikan swasta di Garut, dengan mahasiswa tingkat IIA dan IIB sebagai sampel dengan jumlah 50 mahasiswa. Penelitian menggunakan instrumen berbentuk tes uraian untuk pretest dan posttest. Dari hasil penelitian secara garis besar diketahui bahwa mahasiswa dengan pembelajaran Take and Give mempunyai kemampuan komunikasi matematik yang lebih baik daripada pembandingnya yaitu mahasiswa dengan pembelajaran ceramah biasa. Pembelejaran Take and give terbukti signifikan dalam mengembangkan kemampuan komunikasi matematik. Development of Mathematical Communication Ability through Take and Give LearningAbstractBackground of this study is the fact that mathematical communication ability is proven to be a strategic role in various learning activities, including mathematics. But, the achievement is not optimal. This research included the aim of finding solutions to the development of communication skills in mathematics through Take and Give learning among college students in order to have the competence to communicate mathematics well in preparation for becoming a teacher. This research used The quasi-experimental method. The population chosen is college students of the mathematics department at private education institutes in Garut, with students of level IIA and IIB as a sample with 52 students. The study used a descriptive test instrument for pretest and posttest. Based on the results of this research in broad outline, it is known that students with Take and Give learning have mathematical communication skills that are better than the comparison, namely students with regular lecture learning. Take and give learning proved to be significant in developing mathematical communication skills.
Pengaruh Model Pembelajaran Kontekstual terhadap Pemahaman Konsep Matematika Siswa SMP
Authors: Brinus Kristianti Sry Wahyuningsih , Makur Alberta Parinters , Nendi Fransiskus 
Published: May 2019

AbstrakRendahnya kemampuan pemahaman konsep matematis siswa di kelas VIII SMP Negeri 4 Langke Rembong tahun ajaran 2018/2019 menjadi latar belakang masalah penelitian ini. Tujuan dilakukannya penelitian ini adalah untuk mengetahui pengaruh model pembelajaran kontekstual terhadap pemahaman konsep matematis siswa di sekolah ini. Jenis penelitian ini adalah penelitian eksperimen semu, dengan menggunakan desain Posttest Only Control Group Design. Populasi yang dipilih dalam penelitian ini adalah seluruh siswa kelas VIII SMP Negeri 4 Langke Rembong sebanyak 211 orang. Teknik pengambilan sampel menggunakan random sampling dan anggota sampel dalam penelitian ini adalah 60 orang. Data dikumpulkan dengan menggunakan instrumen tes pemahaman konsep matematika yang berbentuk tes uraian. Hasil penelitian menunjukan bahwa pemahaman konsep matematika siswa yang dibelajarkan dengan model pembelajaran kontekstual lebih baik dari pada pemahaman konsep matematika siswa yang dibelajarkan dengan model pembelajaran konvensional. Model pembelajaran kontekstual dinilai dapat menghubungkan materi yang dipelajari dengan situasi kehidupan nyata. Contextual Learning Model’s Effect on Mathematical Concept Understanding of Middle School StudentsAbstractThe low ability to understand the mathematical concepts of students in grade VIII Langke Rembong 4 Public Middle School 2018/2019 school year fits the background of the problem of this research. The goal of this study was to discover the effect of contextual learning models on understanding the mathematical concepts of students in this school. This type of research is quasi-experimental research, using the design of the Posttest-Only Control Group Design. The population chosen in this study were all eighth -grade students of Langke Rembong 4 SMP Negeri as many as 211 people. The sampling technique used random sampling and the sample members in this study were 60 people. Data was collected by using mathematical concept understanding test instruments in the form of description tests. The results of the study show that understanding the mathematical concepts of students who are taught by the contextual learning model is better than understanding the mathematical concepts of students who are taught with conventional learning models. The contextual learning model is assessed to be able to relate the material learned with real-life situations.
Pengaruh Model Pembelajaran Giving Question Getting Answer dan Think Pair Share terhadap Kemampuan Penalaran Matematika Siswa Kelas VII
Authors: Octaviyunas Asurya , Ekayanti Arta 
Published: May 2019

AbstrakPenelitian ini didasari atas permasalahan pentingnya kemampuan penalaran matematis dan pencapaiannya yang masih rendah. Tujuan dari penelitian ini adalah mengetahui pengaruh model pembelajaran Giving Question Getting Answer dan Think Pair Share terhadap kemampuan penalaran matematika siswa, dan efektifitasnya dalam meningkatkan kemampuan tersebut. Populasi Penelitian eksperimen semu ini mencakup seluruh siswa kelas VII SMPN 1 Balong. Kelas VIIA diberi pembelajaran dengan model TPS sedangkan kelas VIIB dengan model GQGA. Instrumen pengumpulan data berbentuk tes, meliputi soal pretest dan posttest. Hasil penelitian menunjukkan bahwa model pembelajaran GQGA berpengaruh terhadap kemampuan penalaran siswa kelas VIIB dengan peningkatan yang terjadi dari nilai pretest ke posttest. Begitu juga dengan model pembelajaran TPS berpengaruh terhadap kemampuan penalaran matematika siswa kelas VIIA dengan peningkatan nilai pretest ke posttest. Model pembelajaran GQGA tidak lebih efektif daripada model pembelajaran TPS dalam meningkatkan kemampuan penalaran matematika siswa. The Effect of Learning Model Giving Question Getting Answer and Think Pair Share Toward Reasoning Mathematics Ability Student’s Grade VII AbstractThis research is based on the problem of the importance of mathematical reasoning abilities and their low achievement. The purpose of this study was to determine the effect of Giving Question Getting Answer and Think Pair Share learning models on students' mathematical reasoning abilities and their effectiveness in enhancing these abilities. Population This quasi-experimental study included all seventh-grade students of Balong 1 Junior High School. The VIIA class is given learning with the TPS model while the VIIB class is with the GQGA model. The instruments of data collection are in the form of tests, including the questions of the pretest and posttest. The results showed that the GQGA learning model had an effect on the reasoning ability of students in class VIIB with an increase that occurred from the pretest to the posttest. Likewise, the TPS learning model influences the mathematical reasoning abilities of VIIA students with an increase in the value of the pretest to posttest. The GQGA learning model is no more effective than the TPS learning model in improving students' mathematical reasoning abilities.
Peningkatan Kemampuan Literasi Statistis melalui Model Pembelajaran Berbasis Proyek yang Dimodifikasi
Authors: Priyambodo Sudi , Maryati Iyam 
Published: May 2019

