bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining barriers to care: a retrospective cohort analysis investigating the relationship between hospital volume and outcomes in pediatric patients with cerebral arteriovenous malformations
Authors: Brandel Michael G. , Gonzalez Hernan , Gonda David D. , Levy Michael L. , Smith Edward R. , Lam Sandi K. , Couldwell William T. , Steinberg Jeffrey , Ravindra Vijay M. 
Published: May 2024

OBJECTIVE
Comprehensive data on treatment patterns of pediatric cerebral arteriovenous malformations (AVMs) are lacking. The authors’ aim was to examine national trends, assess the effect of hospital volume on outcomes, and identify variables associated with treatment at high-volume centers.

METHODS
Pediatric AVM admissions (for ruptured and unruptured lesions) occurring in the US in 2016 and 2019 were identified using the Kids’ Inpatient Database. Demographics, treatment methods, costs, and outcomes were recorded. The effect of hospital AVM volume on outcomes and factors associated with treatment at higher-volume hospitals were analyzed.

RESULTS
Among 2752 AVM admissions identified, 730 (26.5%) patients underwent craniotomy, endovascular treatment, or a combination. High-volume (vs low-volume) centers saw lower proportions of Black (8.7% vs 12.9%, p < 0.001) and lowest-income quartile (20.7% vs 27.9%, p < 0.001) patients, but were more likely to provide endovascular intervention (19.5%) than low-volume institutions (13.7%) (p = 0.001). Patients treated at high-volume hospitals had insignificantly lower numbers of complications (mean 2.66 vs 4.17, p = 0.105) but significantly lower odds of nonroutine discharge (OR 0.18 [95% CI 0.06–0.53], p = 0.009) and death (OR 0.13 [95% CI 0.02–0.75], p = 0.023). Admissions at high-volume hospitals cost more than at low-volume hospitals, regardless of whether intervention was performed ($64,811 vs $48,677, p = 0.001) or not ($64,137 vs $33,779, p < 0.001). Multivariable analysis demonstrated that Hispanic children, patients who received AVM treatment, and those in higher-income quartiles had higher odds of treatment at high-volume hospitals.

CONCLUSIONS
In this largest study of US pediatric cerebral AVM admissions to date, higher hospital volume correlated with several better outcomes, particularly when patients underwent intervention. Multivariable analysis demonstrated that higher income and Hispanic race were associated with treatment at high-volume centers, where endovascular care is more common. The findings highlight the fact that ensuring access to appropriate treatment of patients of all races and socioeconomic classes must be a focus.
Women’s Struggles through Collective Action in The Gambia, 1950s to 1970
Authors: Janneh Fatou 
Published: May 2024

Women have a long history of organizing collective action in The Gambia. This article argues that, since authorities failed to serve women’s interests, Gambian women resorted to using collective action to overcome their challenges through kafoolu and kompins [women’s grassroots organizations] operating in rural and urban areas. They shifted their efforts towards organizations that focused on social and political change. These women’s organizations grew significantly as they helped women to promote social and economic empowerment. Women cultivated political patronage with male political leaders to achieve their goals. Political leaders who needed popular support to buttress their power under the new republican government cashed in patronage. Despite their efforts in politics, there is very limited research on women’s political contribution to The Gambia, especially through activism. This paper adds much needed data to this discourse by discussing the collective action of Gambian women in their struggles to gain “voice.” Thus, this study relies on primary data from oral interviews. Secondary sources, such as academic journals, and books, provide context to the study.
ANALISIS PENDAPATAN USAHA IKAN NILA (Oreochromis Niloticus) BAKAR DI KOTA TALUK KUANTAN
Authors: Hadi Nariman , Sasmi Meli , Kesambamula Eldipama 
Published: May 2024

