bluuebunny/crossref_metadata_2025_split huggingface dataset:
ІСТОРІЯ ТУРИЗМУ КРІЗЬ ПРИЗМУ НЕДОСКОНАЛОСТІ ЗАКОНОДАВЧОЇ БАЗИ ТУРИЗМУ
Authors: Абрамов Валерій 
Published: January 2023

Вступ. Державна структура управління в галузі туризму в Україні зазнавала значних змін продовж останніх 30 років. У світовій літературі прийнято виділяти три моделі державного управління туризмом: діяльність туристичної галузі контролюється сильним централізованим міністерством; управління туристичної галузі здійснюється в системі багатогалузевого міністерства; відсутність центрального державного туристського органу. Але слід виділити також модель, що існувала в період з квітня 1936 по грудень 1991 рік, коли Україна входила у склад СРСР. Держава делегувала повноваження з розвитку туризму в країні профспілкам, як частини державного апарату правлячої партії, яка виконує специфічні функції.
Мета дослідження. Метою роботи є дослідження шляху становлення апарату державного управління туризмом в Україні та визначення недоліків у статтях Закону України «Про туризм».
Матеріали і методи. В ході роботи були досліджені матеріали, що стосуються розвитку державного управління туризмом в незалежній Україні. Проведено аналіз Закону України «Про туризм» та Закону України про внесення змін до Закону України «Про туризм».
Результати. За період незалежності України модель державного управління туризмом змінювалось багато разів. Таке різноманіття форм структур (агентства, адміністрація, департамент, комітет, міністерство, служба) системи державного управління, коли при цьому змінилося, як мінімум, 7 керівників галузі, не кажучи вже про зміну самого апарату, не може позитивно позначитися на розвиток туризму в країні. Україна була першою країною СНГ яка прийняла Закон «Про туризм», але швидкість його прийняття не дала змогу досконало його пропрацювати, тому він є недосконалим і потребує деяких змін.
Висновки. За для сталого розвитку туризму в Україні перш за все необхідно чітко визначитись із державною структурою управління туристською галуззю. Також розробити Туристський Кодекс України, залучаючи до цього науковий потенціал закладів вищої освіти, які готують туристські кадри, а також фахівців туристичної галузі, що володіють великим практичним досвідом роботи в туризмі.
Defining postoperative C5 palsy and recovery: a systematic review
Authors: Deshpande Nachiket , Stino Amro M. , Smith Brandon W. , Little Ann A. , Yang Lynda J. S. , Park Paul , Saadeh Yamaan S. 
Published: January 2023

OBJECTIVE
Postoperative C5 palsy (C5P) is a well-recognized and often-delayed complication of cervical spine surgery. Most patients recover within 6 months of onset, but the prognosis of severe cases is poor. The clinical significance and natural history of mild versus severe C5P appear to differ substantially, but palsy severity and recovery have been poorly characterized in the literature.

METHODS
Owing to the varying prognoses and expanding treatment options such as nerve transfer surgery to reconstruct the C5 myotome, this systematic review attempted to describe how C5P severity is classified and how C5P and its recovery are defined, with the aim of proposing a postoperative C5P scale to support clinical decision-making. PubMed was searched for articles in English published since 2000 that offer a clear definition of postoperative C5P or its recovery. Only articles reporting exclusively on C5 palsy for patients undergoing surgery for degenerative disease were included. A single reviewer screened titles and abstracts and reviewed the full text of relevant articles, with consultation as needed from a second reviewer. Data collected included postoperative C5P definitions, classification of C5P severity, and definition and/or classification of C5P recovery. Qualitative analysis was performed.

RESULTS
Full-text reviews were conducted of 98 of 272 articles identified and screened, and 43 met the inclusion criteria. Postoperative C5P was most commonly defined as a reduction in deltoid muscle strength by ≥ 1 grade using manual muscle testing (MMT), with potential biceps involvement also noted by some studies. The few studies that stratified C5P on the basis of severity unanimously characterized severe C5P as MMT grade ≤ 2. Nine studies reported on C5P recovery. Deltoid muscle strength improvement of MMT grade 5 commonly defined complete recovery, with no MMT improvement considered partial recovery.

