bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge regarding sexual and reproductive health among adolescents in higher secondary school
Authors: Shrestha Kopila , Awale Shanti 
Published: April 2019

Background: Adolescent reproductive health is one of the component of the reproductive health. It is most important issue in the world. Reproductive capability is taking place at an earlier age and adolescents are indulging in risk taking behaviors day by day. The objective of this study is to assess knowledge regarding sexual and reproductive health among adolescents.
Methods: A descriptive cross-sectional study was conducted in Kathmandu valley to assess the knowledge regarding sexual and reproductive health among adolescents. Total of 200 respondents were selected through non-probability purposive sampling technique. Self-administered written questionnaire was used for data collection. The collected data were analyzed by using descriptive statistics such as frequency, percentage, mean, standard deviation and inferential statistics such as Chi-square test.
Results: The findings revealed that most of the respondents had knowledge regarding transmission and protection of HIV/AIDS and STIs but still some respondents had misconception regarding it. The statistical analysis revealed that the total mean knowledge score with standard deviation was 45.02±8.674. Nearly half of the respondents (49.5%) had moderate level of knowledge, followed by inadequate level of knowledge 29.5% and adequate level of knowledge 21.0% regarding sexual and reproductive health. There was statistically significant association of level of knowledge with area of residence (p-value 0.002).
Conclusion: Nearly half of the respondents possess some knowledge about sexual and reproductive health but still effective educational intervention is required to increase their knowledge.
Factors influencing utilization of cervical cancer screening services among married women in community, Chitwan
Authors: Ranabhat Mina Kumari , Thapa Basanta 
Published: April 2019

Cervical cancer is one of the most prevalent cancers affecting women globally. It is the fourth most common cancer in women and the seventh overall. The morbidity and mortality of cervical cancer can be highly reduced through vaccination against human papilloma virus, regular screening and timely intervention. The objective of this study was to find out the factors influencing utilization of cervical cancer screening services among married women aged 30-60 of Bharatpur Sub-Metropolitan 19, Chitwan. A community based descriptive cross sectional research design was used, 175 married women were selected using simple random sampling technique. Semi- structured interview schedule was used to collect the data within four weeks. The collected data was entered in Epi data 3.1 and exported to IBM SPSS version 20. Out of 175 women, 42.3% of the respondents were of 30-39 years, 72% were literate, 18.9% had good level of awareness of cervical cancer screening, 44% had utilized cervical cancer screening services and 77.9% of the respondents had done screening only one time. The association showed between utilization of cervical cancer screening services such as duration of marriage (p=0.025), involvement in cervical cancer awareness programme (p=<0.001), fear (p=0.007), shyness (p=<0.001), preference of sex of health personnel (p=0.016), time to reach nearest screening center (p=0.024) and need of cervical cancer screening without any problems of cervix (p=<0.001).
Multivariate analysis showed that association between utilization of cervical cancer screening services such as duration of marriage 3.036 times, fear 2.992 times, shyness 3.335 times and need of cervical cancer screening without any problems of cervix 30.720 times more likely to utilize cervical cancer screening services.
Upfront boost Gamma Knife “leading-edge” radiosurgery to FLAIR MRI–defined tumor migration pathways in 174 patients with glioblastoma multiforme: a 15-year assessment of a novel therapy
Authors: Duma Christopher M. , Kim Brian S. , Chen Peter V. , Plunkett Marianne E. , Mackintosh Ralph , Mathews Marlon S. , Casserly Ryan M. , Mendez Gustavo A. , Furman Daniel J. , Smith Garrett , Oh Nathan , Caraway Chad A. , Sanathara Ami R. , Dillman Robert O. , Riley Azzurra-Sky , Weiland David , Stemler Lian , Cannell Ruslana , Abrams Daniela Alexandru , Smith Alexa , Owen Christopher M. , Eisenberg Burton , Brant-Zawadzki Michael 
Published: April 2019

