bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gambaran Dukungan Keluarga Dan Pengetahuan Ibu Serta Pemberian MP-ASI Pada Anak 6-24 Bulan Di Wilayah Kerja Puskesmas Peusangan Kabupaten Bireuen
Authors: Rahmi Maulianur , Al-Rahmad Agus Hendra 
Published: November 2023

WHO dan UNICEF menyatakan permasalahan dalam pemberian MP-ASI disebabkan baik karena ketidaktahuan dan/atau ketidakmampuan menyiapkan MP ASI yang dapat mencukupi kebutuhan gizi, secara tepat dan higienis. Praktik pemberian Makanan Pendamping ASI (MP ASI) pada bayi dan anak juga belum optimal, antara lain pemberian MP ASI yang terlalu dini dan hanya 46,6% anak usia 6-23 bulan yang mengonsumsi MP ASI dari makanan beragam. Mengetahui Gambaran dukungan keluarga dan pengetahuan ibu serta pemberian MP-ASI pada anak umur 6-24 bulan di wilayah kerja Puskesmas Peusangan Kabupaten Bireuen. Jenis penelitian ini adalah survey analitik dengan desain cross sectional. Populasi dalam penelitian ini yaitu seluruh ibu yang memiliki anak usia 6-24 bulan di wilayah kerja Puskesmas Peusangan Kabupaten Bireuen. Sampel penelitian ini yaitu 30 orang ibu yang memiliki anak usia 6-24 bulan di wilayah kerja Puskesmas Peusangan Kabupaten Bireuen. Penelitian dilaksanakan pada bulan Juli – Agusutus 2022 pada 16 Desa. Teknik pengambilan sampel penelitian yang digunakan adalah quota sampling. Data di analisis menggunakan uji chi-square dengan nilai alpha 0.05. Pengetahuan ibu tentang pemberian MP-ASI kategori baik sejumlah 33,3 %, kategori kurang sebesar 66,7 %. Dukungan keluarga dalam pemberian MP-ASI, kategori ada dukungan 33,3 %, kategori tidak ada dukungan sebesar 66,7 %. Pemberian MP-ASI dengan kategori sesuai dan tidak sesuai masing-masing sebesar 50,0 %. Nilai signifikansi hubungan pengetahuan ibu dengan pemberian MP-ASI (p) = 0,007. Nilai signifikansi hubungan dukungan keluarga dengan pemberian MP-ASI (p) = 0,053. Ada hubungan secara signifikan tingkat pengetahuan dengan pemberian MP-ASI (P<0,05). Tidak ada hubungan dukungan keluarga dengan pemberian MP-ASI pada anak umur 6-24 bulan di wilayah kerja Puskesmas Peusangan Kabupaten Bireuen (P >0,05). Kepada petugas kesehatan diharapkan dapat memotivasi keluarga untuk meningkatkan pengetahuan serta perhatian kepada ibu terhadap pemberian MP-ASI.
Pengaruh Pemberian Juice Jambu Biji Merah Terhadap Kadar Asam Urat Darah Pada Penderita Hiperurisemia Di Wilayah Kerja Puskesmas Kota Sigli
Authors: Aulia Rona Nur , Wagustina Silvia 
Published: November 2023

Hiperurisemia adalah kadar asam urat dalam darah yang melebihi batas normal. Asam urat dihasilkan oleh setiap makhluk hidup sebagai hasil dari proses metabolisme sel yang berfungsi untuk memelihara kelangsungan hidup. Jambu biji merah mengandung flavonoid yang berfungsi sebagai antioksidan penghambat enzim xanthine oksidase untuk mensintesis hipoxantine ke xhantine dan xanthine menjadi asam urat. Tujuan Penelitian ini ntuk mengetahui pengaruh pemberian juice jambu biji merah terhadap kadar asam urat darah pada penderita hiperurisemia di wilayah kerja Puskesmas Kota Sigli. Penelitian kuantitatif menggunakan desain Quasi Experimental yang dilakukan secara Pretest Posttest pada 32 orang subjek penelitian di wilayah kerja Puskesmas Kota Sigli dilakukan pada Desember 2022. Kadar asam urat diukur dengan menggunakan GCU Easy touch. Selanjutnya data yang didapat akan di analisis menggunakan statistik-test berupa dependent T-Test dan Indepedent. Rerata dari kadar asam urat menurun sebanyak 1,55 mg/dl setelah pemberian rebusan. Pada kelompok tanpa pemberian rebusan rerata dari kadar asam urat menurun sebanyak 0,03 mg/dl. Ada pengaruh yang signifikan dalam perubahan kadar asam urat pada penderita hiperurisemia di wilayah kerja Puskesmas Kota Sigli setelah 7 hari pemberian jus jambu biji merah dengan nilai rata-rata penurunan sebanyak 1,24 mg/dl.
Fréderic Bastiat. La urgenci de su filosofía en hispanoamérica y más allá
Authors:   Universidad Goethe de Frankfurt, Oblitas Mollinedo Benjamin 
Published: November 2023

