bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining role of atlantoaxial and subaxial spinal instability in the pathogenesis of cervical spinal degeneration: Experience with “only-fixation” without any decompression as treatment in 374 cases over 10 years
Authors: Goel Atul , Vutha Ravikiran , Shah Abhidha , Prasad Apurva , Shukla Ashutosh Kumar , Maheshwari Shradha 
Published: March 2024

ABSTRACT

Aim:
The authors analyze their published work and update their experience with 374 cases of cervical radiculopathy and/or myelopathy related to spinal degeneration that includes ossification of the posterior longitudinal ligament (OPLL). The role of atlantoaxial and subaxial spinal instability as the nodal point of pathogenesis and focused target of surgical treatment is analyzed.

Materials and Methods:
During the period from June 2012 to November 2022, 374 patients presented with acute or chronic symptoms related to radiculopathy and/or myelopathy that were attributed to degenerative cervical spondylotic changes or due to OPLL. There were 339 males and 35 females, and their ages ranged from 39 to 77 years (average 62 years). All patients were treated for subaxial spinal stabilization by Camille’s transarticular technique with the aim of arthrodesis of the treated segments. Atlantoaxial stabilization was done in 128 cases by adopting direct atlantoaxial fixation in 55 cases or a modified technique of indirect atlantoaxial fixation in 73 patients. Decompression by laminectomy, laminoplasty, corpectomy, discoidectomy, osteophyte resection, or manipulation of OPLL was not done in any case. Standard monitoring parameters, video recordings, and patient self-assessment scores formed the basis of clinical evaluation.

Results:
During the follow-up period that ranged from 3 to 125 months (average: 59 months), all patients had clinical improvement. Of 130 patients who had clinical evidences of severe myelopathy and were either wheelchair or bed bound, 116 patients walked aided (23 patients), or unaided (93 patients) at the last follow-up. One patient in the series was operated on 24 months after the first surgery by anterior cervical route for “adjacent segment” disc herniation. No other patient in the entire series needed any kind of repeat or additional surgery for persistent, recurrent, increased, or additional related symptoms. None of the screws at any level backed out or broke. There were no implant-related infections. Spontaneous regression of the size of osteophytes was observed in 259 patients where a postoperative imaging was possible after at least 12 months of surgery.

Conclusions:
Our successful experience with only spinal fixation without any kind of “decompression” identifies the defining role of “instability” in the pathogenesis of spinal degeneration and its related symptoms. OPLL appears to be a secondary manifestation of chronic or longstanding spinal instability.
The impact of robotic assistance for lumbar fusion surgery on 90-day surgical outcomes and 1-year revisions
Authors: Heard Jeremy C. , Lee Yunsoo A. , D’Antonio Nicholas D. , Narayanan Rajkishen , Lambrechts Mark J. , Bodnar John , Purtill Caroline , Pezzulo Joshua D. , Farronato Dominic , Fitzgerald Pat , Canseco Jose A. , Kaye Ian David , Hilibrand Alan S. , Vaccaro Alexander R. , Kepler Christopher K. , Schroeder Gregory D. 
Published: March 2024

ABSTRACT

Objectives:
To evaluate the (1) 90-day surgical outcomes and (2) 1-year revision rate of robotic versus nonrobotic lumbar fusion surgery.

Methods:
Patients >18 years of age who underwent primary lumbar fusion surgery at our institution were identified and propensity-matched in a 1:1 fashion based on robotic assistance during surgery. Patient demographics, surgical characteristics, and surgical outcomes, including 90-day surgical complications and 1-year revisions, were collected. Multivariable regression analysis was performed. Significance was set to P < 0.05.

Results:
Four hundred and fifteen patients were identified as having robotic lumbar fusion and were matched to a control group. Bivariant analysis revealed no significant difference in total 90-day surgical complications (P = 0.193) or 1-year revisions (P = 0.178). The operative duration was longer in robotic surgery (287 + 123 vs. 205 + 88.3, P ≤ 0.001). Multivariable analysis revealed that robotic fusion was not a significant predictor of 90-day surgical complications (odds ratio [OR] = 0.76 [0.32–1.67], P = 0.499) or 1-year revisions (OR = 0.58 [0.28–1.18], P = 0.142). Other variables identified as the positive predictors of 1-year revisions included levels fused (OR = 1.26 [1.08–1.48], P = 0.004) and current smokers (OR = 3.51 [1.46–8.15], P = 0.004).