CONCLUSIONS
This review identified clear discrepancies in the definitions of C5P and its recovery, leading to heterogeneity in its evaluation and management. With the emergence of therapeutic procedures for severe C5P, standardization of the definitions of C5P and its recovery is critical. The authors propose MMT grades of 4, 3, and ≤ 2 to classify C5P as mild, moderate, and severe, respectively, and grades of 5, 4, and 3 to classify recovery as complete, sufficient, and useful, respectively.
Implementation of a spine triage program and its effect on outpatient radiology utilization
Authors: Ryan Emma N. , Yolcu Yagiz , Rizvi Tasneem Z. , Christopher Susan R. , Dunbar Melissa R. , Whitmore Robert G. , Ghogawala Zoher 
Published: January 2023

OBJECTIVE
Clinical care pathways designed to triage spinal disorders have been shown to reduce wait times and improve patient satisfaction. The goal of this study was to perform an analysis of outpatient radiology costs before and after the implementation of a spine care triage pathway.

METHODS
All imaging orders and surgical procedures were captured in a prospective spine registry for patients referred to the department of neurosurgery within a single academic center between July 1, 2017, and November 3, 2020. A spine triage algorithm was developed and implemented January 1, 2018. Healthcare utilization was recorded for 1 year after the first appointment in the department of neurosurgery. Imaging costs were estimated using publicly available data from the Centers for Medicare and Medicaid Services. Statistical analysis consisted of an independent sample t-test or randomization test for continuous variables and a chi-square test for categorical variables.

RESULTS
A total of 3854 patients were included in this study. The mean age was 60 years (50.8% female) and 89.8% had undergone advanced imaging before being referred to the department of neurosurgery. In total, 12.6% of patients were referred with a specific surgical diagnosis (i.e., spinal stenosis, lumbar spondylolisthesis, etc.). During the pretriage phase 1810 patients were enrolled, and there were 2044 patients enrolled after the triage algorithm was implemented. Advanced imaging (CT or MRI) was ordered more frequently by providers before the triage program was initiated, with imaging ordered in 34% (617/1810) of patients pretriage versus 14.8% (302/2044) after the triage pathway was implemented (p < 0.001). The authors calculated a significant reduction in cost associated with reduced radiology utilization. Before triage, the cost of radiology utilization was $85,475/1000 patients compared with $40,107/1000 patients afterward (p < 0.001). The triage program did not change the utilization of surgery (14.6% before, 13.6% after).

CONCLUSIONS
Among patients treated after a spinal triage program was implemented in a single neurosurgery department, there was a substantial reduction in the use of advanced imaging and a 50% reduction in cost associated with outpatient radiology utilization. The triage program did not change the rate of spine surgery being performed.
A multicenter, randomized, placebo-controlled phase IIb trial of an autologous formalin-fixed tumor vaccine for newly diagnosed glioblastomas
Authors: Muragaki Yoshihiro , Ishikawa Eiichi , Maruyama Takashi , Nitta Masayuki , Saito Taiichi , Ikuta Soko , Komori Takashi , Kawamata Takakazu , Yamamoto Tetsuya , Tsuboi Koji , Matsumura Akira , Nakamura Hideo , Kuroda Junichiro , Abe Tatsuya , Momii Yasutomo , Saito Ryuta , Tominaga Teiji , Tabei Yusuke , Suzuki Ichiro , Arakawa Yoshiki , Miyamoto Susumu , Matsutani Masao , Karasawa Katsuyuki , Nakazato Yoichi , Maebayashi Katsuya , Hashimoto Koichi , Ohno Tadao 
Published: January 2023

OBJECTIVE
An autologous formalin-fixed tumor vaccine (AFTV) derived from resected glioblastoma (GBM) tissue can be used against unidentified tumor antigens. Thus, the authors conducted a multicenter double-blind phase IIb trial to investigate the efficacy of an AFTV.

METHODS
Eligible patients were adults with supratentorial GBMs, 16–75 years of age, with Karnofsky Performance Scale (KPS) scores ≥ 60%, and no long-term steroid administration. An AFTV comprising fixed paraffin-embedded tumor tissue with immune adjuvants or an identical placebo without fixed tumor tissue was injected intradermally over three courses before and after chemoradiotherapy. The primary and secondary end points were overall survival (OS), progression-free survival (PFS), and 3-year survival rate.

RESULTS
Sixty-three patients were enrolled. The average patient age was 61 years. The median KPS score was 80%, and the median resection rate was 95%. The full analysis set of 57 patients indicated no significant difference in OS (p = 0.64) for the AFTV group (median OS 25.6 months, 3-year OS rate 38%) compared with the placebo group (31.5 months and 41%, respectively) and no difference in PFS (median PFS 13.3 months in both groups, p = 0.98). For patients with imaging-based total tumor removal, the 3-year PFS rate was 81% in the AFTV group versus 46% in the placebo group (p = 0.067), whereas the 3-year OS rate was 80% versus 54% (p = 0.16), respectively. Similar results were obtained in the p53-negative subgroups. Severe adverse effects were not observed.