Indonesia merupakan negara kepulauan yang memiliki sumber daya perikanan darat dan laut. Ikan Nila (Oreochromis Niloticus) adalah salah satu jenis ikan yang air tawar yang tergolong ekonomis, memiliki daging tebal, rasa yang enak dan digemari masyarakat. Di Kota Taluk Kuantan, Kabupaten Kuantan Singingi, usaha ikan nila bakar mengalami perkembangan yang pesat, banyak yang tertarik untuk menjalankan usaha ini. Penelitian ini bertujuan untuk mengetahui pendapatan, nilai efisiensi dan BEP usaha ikan nila bakar. Masalah yang dihadapi adalah tingginya harga bahan baku, sulitnya mendapatkan ukuran ikan yang homogen dan tingginya tingkat kompetisi dari usaha sejenis. Analisis data yang digunakan yaitu analisis biaya, analisis pendapatan, efisiensi, dan BEP. Kesimpulan, total biaya yang dikeluarkan Rp 393.822,-/produksi, pendapatan kotor Rp 556.667,-/produksi, pendapatan bersih Rp 162.774,-/produksi. Nilai Efisiensi 1,36, artinya setiap Rp. 1,- modal yang dikeluarkan akan diperoleh pendapatan kotor Rp 1,36,- dengan pendapatan bersih Rp 0,36,-/produksi. BEP produksi 5, 6 kg/produksi artinya pengusaha ikan nila bakar harus memproduksi di atas 5, 6 kg untuk memperoleh keuntungan dan sudah tercapai, karena produksi rata-rata adalah 8,0 kg/produksi., Nilai BEP harga Rp. 54.493,-/kg, artinya pengusaha harus menjual ikan nila bakar diatas harga Rp 54.493,-/kg untuk memperoleh keuntungan, sudah tercapai karena harga jual rata-rata saat ini adalah Rp.73.335/kg.
Indonesia is an archipelagic country that has land and sea fisheries resources. Tilapia (Oreochromis Niloticus) is a type of freshwater fish that is classified as economical, has thick flesh, delicious taste and is popular with the public. In Kuantan Taluk City, Kuantan Singingi Regency, the grilled tilapia fish business is experiencing rapid development, many are interested in running this business. This research aims to determine the income, efficiency value and BEP of the grilled tilapia fish business. The problems faced are the high price of raw materials, the difficulty of getting homogeneous fish sizes and the high level of competition from similar businesses. The data analysis used is cost analysis, income analysis, efficiency, and BEP. Conclusion, total costs incurred are IDR 393,822,-/production, gross income IDR 556,667,-/production, net income IDR 162,774,-/production. The Efficiency Value is 1.36, meaning that every Rp. 1.- capital issued will result in a gross income of IDR 1.36,- with a net income of IDR 0.36,-/production. BEP production of 5.6 kg/production means that grilled tilapia entrepreneurs must produce above 5.6 kg to make a profit and this has been achieved, because the average production is 8.0 kg/production. The BEP value is IDR. 54,493,-/kg, meaning that entrepreneurs must sell grilled tilapia above the price of IDR 54,493,-/kg to make a profit, which has been achieved because the current average selling price is IDR 73,335/kg.
تأثير استراتيجية المصفوفة الابتكارية في تطوير بعض مهارات الريشة الطائرة للاعبين
Authors: Dargham Aliwi Hassan  , Prof. Dr. Mazen Abdel Hadi Ahmed  
Published: May 2024

جاءت اهمية هذه الدراسة بالتعرف على تأثير استراتيجية المصفوفة الابتكارية على تعلم المهارات الاساسية بالريشة الطائرة وافترض الباحثان ان هناك تأثير ايجابيا للاستراتيجية المصفوفة الابتكارية في تعلم المهارات بالريشة الطائرة وبعد تشخيص المشكلة للبحث من قبل الباحثان من خلال عملة واطلاعه فقد استخدم المنهج التجريبي بأسلوب المجموعتان المتكافئتان الضابطة والتجريبية. وتحدد مجتمع البحث بلاعبين المدرسة التخصصية في نادي المحاويل للموسم الرياضية 2022-2023 ( والبالغ عددهم (16) للاعب وبعدها تم تقسيمهم الى مجوعة ضابطة وتجريبه بواقع (8) للاعبين لكل مجموعة وطبق عليهم المنهج التعليمي لمدة (18) اسبوع بواقع ثلاث وحدات تدريبية بالأسبوع بمدة 45 دقيقة لكل وحدة باليوم وبعدة الانتهاء من المنهج تم اجراء الاختبارات البعدية وتم استعمال الوسائل الاحصائية في استخراج النتائج بعد تفريغ البيانات التي تم الحصول عليها سابقا وبعدها تم عرض النتائج وتحليلها ومناقشتها .وقد خرج الباحثان بمجموعة من الاستنتاجات . ومنها ضهور نسب تطور للمجموعة التجريبية التي تم تطبيق استراتيجية المصفوفة الابتكارية في تعلم مهارات لعبة الريشة الطائرة. ومن التوصيات التي يروم الباحثان الاخذ بها ضرورة استخدام استراتيجية المصفوفة الابتكارية لأنها تنمي التفكير الابداعي وروح العمل الجماعي لدى اللاعبين وتحمل المسؤولية.
Kesenjangan Digital dan Akses Internet di Kabupaten Katingan: Studi Kasus pada Masyarakat Pedesaan
Authors: Indrawati Reni Sara , Roza Adek Media Roza , Reiginayosi Midori , Wibowo Evanny Silviana Intan , Syifa Adristi Naura 
Published: May 2024