The article highlights the enduring relevance of Frédéric Bastiat's ideas in Hispanoamerica. It explains the paradox of the widespread ignorance of Bastiat's work, both in his native France and among Spanish speakers. Despite his significant contributions to philosophical and economic thought, Bastiat's legacy suffered obscurity, hindering the understanding of timeless principles advocating for individual rights, economic freedom, and free trade.	Comparisons are drawn between Bastiat's comprehensive economic understanding and the limitations of Marx's perspective, emphasizing Bastiat's contribution to the theory of value and his nuanced view of private property and the market. The article underscores the necessity for Hispanic academic circles to engage with Bastiat's works, promoting translations, analyses, and discussions to counter prevalent economic ignorance and challenge authoritarian doctrines. It also emphasizes the importance of Bastiat's ideas in confronting contemporary economic challenges in Spanish-speaking nations, advocating for rectifying this academic omission to foster economic growth, intellectual enlightenment, and combat the historical legacies of colonial centralism and feudal prejudices.
Long-term clinical outcomes of hypofractionated stereotactic radiotherapy using the CyberKnife robotic radiosurgery system for jugular foramen schwannomas
Authors: Zou Wei , Guan Yun , Zhu Huaguang , Gong Xiu , Wang Enmin , Yao Chengjun , Wang Xin 
Published: November 2023

OBJECTIVE
Jugular foramen schwannomas (JFSs) are rarely seen, benign tumors with slow growth. Today, management options for JFSs include observation, surgery, and radiation. However, the optimal treatment strategy remains controversial. Stereotactic radiosurgery serves as a minimally invasive alternative or adjuvant therapeutic regimen of microsurgery. Gamma Knife radiosurgery is suitable for patients with JFS who have small- and medium-sized tumors and normal cranial nerve (CN) function. Hypofractionated stereotactic radiotherapy (HSRT) offers a potential radiobiological advantage and may result in better preservation of normal structures compared to single-fraction stereotactic radiosurgery. The aim of the article was to review the clinical and radiographic outcomes of patients with JFS who were treated using HSRT.

METHODS
The authors retrospectively analyzed 74 patients with JFS who received HSRT between January 2009 and January 2020 in the authors’ center. Among them, 53 patients were newly diagnosed with JFS, 19 patients had a previous history of microsurgical resection, and the other 2 patients underwent CyberKnife because of tumor recurrence after Gamma Knife radiosurgery. A total of 73 patients had preexisting CN symptoms and signs. The median tumor volume was 14.8 cm3 (range 0.5–41.2 cm3), and most of them (70.3%) were ≥ 10 cm3. The radiation dose regimen was prescribed depending on the tumor size, and more fractions were used in larger tumors. The median margin doses prescribed were 18.2 Gy/2 fractions, 21.0 Gy/3 fractions, and 21.6 Gy/4 fractions.

RESULTS
The median follow-up was 103 months (range 18–158 months). After treatment, 42 (56.8%) patients had tumor regression, 27 (36.5%) patients had stable tumors, and 5 (6.8%) experienced tumor progression. Among them, MRI revealed that 1 patient had a complete response. Three patients received surgery at a median of 25 months because of tumor progression. One patient underwent ventriculoperitoneal shunt insertion for hydrocephalus that developed after HSRT independent of tumor progression. The 5-year progression-free survival rate was 93.2%. Preexisting cranial neuropathies improved in 46 patients, remained stable in 14, and worsened in 14.