CONCLUSIONS
The AFTV may have potential effects in certain patient subgroups. A phase III study for patients with total tumor removal remains warranted to confirm these findings.
Clinical trial registration no.: UMIN000010602 (UMIN Clinical Trials Registry)
Failed mechanical thrombectomy: prevalence, etiology, and predictors
Authors: Lajthia Orgest , Almallouhi Eyad , Ali Hamid , Essibayi Muhammed Amir , Bass Eric , Neyens Ron , Anadani Mohamad , Chalhoub Reda , Kicielinski Kimberly , Lena Jonathan , Porto Guilherme , Sattur Mithun , Spiotta Alejandro M. , Kasab Sami Al 
Published: January 2023

OBJECTIVE
Despite advances in endovascular techniques, mechanical thrombectomy (MT) fails to achieve successful reperfusion in approximately 20% of patients. This study aimed to identify common etiologies and predictors of failed thrombectomy in a contemporary series.

METHODS
A prospectively maintained database of MT patients between January 2013 and August 2021 was interrogated. Failed MT was defined as a final modified Thrombolysis in Cerebral Infarction score < 2b. Demographic data, procedural details, stroke etiology, and anatomical data in patients who underwent MT with subsequent failed reperfusion were collected.

RESULTS
Of a total 1010 MT procedures, 120 (11.9%) were unsuccessful. The mean patient age was 66.8 years; 51.5% of patients were male, and 61.1% were White. The most common failure location was intracranial (93.3%) followed by failure at the arch (3.3%) and neck (3.3%). Among patients with intracranial failure, underlying intracranial atherosclerosis (ICAS) was the cause of failure in 84 patients (70%). Compared with patients with successful MT, patients with failed MT had a longer onset to puncture time (p = 0.012) and onset to groin time (p = 0.04). Rescue stenting was performed in 45 cases: 39 patients (4.4%) with successful MT and 6 (5.0%) with MT failure (p = 0.765). Multivariate analysis demonstrated that diabetes mellitus (p = 0.009) was independently associated with unsuccessful reperfusion.

CONCLUSIONS
Failed MT was encountered in approximately 12% of MT procedures. The most common cause of failed MT was underlying ICAS. Further studies to evaluate better ways of early identification and treatment of ICAS-related large-vessel occlusion are warranted.
Postoperative seizure freedom after vagus nerve stimulator placement in children 6 years of age and younger
Authors: Maleknia Pedram , McWilliams Timothy D. , Barkley Ariana , Estevez-Ordonez Dagoberto , Rozzelle Curtis , Blount Jeffrey P. 
Published: January 2023

OBJECTIVE
Food and Drug Administration (FDA) approval for vagus nerve stimulator (VNS) implantation is limited to patients older than 4 years of age with medically refractory partial-onset seizures. In younger children with severe generalized epilepsy, however, VNS implantation remains off-label. In this study, the authors followed up on their previously reported cohort to review the longer-term safety and efficacy of VNS placement in children younger than 6 years with generalized medically refractory epilepsy (MRE), providing the largest cohort with > 2 years of follow-up to date in this age group.

METHODS
This was a retrospective observational cohort study of patients younger than 6 years of age with generalized MRE who underwent VNS implantation at a single institution between 2010 and 2020. Inclusion criteria encompassed failure of more than two antiepileptic drugs alone or in combination, neurologist referral for vagus nerve stimulation, informed consent with knowledge of the off-label status in young children, and > 1 year of follow-up. Outcome measures included seizure reduction rate ≥ 50% and postoperative morbidity defined nominally. Statistical analysis was conducted with Stata/SE.

RESULTS
Forty-five patients were included: 11 patients younger than 4 years of age and 34 between 4 and 6 years of age. There were no intraoperative complications. Perioperative complications within 1 year occurred in 11% (n = 5) of the patients and included two wound infections, a mild cough, hyperactivity, hoarseness, and 1 patient with persistent surgical site pain.
A seizure reduction ≥ 50% was observed in 36.4% (n = 4) of the patients younger than 4 years of age at the 6-month and 1-, 2-, and 5-year follow-ups. In the 4- to 6-year-old cohort, this was observed in 32.4% (n = 11) of the patients at 6 months, 41.2% (n = 14) at 1 year, 38.2% (n = 13) at 2 years, and 41.2% (n = 14) at 5 years.