OBJECTIVEGlioblastoma multiforme (GBM) is composed of cells that migrate through the brain along predictable white matter pathways. Targeting white matter pathways adjacent to, and leading away from, the original contrast-enhancing tumor site (termed leading-edge radiosurgery [LERS]) with single-fraction stereotactic radiosurgery as a boost to standard therapy could limit the spread of glioma cells and improve clinical outcomes.METHODSBetween December 2000 and May 2016, after an initial diagnosis of GBM and prior to or during standard radiation therapy and carmustine or temozolomide chemotherapy, 174 patients treated with radiosurgery to the leading edge (LE) of tumor cell migration were reviewed. The LE was defined as a region outside the contrast-enhancing tumor nidus, defined by FLAIR MRI. The median age of patients was 59 years (range 22–87 years). Patients underwent LERS a median of 18 days from original diagnosis. The median target volume of 48.5 cm3 (range 2.5–220.0 cm3) of LE tissue was targeted using a median dose of 8 Gy (range 6–14 Gy) at the 50% isodose line.RESULTSThe median overall survival was 23 months (mean 43 months) from diagnosis. The 2-, 3-, 5-, 7-, and 10-year actual overall survival rates after LERS were 39%, 26%, 16%, 10%, and 4%, respectively. Nine percent of patients developed treatment-related imaging-documented changes due to LERS. Nineteen percent of patients were hospitalized for management of edema, 22% for resection of a tumor cyst or new tumor bulk, and 2% for shunting to treat hydrocephalus throughout the course of their disease. Of the patients still alive, Karnofsky Performance Scale scores remained stable in 90% of patients and decreased by 1–3 grades in 10% due to symptomatic treatment-related imaging changes.CONCLUSIONSLERS is a safe and effective upfront adjunctive therapy for patients with newly diagnosed GBM. Limitations of this study include a single-center experience and single-institution determination of the LE tumor target. Use of a leading-edge calculation algorithm will be described to achieve a consistent approach to defining the LE target for general use. A multicenter trial will further elucidate its value in the treatment of GBM.
Microinvasive tumor endoresection in combination with ocular stereotactic radiosurgery
Authors: Sinyavskiy Oleg A. , Troyanovsky Roman L. , Ivanov Pavel I. , Golovin Alexandr S. , Tibilov Andrey V. , Solonina Svetlana N. , Astapenko Anna M. , Zubatkina Irina S. 
Published: April 2019