CONCLUSIONS
HSRT proved to be a safe and effective primary or adjuvant treatment strategy for JFSs, although 14 patients (18.9%) experienced some degree of delayed symptomatic deterioration posttreatment. This therapeutic option was demonstrated to provide both excellent tumor control and improvement in CN function.
Focal brain oxygen, blood flow, and intracranial pressure measurements in relation to optimal cerebral perfusion pressure
Authors: Pelah Adam I. , Czosnyka Marek , Menacho Sarah , Nwachuku Enyinna , Hawryluk Gregory W. J. 
Published: November 2023

OBJECTIVE
Different paradigms for neurocritical care of traumatic brain injury (TBI) have emerged in conjunction with advanced neuromonitoring technologies and derived metrics. The priority for optimizing these metrics is not currently clear. The goal of this study was to determine whether achieving cerebral perfusion pressure (CPPopt) also improves other metrics like brain oxygenation and brain blood flow.

METHODS
The authors performed a retrospective analysis of high-frequency data from patients with TBI who were treated at a single center and who had partial pressure of brain oxygen (PbtO2) measurements and/or brain blood flow measurements, while also undergoing intracranial pressure (ICP) monitoring. CPPopt was not calculated or targeted during patient care, but was retrospectively computed, as was the difference between the observed CPP and CPPopt.

RESULTS
A total of 22 patients with ICP, PbtO2, and/or brain blood flow monitoring were included in the analysis, and 245.7 days of measurements obtained every second were analyzed including 6,748,866 PbtO2 measurements, 3,296,405 blood flow measurements, and 10,264,770 ICP measurements. The data obtained every second were averaged by minute for analysis. In summative data, PbtO2 measurements peaked near CPPopt and were not improved above CPPopt. Blood flow measurements remained stable near CPPopt, decreased below it, and increased when CPP exceeded CPPopt. ICP decreased linearly with CPP without a specific relationship with CPPopt. In an inverse analysis, the percentage of CPP values at CPPopt, although significantly higher on the favorable side of contemporary treatment thresholds of PbtO2, ICP, and blood flow, was not found to be strongly correlated with the mean values of the physiological measurements obtained every minute (r = 0.27, r = 0.11, and r = 0.47 for ICP, PbtO2, and blood flow, respectively; p < 0.0001).

CONCLUSIONS
Although CPPopt was not targeted in the patients in this study, CPPopt was a physiologically significant value based on concurrent measurements of PbtO2 and blood flow. In summative data, achievement of CPPopt was associated with optimized PbtO2 and blood flow. Conversely, the correlation between achievement of CPPopt and the mean measurement value was not strong, strengthening the significance of CPPopt. In individual patients, achieving CPPopt is not always associated with optimal PbtO2 or blood flow. Further research should explore these relationships in treatment paradigms that specifically target CPPopt. These data do not support the premise that targeting and achieving CPPopt obviates the need for concurrent PbtO2 and blood flow monitoring. Although these data suggest that targeting CPPopt may be an appropriate initial treatment strategy, they do not provide evidence that CPPopt should be targeted with highest priority.
Transcriptomics of intracranial aneurysms: current state and opportunities in flow diversion
Authors: Srinivasan Visish M. , Shekhtman Oleg , Kandregula Sandeep , Mannam Sneha Sai , Yu Ling Fai Charles , Kan Peter 
Published: November 2023

Over the last 2 decades, the field of transcriptomics has emerged as a major subdiscipline in biology. Transcriptomic techniques have been used by many groups over this time to better understand intracranial aneurysm development, rupture, and treatment. However, only a few studies have applied transcriptomics to understand the mechanisms behind flow diversion (FD) specifically, despite its increasing importance in the neurointerventional armamentarium.
FD is an increasingly safe and effective treatment option for intracranial aneurysms. However, the clinical understanding and use of FD has far outpaced the understanding of the underlying mechanisms. To make FD more predictable, clinically efficacious, and safe, it is important to understand the biological mechanisms at play that lead to successful and unsuccessful FD.
In this review, the authors focus on the current understanding of FD biology, the recent advances in transcriptomics, and what future studies could be performed to deepen the understanding of FD. They propose the new concept of the FD microenvironment to be studied, which may unlock a deeper biological understanding. This review provides the background for prospective studies into the development of targeted aneurysm therapy, whether by modified devices or by medical adjuncts.
Volumetric effect of shunt adjustments in normal pressure hydrocephalus: a randomized, double-blind trial
Authors: Lidén Simon , Farahmand Dan , Laurell Katarina 
Published: November 2023

OBJECTIVE
MRI volumetry could be used as an alternative to invasive tests of shunt function. In this study, the authors aimed to assess the difference in ventricular volume (VV) before and after surgery and at different performance levels (PLs) of the shunt.