Conclusion:
Our study suggests that robotic-assisted and nonrobotic-assisted lumbar fusions are associated with a similar risk of 90-day surgical complications and 1-year revision rates; however, robotic surgery does increase time under anesthesia.
Management of lumbar spondylolisthesis: A retrospective analysis of posterior lumbar interbody fusion versus transforaminal lumbar interbody fusion
Authors: Encarnacion Santos Daniel , Nurmukhametov Renat , Donasov Medet , Volovich Alexander , Bozkurt Ismail , Wellington Jack , Espinal Lendof Miguel , Peralta Ismael , Chaurasia Bipin 
Published: March 2024

ABSTRACT

Background:
One of the most frequent etiologies for spinal surgery is unstable lumbar spondylolisthesis (ULS). To decompress affected structures while maintaining or restoring stability through fusion, surgeons utilize a variety of procedures. When paired with interbody fusion, posterior fusion is most applied, resulting in greater fusion rates. The two most popular techniques for implementing spinal fusion are posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). As a result, these two procedures have been assessed formally.

Methodology:
A retrospective analysis of patients who underwent interbody fusion for lumbar stenosis through PLIF and minimally invasive (MI)-TLIF was performed. The patients were followed up for 24 months and fusion rates, Visual Analog Score (VAS), and Oswestry Disability Index (ODI) alongside the MacNab clinical outcome score, were assessed. The Bridwell interbody fusion grading system was used to evaluate fusion rates in computed tomography (CT).

Results:
Operations were performed in 60 cases where patients suffered from ULS. PLIF was performed on 33 patients (55%) (14 males and 19 females) and 27 patients (45%) (11 males and 16 females) who underwent MI-TLIF. In 87% of our respective cohort, either the L4–5 or the L5–S1 level was operated on. Overall fusion rates were comparable between the two groups; however, the TLIF group improved more in terms of VAS, ODI, and MacNab scores. On average, MI-TLIF surgery was longer and resulted in reduced blood loss. MI-TLIF patients were more mobile than PLIF patients postoperatively.

Conclusion:
With well-established adequate results in the literature, TLIF offers benefits over other methods used for interbody lumbar fusion in ULS or other diseases of the spine. However, MI-TLIF may procure more advantageous for patients if MI methods are implemented. In this instance, TLIF outperformed PLIF due to shorter operating times, less blood loss, faster ODI recovery, better MacNab scores, and a greater decline in VAS pain ratings.
Surgical management of spinal metastases from primary thyroid carcinoma: Demographics, clinical characteristics, and treatment outcomes – A retrospective analysis
Authors: Chaliparambil Rahul Kishore , Krushelnytskyy Mykhaylo , Shlobin Nathan A. , Thirunavu Vineeth , Roumeliotis Anastasios G. , Larkin Collin , Kemeny Hanna , El Tecle Najib , Koski Tyler , Dahdaleh Nader S. 
Published: March 2024

ABSTRACT

Objective:
Metastatic spinal tumors represent a rare but concerning complication of primary thyroid carcinoma. We identified demographics, metastatic features, outcomes, and treatment strategies for these tumors in our institutional cohort.

Materials and Methods:
We retrospectively reviewed patients surgically treated for spinal metastases of primary thyroid carcinoma. Demographics, tumor characteristics, and treatment modalities were collected. The functional outcomes were quantified using Nurik, Modified Rankin, and Karnofsky Scores.

Results:
Twelve patients were identified who underwent 17 surgeries for resection of spinal metastases. The primary thyroid tumor pathologies included papillary (4/12), follicular (6/12), and Hurthle cell (2/12) subtypes. The average number of spinal metastases was 2.5. Of the primary tumor subtypes, follicular tumors averaged 2.8 metastases at the highest and Hurthle cell tumors averaged 2.0 spinal metastases at the lowest. Five patients (41.7%) underwent preoperative embolization for their spinal metastases. Seven patients (58.3%) received postoperative radiation. There was no significant difference in progression-free survival between patients receiving surgery with adjuvant radiation and surgery alone (P = 0.0773). Five patients (41.7%) experienced postoperative complications. Two patients (16.7%) succumbed to disease progression and two patients (16.7%) experienced tumor recurrence following resection. Postsurgical mean Nurik scores decreased 0.54 points, mean Modified Rankin scores decreased 0.48 points, and mean Karnofsky scores increased 4.8 points.

Conclusion:
Surgery presents as an important treatment modality in the management of spinal metastases from thyroid cancer. Further work is needed to understand the predictive factors for survival and outcomes following treatment.
Prevalence and Factors Associated with Internet Gaming Disorder amongst Medical Students in Kodagu District: A Cross-sectional Study
Authors: Madeshan Ashwini , Raja N. Sabari , Udayar Sharvanan E. , Narasimha B. C. 
Published: March 2024

Abstract

Background:
Internet usage amongst young adults and students has increased over the decades. Heavy internet use leads to addiction and internet gaming disorder (IGD) in them.