Penelitian ini menganalisis kesenjangan akses digital di Kabupaten Katingan dengan menggunakan pendekatan kualitatif berdasarkan teori Van Dijk tentang kesenjangan digital. Penelitian dilakukan untuk mengidentifikasi kategori kesenjangan digital yakni akses materi infrastruktur, kesenjangan keterampilan, motivasi dan kesenjangan penggunaan di Kabupaten Katingan. Metode penelitian yang digunakan pendekatan kualitatif dengan mengumpulkan data melalui wawancara mendalam dan observasi partisipatif. Responden penelitian terdiri dari berbagai profesi di Kabupaten Katingan, termasuk perwakilan pemerintah, organisasi non-pemerintah, dan masyarakat lokal. Berdasarkan hasil penelitian disimpulkan perlu adanya sinergi dari seluruh pihak, termasuk pemerintah, organisasi non-pemerintah, dan masyarakat lokal, dalam mengakselerasi akses digital di Kabupaten Katingan. Upaya yang diperlukan antara lain adalah penyediaan infrastruktur yang memadai, pelatihan keterampilan digital, serta kebijakan yang mendukung akses internet yang terjangkau dan merata di masyarakat pedesaan Kabupaten Katingan. Penelitian ini diharapkan dapat memberikan wawasan dan rekomendasi bagi para pemangku kepentingan untuk meningkatkan akses digital di Kabupaten Katingan dan mengurangi kesenjangan digital yang ada.
A Novel 3D-Printed Gravity-Independent Air-Eliminating Filter for Rapid Intravenous Infusions
Authors: Formanek Arthur , Townsend Jacques , Ottensmeyer Mark P. , Kamine Tovy Haber 
Published: May 2024

INTRODUCTION: The absence of a consistent downward G vector can make separation of gases from liquids challenging, such as in field medicine without stable upright equipment or during spaceflight. This limits the use of medical equipment and procedures like administration of intravenous (IV) fluids in microgravity and can make field medicine hazardous. Administering IV fluids and medications in microgravity requires a technique to separate air from the liquid phase. Current commercial filters for separation of gases are incompatible with high flow and blood. We present a novel filter designed to provide adequate air clearance without a consistent downward G vector.
METHODS: Inline air-eliminating filters were designed for use with IV fluid tubing in microgravity using computer-aided design software and printed using nylon 12 on an EOS Selective Laser Sintering 3D printer. A 0.2-μm membrane filter was adhered around a central, hollow pillar with external spiral baffles allowing separation and venting of air from the fluid. Results were compared against commercially available inline air-eliminating filters.
RESULTS: The 3D-printed filters outperformed the commercial filters in both percentage of air removed and flow rates. The centrifugal, baffled filter had flow rates that far exceeded the commercial filters during rapid transfusion.
DISCUSSION: IV fluid administration is an often underappreciated and a necessary basic requirement for medical treatment. An air-eliminating filter compatible with blood and rapid transfusion was developed and validated with crystalloid solutions to allow the successful administration of IV fluid and medication without a consistent downward G vector.
Formanek A, Townsend J, Ottensmeyer MP, Kamine TH. A novel 3D-printed gravity-independent air-eliminating filter for rapid intravenous infusions. Aerosp Med Hum Perform. 2024; 95(6):327–332.
Orbital Solitary Fibrous Tumor in a Commercial Airline Pilot
Authors: Altinbas Munise , Ozpınar Ayse , Akbaba Müslime , Nacaroglu Senay A. , Sargolzaeimoghaddam Mohammad , Sargolzaeimoghaddam Maral 
Published: May 2024