METHODS
This study was a randomized, double-blind trial with a crossover design. The study sample consisted of 36 patients (25 men, 11 women) with a median age of 76 years. All patients had idiopathic normal pressure hydrocephalus (iNPH) and received a Strata shunt at the regional hospital in Östersund, Sweden, with an initial PL of 1.5. Participants underwent MRI with volumetric sequences before surgery and four times postoperatively: at 1 month before randomization to either PL 1.0 (n = 15) or 2.5 (n = 17); at 2 months before crossover to PL 2.5 or 1.0; at 3 months before lowering the PL to 0.5; and finally, at 3 months and 1 day after surgery before resetting the PL to 1.5. VV was measured semiautomatically using quantitative MRI. Both the patient and the examiner of clinical tests and volumetry were blinded to the PL.

RESULTS
VV changed significantly between the presurgical level (median 129 ml) and the different shunt settings, i.e., PL 1.0 (median 115 ml), 1.5 (median 120 ml), and 2.5 (median 128 ml; p < 0.001). A unidirectional change in VV was observed for all participants between PL 1.0 and PL 2.5 (median 12 ml, range 2.1–40.7 ml, p < 0.001). No significant change was noted in VV after 24 hours at PL 0.5. Eight participants had asymptomatic subdural effusions at PL 1.0.

CONCLUSIONS
The consistent decrease in VV after shunt surgery and between PL 2.5 and 1.0 supports the idea that MRI volumetry could be a noninvasive method for evaluating shunt function in iNPH, preventing unnecessary shunt revisions. However, further studies on retest variability of VV as well as verification against advanced testing of shunt function are needed before a clinical implementation of this method can be performed.
Clinical trial registration no.: NCT04599153 (ClinicalTrials.gov)
Acute psychological symptom profiles in high school football players following sport-related concussion
Authors: Jawid Maryam Y. , Williams Kristen L. , Jo Jacob , Hill Tyler M. , Prosak Olivia L. , Amedy Amad , Anesi Trevor J. , Terry Douglas P. , Zuckerman Scott L. 
Published: November 2023

OBJECTIVE
In a cohort of high school football athletes, the authors sought to 1) describe the proportion of those with acute psychological symptoms postconcussion, 2) determine predictors of more acute psychological symptoms postconcussion, and 3) determine if acute psychological symptoms impact recovery.

METHODS
A retrospective cohort study of high school football athletes (14–18 years of age) who sustained a sport-related concussion between November 2017 and April 2022 and presented to a multidisciplinary concussion center was performed. Based on their Post-Concussion Symptom Scale (PCSS) scores at the initial clinic visit, their total psychological symptom cluster score was calculated by summing their scores for the four affective symptoms (irritability, sadness, nervousness, and feeling more emotional). The psychological symptom ratio was defined as the ratio of the psychological symptom cluster score to the total initial PCSS score. Primary outcomes included time to return to learn (RTL), symptom resolution, and return to play (RTP). Uni- and multivariable regression analyses were performed controlling for demographic factors, learning disabilities, attention-deficit/hyperactivity disorder, and personal and/or family history of psychological diagnoses and migraine.

RESULTS
A total of 195 male football players (mean age 16.2 ± 1.2 years) were included in the study. About one-third of the sample (n = 70, 35.9%) reported at least one psychological symptom. Of these 70 athletes, their psychological symptom scores were 1 (10.3%), 2 (7.7%), and ≥ 3 (17.9%). Irritability was the most endorsed psychological symptom (25.1%), followed by nervousness (15.9%), feeling more emotional (12.8%), and sadness (11.8%). The multivariable regression model showed that a positive psychological history (B = 2.66, 95% CI 0.74–4.58, p = 0.007) and family psychological history (B = 2.43, 95% CI 0.98–3.88, p = 0.001) were significant predictors of a higher psychological symptom cluster score. Multivariable linear regression analysis showed that a higher psychological symptom cluster score was associated with a longer time to RTP (B = 1.22, 95% CI 0.17–2.264, p = 0.023) but not with time to symptom resolution or RTL. The psychological symptom ratio was not a significant predictor.

