bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep brain stimulation in Latin America in comparison with the US and Europe in a real-world population: indications, demographics, techniques, technology, and adverse events
Authors: Lopez Rios Adriana Lucia , Piedimonte Fabián , Arango Gabriel J. , Teixeira Manoel J. , Arellano-Reynoso Alfonso , Del Carmen César Griselda , Carmona Hans , Ciampi de Andrade Daniel , Aníbal Restrepo-Bravo Carlos , Gloria Escobar Jose Miguel , Xiong Hui , Martínez Ricardo , Weaver Todd 
Published: July 2024

OBJECTIVE
The aim of this study was to provide geographic comparisons of deep brain stimulation (DBS) procedures in Latin America with the US and Europe regarding primary indications, demographic information, clinical and device-related adverse events, technology used, and patient outcomes using the Medtronic Product Surveillance Registry data as of July 31, 2021.

METHODS
Two thousand nine hundred twelve patients were enrolled in the registry (2782 received DBS and 1580 are currently active). Fourteen countries contributed 44,100 years of device experience to the registry. DBS centers in Latin America are located in Colombia (n = 3), Argentina (n = 1), Brazil (n = 1), and Mexico (n = 1). Fisher’s exact test was used to compare the difference in proportions of categorical variables between regions. The Wilcoxon signed-rank test was used for the EQ-5D index score change from baseline to follow-up.

RESULTS
The most common indication for DBS was Parkinson’s disease across all regions. In Latin America, dystonia was the second most common indication, compared to essential tremor in other regions. There was a striking finding with respect to age—patients were an average of 10 years younger at DBS implantation in Latin America. This difference was most likely due to the greater number of patients with dystonia receiving the device implants. The intraoperative techniques were quite similar, showing the same level of quality and covering the main principles of the surgeries with some variations in the brand of frames, planning software, and microrecording systems. Rechargeable batteries were significantly more common in Latin America (72.37%) than in the US (6.44%) and Europe (9.9%). Staging of the DBS procedure differed, with only 11.84% in Latin America staging the procedure compared with 97.58% and 34.86% in the US and Europe, respectively. The EQ-5D score showed significant improvements in all regions during the first 6–12 months (p < 0.0001). However, the 24-month follow-up only showed an improvement in the scale for Latin America (p < 0.0001).

CONCLUSIONS
DBS was performed in Latin America with similar indications, techniques, and technology as in the US and Europe. Important differences were found, with Latin America implementing more regular use of rechargeable devices, including younger patients at the time of surgery, and showing more sustained quality of life improvements at 24 months of follow-up. The authors hypothesize that these disparities stem from differences in resources among regions. However, more studies are needed to standardize DBS practice across the world to improve patients’ quality of life and provide high-quality care.
Derivation of the Quebec Brain Injury Categories for complicated mild traumatic brain injuries
Authors: Tourigny Jean-Nicolas , Boucher Valérie , Dubucs Xavier , Malo Christian , Mercier Éric , Chauny Jean-Marc , Clark Gregory , Blanchard Pierre-Gilles , Carmichael Pierre-Hugues , Gariépy Jean-Luc , D’Astous Myreille , Émond Marcel 
Published: July 2024

OBJECTIVE
Approximately 10% of patients with mild traumatic brain injury (TBI) present with intracranial bleeding, and only 3.5% eventually require neurosurgical intervention, which often necessitates interhospital transfer. Better guidelines and recommendations are needed to manage complicated mild TBI in the emergency department (ED). The main objective of this study was to derive a clinical decision rule, the Quebec Brain Injury Categories (QueBIC), to predict the risk of adverse outcomes for complicated mild TBI in the ED. The secondary objective was to compare the QueBIC’s performance with those of other existing guidelines.

METHODS
The authors conducted a retrospective multicenter cohort study in 3 level I trauma centers. Consecutive patients with complicated mild TBI (Glasgow Coma Scale [GCS] score 13–15) who were aged ≥ 16 years were included. The primary outcome was a combination of neurosurgical intervention, mild TBI–related death, and clinical deterioration. Statistical analyses included set covering machine analyses.