Aims:
The study was conducted to estimate the prevalence and factors associated with IGD amongst medical students of Kodagu Institute of Medical Sciences, Madikeri, Karnataka.

Methods:
A cross sectional study was conducted amongst 516 medical students from June to July 2022. A universal sampling technique was implied in the study, and data were collected using a pre tested and validated questionnaire (IGD 20 scale). Data were extracted into Excel and analysed using Epi Info (version 7.2).

Results:
The prevalence of IGD amongst medical students was 23.25% (120). The IGD was higher amongst female players, 72 (60%), than the male players, 48 (40%) (P = 0.03). The students staying in the hostel had a high IGD, 112 (93.3%), compared to day scholars, 8 (6.7%) (P = 0.003). As socio economic status increased, the IGD amongst students also increased (P = 0.006).

Conclusions:
The prevalence of IGD amongst medical students was 23.25%. The female students, hostelites and students from the upper class were more prone to develop IGD.
Profile and Outcome of Neonatal Respiratory Distress: A Single-center Study
Authors: Ahuja Sumanyu , Gaur Bablu Kumar , Jain Shruti , Singh Rupa Rajbhandari , Maini Baljeet 
Published: March 2024

Abstract

Background:
Respiratory distress (RD) is one of the common indications of hospitalisation in the neonatal intensive care unit. Due to recent advances in clinical diagnosis and treatment, there is a need for data on the current profile and outcome of neonatal RD (NRD).

Aims:
To determine the clinical presentation, causes, risk factors, severity, and outcome of NRD.

Patients and Methods:
All neonates who presented with signs of RD were enrolled. Neonatal data such as birth weight, mode of delivery, gestational age, saturation on room air, mode of oxygen therapy, and onset and severity of RD were noted in predesigned pro forma. The severity of RD in term and pre-term neonates was assessed by Downe’s score and Silverman–Anderson’s score, respectively. Relevant investigations and treatment were started as per standard protocol.

Results:
The most common cause of NRD was RD syndrome (29%). Chest indrawing was the most prevalent sign of RD (90.0%). There was no significant association of gestational age with the severity of RD (P = 0.140), but the birth weight was significantly associated with the severity of RD (P = 0.002). Severe RD was associated with extreme prematurity, meconium-stained amniotic fluid and birth weight of <1.5 kg. The mortality rate was 12%, with meconium aspiration syndrome and RD syndrome being the common causes.

Conclusions:
Whatever the cause, RD can proceed to respiratory failure and death if it is not promptly diagnosed and treated. Therefore, any clinician providing care for neonates must be able to quickly identify the symptoms and degree of RD, distinguish between different aetiologies, and begin treatment plans to avoid future complications or mortality.
HER2-low breast cancers: challenges in the interpretation of immunohistochemistry
Authors: Chia Noel , Gudi Mihir Ananta , Rakha Emad , Tan Puay Hoon 
Published: March 2024

Abstract
Overexpression of human epidermal growth factor receptor 2 (HER2) protein in breast cancers carries significant prognostic and therapeutic implications. Anti-HER2 blockade has shown to be a useful adjunct to surgery in treating HER2-positive tumours. Up till today, the HER2 immunohistochemistry (IHC) and in situ hybridisation (ISH) scoring algorithms are geared towards identifying HER2-positive cases. A recently published Phase III clinical trial (DESTINY-Breast04) has demonstrated that an antibody–drug conjugate (trastuzumab-deruxtecan) significantly reduced disease progression and death in patients with metastatic disease with IHC score 1+ or 2+ and without ISH amplification, defining a new category of cases known as HER2 low. At present, IHC scores 0, 1+ and 2+ show significant interobserver variability, and identifying HER2-low breast cancers may pose significant challenges with the current algorithms. More work is needed in this area to better define HER2-low breast cancers, target the appropriate group of patients and assess treatment efficacy.
Effect of sowing density on performance and biometric features of pedunculate oak
Authors: Hauke-Kowalska Maria , Kasprzyk Winicjusz 
Published: March 2024