CONCLUSIONS
In a cohort of male football players, 36% reported at least one psychological symptom, with irritability being most commonly reported. Athletes with a personal and/or family history of psychological disorders experienced more acute psychological symptoms following a sport-related concussion. A higher psychological symptom cluster score was associated with delayed time to RTP but not time to RTL or symptom resolution.
Prevention of postoperative stroke in pediatric moyamoya patients: a standardized perioperative care protocol
Authors: Judge Jennifer , Kappel Ari D. , Isibor Christopher , O’Hara Jill E. , Larson Anna , Kleinman Monica , See Alfred P. , Lehman Laura L. , Smith Edward R. 
Published: November 2023

OBJECTIVE
Perioperative stroke is a major complication of revascularization surgery in patients with moyamoya. Vomiting is common after neurosurgical procedures and may result in acute changes in intracranial pressure and cerebral blood flow. The authors instituted a standardized perioperative nausea and vomiting protocol for children with moyamoya undergoing indirect bypass surgery at their institution and analyzed its association with perioperative stroke. They hypothesized that instituting a standardized perioperative nausea and vomiting protocol would be associated with reduction in the number of perioperative strokes in children with moyamoya undergoing indirect bypass surgery.

METHODS
The authors retrospectively reviewed consecutive cases of children and young adults with moyamoya who underwent indirect bypass surgery before and after implementation of a new perioperative nausea and vomiting protocol at a single institution. They compared the rate of strokes in the perioperative period (postoperative days 0 and 1) in the 31 months following implementation to 31 months prior to implementation using Fisher’s exact test.

RESULTS
The median ages pre- and postimplementation were 8.5 (IQR 4–12) years and 8.3 (IQR 5–15) years, respectively. There were no significant differences between the cohorts in disease severity or other potentially confounding factors. In the 31 months prior to initiation of the perioperative nausea and vomiting protocol, there were 5 strokes in 137 surgically treated hemispheres (3.6%). After initiation of the protocol, there were no strokes in 114 surgically treated hemispheres (p = 0.065).

CONCLUSIONS
Instituting a standardized perioperative nausea and vomiting protocol was associated with reduction in perioperative strokes in children with moyamoya treated with indirect bypass surgery.
Incidence of postoperative neurological deficit with the use of an intraoperative neuromonitoring protocol for lateral lumbar interbody fusion
Authors: Mundis Gregory M. , Record Nicole C. , Shahidi Bahar , Lakomkin Nikita , Carnelian Alissa , Brady Kristina C. , Jelousi Michael , Akbarnia Behrooz A. , Eastlack Robert K. 
Published: November 2023

OBJECTIVE
Intraoperative neuromonitoring (IONM) has become commonplace in assessing neurological integrity during lateral approaches to lumbar interbody fusion surgeries. Neuromonitoring is designed to aid surgeons in identifying the potential for intraoperative nerve injury and reducing associated postoperative complications. However, standardized protocols for neuromonitoring have not been provided, and outcomes are not well described. The purpose of this study was to provide a standardized protocol for IONM, and to describe clinical outcomes in a cohort of individuals who underwent lateral lumbar interbody fusion (LLIF) surgery.

METHODS
A retrospective review of 169 consecutive patients who underwent LLIF surgery at a single institution from October 2014 to October 2016 was performed. Patient characteristics, intraoperative details, clinical outcomes, and postoperative deficits (PODs) were compared between patients who did and did not trigger IONM alerts, and between patients who did and did not demonstrate a POD. A protocol for IONM decision-making was generated based on these observations.

RESULTS
Most patients (91.7%) underwent surgery for a degenerative spine condition. Twenty-three patients (13.6%) triggered neuromonitoring alerts, and 16 patients (9.5%) demonstrated a POD. Leg pain, back pain, and disability improved significantly (p < 0.045), and 2 patients had both motor and sensory deficits at the 12-week postoperative time point. Patients with a POD demonstrated greater operating room time (p = 0.034) and a greater number of interbody fusion levels (p = 0.015) but were less likely to have triggered a neuromonitoring alert (p = 0.04). There was no association between retractor time and POD (p = 0.98). When an IONM protocol was followed, individuals who experienced a POD were less likely to trigger an alert than those who did not experience a POD (p = 0.04).

CONCLUSIONS
This study provides a protocol algorithm for IONM alert responses in patients undergoing LLIF surgery. PODs are most associated with multilevel fusion, and patients with alerts had a low rate of persistent deficit. Future research is needed to validate these findings using a more rigorous comparative study design.