RESULTS
In total, 477 patients were included in the study. The mean age was 62.9 years, and 68.1% were male. The algorithm classified patients into three risk categories (low, moderate, and high risk). The high-risk group (128 patients) (subdural hemorrhage [SDH] width > 7 mm or any midline shift) presented a sensitivity of 84% (95% CI 71%–93%) and a specificity of 80% (95% CI 76%–84%) to detect neurosurgical intervention and mild TBI–related death, leaving 8 undetected cases. Patients in the moderate-risk group (169 patients) had at least 1 variable: SDH width > 4 mm, initial GCS score ≤ 14, > 1 intraparenchymal hemorrhage, or intraparenchymal hemorrhage width > 4 mm. The combined QueBIC high- and moderate-risk category had a sensitivity of 100% (95% CI 63%–100%) and a specificity of 53% (95% CI 47%–58%) to detect mild TBI–related death or neurosurgical intervention. The sensitivity and specificity values for clinical deterioration when no death or neurosurgical intervention occurred were 81% (95% CI 64%–93%) and 44% (95% CI 39%–49%), respectively. The remaining 180 patients (37.7%) did not meet any high-risk or moderate-risk criteria and were considered low risk. None had neurosurgical intervention or mild TBI–related death. Only 6 (3.3%) low-risk patients showed clinical deterioration.

CONCLUSIONS
QueBIC is a safe and effective tool to guide the management of patients presenting to the ED with complicated mild TBI. It accurately identifies patients at low risk for specialized neurotrauma or neurosurgical care. Further validation is required before its use in EDs.
An analysis of potentially avoidable neurosurgical transfers to a tertiary-care level I trauma center
Authors: Marks Clifford M. , Burke Ryan C. , Stippler Martina , Rosen Carlo L. 
Published: July 2024

OBJECTIVE
Previous studies of neurosurgical transfers indicate that substantial numbers of patients may not need to be transferred, suggesting an opportunity to provide more patient-centered care by treating patients in their communities, while probably saving thousands of dollars in transport and duplicative workup. This study of neurosurgical transfers, the largest to date, aimed to better characterize how often transfers were potentially avoidable and which patient factors might affect whether transfer is needed.

METHODS
This was a retrospective cohort study of neurosurgical transfers to an urban, tertiary-care, level I trauma center between October 1, 2017, and October 1, 2022. Prior to data analysis, the authors devised criteria to differentiate necessary neurosurgical transfers from potentially avoidable ones. A transfer was considered necessary if 1) the patient went to the operating room within 12 hours of arrival at the emergency department (ED); 2) a neurological MRI study was conducted in the ED; 3) the patient was admitted to the ICU from the ED; or 4) the patient was admitted to either neurology or a surgical service (including neurosurgery). Transfers not meeting any of the above criteria were deemed potentially avoidable. Patient and clinical characteristics, including diagnostic groupings from Clinical Classification Software categories, were collected retrospectively via electronic health record data abstraction and stratified by whether the transfer was necessary or potentially avoidable. Statistical differences were assessed with a chi-square test.

RESULTS
A total of 5113 neurosurgical transfers were included in the study, of which 1701 (33.3%) were classified as potentially avoidable. Four percent of all transferred patients went to the operating room within 12 hours of reaching the receiving ED, 23.4% were admitted to the ICU from the ED, 26.6% had a neurological MRI study performed in the ED, and 54.4% were admitted to a surgical service or to neurology. Potentially avoidable transfers had a higher proportion of traumatic brain injury, headache, and syncope (p < 0.0001), as well as of spondylopathies/spondyloarthropathies (p = 0.0402), whereas patients needing transfer had a higher proportion of acute hemorrhagic cerebrovascular disease and cerebral infarction (p < 0.0001).

CONCLUSIONS
This study demonstrates that a large number of neurosurgical transfers can probably be treated in their home hospitals and highlights that the vast majority of patients transferred for neurosurgical conditions do not receive emergency neurosurgery. Further research is needed to better guide transferring and receiving facilities in reducing the burden of excessive transfers.
The impact of the Woven EndoBridge device on the treatment of anterior circulation wide-neck bifurcation aneurysms: a single-center experience
Authors: El Naamani Kareem , Momin Arbaz A. , Mouchtouris Nikolaos , Hunt Adam , Lawall Charles L. , Ghanem Marc , Koorie Morena Paula , El-Hajj Jad , Vinjamuri Shreya , Alhussein Abdulaziz , AlHussein Ruyof , Tjoumakaris Stavropoula I. , Gooch M. Reid , Rosenwasser Robert H. , Jabbour Pascal M. 
Published: July 2024

OBJECTIVE
The paucity of literature comparing Woven EndoBridge (WEB) embolization to microsurgical clipping for anterior circulation wide-neck bifurcation aneurysms (WNBAs) underscores the need for further investigation into the optimal management of this patient subpopulation. The objective of this study was to compare the rate of endovascular and microsurgical treatment of WNBAs before and after the introduction of the WEB device. In addition, the authors performed a comparison of demographics, aneurysm characteristics, and treatment outcomes in patients before and after the introduction of the WEB device.

