bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Massage, Foot Massage, and Warm Blanket Combination on Ankle Brachial Index in Diabetic Ulcer Risk
Authors: Rizki Mega Safitri  , Tata Mahyuvi  
Published: February 2025

Background: Diabetic ulcers are chronic complications of diabetes mellitus that can lead to infection and gangrene if not properly treated. Complementary therapies can help prevent diabetic ulcers by improving blood circulation and maintaining vasodilation. Preventive measures include massage, foot massage, and the application of warm blankets to support smooth blood flow.
Purpose: This study aimed to evaluate the effect of a combination of massage, foot massage, and warm blankets on changes in the Ankle Brachial Index (ABI) as a marker of diabetic ulcer risk.
Method: The research employed a quasi-experimental design with a one-group pre-test and post-test approach. A total of 30 respondents were selected using total sampling, with inclusion criteria being female diabetes mellitus patients diagnosed for more than a year, aged over 30 years, and free from leg ulcers. Pre-test ABI measurements were conducted on the second day of week 1. The intervention involved a 30-minute combination of massage, foot massage, and warm blankets, administered twice a week over three weeks. Post-test ABI data were collected at the sixth meeting in the third week.
Results: Before the intervention, the average ABI of respondents was 0.57, indicating a moderate risk. Following the intervention, the ABI improved to an average of 0.74, categorized as mild risk. Statistical analysis using the Wilcoxon test showed a significant effect (p < 0.05) of the intervention on ABI changes.
Conclusion: In conclusion, the combination of massage, foot massage, and warm blankets is an effective complementary therapy for maintaining foot health in diabetes mellitus patients, thereby reducing the risk of diabetic ulcers.
Posterior vertebral column resection for recurrent tethered cord syndrome: a 10-year case series
Authors: Shah Harshal A. , Shao Miriam M. , Santhumayor Brandon A. , Golub Danielle , Schneider Daniel , Ber Roee , Sciubba Daniel M. , Mittler Mark A. , Rodgers Shaun D. , Schneider Steven J. , Lefkowitz Michael A. 
Published: February 2025

OBJECTIVE
Tethered cord syndrome (TCS) is a significant cause of debilitation in patients with spinal dysraphisms or tumors. Management of TCS has historically centered on intradural detethering surgery, which is associated with a substantial risk of retethering, symptom recurrence, and repeat surgery. Vertebral column resection (VCR) has recently gained popularity as a treatment option via spinal shortening, but the literature on long-term outcomes is sparse. The objective of this study was to explore long-term clinical outcomes in a series of patients undergoing VCR for recurrent TCS.

METHODS
A retrospective review was conducted of all consecutive patients undergoing VCR for recurrent TCS at a single center between 2014 and 2024. Demographic and radiological characteristics were recorded, including spinal column height reduction as well as symptom improvement rates regarding sensorimotor dysfunction, pain, and incontinence at the latest follow-up. Intra- and postoperative complications were noted, and pre- and postoperative symptomology was compared using McNemar’s test at a significance level of p < 0.05 to identify improvements.

RESULTS
Twenty surgeries in 19 patients (median age 19 years) involving 10 males (52.6%) were assessed. The most common etiology of TCS was lipomyelomeningocele (n = 7, 36.8%), followed by lipoma (n = 6, 31.6%). Patients underwent a mean of 3.4 previous detethering procedures. Osteotomy was most commonly performed at the L1 level (n = 11, 55.0%), and the mean spinal column height reduction was 16.5 mm. At a mean follow-up of 43.1 (range 12–101) months, resolution of symptoms was observed in 10 patients with back pain (71.4%; p = 0.043), 10 patients with leg pain (66.7%; p = 0.004), 9 patients with lower extremity weakness (75.0%; p = 0.008), 4 patients with urinary incontinence (44.4%; p = 0.371), and 1 patient with fecal incontinence (33.3%; p > 0.99). Complications included a CSF leak in 1 patient and repeat VCR in 1 patient.