CONCLUSIONS
VNS implantation for patients younger than 4 years of age with generalized onset MRE has not been approved by the FDA. This retrospective study establishes feasibility, illustrates an acceptable safety profile in children younger than 6 years, and demonstrates efficacy comparable to that reported in older patients.
NORMA INTERNASIONAL DAN KEBIJAKAN PENANGANAN PENGUNGSI DI INDONESIA
Authors: Pramono Sugiarto , Ulfa Diyana Rosyida 
Published: January 2023

One of the contemporary international problems faced by the Governments in the world is asylum seekers and refugees. As an archipelagic country located at the junction of two oceans and two continents, Indonesia is a target for asylum seekers and refugees worldwide. This is certainly a challenge for Jokowi's foreign policy. In this context, Presidential Regulation/ Peraturan Pemerintah Nomer 125, 2016 concerning Handling of Foreign Refugees was issued. Through a qualitative descriptive method with data analysis techniques, this study came to the conclusion that the policy was issued due to at least two factors, namely: (1) as a temporary substitute for the 1951 and 1962 UN Conventions which had not been ratified; (2) The strengthening of international norms in the form of human rights.

Keywords: International Norms, Asylum Seekers, Refugees, Perpres No 125 Tahun 2016

Abstraksi
Salah satu masalah internasional kontemporer yang dihadapi Pemerintah Indonesia adalah Pencari Suaka dan Pengungsi. Sebagai negara kepulauan yang berada di persimpangan dua samudera dan dua benua, Indonesia menjadi sasaran pencari suaka dan pengungsi dunia. Hal itu tentu menjadi tantangan tersediri bagi kebijakan luar negeri Jokowi. Dalam konteks tersebut Peraturan Presiden 125 tahun 2016 tentang Penanganan Pengungsi dari Luar diterbitkan. Melalui metode deskripstif kualitatif dengan teknik analisa data, penelitian ini sampai pada kesimpulan bahwa kebijakan Perpres tersebut diterbitkan karena sedikitnya dua faktor, yaitu: (1) sebagai pengganti sementara Konvesi PBB 1951 dan 1962 yang belum diratifikasi; (2) Menguatnya norma internasional yang berupa hak asasi manusia.

Kata Kunci: Norma Internasional, Pencari Suaka, Pengungsi, Perpres No 125 tahun 2016
Evaluation of Ionizing Radiation Protection among Radiation Workers in X-ray departments in Erbil City
Authors: Ali Runak T. , Hameed Safa M. , Ali Qasim A. 
Published: January 2023

Background: Ionizing radiations are hazardous agents in the workplace, since all forms of ionizing radiation produce some type of injury that is incurable. Therefore, protection against ionizing radiation exposure can play an important role in the health of workers.Objectives: is to evaluate the application of radiation protection among radiation workers at X-ray department in Erbil hospitals.Patients and methods: Six hospitals (General and Private) were visited. Samples of 110 were randomly selected among 135 radiation workers, 47 (42.3%) female and 63 (57.3%) male Data was collected through structured questionnaires. The surveyed data was coded and analyzed by using MS Excel software, and SPSS 18 for analysis. Analysis was performed by means of frequency distributions and cross tabulations.Results: The results showed that there are majority of the workers 51 (46.4%) aged between 21 - 30 years, and Diploma holders 68 (61.8%). Only 49 (44.5%) undergone primary examination while 47 (42.7%) never done periodical examination. According to international commotion of radiation protection regulation of radiation protection, it is mandatory for radiation workers to wear personal detective devices during work. But a large numbers 89 (80.9%) have not supplied with such devices. The study also revealed that the majority of workers were engaged in work beyond 40 hours per week. Calibration of the X-rays machine and radiation survey of the work place have not been regularly done. Only 30 of the sample have no awareness and knowledge about the ionizing radiation, while 95 (86.4%) have no healthy advice.Conclusion: It can be suggested that the level of workers education must be increased and short courses be implemented such as dosimetery and radiation protection performance.
Evaluation of triple hormonal content (ER, PR, and HER\2neu)of breast cancer specimens obtained from breast cancer patients using tru-cut biopsy
Authors: Jasim Mustafa H. , Zaid Akool Mohammed A.- , Al- Obaidi Safa M. 
Published: January 2023