METHODS
This study was a retrospective review of the usage rate of different treatment modalities for WNBAs before and after the WEB device was approved by the US FDA on September 27, 2018.

RESULTS
The study cohort comprised 235 patients with anterior circulation WNBAs treated at the authors’ institution, including 127 aneurysms treated pre-WEB and 108 treated post-WEB. Generally, the rate of endovascular treatment of anterior circulation WNBAs was significantly higher post-WEB (86.1% vs 46.5%, p < 0.001), while the rate of clipping was significantly lower (13.9% vs 53.5%, p < 0.001). During follow-up, the rate of adequate aneurysm occlusion (Raymond-Roy occlusion classification [RROC] grades 1 and 2) was nonsignificantly higher in the post-WEB cohort (83.9% vs 78.5%, p = 0.34), while the rate of RROC grade 3 was nonsignificantly higher in the pre-WEB cohort (21.5% vs 16.1%, p = 0.34). Additionally, and although nonsignificant, the rates of recurrence (pre-WEB 25.3% vs post-WEB 14.9%, p = 0.12) and retreatment (pre-WEB 22.8% vs post-WEB 14.9%, p = 0.22) were higher in the pre-WEB cohort. Recurrence was assessed before retreatment.

CONCLUSIONS
After the introduction of the WEB device, the rate of endovascular treatment of WNBAs increased while the rate of microsurgical clipping decreased. It is essential for neurointerventionalists to become familiar with the indications, advantages, and shortcomings of all these different techniques to be able to match the right patient with the right technique to produce the best outcome.
In-hospital outcomes following surgery versus conservative therapy in elderly patients with C2 fractures: a propensity score–matched analysis
Authors: Jiang Sam H. , Wang Ryan K. , Sadeh Morteza , Almadidy Zayed , Mehta Ankit I. , Chaudhry Nauman S. 
Published: July 2024

OBJECTIVE
Second cervical vertebrae (C2) fractures are a common traumatic spinal injury in the elderly population. Surgical fusion and nonoperative bracing are two primary treatments for cervical instability, but the former is often withheld in the elderly due to concerns for poor postoperative outcomes arising from patient frailty. This study sought to evaluate the in-hospital differences in mortality, outcomes, and discharge disposition in elderly patients with C2 fractures undergoing surgical intervention compared with conservative therapy.

METHODS
The National Trauma Data Bank was queried from 2017 to 2019 for all patients aged ≥ 65 years with C2 fractures undergoing either surgical stabilization or conservative therapy. Propensity score matching was performed using k-nearest neighbors with replacement based on patient demographics, comorbidities, insurance type, injury severity, and fracture type. Group differences were compared using Student t-tests and Pearson’s chi-square tests with Benjamini-Hochberg multiple comparisons correction. Subgroup analyses were performed in the 65–74, 75–79, and 80+ year age subgroups.

RESULTS
Six thousand forty-nine patients were identified, of whom 2156 underwent surgery and 3893 received conservative treatment. Following matching, the surgery group had significantly lower mortality rates (5.52% vs 9.6%, p < 0.001), a longer mean hospital length of stay (LOS; 12.64 vs 7.49 days p < 0.001), and slightly higher rates of several complications (< 3% difference), as well as lower rates of discharge home (14.56% vs 23.52%, p < 0.001) and to hospice (1.07% vs 2.09%, p = 0.02) and a higher rate of discharge to intermediate care (68.83% vs 48.28%, p < 0.001). Similar trends in mortality and LOS were noted in all 3 subgroups.

CONCLUSIONS
In elderly patients with C2 fractures, surgical stabilization confers a small survival advantage with a slightly higher in-hospital complication rate compared to conservative therapy. The increased rate of discharge to rehabilitation may represent better long-term prognosis following surgery. The increased risk of short-term complications is present but relatively small, thus surgery should not be withheld in patients with good long-term prognosis.
Sleep-disordered breathing in children with Chiari type I malformation
Authors: Jarrell Matthew , Caudill Caroline , Haji Faizal , Leon Tofey , Rozzelle Curtis J. , Maddox Mary Halsey , Rocque Brandon G. 
Published: July 2024

OBJECTIVE
The objective was to identify clinical and radiological factors associated with sleep-disordered breathing (SDB) in children with Chiari type I malformation (CIM) and to evaluate the efficacy of foramen magnum decompression (FMD) in resolving SDB.