BACKGROUND: In the literature, central serous retinopathy (CSR) accompanying solitary fibrous tumors (SFT) in a pilot has not been reported. In airline pilots, mass effect-related symptoms such as diplopia, ptosis, etc., seen with orbital tumors may endanger flight safety.
CASE REPORT: A 62-yr-old male commercial airline pilot presented with blurred vision in the right eye. He had been receiving treatment for 2 mo because of CSR. His visual acuity was 10/20 in the right eye and 20/20 in the left. During examination, ptosis and exophthalmos were noticed in the right eye. Ocular movements were free in all cardinal directions and there was downward displacement in the right eye. There was no diplopia. Magnetic resonance imaging revealed a 1.5- to 2-cm well-defined contrast-enhancing mass in the lateral extraconal orbit. His medical flight certificate was suspended for 3 mo due to decreased visual acuity and superior visual defect. Superior orbitotomy was performed without any complication. Ptosis and CSR had regressed 1 wk after surgery. All systemic and ophthalmological examinations met aviation medical certificate requirements. He returned to flight on the condition of being checked every 3 mo. At the 1-yr follow-up, there was no sign of recurrences of SFT or CSR.
DISCUSSION: SFTs are slow-growing neoplasms that can manifest symptoms related to mass effect. In the current literature, there are no reported cases of the coexistence of orbital SFT and CSR or pilots able to resume flight duties only 1 wk after a successful orbitotomy and tumor resection surgery.
Altinbas M, Ozpınar A, Akbaba M, Nacaroglu SA, Sargolzaeimoghaddam M, Sargolzaeimoghaddam M. Orbital solitary fibrous tumor in a commercial airline pilot. Aerosp Med Hum Perform. 2024; 95(6):333–336.
Modafinil Subjectively Does Not Impair Sleep in Aviators After a Period of Extended Wakefulness
Authors: Wingelaar-Jagt Yara Q. , Wingelaar Thijs T. , Riedel Willem J. , Ramaekers Johannes G. 
Published: May 2024

INTRODUCTION: Modafinil is used as a countermeasure to limit the effects of fatigue in military aviation. However, literature is conflicting about its negative effects on subsequent sleep.
METHODS: This randomized placebo-controlled trial conducted by the Center of Man in Aviation of the Royal Netherlands Airforce is part of a larger study. It included 32 subjects (mean age 35 yr old, 84% male) who followed a normal daily routine and stayed awake the subsequent night. At midnight, all subjects received either 300 mg caffeine, 200 mg modafinil, or placebo. At the end of the test night, subjects were awake for a median period of 26 h. Afterwards, sleep questionnaires containing qualitative (Groningen Sleep Quality Scale) and quantitative parameters of sleep for the subsequent day (recovery sleep) and consecutive night (post-test sleep) were completed and statistically analyzed using Friedman and Wilcoxon signed rank tests.
RESULTS: A statistically significant difference in the reported recovery sleep was observed. The modafinil group slept 30% shorter than placebo, but sleep efficiency was not statistically different. Quantitatively post-test sleep did not vary statistically significantly between the three groups. However, Groningen Sleep Quality Scale scores were lower post-test than pre-test in the modafinil group, while this was not the case in the caffeine and placebo group.
DISCUSSION:This study found that modafinil subjectively does not negatively impact recovery sleep or subsequent nighttime sleep after an extended period of wakefulness and suggests it may decrease the need for recovery sleep compared to placebo or caffeine.
Wingelaar-Jagt YQ, Wingelaar TT, Riedel WJ, Ramaekers JG. Modafinil subjectively does not impair sleep in aviators after a period of extended wakefulness. Aerosp Med Hum Perform. 2024; 95(6):290–296.
Functional Dyspepsia and Tricyclic Antidepressant Use in a Naval Flight Officer
Authors: Crutcher Robert , Kolasinski Nathan 
Published: May 2024