Sowing density is one of the most important factors influencing seedling quality. In forest nurseries, to ensure full seeding, it is recommended to obtain approximately 200 seedlings from 1 m2 (ZHL 2012). The aim of the study was to assess the effect of sowing density on sowing efficiency and the morphological features of pedunculate oak seedlings. Acorns were sown directly by broadcast seeding on 20 test plots, each 4 m in length, in four replications. The following variants were used:- 250acorns capable of germination totaling 341 acorns per 1 linear meter (0.9 m2);- 300 acorns capable of germination totaling 410 acorns per 1 linear meter (0.9 m2);- 350 acorns capable of germination totaling 478 acorns per 1 linear meter (0.9 m2);- 400 acorns capable of germination totaling 546 acorns per 1 linear meter (0.9 m2);- 450 acorns capable of germination totaling 614 acorns per 1 linear meter (0.9 m2).
At the end of the growing season, seedlings were counted per 1 m (0.9 m2) in the central part of each plot. Sowing efficiency was determined as a percentage of seedling yield from the sown seeds. For laboratory analysis, 30 seedlings from each plot (600 in total) were collected. Based on biometric features like shoot height, root collar diameter, and dry weights of shoots, roots, and leaves, quality indicators such as the sturdiness quotient (SQ) and the Dickson quality index (DQI) were calculated.
Sowing efficiency at the end of the vegetation season ranged between 39.68% and 50.12% and was not statistically significant. The research revealed that sowing density influenced seedling biometric characteristics. Pearson’s correlation coefficients showed significant negative correlations between the number of seedlings obtained in an experimental plot and the dry weight of the root, number and dry mass of leaves, as well as the DQI. The seedlings from all sowing variants complied with the binding Polish standard, outlined in the Regulation of the Minister for the Environment of 18 February 2004 (Ministerstwo Środowiska 2004) by over 96%.
Keywords: seeding density, sowing rate, seedling quality, sowing performance, sturdiness quotient (SQ), Dickson quality index (DQI), Quercus robur L.
Evaluación de variables bioquímicas en mujeres adultas con síndrome metabólico
Authors: Olvera Fernanda Daniela Peralta , Ortega Tito Emilio Ariza , Riveroll Angel Sebastián López , Rendón Noemí Martínez , Ortega José Alberto Ariza , Franco José Antonio Sánchez , Niño Alexis Ayala , Ramírez Emmanuel Martínez 
Published: March 2024

El síndrome metabólico (SM) en el sexo femenino, ha incrementado su prevalencia a nivel mundial, y en México, hubo un aumento del 22.3%, debido a la menopausia (60.0%), donde se llevan a cabo cambios metabólicos y hormonales. El objetivo del estudio fue, evaluar las variables bioquímicas (glucosa, colesterol total y triglicéridos) en mujeres adultas con diagnóstico de SM del estado de Hidalgo, México. Se realizó un estudio descriptivo transversal, utilizando una muestra de 51 expedientes de pacientes femeninos, sometidos a criterios de inclusión, exclusión y eliminación del consultorio de Manejo Integral de Diabetes por Etapas, de la unidad de medicina familiar del Hospital ISSSTE y se sometieron a análisis descriptivos. La media de las pacientes fue de 50 años, de glucemia e hipertrigliceridemia, en estos últimos, se encontró por encima de los estipulado por ATP-III (glucosa >110 mg/dL y triglicéridos >150 mg/dL). Las pacientes >49 años, mostraron descontrol en todas las variables, mientras que las <49 años, solo mostraron un control, en valores de colesterol en sangre. Por lo que es necesario implementar medidas preventivas, para evitar complicaciones en su salud.
Pemberdayaan Keluarga dalam Upaya Manajemen Gagal Ginjal Terminal (GGT) On Hemodialisis di RSUD Dr. H. Abdul Moeloek Provinsi Lampung
Authors: Wijayanti Sinta , Chloranyta Shanty , Tarman Tarman 
Published: March 2024

Pengendalian pasien gagal ginjal terminal telah terintegrasi dengan baik di Ruang Hemodialisis RSUD Dr. H. Abdul Moeloek Lampung. Terdapat beberapa hambatan yang telah ditemukan yaitu defisit pengetahuan dan tersedianya informasi yang tidak adekuat mengenai manajemen gagal ginjal terminal on hemodialisis pada pasien dan keluarga. Angka kejadian gagal ginjal terminal di RSUD sebanyak 273 orang, dan ±78 orang menjalani hemodialisis dalam satu hari di Ruang Hemodialisis RSUD Dr. H. Abdul Moeloek. Sebagian besar besar pasien hemodialisis tidak mengeluhkan apapun, tetapi ada sebagian dari pasien mengeluhkan kakinya bengkak, sesak napas, serta mual muntah, dan hipertensi. Sehingga, dilakukan Pendidikan Kesehatan tentang manajemen gagal ginjal. Tujuan kegiatan pemberdayaan keluarga yang dilakukan untuk meningkatkan pengetahuan dan kemampuan pasien dan keluarga pasien dalam manajemen gagal ginjal. Kegiatan dilakukan di Ruang Hemodialisis RSUD Dr. H. Abdul Moeloek Bandar bulan Mei 2023. Metode dilakukan yakni dengan ceramah serta diskusi, dengan media PPT. Hasil kegiatan pemberdayaan keluarga dalam upaya meningkatkan manajemen pasien gagal ginjal terminal on hemodialsis ini diketahui adanya peningkatan pada pengetahuan pasien dan keluarga dalam manajemen pasien
SINONIMI VERBA “MAKAN” DALAM BAHASA BALI: KAJIAN SEMANTIK
Authors: Susandhika I Gusti Ngurah Mayun 
Published: March 2024