CONCLUSIONS
These results suggest that in select patients with recurrent TCS, VCR represents a treatment option with high rates of symptomatic improvement and a relatively low risk of retethering as observed over several years of follow-up. These results add to the body of literature supporting VCR and provide a compelling basis for future prospectively designed studies.
Comparison of dosimetric variability in the cervical spine between carbon fiber and titanium instrumentation
Authors: Mansi Ahmed , Rezaii Elhaum G. , Wang Shuo , Zhang Chi , Katzir Miki 
Published: February 2025

OBJECTIVE
Carbon fiber instrumentation has gained popularity in spine oncology for its radiographic advantage of reduced artifact on imaging. With its increased use in patients who undergo radiation therapy, the dosimetric accuracy of postoperative radiation with carbon fiber constructs compared to classic titanium instrumentation becomes an important question. The purpose of this study was to compare the dosimetric accuracy of postoperative radiation in carbon fiber–instrumented versus titanium-instrumented cadaveric cervical spines after corpectomy.

METHODS
Two cadaveric specimens underwent two-level corpectomy using either titanium or carbon fiber instrumentation. Dosimeter chips were placed circumferentially around the constructs to calculate the dose of radiation to surrounding areas. The cadavers underwent one round of radiation with their respective constructs, and the dose of radiation was calculated and compared to the measured dose in each chip. After the first round of radiation, the instrumentation was switched between cadavers and the radiation therapy was repeated. The difference between the calculated and measured dose in carbon fiber versus that in titanium instrumentation in each cadaveric model was subsequently compared.

RESULTS
There was a significant difference in the dosimetry calculated at the area of the spinal cord dorsal to the corpectomy cage, with 68% less variability between the calculated and measured dose in the carbon fiber construct compared to that of the titanium construct. The mean variation of the measured dose at the spinal cord was 7.73% in titanium versus 4.6% in carbon fiber (p = 0.024, 1-tail; p = 0.048, 2-tail). There was also 30% less variability between the measured and calculated dose in the carbon fiber construct at the dosimeter chips lateral to the spinal cord, with a mean variation in the carbon fiber–instrumented cadaver of 4.94% compared to 6.45% with titanium (p = 0.01, 1-tail; p = 0.02, 2-tail). When all the dosimeters were combined without the control group, there was a statistically significant 14.5% difference in the mean variation of the calculated versus measured doses between the carbon fiber–instrumented cadavers versus titanium-instrumented cadavers (4.8% vs 5.5%, respectively; p = 0.015, 1-tail; p = 0.03, 2-tail).

CONCLUSIONS
There is less variation in the calculated versus measured doses of radiation therapy in carbon fiber instrumentation compared to titanium instrumentation. This suggests improved radiation therapy delivering accuracy and complication avoidance in carbon fiber–instrumented spines.
Outcomes following stereotactic radiosurgery for high-grade brain arteriovenous malformations: a systematic review and meta-analysis
Authors: Farhad Imran , Ridzuan-Allen Adam , Ansari Saniya , Al-Munaer Marwan , Hall Benjamin , Taweel Basel , Skourou Christina , Fitzpatrick David , Ali Ahmad M. S. , Hannan Cathal John , Cahill Julian , Yousaf Jawad , Sheehan Jason P. , Javadpour Mohsen 
Published: February 2025

OBJECTIVE
Arteriovenous malformations (AVMs) of the brain are a leading cause of stroke in the young and carry a lifetime risk of intracerebral hemorrhage. The management options for high-grade AVMs are limited. Resection is often associated with high rates of postoperative morbidity, and the results of stereotactic radiosurgery (SRS) for these lesions thus far have been mixed. The aim of this study was to summate the published data on the outcomes of SRS for high-grade AVMs in order to better inform the management of these otherwise untreatable lesions.

METHODS
A search of four online databases for literature pertaining to the use of SRS to treat high-grade (Spetzler-Martin grades IV–VI) AVMs was performed. Data pertaining to AVM obliteration, incidence of adverse radiation effects (AREs), and posttreatment hemorrhage were extracted, and a meta-analysis of proportions was performed. The study protocol was prospectively registered with PROSPERO.

RESULTS
Fifteen studies describing the results of SRS treatment of 562 high-grade AVMs were analyzed. The overall rate of AVM obliteration during a median follow-up period of 50 months was 34.2% (95% CI 27.0%–42.1%, I2 = 65.1%). The pooled rate of hemorrhage following SRS treatment was 12.2% (95% CI 7.8%–18.7%, I2 = 25%). For previously ruptured AVMs, the rate of hemorrhage was 12.7% (95% CI 8.5%–18.7%, I2 = 0%) compared with 5.2% (95% CI 1.0%–23.1%, I2 = 0%) for unruptured AVMs. The overall incidence of AREs was 9.3% (95% CI 5.2%–15.9%, I2 = 0%).