Background: Breast cancer is the commonest type of malignancy among women worldwide and in Iraq. Tru-cut needle biopsy technique provides adequate tissue for histopathological diagnosis of suspected breast lumps and assessment of hormonal receptors (estrogen, progesterone and HER2neu) prior to surgical operation.Objectives: To assess estrogen, progesterone andHER2neu expression using breast cancer tissue specimens obtained by tru-cut biopsy, to correlate the findings with clinicopathological parameters of known prognostic significance in breast cancer patients.Patients and Methods: This prospective study was held within the Main Referral Center for Early Detection of Breast Tumors/Medical City Teaching Hospital and the Iraqi National Cancer Research Center/Baghdad University from May 2012 to the end of December 2012. Sixty-two females aged 25-73 years who presented with a breast lump were involved and examined using the triple assessment technique. A triple hormonal assessment (ER, PR & Her2) of the examined biopsies obtained by tru-cut needle for patients with suspected breast cancer was performed. The results were compared with the corresponding clinical and pathological parameters.Results: Data for excisional biopsy were available for 25 cases of the total number of women presented with breast lump. All of these cases showed similar histopathological results compared to Tru-cut biopsy results. Non-significant correlation was found between expression of ER, PR and HER2neu and the age of women, family history, and the site of the lump.On the other hand, a significant relationship was displayed between HER2neu over expression and the histopathological grading and age of the breast cancer patient. Conclusion: Tru-cut needle biopsy technique should be promoted nationwide in surgical departments to provide an insight to the type of mammary carcinoma, its aggressiveness, hormone receptor content and predict response to primary therapy before mastectomy.
From Association to Intervention: The Alzheimer’s Disease-Associated Processes and Targets (ADAPT) Ontology
Authors: Daly Timothy , Henry Vincent , Bourdenx Mathieu 
Published: January 2023

Background: Many putative causes and risk factors have been associated with outcomes in Alzheimer’s disease (AD) but all attempts at disease-modifying treatment have failed to be clinically significant. Efforts to address this “association—intervention” mismatch have tended to focus on the novel design of interventions. Objective: Here, we instead deal with the notion of association in depth. We introduce the concept of disease-associated process (DAP) as a flexible concept that can unite different areas of study of AD from genetics to epidemiology to identify disease-modifying targets. Methods: We sort DAPs using three properties: specificity for AD, frequency in patients, and pathogenic intensity for dementia before using a literature review to apply these properties in three ways. Firstly, we describe and visualize known DAPs. Secondly, we exemplify qualitative specificity analysis with the DAPs of tau protein pathology and autophagy to reveal their differential implication in AD. Finally, we use DAP properties to define the terms “risk factor,” “cause,” and “biomarker.” Results: We show how DAPs fit into our collaborative disease ontology, the Alzheimer’s Disease-Associated Processes and Targets (ADAPT) ontology. We argue that our theoretical system can serve as a democratic research forum, offering a more biologically adequate view of dementia than reductionist models. Conclusion: The ADAPT ontology is a tool that could help to ground debates around priority setting using objective criteria for the identifying of targets in AD. Further efforts are needed to address issues of how biomedical research into AD is prioritized and funded.
URGENCY OF ISLAMIC MORAL EDUCATION DURING EARLY CHILDHOOD IN THE PERSPECTIVE OF HADITH
Authors: Saputri Alfiah Nursangadah , Lessy Zulkipli , Siskowati Eni , Illahi Rahmat 
Published: January 2023

Education plays an important role in determining the goodness and badness of humans, and Islamic ethics (akhlaq) is the main standard of human quality. In this view, those are an indicator of the success or failure in education. Islamic ethics and moral are essentially a basic value in assessing the nature of a person. The level of education is sometimes not an absolute measure of the tranquility of one's life, but shows how Islamic ethics or moral plays out. For this reason, at an early age children should learn about religion and be provided with a guide for their moral development. The purpose of this study is to find out how the urgency of Islamic ethics education on early childhood and how the hadith illustrates this in children. The research employs the research library method as it depends on investigating written resources such as journals and books. The results of this study showed that Islamic ethics education must be required to begin at an early age because childhood is the most appropriate period to instill good habits. The hadith narrated by Bukhari Muslim on Islamic ethics education in children demonstrates that parents have an important role and contribute significantly in implanting moral values in their children. There are two factors that influence Islamic ethics development in children. First, internal factor includes the innate such as physical, intellectual, and the potential of spirituality. Second, external factors encompass roles of the parents at home, teachers at school, and community leaders in society.