ABSTRAK Tujuan penulisan artikel ini untuk mendeskripsikan bidang ilmu semantik terutama adalah mengenai hubungan relasi makna (sinonim) dalam ragam bentuk frasa pada bahasa Bali. Data penelitian ini dikumpulkan bersumber dari data lisan yang merupakan hasil pengamatan terhadap verba ‘makan’ dalam bahasa Bali. Metode penyimakan (simak) adalah metode yang digunakan untuk memperoleh data dengan menyimak penggunaan bahasa. Hasil penelitian menyimpulkan ada beberapa konsep semantik relasi makna dan bentuk ragam frasa dari verba “makan” dalam bahasa Bali, korelasi makna yang berarti setiap frasa mengenai verba makan tersebut bersinonim, dan cara penggunaan ragam frasa pada makna verba “makan” dalam bahasa Bali. Kata Kunci: Relasi Makna, Verba ‘Makan’, Bahasa Bali.
IMPLEMENTASI KEBIJAKAN PELAYANAN KESEHATAN TRADISIONAL DI PUSKESMAS I DENPASAR UTARA
Authors: Arwidiana Dewa Putu , Sudiari Made 
Published: March 2024

Abstrak – Visi dan Misi Pembangunan Bali periode tahun 2018- 2023 Nagun Sat Kerthi Loka Bali, maka arah kebijakan dan program Pembangunan Bali dengan Pola Pembangunan Semesta Berencana yang dituangkan dalam dua kelompok program yaitu, program prioritas dan program pendukung. Pengembangan kebijakan sekaligus mendukung kearifan local dan budaya Bali yang kaya dengan adat dan istiadatnya serta mengkombinasikan dengan sumber daya alam. Kolaborasi pelayanan Kesehatan yang bersifat holistic melalui pelayanan Kesehatan tradisional terpadu dengan adat dan sumber daya alam akan meningkatkan kualitas hidup masyarakat dan memberikan daya Tarik bagi wisatawan. Pelayanan kesehatan tradisional telah menjadi bagian integral dari sistem kesehatan di banyak negara. Namun, implementasi kebijakan pelayanan kesehatan tradisional masih menghadapi tantangan yang signifikan. Tujuan dari penelitian ini adalah untuk menggambarkan implementasi kebijakan pelayanan kesehatan tradisional di lokasi penelitian, serta mengidentifikasi faktor-faktor yang mempengaruhi keberhasilan implementasi tersebut. Metode penelitian yang digunakan adalah pendekatan deskriptif kuantitatif dengan pengumpulan data melalui wawancara dan kuesioner terkait pelayanan kesehatan tradisional. Data yang terkumpul dianalisis menggunakan teknik analisis secara univariat. Hasil penelitian menunjukkan bahwa implementasi kebijakan pelayanan kesehatan tradisional di di wilayah kerja puskesmas 1 Denpasar Utara menghadapi beberapa tantangan, termasuk kurangnya dukungan dari sektor kesehatan konvensional, kurangnya pemahaman dan kesadaran masyarakat tentang pentingnya pelayanan kesehatan tradisional, serta keterbatasan sumber daya yang tersedia. Penelitian ini juga mengidentifikasi beberapa faktor yang dapat meningkatkan keberhasilan implementasi kebijakan pelayanan kesehatan tradisional. Faktor-faktor tersebut meliputi adanya kerjasama yang kuat antara pihak-pihak terkait, pendidikan dan pelatihan bagi praktisi kesehatan tradisional, serta partisipasi aktif masyarakat dalam pengambilan keputusan terkait pelayanan kesehatan tradisional. Penelitian ini memberikan wawasan yang berharga bagi pengambil kebijakan dalam mengatasi tantangan implementasi kebijakan pelayanan kesehatan tradisional. Diharapkan hasil penelitian ini dapat digunakan sebagai acuan untuk meningkatkan kualitas pelayanan kesehatan tradisional dan memperkuat peran pelayanan kesehatan tradisional dalam sistem kesehatan secara keseluruhan