CONCLUSIONS
SRS for high-grade AVMs is associated with a modest rate of obliteration and is complicated by AREs in 9% of cases. Patients harboring previously ruptured AVMs or lesions with high-risk angioarchitectural features may be more likely to benefit from this treatment.
Stereo-electroencephalography pattern and long-term seizure outcome in hypothalamic hamartoma treated by radiofrequency thermocoagulation
Authors: Liu Chang , Wang Xiu , Zheng Zhong , Hu Wenhan , Yang Xiaoli , Shao Xiaoqiu , Zhang Kai , Liang Shuli 
Published: February 2025

OBJECTIVE
The aim of this study was to investigate the long-term outcomes and clinical predictors for seizure freedom in patients with hypothalamic hamartomas (HHs) undergoing radiofrequency thermocoagulation (RFTC) guided by stereo-electroencephalography (SEEG).

METHODS
The authors enrolled 30 patients with HH-related epilepsy who underwent SEEG-guided RFTC and were followed up for at least 3 years. Seizure outcomes were assessed using the International League Against Epilepsy (ILAE) classification, with classes 1 and 2 defined as seizure freedom. Considering the observed time to relapse, the authors defined postoperative follow-up within 1 year as short-term follow-up. They analyzed lesion features, epileptic characteristics, and SEEG patterns for their relationship with short-term and long-term seizure freedom separately. Long-term complications were also reported.

RESULTS
The mean follow-up was 69.2 months (range 36–107 months) since the first RFTC. At the last follow-up, 20 patients (66.7%) achieved seizure freedom (ILAE classes 1 and 2). Regarding different seizure types, freedom was achieved in 81.8% of patients (18/22, after 2 cases relapsed) with gelastic seizures (GS) and in 52.9% patients (9/17, after 4 cases relapsed) with other types of seizures (i.e., nongelastic seizures [NGS]). Seizures characterized by focal low-voltage fast activity recorded by SEEG were more likely to achieve freedom both in the short term (p = 0.021) and the long term (p = 0.022). A history of HH resection might negatively impact a patient’s outcome at long-term follow-up, whereas lesion location, volume, seizure types, or the seizure duration showed no significant influence on both short-term and long-term outcomes. Weight gain was the most common long-term complication (26.7%).

CONCLUSIONS
The SEEG signal can guide HH ablation and serve as an important predictor for favorable seizure outcomes in both the short term and long term, a capability not exhibited by other factors thus far. Patients with a history of HH resection but who still experience NGSs should be considered carefully, as there may be a speculated mechanism of an NGS network re-forming, which can partly explain the outcome difference between patients with GSs and those with NGSs, as well as the progression of secondary epileptogenesis.
Effects of the length of preoperative conservative management on postoperative outcomes after primary microvascular decompression for trigeminal neuralgia
Authors: Kalluri Anita L. , Ejimogu Emeka , Chandan Reddy Sai , Nair Sumil K. , Alkhars Hussain , Kilgore Collin , Abdulrahim Mostafa , Yedavalli Vivek , Lim Michael , Jackson Christopher M. , Huang Judy , Bettegowda Chetan , Xu Risheng 
Published: February 2025

OBJECTIVE
Although trigeminal neuralgia (TN) is initially managed conservatively, approximately half of all patients will eventually undergo surgery. Despite this outcome, there is limited understanding of the relationship between preoperative length of conservative management and pain outcomes after microvascular decompression (MVD). In this study, the authors aimed to describe the relationship between the duration of preoperative conservative management and postoperative outcomes in patients undergoing MVD for TN.

METHODS
The electronic medical records of 381 patients with TN who underwent primary MVD at the authors’ institution between 2007 and 2023 were reviewed. Patients were dichotomized based on whether the duration of conservative management, defined as the duration of anticonvulsant use, was greater than, or less than or equal to, the median duration of conservative management for the entire cohort. For adjusted analysis, duration of conservative management was also assessed as a continuous variable. Demographic information, comorbidities, clinical TN characteristics, pain recurrence, and pre- and postoperative modified Barrow Neurological Institute (BNI) pain and numbness scale scores were recorded and compared between groups. Differences in pain outcomes were assessed via multivariate ordinal regression, Kaplan-Meier analysis, and Cox proportional hazards analysis.