OBJECTIVEThe use of Gamma Knife radiosurgery (GKRS) as monotherapy in the treatment of uveal melanoma (UM) allows clinicians to achieve high local tumor control with low recurrence but does not prevent secondary enucleation due to glaucoma in cases of large tumors. The authors analyzed indications for tumor endoresection (ER), the time interval between irradiation and surgery, and the features and results of performing ER for UM after GKRS.METHODSThirty-seven patients between 28 and 78 years of age (16 male and 11 female patients) with UM underwent GKRS with a dose of 70 to 80 Gy that was applied to the center of the tumor with complete immobilization of the eye during the procedure. Tumor resection with histological investigation was performed in 24 eyes (transscleral resection was performed in 3 eyes, and ER was performed in 21 eyes) at 3 to 97 days after GKRS, mainly during the first 2 or 3 weeks. As a rule, ER (21 eyes) was performed to treat large, centrally localized, or equatorial UMs with exudative macula-on retinal detachment that reduced vision. The average tumor height was 8.9 mm, and the average width was 13.7 mm at the base. ER for UM included phacoemulsification, microinvasive vitrectomy with transretinal tumor resection, laser photocoagulation, and application of a temporary silicone oil tamponade. Seven patients received intraocular injections of inhibitors of angiogenesis for the prevention and treatment of radiation neuroretinopathy. The follow-up period ranged from 8 to 41 months.RESULTSPreservation of the eyes without tumor recurrence was achieved in all 37 patients after GKRS (monotherapy and combined therapy). One patient died of liver metastases at 21 months after GKRS. In the ER group (21 eyes), drug-resistant glaucoma with low visual acuity appeared in 4 eyes (19%) with long-existing total exudative retinal detachment and delayed operations. Severe radiation neuroretinopathy with macular edema occurred in 4 of 21 cases (19%). Intraocular injections of inhibitors of angiogenesis significantly decreased retinal edema. Residual rhegmatogenous retinal detachment was revealed in 1 eye (4.8%). The conservation of the patient's primary vision or its improvement were observed in 11 eyes (52.4%). Useful vision more than 0.1 was achieved in 12 cases (57%), and more than 0.3 was achieved in 8 cases (38%).CONCLUSIONSAs a result of this research, ER for UM after GKRS proved to be an effective method of combined eye-conserving treatment for large centrally localized or equatorial tumors at high risk of the emergence and development of toxic tumor syndrome. Perfect eye immobilization, timely ER, and multiple intraocular injections of inhibitors of angiogenesis saved not only the eye in all cases, but also useful vision in many cases. Close cooperation among radiosurgeons, ophthalmologists, and vitreoretinal surgeons is the key to effective treatment.
Comprehensive anatomy of the foramen ovale critical to percutaneous stereotactic radiofrequency rhizotomy: cadaveric study of dry skulls
Authors: Elnashar Adel , Patel Smruti K. , Kurbanov Almaz , Zvereva Kseniya , Keller Jeffrey T. , Grande Andrew W. 
Published: April 2019

OBJECTIVEPercutaneous stereotactic radiofrequency rhizotomy (PSR) is often used to treat trigeminal neuralgia, a serious condition that results in lancinating, episodic facial pain. Thorough understanding of the microsurgical anatomy of the foramen ovale (FO) and its surrounding structures is required for efficient, effective, and safe use of this technique. This morphometric study compares anatomical and surgical orientations to identify the variations of the FO and assess cannulation difficulty.METHODSBilateral foramina from 174 adult human dry skulls (348 foramina) were analyzed using anatomical and surgical orientations in photographs from standardized projections. Measurements were obtained for shape, size, adjacent structures, and morphometric variability effect on cannulation. The risk of potential injury to surrounding structures was also assessed.RESULTSThe authors identified 6 distinctive shapes of the FO and 5 anomalous variants from the anatomical view, and 6 shapes from the surgical view. In measurements of surface area of this foramen obtained using the surgical view, loss (average 18.5% ± 5.7%) was significant compared with the anatomical view. Morphometrically, foramen size varied significantly and obstruction from a calcified pterygoalar ligament occurred in 7.8% of specimens. Importantly, 8% of foramina were difficult to cannulate, thus posing a 12% risk of inadvertent cannulation of the foramen lacerum.CONCLUSIONSSignificant variability in the FO’s shape and size probably affected its safe and effective cannulation. Preoperative imaging by 3D head CT may be helpful in predicting ease of cannulation and in guiding treatment decisions, such as a percutaneous approach over microvascular decompression or radiosurgery.
Clinical outcome of V-Y flap with latissimus dorsi and gluteal advancement for treatment of large thoracolumbar myelomeningocele defects: a comparative study
Authors: Masoudi Mohammad Sadegh , Hoghoughi Mohammad Ali , Ghaffarpasand Fariborz , Yaghmaei Shekoofeh , Azadegan Maryam , Ilami Ghazal 
Published: April 2019