METHODS
A retrospective chart review was conducted for all children evaluated for CIM at a single institution from 2002 to 2022, identifying all children who had undergone nocturnal polysomnography (PSG). Apnea-hypopnea index (AHI) score, sleep apnea type (obstructive, central, mixed, and unspecified), clinical manifestations, and radiological measurements were recorded. SDB was considered present when officially diagnosed in the PSG report. Logistic regression was performed to identify factors correlating with the presence of SDB. For children with SDB who underwent FMD, the Wilcoxon signed-rank test was used to assess AHI improvement.

RESULTS
Of the 997 children referred for CIM, 310 completed PSG. SDB was diagnosed in 147 patients (overall prevalence 14.7%, 95% CI 12.7%–17.1%; prevalence among children with PSG 47.4%, 95% CI 41.9%–53%). Specific SDB diagnosis consisted of 33% of patients with central sleep apnea, 27% with obstructive sleep apnea, 9% mixed, and 31% unspecified. Lower cranial nerve (CN) dysfunction (OR 3.891, p = 0.009), tonsillar position (OR 1.049, p = 0.017), Chiari type 1.5 malformation (OR 1.862, p = 0.044), and BMI (OR 1.039, p = 0.036) were significantly associated with presence of SDB. Of the 310 patients who underwent PSG, 47 were originally categorized as asymptomatic: 27 (57%) of these asymptomatic patients were diagnosed with SDB on PSG. Of children diagnosed with SDB, 34 completed PSG before and after FMD. Median AHI score decreased from 6.5 preoperatively to 1.8 postoperatively, with a median (IQR) difference of −2.3 (−11.9 to 0.1) (p = 0.001). Twelve (35%) had resolution of SDB.

CONCLUSIONS
The authors’ findings suggest that the prevalence of SDB in children with CIM is high (15%–47%). Furthermore, lower CN dysfunction, Chiari type 1.5, lower tonsillar position, and higher BMI may be risk factors. Notably, SDB can be present even in the absence of clinical symptoms. This study also demonstrates that surgical intervention has the potential to reduce the severity of SDB. These results could help clinicians identify CIM patients at risk for SDB and those who may benefit from surgical decompression.
Pengaruh Lab Matematika Virtual Terhadap Hasil Belajar Matematika Siswa SDN 80 Parepare
Authors: Denny Kurniawan  , Nurhaedah P  
Published: July 2024

This study aims to determine that the use of the Lab Matematika Virtual application has a positive effect on mathematics learning outcomes for grade V students of UPTD SD Negeri 80 Parepare. This type of research is a quasi-experiment without a control class which is carried out in one group. The variables studied in this study were the mathematics learning outcomes of class V students of UPTD SD Negeri 80 Parepare as the dependent variable and learning by using the Lab Matematika Virtual application as the independent variable.
The population of this research is all students of class V UPTD SD Negeri 80 Parepare for the academic year 2021/2022. Sampling was done by saturation sampling, the sample of this research is all students of class V. The instruments used in this research are learning outcomes tests and student response questionnaires that have been validated. Based on descriptive statistical analysis, the average value of mathematics learning outcomes before learning using the Lab Matematika Virtual application is 10 and the average value of mathematics learning outcomes after learning using the Lab Matematika Virtual application is 65,71. So it can be concluded that the use of the Lab Matematika Virtual application has a positive effect on mathematics learning outcomes in class V students of UPTD SD Negeri 80 Parepare.
Pengelolaan Sampah dalam Sudut Pandang Administrasi Publik pada Kabupaten Tabalong
Authors: Ifansyah Muhammad Noor 
Published: July 2024