AbstrakKemampuan literasi statistis siswa sekolah menengah pertama masih rendah. Salah satu cara untuk meningkatkan kemampuan tersebut dengan melakukan inovasi terhadap model pembelajaran yang diterapkan. Berkaitan dengan peningkatan kemampuan literasi statistis tersebut diterapkan model pembelajaran berbasis proyek yang dimodifikasi. Metode dalam penelitian ini metode kuasi-eksperimen dengan instrumen penelitian soal tes berupa indikator kemampuan literasi statistis. Subjek penelitian siswa kelas VIII pada Madrasah Tsanawiyah berjumlah 36 orang siswa. Hasil dari penelitian ini adalah terdapat perbedaan kemampuan literasi statistis yang signifikan antara siswa yang mendapat model pembelajaran berbasis proyek yang dimodifikasi dengan model pembelajaran ekspositori. Model pembelajaran berbasis proyek yang dimodifikasi dapat digunakan sebagai alternatif model pembelajaran dalam meningkatkan kemampuan literasi statistis. Enhancing Statistical Literacy Abilities through Modified Project-Based LearningAbstractThe statistical literacy ability of junior high school students is still low. One way to improve this ability is by innovating the applied learning model. Regarding the increase in statistical literacy skills, a modified project-based learning model is applied. The method in this study is a quasi-experimental method with a research instrument about test questions in the form of indicators of statistical literacy. The research subjects of class VIII students at the Tsanawiyah Madrasah were 36 students. The results of the study are that there are significant differences in statistical literacy skills between students who receive a project-based learning model modified by the expository learning model. The modified project-based learning model can be used as an alternative learning model for improving statistical literacy skills.
Londra’da yaşayan Türkiyeli göçmenlerin etnik ve mezhepsel aidiyetlerinin siyasal tutum ve davranışlarına etkisi
Authors: Bilecen Tuncay , Araz Mustafa Saygın 
Published: May 2019

Bu makalede, Londra’da genellikle “Türkçe konuşan topluluk” başlığı altında sınıflandırılan Türkiyeli göçmenlerin etnik (Türk/Kürt) ve mezhepsel (Sünni/Alevi) kimliklerinin Türkiye ve İngiltere siyasetine yönelik ilgi ve katılım düzeylerine ne ölçüde etki ettiği incelenmektedir. Çalışmada, Haziran – Eylül 2013 tarihleri arasında Londra’da 213 göçmenle yapılan anket çalışması neticesinde elde edilen veriler önce Faktör Analizi daha sonra MANOVA (Tek Yönlü Çok Değişkenli Varyans Analizi) testinden geçirilmiştir. Faktör analizi ile bireylerin siyasal yaşama katılımlarını gösteren (“sivil katılım”, “siyasal ilgi”, “siyasal eylem” olmak üzere üç başlıkta sınıflandırılan) anlamlı değişkenler (faktörler) elde edilmiştir. Değişkenler elde edildikten sonra ise MANOVA analizinden yararlanılarak farklı etnik ve mezhepsel aidiyet gruplarının bu değişkenler üzerinde etkisi olup olmadığına bakılmıştır. Çalışmanın sonunda Londra’da yaşayan Türkiyeli göçmenlerin etnik ve mezhepsel kökenlerinin siyasal katılım düzeyleri üzerinde etkili olduğu sonucuna ulaşılmıştır.ENGLISH ABSTRACTTurkish migrants living in London and the impact of ethnic and religious belongings on their political attitude and behvaiourThis article investigates levels of the participation in political life of a particular migrant community referred to as ‘Turkish speaking community’ both in their country of origin (Turkey) and their country of residence (UK). This article specifically focuses on the effects of these migrants groups’ ethnic (i.e. Kurdish/ Turkish) and religious/sectarian (i.e. Alevi/Sunni) identities on their level of participation in the political life in Turkey and in the UK. The data informing this article was collected via administration of surveys with 213 participants between June and September 2013 with aforementioned migrant population. The data was analysis consisted of initial factor analysis followed by MANOVA. Through factor analysis meaningful variances in demonstrating the three types of participation in political life (civil participation, political interest and political activism) was revealed (bu umleyihala anlamadim ama sent mm diyorsan). After the determining of the dependant variables MANOVA analysis were conducted to determine the role of ethnic and religious belongingness on the dependent variables, i.e. types of participation in the political life. The research concluded that ethnic and religious belongingness directly influience degree of political participation of the migrants from Turkey.
Kitap İnceleme
Authors: Üreten Hüseyin 
Published: May 2019

Bu sayıda kitap inceleme bölümümüzde Prof. Dr. Ekrem Memiş ve Yrd. Doç. Dr. Cemil Bülbül’ün Eskiçağda Göçler adlı kitabının, Hüseyin Üreten tarafından kaleme alınan inceleme ve eleştiri yazısı yer almaktadır.