OBJECTIVESurgical repair and closure of myelomeningocele (MMC) defects are important and vital, as the mortality rate is as high as 65%–70% in untreated patients. Closure of large MMC defects is challenging for pediatric neurosurgeons and plastic surgeons. The aim of the current study is to report the operative characteristics and outcome of a series of Iranian patients with large MMC defects utilizing the V-Y flap and with latissimus dorsi or gluteal muscle advancement.METHODSThis comparative study was conducted during a 4-year period from September 2013 to October 2017 in the pediatric neurosurgery department of Shiraz Namazi Hospital, Southern Iran. The authors included 24 patients with large MMC defects who underwent surgery utilizing the bilateral V-Y flap and latissimus dorsi and gluteal muscle advancement. They also retrospectively included 19 patients with similar age, sex, and defect size who underwent surgery using the primary or delayed closure techniques at their center. At least 2 years of follow-up was conducted. The frequency of leakage, necrosis, dehiscence, systemic infection (sepsis, pneumonia), need for ventriculoperitoneal shunt insertion, and mortality was compared between the 2 groups.RESULTSThe bilateral V-Y flap with muscle advancement was associated with a significantly longer operative duration (p < 0.001) than the primary closure group. Those undergoing bilateral V-Y flaps with muscle advancement had significantly lower rates of surgical site infection (p = 0.038), wound dehiscence (p = 0.013), and postoperative CSF leakage (p = 0.030) than those undergoing primary repair. The bilateral V-Y flap with muscle advancement was also associated with a lower mortality rate (p = 0.038; OR 5.09 [95% CI 1.12–23.1]) than primary closure. In patients undergoing bilateral V-Y flap and muscle advancement, a longer operative duration was significantly associated with mortality (p = 0.008). In addition, surgical site infection (p = 0.032), wound dehiscence (p = 0.011), and postoperative leakage (p = 0.011) were predictors of mortality. Neonatal sepsis (p = 0.002) and postoperative NEC (p = 0.011) were among other predictors of mortality in this group.CONCLUSIONSThe bilateral V-Y flap with latissimus dorsi or gluteal advancement is a safe and effective surgical approach for covering large MMC defects and is associated with lower rates of surgical site infection, dehiscence, CSF leakage, and mortality. Further studies are required to elucidate the long-term outcomes.
Lumbar laminotomy for the intrathecal administration of nusinersen for spinal muscular atrophy: technical note and outcomes
Authors: Ko Diana , Blatt Daniel , Karam Chafic , Gupta Kunal , Raslan Ahmed M. 
Published: April 2019

Nusinersen (Spinraza) is a US Food and Drug Administration–approved intrathecal medication for the treatment of spinal muscular atrophy (SMA). Adult patients with SMA often undergo thoracolumbar fusion to treat neurogenic scoliosis, preventing thecal access. The authors report a laminotomy technique and the ease of intrathecal access in three SMA patients with prior thoracolumbar fusions.Patients were positioned in the lateral decubitus position or prone. Lumbar laminotomy was performed below the conus, between the lateral longitudinal rods, to preserve mechanical stability. Fluoroscopy provided real-time identification of instruments. Hardware was contoured with a carbide drill bit to develop the surgical window. Fiducial screws were placed along the perimeter for demarcation. Sublaminar wire removal caused dural defects that were repaired with a layer of dural substitute onlay and sealant. All patients successfully received nusinersen thecal injections via lumbar puncture by an interventional radiologist. Fluoroscopy time ranged from 6 to 36 seconds. No postoperative pseudomeningoceles, cerebrospinal fluid leaks, or wound complications occurred.For patients with SMA and posterior fusion from prior scoliosis treatment, lumbar laminotomy is an effective method for creating thecal access for the administration of nusinersen.
Understanding quality of life and treatment history of patients with Bertolotti syndrome compared with lumbosacral radiculopathy
Authors: Golubovsky Joshua L. , Momin Arbaz , Thompson Nicolas R. , Steinmetz Michael P. 
Published: April 2019