BACKGROUND: Functional dyspepsia is a disorder of gut–brain interaction that has the potential to impact aviation performance. Proton pump inhibitors are well-tolerated but are only effective in one half of cases. Second-line treatments, including tricyclic antidepressants, are associated with drowsiness and are not routinely approved for use in aviators. We present a case of a Naval Flight Officer with functional dyspepsia who was successfully treated with amitriptyline and returned to flying status.
CASE REPORT: A 23-yr-old male Naval Flight Officer presented with postprandial fullness and epigastric pain. His symptoms were refractory to trials of acid suppression and lifestyle modification. An extensive evaluation by Gastroenterology, including upper endoscopy, did not reveal an organic cause of his symptoms and he was diagnosed with functional dyspepsia. The patient’s symptoms resolved with a trial of amitriptyline. Neuropsychological testing demonstrated no medication effect on cognitive performance. A waiver to resume flying duties on amitriptyline was submitted to the Naval Aerospace Medical Institute and was approved.
DISCUSSION: We present the second known waiver issued in U.S. Naval aviation history for the use of amitriptyline to treat a gastrointestinal disorder. Amitriptyline is not commonly waived due to the potential for unacceptable cognitive side-effects in the flight environment. However, neuropsychological testing to assess for a possible medication effect on performance can be used to inform an aeromedical disposition and, in this case, allowed for a return to flight status.
Crutcher R, Kolasinski N. Functional dyspepsia and tricyclic antidepressant use in a naval flight officer. Aerosp Med Hum Perform. 2024; 95(6):337–340.
A Grounded Theory Exploration of Addictions Treatment Within a Commercial Airline Setting
Authors: Nairn Jessica , Bell Elliot , Myers Julia , Higgins Matthew , Johnston Ben , Newton-Howes Giles 
Published: May 2024

INTRODUCTION: An Australasian Airline’s Alcohol and Other Drug (AOD) Program demonstrates abstinence rates that exceed those of general AOD programs. The reasons for this are unclear. The purpose of this research was to develop a theory as to why this program is successful.
METHODS: A qualitative examination following grounded theory methodology was undertaken. AOD program patients and healthcare professionals were interviewed until content saturation was reached. Data analysis followed grounded theory to identify the key concepts associated with the program’s success.
RESULTS: The core theory that emerged highlighted the pivotal roles of a strong employee–company relationship, shared values, and a safety-focused culture in explicating the program’s success. This moves beyond the “carrot and stick” model of motivation, where belonging to this organization and safety consciousness serve as powerful drivers for abstinence. Challenges and barriers highlighted some unique challenges to the program in managing the coronavirus pandemic and the difference in approach to substance use in community spaces versus safety-critical employment.
DISCUSSION: This research expands the understanding of this AOD program’s success in a safety-critical industry, emphasizing the elements of a working relationship that are beyond positive or negative reinforcement. Future research should work to quantify and test the generalizability of these findings.
Nairn J, Bell E, Myers J, Higgins M, Johnston B, Newton-Howes G. A grounded theory exploration of addictions treatment within a commercial airline setting. Aerosp Med Hum Perform. 2024; 95(6):313–320.
Oscillations of Hemodynamic Parameters Induced by Negative Pressure Breathing in Healthy Humans
Authors: Semenov Yury S. , Melnikov Ivan S. , Luzhnov Petr V. , Dyachenko Alexander I. 
Published: May 2024