RESULTS
The median preoperative duration of conservative management was 1.74 years. Patients with a prolonged duration of conservative management were significantly more likely to be male (p = 0.028) and less likely to preoperatively use opioids (p = 0.037). At final follow-up, those with a prolonged duration of conservative management had significantly higher reported BNI pain scores (p = 0.021) and higher rates of pain recurrence (p = 0.021). On multivariable ordinal regression analysis, younger age (p < 0.001) and prolonged duration of conservative management, which was assessed as both a dichotomized (p = 0.002) and continuous variable (p = 0.011), were associated with higher BNI pain scores at final follow-up. Patients with a longer duration of conservative management also had a significantly shorter time to pain recurrence, as assessed by Kaplan-Meier survival analysis (p = 0.0037) as well as Cox proportional hazards analysis (p = 0.001, dichotomized; p = 0.008, continuous).

CONCLUSIONS
In the setting of primary MVD for patients with TN, a longer duration of preoperative conservative management was associated with higher postoperative BNI pain scores and increased risk of pain recurrence. These findings suggest a potential beneficial role for early surgical intervention.
An evidence-based review of the current surgical treatments for chronic low-back pain: rationale, indications, and novel therapies
Authors: Giraldo Juan P. , Williams Gabriella P. , Lee Jonathan J. , Potts Eric A. , Uribe Juan S. 
Published: February 2025

OBJECTIVE
This review analyzes the current surgical strategies and management modalities for chronic low-back pain (CLBP). In this study, the authors provide a structured review of the current state of surgical treatments for CLBP, including the rationale for surgery, indications, and novel therapies.

METHODS
An extensive review of the literature on the surgical management of CLBP was performed using the MEDLINE, Cochrane, Google Scholar, Embase, and Cochrane Central Register of Controlled Trials databases from March 1993 to May 2024. Terms used in the search were ("low back pain/surgery" [MeSH] AND "chronic" AND "lumbar") and ("chronic" AND "low back pain" AND "lumbar spine" AND "surgery"). The search produced 1951 articles, of which 167 were removed as duplicates, leaving 1784 for screening. Of these, 1593 articles were excluded, and 191 were retrieved to evaluate eligibility. After this evaluation, 76 articles were included in the review. No statistical analysis was performed.

RESULTS
This structured review revealed a range of surgical interventions available for CLBP. These interventions included fusion, stabilization, posterior interspinous devices, and nonoperative management, such as intensive rehabilitation and cognitive behavioral therapy. The evidence suggests that although spinal fusions are not superior in terms of Oswestry Disability Index function or pain level, they do outperform nonoperative management without intensive rehabilitation therapy. This finding is significant because it highlights the potential of surgical strategies to complement other treatments, such as pharmacological and noninterventional procedures, in managing CLBP.

CONCLUSIONS
The current evidence strongly advocates for a comprehensive approach to the management of CLBP. Patients with CLBP should be evaluated for surgical approaches when anatomical causes have been identified and multidisciplinary strategies have been implemented. It is reassuring to note that emerging multimodal strategies are beginning to complement neurosurgery care, and they should be integrated into the treatment plan as more substantial evidence becomes available. This emphasis on a multidisciplinary approach underscores the importance of considering all available strategies in CLBP management.
Association between deformity angular distance ratio and neurological risk in patients undergoing three-column osteotomy
Authors: Ni Jiajun , Yuan Lei , Yan Shi , Xian Siming , Chen Zhongqiang , Li Weishi , Zeng Yan 
Published: February 2025

OBJECTIVE
Postoperative neurological deficits are a significant concern for surgeons during spinal deformity correction surgery. Preoperative identification of high-risk patients can help ensure that appropriate measures are taken to minimize the risk of neurological deficits during these procedures. Previous studies have shown that patients with large Cobb angles or deformity angular ratios (DARs) are at higher risk for postoperative neurological deficits. However, some curves with similar Cobb angles and DARs may exhibit significantly different risks of neurological deficits during surgery. Existing methods for evaluating the degree of deformity cannot fully or accurately reflect the degree of spinal deformity. The aim of this study was to determine whether the deformity angular distance ratio (DADR) can reliably assess the neurological risks of patients undergoing three-column osteotomy (3CO).