OBJECTIVEBertolotti syndrome is a rare spinal condition that causes low-back pain due to a lumbosacral transitional vertebra (LSTV), which is a pseudoarticulation between the fifth lumbar transverse process and the sacral ala. Bertolotti syndrome patients are rarely studied, particularly with regard to their quality of life. This study aimed to examine the quality of life and prior treatments in patients with Bertolotti syndrome at first presentation to the authors’ center in comparison with those with lumbosacral radiculopathy.METHODSThis study was a retrospective cohort analysis of patients with Bertolotti syndrome and lumbosacral radiculopathy due to disc herniation seen at the authors’ institution’s spine center from 2005 through 2018. Diagnoses were confirmed with provider notes and imaging. Variables collected included demographics, diagnostic history, prior treatment, patient-reported quality of life metrics, and whether or not they underwent surgery at the authors’ institution. Propensity score matching by age and sex was used to match lumbosacral radiculopathy patients to Bertolotti syndrome patients. Group comparisons were made using t-tests, Fisher’s exact test, Mann-Whitney U-tests, Cox proportional hazards models, and linear regression models where variables found to be different at the univariate level were included as covariates.RESULTSThe final cohort included 22 patients with Bertolotti syndrome who had patient-reported outcomes data available and 46 propensity score–matched patients who had confirmed radiculopathy due to disc herniation. The authors found that Bertolotti syndrome patients had significantly more prior epidural steroid injections (ESIs) and a longer time from symptom onset to their first visit. Univariate analysis showed that Bertolotti syndrome patients had significantly worse Patient-Reported Outcomes Measurement Information System (PROMIS) mental health T-scores. Adjustment for prior ESIs and time from symptom onset revealed that Bertolotti syndrome patients also had significantly worse PROMIS physical health T-scores. Time to surgery and other quality of life metrics did not differ between groups.CONCLUSIONSPatients with Bertolotti syndrome undergo significantly longer workup and more ESIs and have worse physical and mental health scores than age- and sex-matched patients with lumbosacral radiculopathy. However, both groups of patients had mild depression and clinically meaningful reduction in their quality of life according to all instruments. This study shows that Bertolotti syndrome patients have a condition that affects them potentially more significantly than those with lumbosacral radiculopathy, and increased attention should be paid to these patients to improve their workup, diagnosis, and treatment.
ANALISIS 〖SF〗_6 PADA SEALINGEND TERHADAP TEKANAN MOISTURE CONTENT DAN DEWPOINT GIS KIARACONDONG
Authors: Pratama Irvan Aditia , Arfianto Teguh 
Published: April 2019

Gas Insulated Substation (GIS) didefinisikan sebagai rangkaian beberapa peralatan yang terpasang di dalam sebuah metal enclosure dan diisolasi oleh gas bertekanan.Pada umumnya gas bertekanan yang digunakan adalah Sulfur Hexafluoride ( ). Berdasarkan uraian diatas maka penulis ingin menguji dan menganalisis kualitas gas pada GIS untuk tetap menjaga dan meningkatkan keandalan pada GIS . metode yang dilakukan adalah mengihitung nilai dew point , moisture content dan menghitung laju penurunan tekanan gas pada Sealingend serta membandingkanya dengan standar Internasional. Pada penelitian ini penulis mendapat hasil nilai dewpoint -44 °C pada pole A dan Pole B ini menunjukan bahwa nilai dewpoint masih sesuai dengan standar internasional yaitu <-5 °C dan pada hasil penurunan tekanan pole A dan pole B mendapat hasil penurunan sebesar 26,10% dan 0 % ini mengindikasikan bahwa pada kompartement sealing end pole A mengalami kebocoran karena sudah tidak sesuai dengan standar laju kebocoran yaitu <1% sehingga akan berpengaruh kepada kualitas gas ,akan tetapi untuk pole B masih sesuai dengan standar yang berlaku. Sehingga untuk nilai kandungan dewpoint dan moisture content pada sealingend masih sesuai standar akan tetapi sealing end pole A sudah mengalami kebocoran .
ANALISIS TRANSPORTASI TERHADAP PENERAPAN ARUS LALU LINTAS SATU ARAH
Authors: Ishak Ishak 
Published: April 2019