Permasalahan sampah di Indonesia terus menjadi persoalan yang belum dapat sepenuhnya diatasi. Pertumbuhan timbulan sampah di Indonesia selama tiga tahun terakhir 2020-2023 terus mengalami peningkatan yaitu berjumlah sebesar 37.370.425 Ton/thn . Dalam ranah global pengelolaan sampah merupakan kerangka Tujuan Pembangunan Berkelanjutan Perserikatan Bangsa-Bangsa. Berdasarkan beberapa penelitian terdahulu menunjukkan bahwa pengelolaan sampah erat kaitannya dengan pencapaian beberapa tujuan pembangunan berkelanjutan. Penelitian ini bertujuan mengetahui pengelolaan sampah dalam sudut pandang administrasi publik dilihat dari kontek good governance. Penelitian ini didesain menggunakan studi pustaka yang secara teoritis, studi pustaka. Analisis dilakukan dengan menggunakan konsep triangulasi data dari berbagai sumber pustaka yang ditemukan dengan mengacu pada pemikiran model analisis interaktif yang dikembangkan oleh (Miles, Matthew B. Huberman, A Michael. Saldana, 2014). Hasil analisis kemudian dijadikan rangkuman yang dapat ditarik kesimpulan tentang topik penelitian. Kebijakan pengelolaan sampah yang telah ada di Kabupaten Tabalong sangatlah penting dalam menjamin berlangsungnya pengelolaan sampah yang berkelanjutan. Sehingga dengan adanya kebijakan yang mengatur tentang pengelolaan sampah memainkan peran penting dalam upaya memerangi timbulan sampah yang terus bertambah. Di Nola et al., dalam penelitiannya menyarankan model pendekatan dinamis dalam pembuatan kebijakan pengelolaan sampah berkelanjutan. Bahkan Manaf, et al. menekankan pada restrukturisasi lembaga dan penyusunan kebijakan baru perlu dibuat dalam rangka membangun sistem pengelolaan sampah yang holistik, terintegrasi dan hemat biaya. Pada pengelolaan sampah pada Kabupaten Tabalong Pemerintah Kabupaten Tabalong melimpahkan kegiatan persampahan pada Dinas Lingkungan Hidup yang kemudian melibatkan masyarakat sebagai pelaku utama kegiatan. Sampah yang telah dipilah tidak akan memiliki nilai apabila pengepul tidak bersedia membeli. Sehingga guna memberikan jaminan keberlangsungan sirkulasi penjualan pilah sampah, Dinas Lingkungan Hidup terus memberikan pendampingan dan bekerjasama dengan pengepul. Sehingga sangat penting bagi masyarakat mengetahui kegiatan pengelolaan sampah yang telah dilakukan dan akan meningkatkan partisipasi masyarakat.
THE EFFECT OF STAD TYPE COOPERATIVE LEARNING MODEL ASSITED BY VIDEO MEDIA ON STUDENT LEARNING OUTCOMES ON REACTION RATE MATERIAL IN HIGH SCHOOL
Authors: Napitupulu Rahel Ronauli Kurniaasih , Silaban Ramlan , Nurfajriani Nurfajriani , Nainggolan4 Bajoka , Simatupang Lisnawaty 
Published: July 2024

: This study aims to determine the effect of the Stad Type Cooperative learning model assisted by video media on student learning outcomes on reaction rate material in high school. This research was conducted with a quasi-experimental method of two group pretes-posttes design. The sampling technique used random sampling technique. The research sample consisted of two classes, namely XI-IPA1 and XI-IPA2 classes, each consisting of 31 students. Class XI-IPA1 was the experimental class taught using the stad type cooperative learning model. While class XI-IPA2 was the control class taught with conventional learning. The research instruments used were non-test and test. The test instrument was used to determine the knowledge of students in the cognitive domain, as many as 20 items with four choices that have been tested for feasibility. The non-test instrument used is a questionnaire to measure student learning independence. The pretest and post-test data of student learning outcomes in the experimental class were 40.5 and 84.5 while the control class data were 40.7 and 67.5. The percentage increase in n-Gain of student learning outcomes in the experimental class was 75% with a high category and the control class was 47% respectively with a medium category. Meanwhile, the percentage increase in N-gain of student learning independence in the experimental and control classes was 71% and 51% in the high and medium categories. There is a positive correlation between student learning independence and student learning outcomes, namely 0.635 with a moderate category.
DIGITAL TEXTBOOK OF ENGINEERING MECHANICS WITH A SCIENCE PROCESS AND ETHNOSCIENCE APPROACH FOR VOCATIONAL COLLEGE STUDENTS
Authors: Polonia Betti Ses Eka , Ravi Ahmad 
Published: July 2024

Students at the vocational higher education level prepare to become graduates and are ready to be used by industry. The objectives of vocational higher education are to develop other skills and valuable training for students facing the industry world in the future. This skill is called scientific skill. Students need to be involved in various appropriate activities in the learning process to develop students' scientific skills. Students need scientific skills to design their work steps, process skills, and report practicum results in reports and presentations. Ethnoscience is related to the culture of a society. It contains local or original science, where knowledge has become part of a society's culture and is passed down from generation to generation. Students learn by integrating scientific science with original science so that students make more sense in learning. Living knowledge in society can be transformed into scientific knowledge and used as a good learning resource for students. Ethnoscience-based textbooks can be a suitable learning resource to support culture-based learning activities from the natural environment realized in textbooks and audio-visuals. The validation of ethnoscience-based textbooks obtained 3.28 points over 4, which includes the feasible-to-use category