INTRODUCTION: Negative pressure breathing is breathing with decreased pressure in the respiratory tract without lowering pressure acting on the torso. We lowered air pressure only during inspiration (NPBin). NPBin, used to increase venous return to the heart, is considered a countermeasure against redistribution of body fluids toward the head during spaceflight. We studied NPBin effects on circulation in healthy humans with an emphasis on NPBin-induced oscillations of hemodynamic parameters synchronous with breathing. We propose an approach to analyze the oscillations based on coherent averaging.
METHODS: Eight men ages 24–42 yr participated in the NPBin and control series. During the series, to reproduce fluids shift observed under microgravity, subjects were supine and head down (−8°). Duration of NPBin was 20 min, rarefaction −20 cm H2O. Hemodynamic parameters were measured by Finometer. Electrical impedance measurements were used to estimate changes in blood filling of cerebral vessels.
RESULTS: Mean values of hemodynamic parameters virtually did not change under NPBin, but NPBin induced oscillations of the parameters synchronous with respiration. Peak-to-peak amplitude under NPBin were: mean arterial pressure, 4 ± 1 (mmHg); stroke volume, 7 ± 3 (mL); and heart rate, 4 ± 1 (bpm). Electrical impedance of the head increased during inspiration. The increase under NPBin was three times greater than under normal breathing.
DISCUSSION: Analysis of oscillations gives more information than analysis of mean values. NPBin induces short-term decrease in left ventricle stroke volume and arterial blood pressure during each inspiration; the decrease is compensated by increase after inspiration. NPBin facilitates redistribution of body fluids away from the head.
Semenov YS, Melnikov IS, Luzhnov PV, Dyachenko AI. Oscillations of hemodynamic parameters induced by negative pressure breathing in healthy humans. Aerosp Med Hum Perform. 2024; 95(6):297–304.
Pengaruh Job Insecurity Dampak Pandemi COVID-19 Terhadap Kinerja dan Kecemasan Pekerja Katering dan Akomodasi PT. Patra Drilling Contractor di Pertamina Shu Zona 10
Authors: Sunandar Hendar 
Published: May 2024

Pandemi COVID-19 yang ditetapkan WHO sejak 11 Maret 2020 menuntut banyak perusahaan untuk melakukan upaya-upaya pencegahan dan penanggulangan di tempat kerja agar operasional perusahan tidak terganggu. Banyak perusahaan yang melakukan efisiensi dengan pengurangan jam kerja, pembagian sebagian bekerja di kantor dan sebagian bekerja di rumah serta pengaturan jadwal kerja menyesuaikan dengan kebijakan pemerintah setempat. Bagi banyak pekerja, kondisi ini bersama dampak ekonomi yang ditimbulkannya menjadi pemicu timbulnya masalah mental seperti kekhawatiran akan hilangnya pekerjaan saat ini dan masa mendatang (job insecurity). Penelitian ini dilakukan untuk mendapatkan gambaran mengenai job insecurity dan pengaruhnya terhadap kinerja dan kecemasan pekerja katering dan akomodasi PT. PDC di lingkungan kerja Pertamina SHU Zona 10. Terdapat 153 responden yang berpartisipasi secara sukarela dalam penelitian ini dan hanya 147 yang datanya dapat dianalisis lebih lanjut. Pengukuran variabel dilakukan dengan menggunakan skala likert. Analisis data dilakukan dengan menggunakan metode Partial Least Square â€“ Structural Equation Model (PLS-SEM). Perangkat lunak yang digunakan untuk analisis model pengukuran dan model struktural adalah SmartPLS 3 dan untuk analisis deskriptif menggunakan SPSS 25. Hasil penelitian menunjukan bahwa pekerja katering dan akomodasi merasakan ancaman job insecurity namun tidak sampai menimbulkan kecemasan yang berarti. Pekerja juga mempunyai kinerja yang bagus diserta resiliensi yang tinggi. Analisis dengan metode PLS-SEM menunjukkan bahwa job insecurity berdampak pada peningkatan kecemasan namun tidak berdampak pada kinerja. Kecemasan berdampak pada kinerja sekaligus memediasi pengaruh job insecurity terhadap kinerja. Resiliensi menjadi variabel yang memoderatori pengaruh job insecurity terhadap kecemasan. Perusahaan disarankan untuk konsisten memberikan kepastian jaminaan keberlangsungan pekerjaan bagi pekerja, menyediakan fasilitas penunjang operasional dan non-operasional, melakukan kajian ulang risiko terkini pandemi COVID-19, mengembalikan jadwal kerja normal, dan meningkatkan komunikasi yang baik dengan para pekerja.