Perubahan arus lalulintas satu arah (One Way Street) pada ruas jalan yang diterapkan Pemerintah Kota Jambi tentunya akan berimbas pada pengguna jalan yang semakin meningkat karena menghubungkan ke jalan utama. Dengan semakin meningkatnya para pengguna jalan (kendaraan bermotor) maka akan mempengaruhi kinerja dan tingkat pelayanan jalan tersebut. Metodologi penelitian yang digunakan dalam penelitian ini memiliki tahapan-tahapan, mulai dari studi literatur dan pengumpulan data secara primer dan sekunder. Selanjutnya pengumpulan data hambatan samping dilakukan dengan menghitung dan mencatat jumlah aktivitas samping jalan pada lokasi penelitian selama periode pengamatan yang dilakukan oleh beberapa surveyor. Hasil perhitungan kecepatan arus bebas Kol. Amir Hamzah yang menggunakan arus satu arah didapat sebesar 51 km/. Derajat kejenuhan ( DS) atau tingkat pelayanan jalan satu arah (One Way Street) Kategori C dan Kategori B, berarti arus lalu lintas masih baik (lancar)
PENGARUH VARIASI PENAMBAHAN ABU SERBUK GERGAJI KAYU PADA PASTA SEMEN TERHADAP UJI BAHAN SEMEN
Authors: Hepiyanto Rasio , Arif Samsul 
Published: April 2019

ABSTRAKSemen adalah suatu jenis bahan yang memiliki sifat adhesif dan kohesif yang memungkinkan melekatnya fragmen-fragmen mineral menjadi satu massa yang padat. Meskipun definisi ini dapat diterapkan untuk banyak jenis bahan, semen yang dimaksudkan untuk konstruksi beton adalah bahan jadi dan mengeras dengan adanya air yang dinamakan semen hidraulis. Hidraulis berarti semen bereaksi dengan air dan membentuk suatu bahan massa Komposisi kimia semen portland pada umumnya terdiri dari CaO, SiO2,Al2O3 dan Fe2O3, yang merupakan oksida dominan. Sedangkan oksida lain yang jumlahnya hanya beberapa persen dari berat semen adalah MgO, SO3, Na2O dan K2O. Variasi penambahan campuran serbuk kayu berpengaruh terhadap waktu pengikatan awal sedangkan pada waktu pengikatan akhir pasta semen tidak berpengaruh (ada pengaruh tapi sangat kecil) Penambahan prosentase serbuk kayu selalu menunjukan adanya penambahan terhadap waktu pengikatan awal maupun akhir pasta semen hal ini terlihat pada hubungan waktu ikat dan prosentase semen.Kata kunci: Beton Campuran,Serbuk kayu, Semen,Konsistensi semen, waktu ikat semen
ANALISIS STRAIN HARDENING DENGAN VARIASI MEDIA QUENCHING DALAM MENINGKATKAN MUTU PRODUK PENGRAJIN PANDAI BESI SUNGAI PUAR, KAB. AGAM SUMATERA BARAT
Authors: Armila Armila 
Published: April 2019

Blacksmith at Sungai Puar Region was decreasing caused by low quality and global marked. China’s product more cheaper n hight quality. Heat Treatment process not worked as metallurgy rules, its still in traditional working. Mechanical properties such, toughness, strength, hardness strength can easily be modified by heat treating for medium carbon steel, were subjected to various forms of heat treatment processes like hardening and tempering. Samples were austenitised at 850-9000C followed by holding times and finally they were quenched in salt water, oil, and fresh water. The specimen with the highest hardness was found in samples quenched in salt water, they are 869,66 VHN in salt water, 605.52 in oil, and 652 VHN in fresh water. Its because salt water have hight density n low viscosity were sample cooled fast, and martensite structure obtained, and hardness increased. Micro Vickers hardness used for samples. Behavior of hight hardness quenched in salt water must be learning more, to measure corrosion rate and toughness.