METHODS
A consecutive series of 266 patients with a deformity apex at T1–L1 who underwent 3CO at a single academic center from December 2010 to January 2024 were included in the study. Preoperative radiograph measurements were used to calculate DAR and DADR. Binary logistic regression was used to model the relationship between DADR and postoperative neurological deficits. Receiver operating characteristic analysis and the area under the curve (AUC) were used to assess the performance of the model.

RESULTS
The 266 patients had a median (IQR) age of 48.0 (30.0–60.0) years, with 128 (48.1%) females and 138 (51.9%) males. The incidence of postoperative neurological deficits was 11.3% in this series of patients. Among patients undergoing 3CO, sagittal DADR (OR 1.086, 95% CI 1.045–1.129; p < 0.001) and total DADR (OR 1.080, 95% CI 1.046–1.116; p < 0.001) were associated with an increased incidence of postoperative neurological deficits. A total DADR > 30.4 or a sagittal DADR > 26.4 were associated with a 30% incidence of postoperative neurological deficits, which increased to 50% when the total DADR reached 41.4 or the sagittal DADR exceeded 36.6. The overall predictive performances of sagittal DADR (AUC 0.781) and total DADR (AUC 0.799) for postoperative neurological deficits were comparable and considered to be good.

CONCLUSIONS
In patients undergoing 3CO for severe spinal deformities, the DADR can be used to quantify the severity of the deformity, which is strongly correlated with the risk of postoperative neurological deficits. Patients with a total DADR > 30.4 or a sagittal DADR > 26.4 are at much higher risk for developing new neurological deficits after surgery.
Internet of Things and LoRa-based monitoring system on solar dryer dome for coffee drying
Authors: Amuddin Amuddin , Sumarsono Joko , Salman Salman 
Published: February 2025

Coffee drying is a critical stage in post-harvest processing to enhance product quality and market value. Karang Sidemen Village, Central Lombok, has significant potential to adopt renewable energy-based technology to support agricultural processing. This study aims to develop an Internet of Things (IoT) and LoRa-based monitoring system for solar dryer domes in the coffee drying process in Karang Sidemen Village, Central Lombok. The system integrates hardware and software to monitor temperature and humidity in real-time using SHT10 sensors, LoRa ESP32 modules, and the ThingSpeak platform. The method used is experimental to test the application of a temperature and humidity monitoring system on a solar dryer dome using IoT technology. The findings indicate that optimal drying occurs at temperatures between 50°C–55°C with low humidity, enhancing coffee product quality. The implementation of this technology reduces operational costs and supports sustainable agriculture through the utilization of renewable energy. The success in remote monitoring and power efficiency positions this system as an innovative solution for agricultural processing.
PRO DAN KONTRA HAK HIDUP DI KONSTITUSI DALAM KASUS FERDI SAMBO
Authors: Erlande Rike , Alba Akbar , Purnama Mita 
Published: February 2025

Abstrak. Konstitusi Indonesia adalah hukum dasar yang mengatur kehidupan masyarakat. Bangsa dan negara untuk rakyat negeri ini. Salah satu yang didefinisikan dalam konstitusi ini tentang hak untuk hidup. Penulisan artikel ini bertujuan untuk mendeskripsikan Pro dan Kontra hak hidup di konstitusi dalam kasus Ferdi Sambo. Dari hasil pembahasan ditemukan bahwa pro dan kontra terjadi karena hak hidup itu dijamin oleh konstitusi berdasarkan beberapa pasal UUD seperti Pasal 28A, 28 B ayat 2. Namun disisi lain Ferdi sambo juga merenggut hak untuk hidup seseorang dengan melakukan pembunuhan berencana. Sehingga disini terdapat pro dan kontra mengenai vonis hukuman mati yang ditetapkan pada dirinya. Kata kunci: Konstitusi, Hak Untuk Hidup, Kasus Ferdi Sambo Abstract. The Indonesian Constitution is the basic law that regulates people's lives. Nation and country for the people of this country. One that is defined in this constitution about the right to life. Writing this article aims to describe the pros and cons of the right to life in the constitution in the case of Ferdi Sambo. From the results of the discussin it was found that the pros and cons occurred because the right to life is guaranteed by the constitution based on several articles of the Constitution such as Articles 28A, 28B paragraph 2. However, on the other hand Ferdi Sambo also took away a person's right to life by committing premeditated murder. So that here there are pros and cons regarding the death penalty imposed on him. Keywords: Constitution, Right to Life, Ferdi Sambo Case